• SexRx: Yohimbine and Your Sex Life

    IMAGEYohimbine is an alkaloid that is found in the bark of a West African evergreen tree—the yohimbe tree. Yohimbine might help treat impotence that can be caused by a variety of factors, although it comes with many risks.

    Commonly Used Product Names

    • Yohimbine hydrochloric acid (HCL)—a prescription drug in a tablet
    • Yohimbe bark—available in the following forms:
      • Capsule
      • Concentrated drops
      • Decoction (an extract obtained from boiling)
      • Tablet
      • Tea
      • Tincture
    Yohimbe bark is often not standardized based on yohimbine content. Therefore, it is a less reliable source than the drug form.

    Sexual Effects

    Yohimbine has a long history of being used as an aphrodisiac. Some studies have suggested that it may have the following pro-sexual effects:
    • Helps to obtain and maintain erection
    • Enhances quality of erection

    Side Effects

    Since the effective level of yohimbine is close to its toxic level, it is not clear that its benefits outweigh its risks. Side effects include:
    • Anxiety
    • Nervousness
    • Panic attacks
    • Tremors
    • Elevated blood pressure and heart rate
    • Salivation
    • Nausea
    • Irritability
    • Insomnia
    • Urinary frequency
    • Excessive sweating
    • Fatigue
    • Hallucinations
    • Paralysis

    Cautions

    Medications

    Yohimbine may cause adverse reactions when taken with certain medicines. These include:
    • MAO inhibitors—When combined with yohimbine, MAO inhibitors can cause dangerously high blood pressure.
    • Antidepressants—Yohimbine can interact with most types of antidepressants.
    • Antihypertensives—Yohimbine may increase blood pressure-lowering effects.
    • Nasal decongestants
    • Phenylpropanolamine-containing diet aids

    Health Conditions

    If you have one of the following conditions, talk to your doctor before taking yohimbine:
    Yohimbine is not usually prescribed for women. It should never be taken during pregnancy or while breastfeeding.
    If you have one of the following conditions, talk to your doctor before taking yohimbine:
    Yohimbine is not usually prescribed for women. It should never be taken during pregnancy or while breastfeeding.

    Dietary Considerations

    Yohimbine is classified as an MAO inhibitor. When taking MAOIs, you should avoid the following foods:
      Foods with a high-tyramine content, such as
      • Cheese
      • Alcohol
      • Pickled or marinated or smoked or cured or fermented foods
      • Organ meats
      • Nuts, peanut butter
      • Fava beans
      • Onions
      • Avocados
      • Canned figs
      • Chocolate
      • Excess amounts of caffeine
    • Foods containing monosodium glutamate (MSG)

    RESOURCES

    Family Doctor.org http://familydoctor.org/

    National Center for Complementary and Alternative Medicine http://nccam.nih.gov/

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca/

    Men's Health Centre http://www.menshealthcentre.net/

    References

    Crenshaw TL, Goldberg JP. Sexual Pharmacology: Drugs that Affect Sexual Function. WW Norton & Company; 1996.

    Guay AT, Spark RF, Jacobson J, Murray FT, Geisser ME. Yohimbine treatment of organic erectile dysfunction in a dose-escalation trial. Int J Impot Res. 2002;14:25-31.

    Hall-Flavin DK. MAOIs and diet: is it necessary to restrict tyramine? Mayo Clinic website. Available at: http://www.mayoclinic.com/health/maois/HQ01575. Updated September 1, 2010. Accessed July 30, 2012.

    Lebret T, Hervé JM, Gorny P, et. al. Efficacy and safety of a novel combination of L-arginine glutamate and yohimbine hydrochloride: a new oral therapy for erectile dysfunction. Eur Urol. 2002;41:608-613.

    Peirce A, American Pharmaceutical Association. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York, NY: Morrow; 1999.

    Yohimbe. EBSCO Publishing Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated August 2011. Accessed July 17, 2010.

    Yohimbe: science and safety. National Center for Complementary and Alternative Medicine website. Available at: http://nccam.nih.gov/health/yohimbe. Updated June 2010. Accessed July 17, 2012.

    Yohimbine (oral route). Mayo Clinic website. Available at: http://www.mayoclinic.com/health/drug-information/DR601453. Updated November 2011. Accessed July 17, 2012.

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