title: A Urologist's Guide to Ingredients Found in Top-Selling Nutraceuticals for Men's Sexual Health.
abstract: BACKGROUND
  Use of supplements is common among men seeking urologic evaluation for sexual health matters. With a dizzying array of formulations available and little regulation on the dosage, purity, or ingredients found in these products, the health effects of nutraceuticals are often confusing to patients and medical practitioners alike.
  
  
  OBJECTIVE
  In this review, we set out to concisely summarize the data on ingredients found within the top-selling nutraceutical agents marketed for men's sexual health in order to provide a clinical guide for urologists.
  
  
  METHODS
  We used sales data from the most popular retail provider of men's health supplements to identify the top-selling products marketed toward improvement of men's sexual health. We summarized the available information related to the ingredients, dosage, cost, and mechanism of action for these substances and performed an extensive literature search to identify and review the current evidence available for each of the most common ingredients found in these nutraceuticals.
  
  
  RESULTS
  The top-selling nutraceuticals marked for men's sexual health contain a blend of multiple supplements (up to 33 in one formulation identified), the most common being ginseng, tribulus, zinc, horny goat weed, B complex vitamins/trace minerals, fenugreek, L-arginine, maca, DHEA, ginkgo, and yohimbine. The currently available medical literature evaluating the efficacy of these substances is generally of low quality.
  
  
  CONCLUSIONS
  Despite the dearth of evidence supporting nutraceutical agents in the men's health arena, these substances are still commonly used by patients. As these products can affect the health and well-being of men presenting to a urology clinic, a familiarity with commonly used agents can help the urologist appropriately counsel their patients.
authors.affiliation: Department of Urology, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: Tao
authors.initials: T
authors.lastname: Cui
authors.affiliation: Department of Urology, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kovell
authors.affiliation: Department of Urology, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Brooks
authors.affiliation: Department of Urology, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Terlecki
mesh_terms: D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D034181:Epimedium; D020441:Ginkgo biloba; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional / Q000706:statistics & numerical data; D054526:Men's Health; D008875:Middle Aged; D060946:Pharmaceutical Services, Online; D010820:Physicians; D010946:Plants, Medicinal; D060728:Reproductive Health; D012725:Sexual Behavior / Q000187:drug effects*; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy* / Q000523:psychology; D014572:Urology; D015016:Yohimbine / Q000494:pharmacology
chemical_list: D015016:Yohimbine
keywords: Decreased Libido; Dietary Supplement; Erectile Dysfunction; Men's Sexual Health; Neutraceutical