Herbal supplements might seem like a good idea if you are a man who is having “trouble” in the bedroom. They’re easy to buy—locally or online—and you don’t have to discuss this embarrassing problem with your doctor.

Or maybe you think these natural products are safer than Viagra or other pharmaceuticals and may, in fact, have health benefits that go beyond improving your sex life.

But…some of the most common herbs for male sexual enhancement have been bashed by the medical establishment—yohimbe, maca, horny goat weed and even ginkgo biloba.

How much weight should you give that news? First, let’s examine what’s being said about male sexual-enhancement herbs. Then let naturopathic sex-health and Traditional Chinese Medicine expert Laurie Steelsmith, ND, LAc, reveal the real dos, don’ts and dangers of these herbs.

THE DANGER OF SEXY SUPPLEMENTS

A recent article by a team of British and Italian researchers said that the business of selling herbal supplements for male sexual enhancement—or dysfunction—is a major health hazard. Because these supplements are marketed as “natural,” many consumers assume that they are safe. In fact, they can cause serious side effects in some users.

In their exposé, the researchers focused on supplements that contained four herbs commonly used to treat male sexual dysfunction—yohimbe, maca, horny goat weed and ginkgo biloba. In brief, they concluded that all of these herbs were linked to dangerous side effects, including cardiovascular problems, mood swings, anxiety, hallucinations and addictive behavior.

Dr. Steelsmith, however, believes that these researchers have been overly harsh. “They are making herbs, such as ginkgo, out to be radical villains, which they are not,” she said, adding that ginkgo and maca have long-term safety records. She also said that horny goat weed is safe when used according to the principles of Traditional Chinese Medicine. But she agreed that the researchers made some good points about yohimbe, which can cause high blood pressure, dangerously low blood pressure, increased heart rate and palpitations, breathing difficulties, headaches and anxiety among other symptoms. “It is a potentially dangerous herb. Unlike the other herbs discussed, I don’t think it should be sold over the counter, but certain formulations of the herb can be used with medical supervision,” she said.

PRACTICE “SAFE SEX SUPPLEMENTS”

Most common sex-enhancement herbs are safe and effective when used correctly, said Dr. Steelsmith, who is the coauthor of the book Great Sex, Naturally. Rather than self-treating, it is best to consult a naturopathic doctor or similarly trained professional who can properly diagnose your health concern and treat you with specially compounded herbal extracts and extracts from high-quality professional-grade manufacturers. Here are her expert thoughts on the sex-boosting herbs mentioned in the British-Italian study…

Yohimbe. Rather than use over-the-counter extracts, always consult a naturopathic doctor if you want to try yohimbe. Dr. Steelsmith reserves such treatment for patients who are in good health but have erectile dysfunction that does not respond to other less potentially toxic remedies.If yohimbe is right for you, a naturopath will treat you with a prescription form of the herb called alpha yohimbine HCl, said Dr. Steelsmith. The naturopath will monitor you while you take yohimbe to make sure that the dosage is optimal and side effects are kept at bay. Men with kidney problems or psychological issues should not take or be treated with this herb.

Horny goat weed. This herb is useful for men who have decreased libido, a slow metabolism and chronically cold hands and feet. In Traditional Chinese Medicine, horny goat weed is never prescribed on its own but rather in combination with herbs that support its ability to boost sexual energy while preventing side effects of overstimulation, said Dr. Steelsmith. Because horny goat weed can act as a stimulant, it is not for you if you suffer from insomnia or anxiety symptoms. Dr. Steelsmith also does not recommend it’s use in people who are on are on blood-thinning medications. Important: Make sure that the herbal extract prescribed by the naturopath is a standardizedextract that contains at least 20% of the active compound icariin.

Maca. This Peruvian herb, traditionally used to increase male sexual potency and endurance, enhances male fertility, said Dr. Steelsmith. It increases sperm production and renders those critters into super-triathlete swimmers (it keeps them strongly mobile, that is). So if a man is ready to start a family, Dr. Steelsmith often prescribes maca. It is generally safe, but be aware that it can increase blood pressure, an issue that you should discuss with the naturopath, especially if you already have high blood pressure.

Ginkgo biloba. Besides boosting memory and cognitive function, ginkgo biloba can boost libido and enhance sexual performance. It is especially useful in both men as well as women who are suffering sexual dysfunction as a side effect of antidepressant medication, said Dr. Steelsmith. A word of caution, though…ginkgo is a natural blood thinner and can interact with blood-thinning drugs as well as other drugs that are broken down by the liver (and most are)—so if you are on a blood thinner or any other type of medication or supplement, ginkgo biloba may not be the right herb for you. This aside, Dr. Steelsmith said that it is safe at the dosages that naturopaths use to treat erectile dysfunction. The product prescribed should be a standardized extract of 24% ginkgo flavone glycosides.

Beside these herbs mentioned in the alarming Brit-Italian study, Dr. Steelsmith treats patients with Tribulus terrestris, which acts similarly to DHEA, an essential building block of estrogen and testosterone that can help keep you young and fit. The extract should contain 45% of the active ingredient protodioscin. It is especially useful in men whose low sex drive is attributed to low testosterone, said Dr. Steelsmith. The herb may support testosterone production. Dr. Steelsmith cautioned that lithium and diabetes drugs can interact with this herb, so anyone taking those medications is not a candidate for use of this herb.

MORE THAN JUST SEX

Before grabbing any herb or drug to fix a sexual-performance problem, it’s wise to reflect on the underlying cause of the problem and make the necessary lifestyle changes, said Dr. Steelsmith. Are you stressed or sleep-deprived? Anxious or depressed? Is a physical health condition getting in the way of good sex? Treating the root cause may solve your sexual dysfunction without any other measures.