39

REVIEW
Natural Aphrodisiacs

jsm_1521

39..49

Rany Shamloul, MD
Queens UniversityPharmacology, Kingston, Ontario, Canada; Cairo UniversityAndrology and Sexology department,
Cairo, Egypt
DOI: 10.1111/j.1743-6109.2009.01521.x

ABSTRACT

Introduction. The search for a remedy or a prescription that can enhance sexual function and/or treat male erectile
dysfunction has been an obsession throughout known history. Whether it was an Eastern civilization or a Western
one, religious or atheist, mans aspiration for a better or best manhood has been a history-time goal.
Aim. This review will discuss the current research done on the most popular natural aphrodisiacs and examine the
weight of evidence to support or discourage the use of any of these substances to enhance sexual desire and/or function.
Methods. Review of the current evidence on the use of natural substances as aphrodisiacs.
Main Outcome Measures. Efcacy of natural aphrodisiacs in enhancing sexual function in men and women.
Results. There is little evidence from literature to recommend the usage of natural aphrodisiacs for the enhancement
of sexual desire and/or performance. Data on yohimbines efcacy does not support the wide use of the drug, which
has only mild effects in the treatment of psychogenic ED. Although theres a positive trend towards recommending
ginseng as an effective aphrodisiac, however, more in depth studies involving large number of subjects and its
mechanism of action are needed before denite conclusions could be reached. Data on the use of natural aphrodisiacs
in women is limited.
Conclusions. The current body of objective evidence does not support the use of any natural aphrodisiac as an
effective treatment for male or female sexual dysfunctions. Potent men and men with ED will continue the search
for natural aphrodisiacs despite the current disappointing data on their effectiveness. Care should be taken regarding
the fraud addition of sildenal analogues to natural aphrodisiacs. Shamloul R. Natural aphrodisiacs. J Sex Med
2010;7:3949.
Key Words. Natural Aphrodisiacs; Ginseng; Yohimbine

Introduction

s a sexual medicine specialist whether you

were in a bar in downtown New York or in a
downtown Cairo cafe you probably might have
been asked about natural substances that can
enhance libido and/or performance. By scientic
terms, these substances are called aphrodisiacs.
Aphrodisiacs take their name from Aphrodite, the
Greek goddess of love and beauty. According to
Greek poet Hesiod, she was born when Uranus
was castrated by his son Cronus. Cronus threw his
severed genitals into the sea, and from the aphros
(sea foam) arose Aphrodite.
2009 International Society for Sexual Medicine

The search for a remedy or a prescription that

can enhance sexual function and/or treat male erectile dysfunction (ED) has been an obsession
throughout known history. Whether it was an
Eastern civilization or a Western one, religious or
atheist, mans aspiration for a better or best
manhood has been a history-time goal. In a
review by Shah, different civilizations thoughts
and reactions concerning this goal is eloquently
discussed [1]. For example, poems from the Hindu
civilization dating back to 3,000 to 4,000 years are
the earliest recordings of the human eternal search
for substances that can enhance sexual experiences
lead to the much unknown, supersex, and/or treat
J Sex Med 2010;7:3949

40
ED [2]. One of these poems describes natural high
nutritional value treatments, perfumes and even
spices that can enhance mans sexual abilities [1].
In an old Chinese text (2697 to 2595 BC), a
remedy consisting of 22 ingredients is described to
the contemporary emperor who drank it and was
able to mount 1,200 women and achieved immortality [3]. Moving on in history the Romans and
Chinese shared the same aphrodisiac concept (or
truly, misconception) that consuming the animal
genitals can enhance mens sexual function [1].
The ancient Egyptians had their share of aphrodisiacs with several papyri describing many medications for ED including local penile application of
oiled baby crocodile hearts, ingestion of pine, salt,
and watermelon [4,5].
In recent history, the search for the ultimate
aphrodisiac did not stop with hundreds and hundreds of natural and unnatural substances tried. It
was expected that the advent of phosphodiesterase
type 5 inhibitors (PDE5s) and other evidencebased successful oral pharmacotherapy for ED will
lead to less interest in aphrodisiacs. However, the
reverse occurred and a simple Medline search
using the term aphrodisiac between 2000 and
2009 yielded more than 146 citations compared
with that 86 articles between 1990 and 1999, a net
increase of 59%. This may be because of the fact
that the discovery of very successful therapies of
ED may have led to increased expectations of
nding a natural substance that may have similar
effects to PDEs without their known side-effects.
Also, it may be that men requesting aphrodisiacs
are suffering from a mild form of decreased libido,
which cannot be treated with PDEs. Another
important reason is that it seems that some men
seeking aphrodisiacs are normal and potent but
just looking for an unrealistic heightened sexual
satisfaction that they couldnt attain using PDEs,
which only work on men with various degrees of
ED and normal libido.
Because of their huge diversity of chemical
content, there appears to be no known universal
classication of aphrodisiacs. However, a working
classication can be designed to term aphrodisiacs made from natural sources as natural aphrodisiacs whereas others made of synthetic
compounds are called non-natural aphrodisiacs.
Intracavernosal, intra-urethral, and oral PDEs
drugs used for the treatment of ED and synthetic
androgens can all be classied as non-natural
aphrodisiacs. Natural aphrodisiacs can be further
classied into plant aphrodisiacs and nonplant
aphrodisiacs.
J Sex Med 2010;7:3949

Shamloul
This review will discuss the current research
done on the most popular natural aphrodisiacs and
examine the weight of evidence to support or discourage the use of any of them to enhance sexual
desire and/or function.
Natural Aphrodisiacs

Nonplant Natural Aphrodisiacs

Ambrein
Ambrein a major constituent of Ambra grisea is
used in Arab countries [6,7]. It is found in the gut
of sperm whales, and its use in folk medicine is
wide, ranging from treatment of headache, rheumatism, and improvement of sexual performance.
Only animal studies were conducted to investigate
the sexual enhancing properties of this substance
showing that it can stimulate pituitary secretion of
luteinizing hormone (LH) leading to increased
serum testosterone [8]. It has been also shown to
antagonize the effects of noradrenalin and other
vasoconstricting agents on smooth muscles [5].
Bufo Toad
The skin and glands of this toad contain bufotenine, a putative hallucinogen congener of serotonin [9]. It is the active ingredient in West Indian
love stone and the Chinese medication chan su
[10]. No mechanism is known regarding its
popular aphrodisiac effects but it is assumed that it
may have central stimulatory actions because of its
hallucinogenic properties [8].
Spanish Fly
The Spanish y is an emerald-green beetle in the
family Meloidae, Lytta vesicatoria. The beetle
contains up to 5% cantharidin that irritates animal
tissues. Cantharides are excreted in urine and can
irritate the urethral passages, causing inammation in the genitals [11]. Orally, cantharides exhibit
their actions by inhibition of phosphodiesterase
and protein phosphatase activity and stimulation
of b-receptors, inducing vascular congestion and
inammation and thus may lead to sexual arousal
[8]. However, contrary to popular beliefs
cantharides actions are not specic to females,
developing equally in men and women. Side
effects, including renal toxicity and gastrointestinal hemorrhages, are a major limitation due the
human use of Spanish y [8]. Cantharides have
very limited clinical uses.
Plant-Related Natural Aphrodisiacs
Yohimbine
Yohimbine is an indole alkaloid extracted from the
bark of West African yohim trees. It is a prescrip-

Natural Aphrodisiacs
tion drug approved by the Food and Drug Administration (FDA) as a mydriatic. Prior to the advent
of the PDE5s, and owing to its central action as an
a-2 adrenergic antagonist, yohimbine was one of
the few oral pharmacological agents prescribed
for the treatment of ED. Several randomizedcontrolled trials reported various efcacy rates of
yohimbine ranging from 34% to 73% [915]. A
meta-analysis of these trials commented that this
large variability of success rates may be caused by
the difference in the patients ages and the etiology
of ED. Also, it is thought that different methods of
assessment of the degree of ED in these trials may
have impacted the results. In general, yohimbine
may be effective but primarily in patients with
psychogenic ED [16]. More recent studies
reported that a combination therapy of Larginine/yohimbine may yield improvement of
erectile function [17,18]. These studies on Larginine/yohimbine are preliminary and should
not be considered denitive until they are conrmed by larger, more rigorous studies. Sideeffects related to yohimbine include hypertension,
anxiety and palpitations.

Tribulus Terrestris
Tribulus terristrus (TT) is a perennial creeping
herb with a worldwide distribution. This plant has
been used for a long time as a traditional sexual
stimulant. Current research is only limited to
animal studies that have shown signicant
increases in erectile function after oral administration of the plant extract [19,20]. Several reports
demonstrated that, indeed, TT is able to increase
endogenous testosterone levels, which might be
the underlying mechanism for its erectileenhancing ability [1921]. However, exactly how
TT increases testosterone levels is still unclear.
Also, it is unknown if TT has nonandrogenic
effects that might contribute to its erectogenic
actions. Also, no clinical studies have been performed to date and recommendation for the usage
of TT in ED would be very premature.
Epimedii Herba (Horny Goat Weed)
Epimedii herba has been used as an energy and
erectile-enhancing drug in traditional Chinese
medicine for centuries. Icariin has been determined to be the main active component of Epimedii herba [22]. Animal studies reported signicant
increase in intracavernosal pressure following
administration of icariin [2325]. This was also
coupled to signicant increase in the expression
levels of inducible and neuronal nitric oxide synthases in the corpus cavernosum [25]. It is expected

41
that future clinical studies will delineate whether
or not Epimedii Herba is a successful natural
aphrodisiac.

Muira Puama (Potency Wood)

This herb grows primarily in Brazil with many folk
observations that it can promote sexual activities
especially in old men. To date, only two clinical
studies and no animal studies examined the prosexual effects of Muira Puama [26,27]. In one
study, 60% of men with initial low libido reported
increase in their sexual desire following intake of
the herb. Also 50% of men initially with poor
erection reported a benecial effect of the herb on
their erectile function [26]. The other study demonstrated that Muira Puama can improve sexual
desire, sexual fantasies and the ability to reach
orgasm in 65% of women with prior sexual dysfunctions [27]. No mechanism is still known for
these prosexual effects of Muira Puama and, denitely, randomized placebo-controlled studies are
recommended to further conrm the sexual
enhancing effects of this herb.
Saw Palmetto
This is a small palm-like plant native to southeastern North America. Despite its documented effects
in improvement of lower urinary tract symptoms
and benign prostatic hyperplasia, no study reported
a direct effect of Saw Palmetto on sexual performance [28]. Interestingly, urological actions of
Saw Palmetto have been attributed to its antiandrogenic effects, further reducing the herbs
potential to be a successful aphrodisiac [2932].
Ginseng
Ginseng refers to species within Panax, a genus of
11 species of slow-growing perennial plants with
eshy roots, in the family Araliaceae. Two species
of ginseng widely studied with respect to their
medicinal benets are Panax ginseng (Asian
ginseng) and Panax quinquefolium (American
ginseng) [33]. The principle active constituents in
ginseng are ginsenosides, saponin glycosides
unique to the Panax species. Ginseng cultivated in
Korea is classied into three types, depending on
how it is processed: fresh ginseng (<4 years old),
white ginseng (46 years old), and red ginseng
(6 years old, steamed and dried) [34]. Red ginseng
is the type of ginseng with mostly reported aphrodisiac effects [35]. Jang et al conducted a detailed
systematic review on the effects of red ginseng on
the treatment of ED and reported that out of 28
published articles only seven satised their strict
criteria of being double-blind and placeboJ Sex Med 2010;7:3949

42
controlled trials [36]. All in all the seven studies
evaluated 363 men aged from 24 to 70 years old.
The seven trials differed regarding the duration of
ED (130 years), etiology of ED (purely psychogenic in three studies, purely organic in 1 study
and mixed in the remaining three studies), duration of treatment (412 weeks), doses of ginseng
used (6001,000 mg, three times daily), and the
method of erectile function assessment (IIEF in
three studies, Watts sexual function questionnaire
in one study and the global efcacy question in
three studies) [3743]. The meta-analysis reached
the conclusion that ginseng improved sexual performance more than placebo. However, it should
be taken into account that some of these seven
studies did not report the nature of placebo used,
some did not report power calculation and some
did not describe baseline comparisons of ED
symptoms between the two arms (drug vs. placebo)
or obtain sufcient ethical approval. Thus,
drawing denitive conclusions of the aphrodisiac
effects of ginseng is very difcult [36]. Also, all
these studies focused completely on male sexual
dysfunction and ignored female sexual dysfunctions further undermining the ability to accurately
assess the aphrodisiac effects of red ginseng. The
mechanism of action of red ginseng is largely
unknown, with some animal studies reporting that
ginsenosides, the principle active constituents of
red ginseng, can lead to an increased release of
nitric oxide from the smooth muscles of the cavernous tissue, resulting in muscle relaxation
[37,38]. There is no known effective dose of red
ginseng, and side effects reported are usually mild
gastrointestinal upset [39,40].

Chocolate (Cacao)
Chocolate is made originally from the Cacao beans
after fermentation and multiple processing.
Chocolate often is considered the food with the
greatest impact on mood [44,45] and it has shown
a potential impact on overall human health
[46,47]. Chocolate contains a wide range of
chemical compounds that are pharmacologically
active such as methylxanthines and Narachidonoylethanolamine (a brain lipid that can
mimic the psychoactive effects of cannabinoids
[48]. Interestingly, several studies reported that
some chocolate constituents (especially serotonin
and avinoids) may be involved in modulating
womens genital sexual functioning [49,50]. Serotonin, which may act both as a vasoconstrictor and
vasodilator, has been located in several regions of
the female genital tract in both animals and
J Sex Med 2010;7:3949

Shamloul
humans. Recently, Salonia and colleagues tried
to examine the effects of chocolate on womens
sexual health [51]. Using several female sexual
function questionnaires they reported a positive
trend of higher scores (and therefore better sexual
function) in women consuming daily chocolate vs.
women who do not. However, when the data was
adjusted to age, this difference was lost. Finding an
association between chocolate and sexual health is
very tempting, however, further in-depth studies
should be conducted before a solid conclusion
could be reached [51].

Lepidium Meyenii (Maca)

Lepidium meyenii (Maca) is an Andean cultivated
root that belongs to the brassica (mustard) family.
Dried Maca root is rich in amino acids, iodine,
iron and magnesium. Traditionally, Maca roots
have been used in the Andean region for their
supposed aphrodisiac and/or fertility enhancing
properties [52]. Andean Maca is one of the most
commonly cited natural drugs on internet as sexual
dysfunction improvers. This claim is supported by
animal studies [53,54]. Most clinical studies done
on the aphrodisiac properties of Maca are small
and did not employ reliable measures of sexual
function [55]. Zenico et al. reported recently, in a
double-blinded, placebo-controlled study, no signicant difference in terms of International Index
of Erectile Function (IIEF) scores between men
who consumed Maca and those who used placebo
[55]. However, the overall sense of well being was
signicantly higher in the Maca group. These
results are conrmatory to previously reported
data suggesting that Macas aphrodisiac effects are
mainly because of its nutritional properties being
rich in essential amino acids and minerals [56].
Alcohol
Alcohol, the most commonly used recreational
drug, has been associated with sexuality for a long
time. In Shakespeares Macbeth Act 2, Scene 3, we
read What three things does drink especially provoke. . . . lechery, sir, it provokes, and unprovokes; it provokes the desire, but it takes away the
performance. Indeed, there is some scientic evidence backing these historical claims. Alcohol is a
central nervous system depressant that acts by
increasing the levels of the inhibitory neurotransmitter, gamma amino butyric acid [57]. On the
other hand, alcohol causes disinhibition and thus
can potentiate sexual desire. Also, several studies
did conrm the potential harmful effects chronic
alcohol drinking has on male and female sexual
functions, probably through its effect on cardio-

43

Natural Aphrodisiacs
Table 1

Popular traditional aphrodisiacs plants and herbs

Plant

Nature and origin

Effects

*Type of studies

Mechanism of action

Myristica fragrans (nutmeg)

India, Indonesia, and

Srilanka
Evergreen shrub or a tree;
Southeast Asia
Fruits; West Africa

Potentiates penile erection

*Animal [69,70]

Unknown

Delays ejaculation time

*Animal [71]

Testosterone

Potentiates penile erection

*Animal [72,73]

Unknown

Rhizomes; India

Potentiates penile erection

*Animal [74,75]

?Testosterone

Roots; West Africa

Potentiates penile erection

*Animal [76,77]

Mucuna pruriens

Seeds; India

Potentiates penile erection

*Animal [78]

Eurycoma longifolia Jack

(Tongkat Ali)
Ferula harmonis, Zallouh
Root

Shrub; Southeast Asia,

especially Malaysia
Shrub root; Lebanon

Potentiates penile erection

*Animal [7986]

?eNOS
?Antioxidant
?Testosterone
?Brain dopamine
Unknown

Potentiates penile erection

**Animal [8793]

Camellia sinensis
Aframomum melegueta and
Piper guineense
Curculigo orchioides (Kali
Musli)
Microdesmis keayana

?Indirect LH secretion
Smooth muscle contraction
Many toxic effects
Female sexual function

*Males only; apart from th three studies on Tongkat Ali [8082], all other studies involved young animals (<20 weeks old).
**References [75,77] used female rats.
eNOS = endothelial nitric oxide synthase; LH=luteinizing hormone.

vascular functions [5860]. However, recent

reports have produced strong evidence to the contrary. In their excellent meta-analysis Chew et al
demonstrated that chronic alcohol signicantly
decreased odds of ED among alcohol drinkers in 7
of the 11 cross-sectional studies cited. Whereas
drinking less than eight drinks per week had the
lowest, but nonsignicant, risk for ED, drinking
more than eight standard drinks a week was associated with a statistically signicant but with
higher ED risk [61]. Similar results were reported
from other studies [62,63]. Studies examining the
effect of alcohol on female sexual function are very
limited with inconclusive results [64]. As a whole,
these contradictory results from epidemiological
studies are not sufcient to make a solid conclusion regarding the role of alcohol consumption as
an aphrodisiac. Further basic and clinical studies
examining the nature of alcohol consumption,
including amount, duration and type, and its relationship to sexual function are needed [65]. Other
recreational drugs that have been considered as
natural aphrodisiacs include cannabis and its more
popular derivative, marijuana. However, physiological evidence to date demonstrates that cannabis and its derivatives inhibit libido and sexual
function [66]. Also, contrary to the popular belief,
the use of marijuana was associated with inhibited
orgasm, dyspareunia and sexual dysfunction in a
large study of 3004 men and women [67]. Furthermore, ED was found to be a side effect in a
randomized, controlled study investigating the

appetitive stimulatory effects of dronabinol (delta9-tetrahydrocannabinol) [68].

Other Plant-Related Traditional Aphrodisiacs

There are a huge number of folklore plants and
herbs that are used by humans as aphrodisiacs.
Table 1 lists some of the most popular traditional
plants and herbs used as aphrodisiacs and studies
examining their effectiveness. It can be easily
deducted from this list that the majority of these
studies were done on animals, which examined
their effects on male sexual function. More importantly, all mechanisms proposed for the effects
of this group of aphrodisiacs are not evidencebased and are only hypotheses that need rigorous
investigations.
Other Nonstudied Aphrodisiacs
Currently, many beverages and foods are used
popularly as aphrodisiacs. Some of these are very
common and some are extremely difcult to nd.
For example some Eastern cultures consider tea as
a good aphrodisiac. Also, kebob (barbequed beef) is
considered as a strong aphrodisiac by Middle
Eastern people. It could be speculated that this
may be true because of its very high protein
content that increases body vitality as a whole and
therefore increases energy to perform sex. Another
common food thought to be a strong aphrodisiac is
sea food; however, it is believed that this may be
caused by its relation to Aphrodite, who was born
at sea [94]. Spicy food and chili are believed to be
J Sex Med 2010;7:3949

44
aphrodisiacs, however, this may be because of the
fact that their consumption lead to sweating,
burning, and distraction, physical responses very
similar to that a encountered during sexual intercourse [95]. Other popular aphrodisiacs include
oysters, shark components, rhinoceros horn and
snakes are largely used because of their physical
similarity to the genital organs. Several other hard
to nd substances are still used as aphrodisiacs, for
example, dried tigers penises soup, snake blood,
and even the melted fat of a camel hump and
leeches [1]. Although any substance may be
claimed as a good aphrodisiac, however, scientic
data is needed to prove these claims.
Discussion

Countless natural substances have been used by

humans as aphrodisiacs. From plants to animal
body parts to blood, all searched by man to nd
substance(s) that could heighten his sexual desire
and performance. Natural aphrodisiacs are used by
men complaining of various degrees of ED and by
normal potent men as well. Although the quest for
successful erectogenic drugs is understandable for
men with ED or low desire, it is undoubtedly,
surprising that normal potent men continue to use
aphrodisiacs. This may be because of misconceptions regarding sexual satisfaction, orgasm, and
also may be because of unrealistic expectations of
pleasure from sex.
There is little evidence from literature to recommend the usage of natural aphrodisiacs for the
enhancement of sexual desire and/or performance.
The vast majority of studies on natural aphrodisiacs were conducted on animals with very few clinical studies done mostly on red Ginseng [36].
Furthermore, these studies (except few [8082]
using Tongkat Ali) were conducted on normal
young (<20 weeks old) animals, who were potent
by nature. Moreover, most mechanisms of action
to support the use of these substances as natural
aphrodisiacs are either unknown [69,70,72,73,79
86], controversial [87,89] or largely hypothetical
[8793] with no backup by solid scientic evidence. Also, side effects and toxic prole are
largely unknown and may be hazardous [87,93].
Collectively, these serious concerns drastically
undermine the clinical value of these aphrodisiacs
and further conrm the 1989 decision by the FDA
not to recommend the over-the-counter use of
these substances [96]; at least until sufcient scientic evidence through robust randomized controlled trials [97] is presented.
J Sex Med 2010;7:3949

Shamloul
Yohimbine, Ginseng and Maca are examples of
the very limited number of natural aphrodisiacs
that underwent rigorous scientic investigations
to explore their aphrodisiac properties. Data on
yohimbines efcacy does not support the wide use
of the drug; it has only mild effects in the treatment of psychogenic ED. Although there is a positive trend towards recommending red ginseng as
an effective aphrodisiac, however, more in depth
studies involving large number of subjects with
elucidation of its mechanism of action(s) are
needed before denite conclusions could be
reached. Macas aphrodisiac effects are through
the enhancement of whole body vitality with no
specic benet on sexual function. Recent scientic evidence regarding the use of alcohol as an
aphrodisiac is potentially interesting; however, the
existence of controversial data necessitates extensive future investigations. Current scientic body
of literature refutes the claims that cannabis and
marijuana have any aphrodisiac properties and
provides evidence to the exact contrary [98].
Despite the fact that many aphrodisiacs may be
used by men and women alike, (ginseng, maca,
tongkat ali) studies on the use of aphrodisiacs by
women or female animals are extremely rare
(Table 1). A reasonable explanation for this paucity
is that scientic interest in exploring female sexual
dysfunctions only began few decades ago [99101]
and more time may be needed to investigate
womens attitude towards aphrodisiacs. Also, this
may be because of the gender differences between
men and women regarding sexual behavior [99].
Obviously, there is a strong need to understand the
effects of different aphrodisiacs on women sexual
function.
A whole industry is built on manufacturing
natural aphrodisiacs. Although the precise size of
this industry is unknown, a quick visit to any drug
store and examination of the number of products
being marketed as natural aphrodisiacs will give an
idea on the huge amounts of money invested in
this industry. Unfortunately, some medicinal drug
manufacturers, realizing the huge demand towards
natural aphrodisiacs, go ahead and deceive the
public concerning the natural aphrodisiac products they market. In 2002, Mikami et al, reported
for the rst time the discovery of sildenal analogues in herbal aphrodisiacs [102]. Most
sildenal analogues found as adulterants have been
modied in the piperazine portion of the molecule
[103107]. However, recently, herbal dietary
supplements were found to contain sildenal analogues developed by replacing a carbonyl group in

45

Natural Aphrodisiacs
sildenal with a thiocarbonyl group, making their
detection more difcult [108110]. These sildenal analogues can inhibit PDE5 and/or PDE6 in
vitro, meaning the content of a capsule may cause
pharmacological effects [111]. In 2009, several
studies employed a new technique to detect the
newly-developed sildenal analogues, and reported the presence of sildenal analogues in at
least 10 herbal supplements marketed as natural
aphrodisiacs [111113]. Health authorities
should be aware of this problem and must take
necessary precautions to protect the public against
consumption of false natural aphrodisiacs.
In conclusion, the current body of objective evidence does not support the use of any natural
aphrodisiac as an effective treatment for male or
female sexual dysfunctions. Despite the recent
advances in the science of sexual medicine regarding the development of successful erectogenic
drugs and the current disappointing data on the
efcacy of natural aphrodisiacs, men with ED and
otherwise potent men will continue the unstoppable search for natural aphrodisiacs to increase
their sexual desire and performance. Sexual medicine specialists should keep their patients and the
public aware of the current evidence regarding the
use of natural aphrodisiacs and the hazards related
to their consumption.
Corresponding Author: Rany Shamloul, MD,
Queens University, Kingston, ON, Canada, K7L3N6.
Tel: 1-6135336432; Fax: 1-6135336412; E-mail:
ranyshamloul@gmail.com
Conict of interest: None.

Statement of Authorship

Category 1
(a) Conception and Design
Rany Shamloul
(b) Acquisition of Data
Rany Shamloul
(c) Analysis and Interpretation of Data
Rany Shamloul

Category 2
(a) Drafting the Article
Rany Shamloul
(b) Revising It for Intellectual Content
Rany Shamloul

Category 3
(a) Final Approval of the Completed Article
Rany Shamloul

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