By 2025, over 320 million men are expected to suffer from erectile dysfunction. In Ghana and other African countries, people resort to herbal supplements to improve their sexual performance rather than approved synthetic drugs such as Viagra. However, these herbal supplements sometimes contain similar or toxic levels of the synthetic drugs, Felicia Akuamoa discovered in her PhD research.
Felicia Akuamoa (Toxicology) tested for the presence of adulterants in forty herbal supplements sold in Accra (Ghana) for improving sexual performance, especially erectile dysfunction. ‘An adulterant is any substance in a product that is not supposed to be there and which compromises the safety or effectiveness of the product,’ Akuamoa explains. Erectile dysfunction is a well-known problem that increases with age. Still, major causes for men under 40 years old are drug and alcohol abuse and smoking and vaping. Among treatments, approved synthetic drugs are the PDE-5 inhibitors, which dilate blood vessels in the penis and thus enhance erection.
Too spicy
Due to the high cost of medical consultation in Ghana and the side effects of synthetic PDE-5 inhibitors, such as headache, blurry vision and priapism (prolonged and painful erection), men prefer herbal supplements as a remedy for their sexual challenges. Besides individuals who have erectile dysfunction, the youth are increasingly using these herbal aphrodisiacs as a recreational drug to impress their sexual partner. However, there have been several incidents of adverse health risks such as priapism and severe hypotension leading to stroke, cardiac arrest, and sometimes even death.
Although producers advertise these products as ‘all-natural’, Akuamoa found that producers add synthetic PDE-5 inhibitors to guarantee the expected outcome. A high dosage of inhibitors can cause extreme relaxation of smooth muscles and may explain the severe side effects. Akuamoa conducted a bioassay on the PDE-5 inhibition potential of the herbal products and analysed the compounds in each product.
Exceeding 100 mg
Ninety per cent of the supplements had an inhibiting effect and thus the potential to enhance erection, but in sixty per cent this was due to the presence of synthetic PDE-5 inhibitors such as sildenafil (the active compound in Viagra). In thirteen products, the concentration was between 25 and 100 mg, similar to that in pharmaceutical drugs. In six products, the concentration exceeded 100 mg. ‘Such high concentrations are almost guaranteed to give consumers the expected outcomes and equally guaranteed to result in adverse effects’, says Akuamoa.
The tests Akuamoa developed are easily applicable in Ghana and neighbouring countries. ‘With some money and equipment, we should be able to set up these tests and help identify synthetic drugs in herbal products. It should not cost much. We can transfer the knowledge to surrounding countries such as Nigeria, Togo, Benin, Côte d’Ivoire.’ This can help combat the illegal adulteration of herbal-based sexual enhancers and prevent their painful consequences.