What the Category Pages Say

This post reads the federal pages on the category this product is sold in and quotes them rather than summarising. Two words are printed on the front of the jar — male enhancement — and there is a federal page about that category.

NCCIH, the National Institutes of Health centre for exactly this kind of product, puts its conclusion in one sentence: “No complementary health approaches have been shown to be safe and effective for sexual enhancement or treating erectile dysfunction (ED).” And on herbal products for the condition most often behind a purchase here: “Currently, there is no definite evidence that any herbal products are effective or safe for ED.”

There is no way to soften those without misreporting them. They are also not the whole page: NCCIH carries findings on two of the nine ingredients here, and one is positive.

First the quantities, once, because a finding attaches to an amount and not to a name. FDA requires blend members to be listed “in descending order of predominance by weight”, and caffeine is printed fifth of nine at 5 mg inside an 82 mg blend. Anything below a 5 mg row is 5 mg or less, so rows six to nine — ashwagandha, L-arginine, tribulus terrestris and horny goat weed extract — are each no more than 5 mg. The derivation is in The Descending Order Trick, the panel on the supplement facts page, and the method on reading a blend.

Ashwagandha is the other ingredient with something behind it, and the detail is the whole story. NCCIH: “There is some limited evidence that suggests that taking ashwagandha for 2 to 4 months may increase testosterone levels and sperm quality.”

Read what that sentence is about. Testosterone levels and sperm quality are fertility markers. Not erection, not libido and not performance, and a page that quotes the sentence under a heading about sexual enhancement has changed its meaning while keeping its words. NCCIH’s own effectiveness verdict for ashwagandha names two conditions and neither is sexual: “Research shows that some ashwagandha preparations may be effective for insomnia and stress.”

The preparations in the trials NCCIH describes are dosed in the hundreds of milligrams. Ashwagandha is row six here, capped at 5 mg. And a caution belongs in the same breath as any positive note: “Although it is rare, there have been a number of cases that link liver injury to ashwagandha supplements.” That one and the green tea cautions are on the safety page.

Which brings this to the thing the whole site is for, and it has nothing to do with a jar. A man with a new or worsening sexual symptom has a medical question. MedlinePlus is direct about what the symptom can mean: “ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes.” And about the cost of not asking: “If you don’t see your doctor, these problems will go untreated.” It names the reason people do not ask, without making anyone feel foolish for it: “Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor.”

FDA puts the cost of the alternative in one line: “Health fraud scams waste money and can lead to delays in getting proper diagnosis and treatment. They can also cause serious or even fatal injuries.” The money is the smaller half of that sentence; the delay is the part that matters.