yohimbe

Yohimbe refers to products derived from the bark of the evergreen tree Pausinystalia johimbe (also called Corynanthe johimbe), native to West Africa. The bark contains several indole alkaloids, with yohimbine being the primary active compound. Yohimbine is an alpha-2-adrenergic receptor antagonist and has been used as a prescription medicine for erectile dysfunction in some countries. The term yohimbe is also used for dietary supplements marketed for sexual enhancement.

Traditional use and clinical evidence: In West Africa, yohimbe bark has historically been used as an aphrodisiac and to treat fatigue or fevers. In Western medicine, yohimbine has been studied for erectile dysfunction. Systematic reviews show limited, inconsistent efficacy, with small benefits and higher adverse-effect risk. Some supplements claim weight loss or athletic performance benefits, but evidence is weak.

Pharmacology and safety: Yohimbine increases sympathetic activity by blocking alpha-2 receptors, raising blood pressure and heart rate. Common side effects include anxiety, tremor, dizziness, headaches, nausea, and hypertension. Serious adverse events can occur, including cardiovascular events and seizures, especially at high doses or with stimulants. It is contraindicated in people with cardiovascular disease, psychiatric disorders, or those taking certain medications (such as MAO inhibitors, nitrates, or antihypertensives).

Regulatory status: In the United States, the FDA has raised safety concerns about yohimbe-containing dietary supplements and has taken actions against products with unsafe labeling or leading to adverse events. Yohimbine is legally available as a prescription drug in some jurisdictions but is tightly regulated due to safety risks. Product quality and yohimbine content in supplements vary, and adulteration or mislabeling has been reported.

Overall, yohimbe products present a safety risk that has led health authorities to caution against routine use outside medical supervision. The balance of evidence for erectile dysfunction remains inconclusive, and regulatory scrutiny emphasizes accurate labeling and risk disclosure.