Sexual and reproductive health: the science behind supplementation in aging

Introduction Throughout lifespan people are increasingly committed to take control of their own health and well-being, including fertility sexual enhancement. Food supplements (FS) industry specifically caters for this segment market. However, FS not medicines thus, subject the same strict regulations. Misbranded, unsafe unlawful products on market [1 Tucker J, Fischer T, Upjohn L, et al. Unapproved pharmaceutical ingredients included in dietary associated with US Drug Administration warnings. JAMA Netw Open. 2018;1(6):e183337.[Crossref], [PubMed], [Web Science ®] , [Google Scholar]], claiming scientifically unsubstantiated benefits, without disclosing potential side effects [2 Navarro VJ, Khan I, Björnsson E, Liver injury from herbal supplements. Hepatology. 2017;65(1):363–373.[Crossref], Scholar]] and/or interactions [3 Chauhan NS, Sharma V, Dixit VK, A review plants used improvement performance virility. Biomed Res Int. 2014;2014:868062.[Crossref], thus representing a public hazard. The purpose work was give an overview main intended male female reproductive health, available Portugal.Materials methods Consumption data pharmacies (2015–2018) provided by ANF inclusion criteria which sold >1000 units/year. Formulas were analysed, address alleged bioactive substances, perspective efficacy safety.Results Overall consumption studied has risen 48% years analysed target mainly population (≈70% products), although there brands designed women. Botanicals, isolated or combined, problems, such as erectile dysfunction low desire, mostly claim to: (a) improve genital blood flow [vasodilators Pausinystalia macroceras, Ferula asafoetida L., Pinus pinaster, Gingko biloba, Epimedium grandiflorum L.], (b) increase testosterone levels [Withania somnifera, Tribulus terrestris, Maca- Lepidium meyenii], (c) act tonics/stimulants [Eleutherococcus senticosus, Panax ginseng, Turnera diffusa, guarana]. Plant extracts at times vitamins (A,D,E,C, folic acid), minerals (Zn, Se, Fe, Mg) amino acids (arginine aspartate, L-carnitine). For fertility/climacterium symptoms, DHA, EPA, lycopene CoQ10 also found.Discussion conclusions Scientific evidence support claims enhancement is low/medium all plants, however harm. There lack studies humans, no established daily doses many (e.g. severe hepatotoxicity genus Pausinystalia; estrogen-like effect Maca gynaecological cancers) well documented. Associations bioactives common effects/toxicity should be avoided. Relevant drugs [e.g. MAO inhibitors P. ginseng; anticoagulants warfarin) maritima, E. G. F. asafoetida, grandiflorum; antihypertensive T. grandiflorum, W. somnifera Pausinystalia] possible, especially case polymedicated aging consumers. Moreover, since potentially harmful active pharmaceuticals, its analogs, continue identified FS, consumers aware risk they incur. Informed counselling health-professionals utmost importance taught doctors, pharmacists, nutritionists nurses.