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Men's Sexual Health and Fertility pp 183–228Cite as

Nutraceuticals for Fertility and Erectile Health: A Brief Overview of What Works and What Is Worthless

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Abstract

“Heart health is tantamount to fertility and erectile health,” and “first do no harm” are the mantras of this chapter. Lifestyle changes to improve fertility and erectile function are no longer a theory, but sufficient clinical data exists to emphasize a variety of heart healthy behaviors to enhance overall male health, and specific urologic concerns such as infertility and erectile dysfunction (ED). Nutraceuticals for fertility and erectile health appear to exist or be perceived by clinicians and patients on opposite ends of the treatment validation spectrum. Numerous fertility supplements have preliminary evidence and are utilized in urology in addition to assisted reproductive technologies (ART). In fact, their ongoing use continues to be validated by meta-analyses of randomized trials examining pregnancy and live birth rates. Yet the issue with fertility nutraceuticals is the lack of discrimination over which ones to potentially recommend and discourage based on their overall safety in medicine. A plethora of nutraceuticals has been suggested to be of benefit, but one or several have not in general been recommended. Clinicians need to review the latest list of these supplements and review cost, and especially overall safety and efficacy especially outside of the urologic specialty. For example, high-dose vitamin E supplements have been found to increase the risk of prostate cancer, and regardless of their potential positive data in fertility, there are numerous other options, which could parallel the benefits of vitamin E, but without the potential harm. Erectile dysfunction nutraceuticals have arguably one of the most sordid pasts in the dietary supplement milieu, and it is rightly deserved because the FDA has removed more of these supplements from the market compared to any other type of supplement based on nefarious activities, from the addition of PDE-5 contaminants, to the promotion of a variety of benefits without adequate research. However, despite such a problem with ED nutraceuticals, it appears to have created an unnecessary bias in this category from clinicians, which is not warranted because several nutraceuticals for ED have arguably stronger methodological clinical trials compared to fertility nutraceuticals. This chapter highlights some of the most promising nutraceuticals that have the ability to be utilized with conventional options such as PDE-5 inhibitors and/or ART, and it discourages the vast majority of other ED or fertility-enhancing compounds that simply have no efficacy or are not safe.

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  1. Department of Urology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA

    Mark A. Moyad

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  1. Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    John P. Mulhall

  2. Department of Urology, Kaiser Permanente, Oakland Medical Center, Oakland, California, USA

    Wayland Hsiao

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Moyad, M.A. (2014). Nutraceuticals for Fertility and Erectile Health: A Brief Overview of What Works and What Is Worthless. In: Mulhall, J., Hsiao, W. (eds) Men's Sexual Health and Fertility. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0425-9_12

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