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Yohimbe and erectile dysfunction


By Serge Kreutz

Yohimbe is a herbal medication made of the bark of an African tree (Corynanthe yohimbe or Pausinystalia yohimbe). One of the components of yohimbe, named yohimbine, was the only medication approved by the FDA for the treatment of impotence before Pfizer’s Blue.

Yohimbine is an indole alkaloid that makes for about 1 percent of the volume of yohimbe bark. Other indole alkaloids contained in yohimbe bark are: isoyohimbine, allo-yohimbine (dihydroyohimbine), yohimbinine, yohimbane, yohimbenine, corynanthein, and others (Betz et al., 1995; Budavari, 1996; Leung and Foster, 1996).

Yohimbine is also found in other, mostly related plants such as Pausinystalia macroceras and Pausinystalia tillesii, Indian snakeroot (Rauwolfia serpentina), quebracho (Aspidosperma quebracho-blanco), and Pausinystalia lane-poolei (pamprana, igbepo).

While sildenafil citrate may be the medication of choice for plain erectile dysfunction, yohimbe has a wider effect (and many, many unwanted side effects).

This is the case because yohimbine, and the unrefined yohimbe, do not just work on the male organ but makes those who ingest it heavily agitated. There is a sexual component in this agitation, which is not available from ingesting sildenafil citrate.

Therefore, while sildenafil citrate may be the preferred choice of prescribing doctors because of fewer side effects, yohimbine and yohimbe are not just older alternatives but earn their place in the materia medica in their own right.

Earlier versions of this article contained the following paragraphs:

“Furthermore, the real promise of yohimbe actually is not its value as medication for erectile dysfunction in men who indeed suffer from the condition, but its power to enhance sexuality in healthy subjects. Yohimbe is probably the most underrated recreational drugs around. It’s not just a sex enhancer; it’s a philosophical life enhancer. It has the clear potential to give new meaning to the lives of men at mid-life and beyond. Yohimbe restores pride and enjoyment. For performance and sheer manhood, men at 50 who have ingested yohimbe can compete with any young gigolo. Forget such esoteric nonsense as tantra yoga and the tao of love. All you need is yohimbe.

“Because of its potential as recreational drug, some eager government may sooner or later prohibit yohimbe. It has escaped this fate because as recreational drug, its target groups are not the young but mid-age adults (and adulterers).”

I retract from the above enthusiastic statement, and I have stopped taking yohimbe or yohimbine several years ago. The reason for my abandoning yohimbe and yohimbine were severe side effects. Like cocaine, yohimbine surely feels good when you take it the first few times. But the side effects are so strong that yohimbe also feels as if it harms overall health. Among the severe side effects are heart palpitations, insomnia, and blood pressure irregularities.

And just like cocaine, yohimbine makes you crash when the effect wanes. You can be high of Sunday, but on Monday, you aren’t good for anything (and certainly not for sex).

As predicted a few years ago, yohimbine and yohimbe are now controlled substances in many countries (e.g. Australia), and I am sure others will follow.

Several years ago, I have switched from yohimbe to tongkat ali. Tongkat ali doesn’t cause excitation like yohimbe and yohimbine, but it also isn’t accompanied by insomnia, heart palpitations, and other severe side effects.

As a matter of fact, not only the sexuality-enhancing effects of tongkat ali, but also the positive effect on overall health, have been proven in scientific (double-blind) studies.

The following is from earlier versions of this article:

“How do yohimbe and yohimbine feel? If you have enough experience with it to be aware of slight symptoms, you will know that yohimbine is taking over when you notice increased salivation. There will be a tendency for an accelerated heartbeat, mostly effected by mental stimulation. There will not necessarily be an increased heartbeat from physical exercise.

“Rather, the capacity for physical exercise will probably be enhanced for many people, with a pulse frequency ordinary for the chosen exercise. Some users have mentioned that they sweat less when on yohimbe, but for me, excessive sweating is more likely. Scientific studies have confirmed that yohimbine does not raise blood pressure, even though one may feel as if one has an elevated blood pressure because of a certain degree of nervousness caused by the drug. But a dangerously low blood pressure, rather than an elevated one, is associated with a yohimbine overdose.

“Yohimbe will not make you desire a sexual partner whom you would not desire when not on yohimbe. Rather the opposite. But you can become mentally very fixed on a partner you actually do desire.

“Yohimbe and yohimbine will make those who have ingested it easier to stimulate sexually. Yohimbe works mentally and physically towards this end, with both aspects strongly interacting. Men who normally have problems having an erection will feel a mental stimulation from the fact that a hard-on comes easy.

” Yohimbe definitely increases erectile rigidity, and may increase erectile capacity.

“As promoters of ginkgo biloba claim that that herb improves blood flow to the extremities, I have tried it in combination with yohimbe, but I have never felt a definite benefit from the added ginkgo biloba.

“For many people, sleep will be impossible for many hours (up to 20 hours) after having ingested yohimbe the bark, or yohimbine the pharmaceutical product. Melatonin will not induce sleep when on yohimbe or yohimbine. Kava-kava also is completely useless to get down from yohimbe or yohimbine. I have tried a Valerian tea from a generous dosage of the herb (one table spoon or more). It doesn’t work either. Valium after ingesting yohimbine is dreadful. It doesn’t send me to sleep, but just makes me drowsy. Beta-blockers can help against palpitations but will not induce sleep either.

“It took me years until I found out what to take to reliably go to sleep after ingesting yohimbe, the bark, or yohimbine, the pharmaceutical.

“Apart from sleeplessness, Yohimbe and yohimbine can have other uncomfortable side effects in many people, and one should always first check one’s tolerance with very small dosages. Proper yohimbe is a powerful drug, nothing like supplements such as ginkgo biloba, vitamin C, or royal jelly. One can clearly overdose on yohimbe.

“I recommend yohimbine, the pharmaceutical, over yohimbe, the bark.

“The problem with bark products is that you never know how potent it actually is. While most yohimbe bark products are on the weak side, you can occasionally get one that knocks you off your feet. With the most potent yohimbe bark products we know and have tested ourselves, even half the recommended dosage is too much for most people. They’ll be worried about how to get off the yohimbe, rather than be concerned with sexual pleasure.

“The great advantage of pharmaceutical yohimbine over plain yohimbe bark products is that with the pharmaceutical, you know what amount of yohimbine you are ingesting. But yohimbine is a prescription medication most everywhere in the world.

“As it is the case with most medications, one will, after a while, develop a certain tolerance for yohimbine. You can expect that after the 500th time, you can easily ingest double the amount you ingested initially, and you will likely have fewer problems with side effects. Unfortunately, for the desired sexual effect, you will probably still need a dosage at which side effects, such as nervousness, will again occur. You can’t have the roses without the thorns.

“Nevertheless, the pro-sexual effect of yohimbine doesn’t wear off in the same way the pro-sexual effect of neurophysiological agents. Sexuality-enhancing neurophysiological agents are usually medications for Parkinson’s Disease, and that their therapeutic effect loses strength with time is what limits the value of these medications. In this instance, we are not primarily talking about sexual enhancement. For people who need dopamine-supporting medications such as bromocriptine, their loss of therapeutic effect is often a death sentence.

“While for the sexuality-enhancing effect of yohimbine, one will need a dosage high enough to also cause a certain degree of nervousness, one can try to keep the nervousness side effect under control by avoiding most other stimulants in combination with yohimbe or yohimbine. Especially coffee and tea seem to bring out the bad in yohimbine while suppressing the good. And mind you, most commercial soft drinks (not just the black ones such as Coke and Pepsi) are heavily caffeinated.”