Current Sexual Health Reports

, Volume 11, Issue 3, pp 144–155 | Cite as

Plant-Derived Supplements for Sexual Health and Problems, Part 2: Further Evidence for Specific Herbal Effects

  • David L. RowlandEmail author
  • Sean M. McNabney
  • Krystal R. Mulzon
  • Samantha Trammell
Preclinical and Psychophysiology (F Guarraci and L Marson, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Preclinical and Psychophysiology


Purpose of Review

In this review, we revisit and evaluate empirical research on six herbal supplements purported to affect sexual and/or reproductive function in men and women.

Recent Findings

We summarize and critically review recent evidence—both human and non-human—supporting the role of six commonly cited herbs on men’s and women’s sexual health, identifying possible mechanisms of action, as well as gaps in the literature.


Burgeoning interest in phytochemical research over the past decade has helped to elucidate potential mechanisms of action through which these plant-derived supplements may exert pro-sexual benefits. More methodologically rigorous, large-scale clinical trials are still needed to determine the extent to which encouraging findings in rodent, cell culture, and ex vivo models are generalizable to human populations.


Phytochemicals Herbs Plant-derived supplements Sexual health Sexual dysfunction Sexual desire Erectile function 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Rowland DL, Burek M, Macias L. Plant-derivatives and herbs used for the promotion of sexual health and the treatment of sexual problems. Annu Rev Sex Res. 2007;18(1):225–57. Scholar
  2. 2.
    Kim NN, Christianson DW, Traish AM. Role of arginase in the male and female sexual arousal response. J Nutr. 2004;134(10 Suppl):2873S–9S; discussion 95S. Scholar
  3. 3.
    Panjari M, Davis SR. DHEA therapy for women: effect on sexual function and wellbeing. Human reproduction update. 2007;13(3):239–48. Scholar
  4. 4.
    George A, Henkel R. Phytoandrogenic properties of Eurycoma longifolia as natural alternative to testosterone replacement therapy. Andrologia. 2014;46(7):708–21. Scholar
  5. 5.
    Rehman SU, Choe K, Yoo HH. Review on a Traditional Herbal Medicine, Eurycoma longifolia Jack (Tongkat Ali): Its Traditional Uses, Chemistry, Evidence-Based Pharmacology and Toxicology. Molecules. 2016;21(3):331. Scholar
  6. 6.
    Thu HE, Mohamed IN, Hussain Z, Jayusman PA, Shuid AN. Eurycoma longifolia as a potential adoptogen of male sexual health: a systematic review on clinical studies. Chinese journal of natural medicines. 2017;15(1):71–80. Scholar
  7. 7.
    Ang HH, Lee KL, Kiyoshi M. Sexual arousal in sexually sluggish old male rats after oral administration of Eurycoma longifolia Jack. Journal of basic and clinical physiology and pharmacology. 2004;15(3-4):303–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Zanoli P, Zavatti M, Montanari C, Baraldi M. Influence of Eurycoma longifolia on the copulatory activity of sexually sluggish and impotent male rats. Journal of ethnopharmacology. 2009;126(2):308–13. Scholar
  9. 9.
    Low BS, Choi SB, Abdul Wahab H, Das PK, Chan KL. Eurycomanone, the major quassinoid in Eurycoma longifolia root extract increases spermatogenesis by inhibiting the activity of phosphodiesterase and aromatase in steroidogenesis. J Ethnopharmacol. 2013;149(1):201–7. Scholar
  10. 10.
    Manna PR, Stetson CL, Slominski AT, Pruitt K. Role of the steroidogenic acute regulatory protein in health and disease. Endocrine. 2016;51(1):7–21. Scholar
  11. 11.
    Miller WL. Androgen biosynthesis from cholesterol to DHEA. Molecular and cellular endocrinology. 2002;198(1-2):7–14.CrossRefPubMedGoogle Scholar
  12. 12.
    Low BS, Das PK, Chan KL. Standardized quassinoid-rich Eurycoma longifolia extract improved spermatogenesis and fertility in male rats via the hypothalamic-pituitary-gonadal axis. Journal of ethnopharmacology. 2013;145(3):706–14. Scholar
  13. 13.
    Erasmus N, Solomon MC, Fortuin KA, Henkel RR. Effect of Eurycoma longifolia Jack (tongkat ali) extract on human spermatozoa in vitro. Andrologia. 2012;44(5):308–14. Scholar
  14. 14.
    Tambi MI, Imran MK. Eurycoma longifolia Jack in managing idiopathic male infertility. Asian J Androl. 2010;12(3):376–80. Scholar
  15. 15.
    Udani JK, George AA, Musthapa M, Pakdaman MN, Abas A. Effects of a Proprietary Freeze-Dried Water Extract ofEurycoma longifolia(Physta) andPolygonum minuson Sexual Performance and Well-Being in Men: A Randomized, Double-Blind, Placebo-Controlled Study. Evid-based Complement Alternat Med: eCAM. 2014;2014:179529–10. Scholar
  16. 16.
    Alexandre EC, Calmasini FB, Sponton A, de Oliveira MG, Andre DM, Silva FH, et al. Influence of the periprostatic adipose tissue in obesity-associated mouse urethral dysfunction and oxidative stress: effect of resveratrol treatment. European journal of pharmacology. 2018;836:25–33. Scholar
  17. 17.
    Henkel R, Kierspel E, Hajimohammad M, Stalf T, Hoogendijk C, Mehnert C, et al. DNA fragmentation of spermatozoa and assisted reproduction technology. Reproductive biomedicine online. 2003;7(4):477–84.Google Scholar
  18. 18.
    Miner M, Esposito K, Guay A, Montorsi P, Goldstein I. Cardiometabolic risk and female sexual health: the Princeton III summary. J Sex Med. 2012;9(3):641–51; quiz 52. Scholar
  19. 19.
    Dow CA, Lincenberg GM, Greiner JJ, Stauffer BL, DeSouza CA. Endothelial vasodilator function in normal-weight adults with metabolic syndrome. Appl Physiol Nutr Metab = Physiologie appliquee, nutrition et metabolisme. 2016;41(10):1013–7.
  20. 20.
    Esposito K, Pontillo A, Di Palo C, Giugliano G, Masella M, Marfella R, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. Jama. 2003;289(14):1799–804. Scholar
  21. 21.
    Yuan T, Yang T, Chen H, Fu D, Hu Y, Wang J, et al. New insights into oxidative stress and inflammation during diabetes mellitus-accelerated atherosclerosis. Redox biology. 2019;20:247–60.
  22. 22.
    Campbell JM, Lane M, Owens JA, Bakos HW. Paternal obesity negatively affects male fertility and assisted reproduction outcomes: a systematic review and meta-analysis. Reproductive biomedicine online. 2015;31(5):593–604. Scholar
  23. 23.
    Han YM, Woo SU, Choi MS, Park YN, Kim SH, Yim H, et al. Antiinflammatory and analgesic effects of Eurycoma longifolia extracts. Archives of pharmacal research. 2016;39(3):421–8.
  24. 24.
    Solomon MC, Erasmus N, Henkel RR. In vivoeffects ofEurycoma longifoliaJack (Tongkat Ali) extract on reproductive functions in the rat. Andrologia. 2014;46(4):339–48. Scholar
  25. 25.
    Choi YS, Lee SK, Bae WJ, Kim SJ, Cho HJ, Hong SH, et al. Bariatric surgery improves the cavernosal neuronal, vasorelaxation, and contraction mechanisms for erectile dysfunction as result of amelioration of glucose homeostasis in a diabetic rat model. PloS one. 2014;9(8):e104042.
  26. 26.
    Kelly DM, Jones TH. Testosterone and obesity. Obes Rev. 2015;16(7):581–606. Scholar
  27. 27.
    Rowland DL, McNabney SM, Mann AR. Sexual function, obesity, and weight loss in men and women. Sex Med Rev. 2017;5(3):323–38. Scholar
  28. 28.
    Husen R, Pihie AH, Nallappan M. Screening for antihyperglycaemic activity in several local herbs of Malaysia. J Ethnopharmacol. 2004;95(2-3):205–8. Scholar
  29. 29.
    • Kim JW, Oh MM, Yoon CY, Bae JH, Kim JJ, Moon DG. The effect of diet-induced insulin resistance on DNA methylation of the androgen receptor promoter in the penile cavernosal smooth muscle of mice. Asian J Androl. 2013;15(4):487–91. [This study elucidates potential molecular mechanisms through which diet-induced insulin resistance may negatively influence reproductive physiology.].CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Low BS, Das PK, Chan KL. Acute, reproductive toxicity and two-generation teratology studies of a standardized quassinoid-rich extract of Eurycoma longifolia Jack in Sprague-Dawley rats. Phytotherapy research : PTR. 2014;28(7):1022–9. Scholar
  31. 31.
    George A, Udani J, Abidin NZ, Yusof A. Efficacy and safety of Eurycoma longifolia (Physta((R))) water extract plus multivitamins on quality of life, mood and stress: a randomized placebo-controlled and parallel study. Food Nutr Res. 2018;62.
  32. 32.
    George A, Suzuki N, Abas AB, Mohri K, Utsuyama M, Hirokawa K, et al. Immunomodulation in Middle-Aged Humans Via the Ingestion of Physta® Standardized Root Water Extract ofEurycoma longifoliaJack-A Randomized, Double-Blind, Placebo-Controlled, Parallel Study. Phytotherapy Res: PTR. 2016;30(4):627–35.
  33. 33.
    •• Corazza O, Martinotti G, Santacroce R, Chillemi E, Di Giannantonio M, Schifano F, et al. Sexual enhancement products for sale online: raising awareness of the psychoactive effects of yohimbine, maca, horny goat weed, and Ginkgo biloba. BioMed Res Int. 2014;2014:841798. [Helps to temper/moderate public interest in herbal supplementation by describing possible adverse psychological effects, often inadequately addressed by supplement manufacturers and online vendors.].CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Liu T, Xin H, Li WR, Zhou F, Li GY, Gong YQ, et al. Effects of icariin on improving erectile function in streptozotocin-induced diabetic rats. J Sex Med. 2011;8(10):2761–72.
  35. 35.
    Zhou F, Xin H, Liu T, Li GY, Gao ZZ, Liu J, et al. Effects of icariside II on improving erectile function in rats with streptozotocin-induced diabetes. J Androl. 2012;33(5):832–44.
  36. 36.
    Rowland D, Burnett A. Pharmacotherapy in the treatment of male sexual dysfunction. J Sex Res. 2000;37(3):226–43. Scholar
  37. 37.
    Ding J, Tang Y, Tang Z, Zu X, Qi L, Zhang X, et al. Icariin improves the sexual function of male mice through the PI3K/AKT/eNOS/NO signalling pathway. Andrologia. 2018;50(1).
  38. 38.
    Shindel AW, Xin ZC, Lin G, Fandel TM, Huang YC, Banie L, et al. Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. J Sex Med. 2010;7(4 Pt 1):1518–28.
  39. 39.
    Dietz BM, Hajirahimkhan A, Dunlap TL, Bolton JL. Botanicals and their bioactive phytochemicals for women’s health. Pharmacol Rev. 2016;68(4):1026–73. Scholar
  40. 40.
    Borrelli F, Colalto C, Delfino DV, Iriti M, Izzo AA. Herbal dietary supplements for erectile dysfunction: a systematic review and meta-analysis. Drugs. 2018;78(6):643–73. Scholar
  41. 41.
    Murphy LL, Lee TJ. Ginseng, sex behavior, and nitric oxide. Ann N Y Acad Sci. 2002;962:372–7.CrossRefPubMedGoogle Scholar
  42. 42.
    Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. British journal of clinical pharmacology. 2008;66(4):444–50. Scholar
  43. 43.
    Choi YD, Park CW, Jang J, Kim SH, Jeon HY, Kim WG, et al. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study. International journal of impotence research. 2013;25(2):45–50.
  44. 44.
    Leung KW, Wong AS. Ginseng and male reproductive function. Spermatogenesis. 2013;3(3):e26391. Scholar
  45. 45.
    Ying A, Yu QT, Guo L, Zhang WS, Liu JF, Li Y, et al. Structural–Activity Relationship of Ginsenosides from Steamed Ginseng in the Treatment of Erectile Dysfunction. Am J Chin Med. 2018;46(1):137–55.
  46. 46.
    Park EH, Kim DR, Kim HY, Park SK, Chang MS. Panax ginseng induces the expression of CatSper genes and sperm hyperactivation. Asian journal of andrology. 2014;16(6):845–51. Scholar
  47. 47.
    Kim SO, Lee M, Xui Y, Ahn KY, Hong HD, Kim SS, et al. Effects of Korean red ginseng on the vaginal blood flow and structure in female castrated rats. Korean J Urol. 2006;47(8):888–94.
  48. 48.
    Kim SO, Kim MK, Chae MJ, Kim HY, Park JK, Park K. Effect of Korean red ginseng on the relaxation of clitoral corpus cavernosum in rabbit. Korean J Androl. 2006;24(1):29–34.Google Scholar
  49. 49.
    Kim SO, Kim MK, Lee HS, Park JK, Park K. The effect of Korean red ginseng extract on the relaxation response in isolated rabbit vaginal tissue and its mechanism. J Sex Med. 2008;5(9):2079–84. Scholar
  50. 50.
    Oh KJ, Chae MJ, Lee HS, Hong HD, Park K. Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study. J Sex Med. 2010;7(4 Pt 1):1469–77. Scholar
  51. 51.
    Chung HS, Hwang I, Oh KJ, Lee MN, Park K. The Effect of Korean red ginseng on sexual function in premenopausal women: placebo-controlled, double-blind, crossover clinical trial. Evid-based Complement Alternat Med : eCAM. 2015;2015:913158–5. Scholar
  52. 52.
    Tam DNH, Truong DH, Nguyen TTH, Quynh LN, Tran L, Nguyen HD, et al. Ginsenoside Rh1: a systematic review of its pharmacological properties. Planta Med. 2018;84(3):139–52.
  53. 53.
    Park J, Song H, Kim SK, Lee MS, Rhee DK, Lee Y. Effects of ginseng on two main sex steroid hormone receptors: estrogen and androgen receptors. J Ginseng Res. 2017;41(2):215–21. Scholar
  54. 54.
    Polan ML, Hochberg RB, Trant AS, Wuh HC. Estrogen bioassay of ginseng extract and ArginMax, a nutritional supplement for the enhancement of female sexual function. J Womens Health (Larchmt). 2004;13(4):427–30. Scholar
  55. 55.
    Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Saf. 2002;25(5):323–44. Scholar
  56. 56.
    Dickman JR, Koenig RT, Ji LL. American ginseng supplementation induces an oxidative stress in postmenopausal women. Journal of the American College of Nutrition. 2009;28(2):219–28.CrossRefPubMedGoogle Scholar
  57. 57.
    Parlakpinar H, Ozhan O, Ermis N, Vardi N, Cigremis Y, Tanriverdi LH, et al. Acute and subacute effects of low versus high doses of standardized Panax ginseng extract on the heart: an experimental study. Cardiovasc Toxicol. 2019.
  58. 58.
    Gan XT, Karmazyn M. Cardioprotection by ginseng: experimental and clinical evidence and underlying mechanisms. Can J Physiol Pharmacol. 2018;96(9):859–68. Scholar
  59. 59.
    Karmazyn M, Moey M, Gan XT. Therapeutic potential of ginseng in the management of cardiovascular disorders. Drugs. 2011;71(15):1989–2008. Scholar
  60. 60.
    Mancuso C, Santangelo R. Panax ginseng and Panax quinquefolius: from pharmacology to toxicology. Food Chem Toxicol. 2017;107(Pt A):362–72. Scholar
  61. 61.
    Do J, Choi S, Choi J, Hyun JS. Effects and mechanism of action of a Tribulus terrestris extract on penile erection. Korean journal of urology. 2013;54(3):183–8. Scholar
  62. 62.
    Neychev V, Mitev V. Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: Fact or Fiction. Journal of ethnopharmacology. 2016;179:345–55. Scholar
  63. 63.
    Gauthaman K, Ganesan AP. The hormonal effects of Tribulus terrestris and its role in the management of male erectile dysfunction--an evaluation using primates, rabbit and rat. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2008;15(1-2):44–54. Scholar
  64. 64.
    Gauthaman K, Ganesan AP, Prasad RN. Sexual effects of puncturevine (Tribulus terrestris) extract (protodioscin): an evaluation using a rat model. J alternat Complement Med (New York, NY). 2003;9(2):257–65. Scholar
  65. 65.
    Gauthaman K, Adaikan PG, Prasad RN. Aphrodisiac properties of Tribulus Terrestris extract (Protodioscin) in normal and castrated rats. Life Sci. 2002;71(12):1385–96.CrossRefPubMedGoogle Scholar
  66. 66.
    • Meldrum DR, Burnett AL, Dorey G, Esposito K, Ignarro LJ. Erectile hydraulics: maximizing inflow while minimizing outflow. J Sex Med. 2014;11(5):1208–20. [This paper provides an excellent overview regarding the physiological processes that facilitate penile erection. It discusses the role of nitric oxide, which appears to be implicated in several pro-sexual benefits attributed to the herbal supplements described in this review.].CrossRefPubMedGoogle Scholar
  67. 67.
    Musicki B, Hannan JL, Lagoda G, Bivalacqua TJ, Burnett AL. Mechanistic link between erectile dysfunction and systemic endothelial dysfunction in type 2 diabetic rats. Andrology. 2016;4(5):977–83. Scholar
  68. 68.
    Hurt KJ, Sezen SF, Lagoda GF, Musicki B, Rameau GA, Snyder SH, et al. Cyclic AMP-dependent phosphorylation of neuronal nitric oxide synthase mediates penile erection. Proc Natl Acad Sci U S A. 2012;109(41):16624–9.
  69. 69.
    Martino-Andrade AJ, Morais RN, Spercoski KM, Rossi SC, Vechi MF, Golin M, et al. Effects of Tribulus terrestris on endocrine sensitive organs in male and female Wistar rats. Journal of ethnopharmacology. 2010;127(1):165–70.
  70. 70.
    Neychev VK, Mitev VI. The aphrodisiac herb Tribulus terrestris does not influence the androgen production in young men. Journal of ethnopharmacology. 2005;101(1-3):319–23. Scholar
  71. 71.
    Polari L, Yatkin E, Martinez Chacon MG, Ahotupa M, Smeds A, Strauss L, et al. Weight gain and inflammation regulate aromatase expression in male adipose tissue, as evidenced by reporter gene activity. Mol Cell Endocrinol. 2015;412:123–30. Scholar
  72. 72.
    Xu X, Wang L, Luo D, Zhang M, Chen S, Wang Y, et al. Effect of testosterone synthesis and conversion on serum testosterone levels in obese men. Horm Metab Res. 2018;50(9):661–70.
  73. 73.
    •• Vale FBC, Zanolla Dias de Souza K, Rezende CR, Geber S. Efficacy of Tribulus terrestris for the treatment of premenopausal women with hypoactive sexual desire disorder: a randomized double-blinded, placebo-controlled trial. Gynecol Endocrinol. 2018;34(5):442–5. [A recent clinical study indicating benefits from Tribulus supplementation on both subjective sexual functioning questionnaires and bioavailable testosterone levels in premenopausal women .].CrossRefPubMedGoogle Scholar
  74. 74.
    Kamenov Z, Fileva S, Kalinov K, Jannini EA. Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction-A prospective, randomized, double-blind, placebo-controlled clinical trial. Maturitas. 2017;99:20–6. Scholar
  75. 75.
    Gandhi S, Srinivasan BP, Akarte AS. Potential nephrotoxic effects produced by steroidal saponins from hydro alcoholic extract of Tribulus terrestris in STZ-induced diabetic rats. Toxicol Mech Methods. 2013;23(7):548–57. Scholar
  76. 76.
    Ryan M, Lazar I, Nadasdy GM, Nadasdy T, Satoskar AA. Acute kidney injury and hyperbilirubinemia in a young male after ingestion of Tribulus terrestris. Clin Nephrol. 2015;83(3):177–83. Scholar
  77. 77.
    Talasaz AH, Abbasi MR, Abkhiz S, Dashti-Khavidaki S. Tribulus terrestris-induced severe nephrotoxicity in a young healthy male. Nephrol Dial Transplant. 2010;25(11):3792–3. Scholar
  78. 78.
    Campanelli M, De Thomasis R, Tenaglia RL. Priapism caused by ‘Tribulus terrestris’. International journal of impotence research. 2016;28(1):39–40. Scholar
  79. 79.
    Gonzales GF. Ethnobiology and ethnopharmacology of Lepidium meyenii (maca), a plant from the Peruvian highlands. Evid-based Complement Alternat Med : eCAM. 2012;2012:193496–10. Scholar
  80. 80.
    Gonzales-Arimborgo C, Yupanqui I, Montero E, Alarcon-Yaquetto DE, Zevallos-Concha A, Caballero L, et al. Acceptability, safety, and efficacy of oral administration of extracts of black or red maca (Lepidium meyenii) in adult human subjects: a randomized, double-blind, placebo-controlled study. Pharmaceuticals (Basel). 2016;9(3).
  81. 81.
    Melnikovova I, Fait T, Kolarova M, Fernandez EC, Milella L. Effect of Lepidium meyenii Walp. on semen parameters and serum hormone levels in healthy adult men: a double-blind, randomized, placebo-controlled pilot study. Evid-based Complement Alternat Med: eCAM. 2015;2015:324369. Scholar
  82. 82.
    Lorenz T, Rullo J, Faubion S. Antidepressant-induced female sexual dysfunction. Mayo Clin Proc. 2016;91(9):1280–6. Scholar
  83. 83.
    Dording CM, Schettler PJ, Dalton ED, Parkin SR, Walker RS, Fehling KB, et al. A double-blind placebo-controlled trial of maca root as treatment for antidepressant-induced sexual dysfunction in women. Evid-based Complement Alternat Med: eCAM. 2015;2015:949036–9. Scholar
  84. 84.
    Estrada-Reyes R, Ortiz-Lopez P, Gutierrez-Ortiz J, Martinez-Mota L. Turnera diffusa Wild (Turneraceae) recovers sexual behavior in sexually exhausted males. Journal of ethnopharmacology. 2009;123(3):423–9. Scholar
  85. 85.
    Kumar S, Madaan R, Sharma A. Pharmacological evaluation of bioactive principle of Turnera aphrodisiaca. Indian J Pharm Sci. 2008;70(6):740–4. Scholar
  86. 86.
    Avelino-Flores Mdel C, Cruz-Lopez Mdel C, Jimenez-Montejo FE, Reyes-Leyva J. Cytotoxic activity of the methanolic extract of Turnera diffusa Willd on breast cancer cells. J Med Food. 2015;18(3):299–305. Scholar
  87. 87.
    Arletti R, Benelli A, Cavazzuti E, Scarpetta G, Bertolini A. Stimulating property of Turnera diffusa and Pfaffia paniculata extracts on the sexual-behavior of male rats. Psychopharmacology. 1999;143(1):15–9.CrossRefPubMedGoogle Scholar
  88. 88.
    Kumar S, Sharma A. Anti-anxiety activity studies on homoeopathic formulations of Turnera aphrodisiaca Ward. Evid-based Complement Alternat Med : eCAM. 2005;2(1):117–9. Scholar
  89. 89.
    Alcaraz-Melendez L, Delgado-Rodriguez J, Real-Cosio S. Analysis of essential oils from wild and micropropagated plants of damiana (Turnera diffusa). Fitoterapia. 2004;75(7-8):696–701. Scholar
  90. 90.
    Zhao J, Dasmahapatra AK, Khan SI, Khan IA. Anti-aromatase activity of the constituents from damiana (Turnera diffusa). J Ethnopharmacol. 2008;120(3):387–93. Scholar
  91. 91.
    McCabe M, Althof SE, Assalian P, Chevret-Measson M, Leiblum SR, Simonelli C, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2010;7(1 Pt 2):327–36.
  92. 92.
    • Brotto L, Atallah S, Johnson-Agbakwu C, Rosenbaum T, Abdo C, Byers ES, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2016;13(4):538–71. [Detailed analysis of the psychological, age-related, and interpersonal factors that may contribute to sexual dysfunction in men and women. Provides a multidisciplinary framework for treating sexual problems, particularly when no apparent pathophysiology can be identified.].CrossRefPubMedGoogle Scholar
  93. 93.
    Rowland D. Sexual dysfunction in men. Cambridge, MA: Hogrefe Publishing; 2012.Google Scholar
  94. 94.
    Szewczyk K, Zidorn C. Ethnobotany, phytochemistry, and bioactivity of the genus Turnera (Passifloraceae) with a focus on damiana--Turnera diffusa. Journal of ethnopharmacology. 2014;152(3):424–43. Scholar
  95. 95.
    Estrada-Reyes R, Carro-Juarez M, Martinez-Mota L. Pro-sexual effects of Turnera diffusa Wild (Turneraceae) in male rats involves the nitric oxide pathway. Journal of ethnopharmacology. 2013;146(1):164–72. Scholar
  96. 96.
    Kotta S, Ansari SH, Ali J. Exploring scientifically proven herbal aphrodisiacs. Pharmacogn Rev. 2013;7(13):1–10. Scholar
  97. 97.
    Yang R, Wang J, Chen Y, Sun Z, Wang R, Dai Y. Effect of caffeine on erectile function via up-regulating cavernous cyclic guanosine monophosphate in diabetic rats. J Androl. 2008;29(5):586–91. Scholar
  98. 98.
    Guarraci FA, Benson A. Coffee, tea, and me: moderate doses of caffiene affect sexual behavior in female rats. Pharm Biochem Behav. 2005;82(3):522–30.CrossRefGoogle Scholar
  99. 99.
    Li W, Pandey AK, Yin X, Chen JJ, Stocco DM, Grammas P, et al. Effects of apigenin on steroidogenesis and steroidogenic acute regulatory gene expression in mouse Leydig cells. The Journal of Nutritional Biochemistry. 2011;22(3):212–8.
  100. 100.
    Ito TY, Trant AS, Polan ML. A double-blind placebo-controlled study of ArginMax, a nutritional supplement for enhancement of female sexual function. J Sex Marital Ther. 2001;27(5):541–9. Scholar
  101. 101.
    Ito TY, Polan ML, Whipple B, Trant AS. The enhancement of female sexual function with ArginMax, a nutritional supplement, among women differing in menopausal status. J Sex Marital Ther. 2006;32(5):369–78. Scholar
  102. 102.
    Parra-Naranjo A, Delgado-Montemayor C, Fraga-Lopez A, Castaneda-Corral G, Salazar-Aranda R, Acevedo-Fernandez JJ, et al. Acute hypoglycemic and antidiabetic effect of teuhetenone A isolated from Turnera diffusa. Molecules. 2017;22(4).
  103. 103.
    Rowland D. Culture and the Practice of Sexual Medicine. In: Rowland DL, EA J, editors. Cultural differences and the practice of sexual medicine. Switzerland: Springer Nature; In Press.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • David L. Rowland
    • 1
    Email author
  • Sean M. McNabney
    • 1
  • Krystal R. Mulzon
    • 1
  • Samantha Trammell
    • 1
  1. 1.Department of PsychologyValparaiso UniversityValparaisoUSA

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