Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Research
  • Published:

Internet websites selling herbal treatments for erectile dysfunction

Abstract

The objective of the study was to investigate the safety and reliability of internet websites selling and providing medical information regarding herbal substitutes for Viagra. Using keywords ‘Herbal’ and ‘Viagra’, websites selling and providing medical information regarding herbal substitutes were identified. The top 50 sequential sites were assessed for safety and reliability against the Health on the Net (HON) criteria. Medically trained staff provided information in only 21% of the sites yet just 24% stated that the information was not a replacement for medical advice. No sites warned patients about erectile dysfunction (ED)-associated cardiovascular disease. In all, 88 and 70% of sites indicated drug efficacy and ingredients but only 36 and 21% provided contraindications and side effects, respectively. All sites fell short of the HON requirements. In conclusion, acquiring medical information and herbal substitutes for ED from the internet is convenient and easy. However, patients should be cautious as safety and reliability of this approach is poor.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Feldman HA et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  Google Scholar 

  2. Matfin G . New treatments for erectile dysfunction. Sexuality Reprod Menopause 2003; 1: 40–45.

    Article  Google Scholar 

  3. NIH Consensus Development Panel on Impotence. NIH Consensus Conference. Impotence. J Am Med Assoc 1993; 270: 83–90.

  4. Jemal A, Thomas A, Murray T . Cancer statistics. CA Cancer J Clin 2002; 52: 23–47.

    Article  Google Scholar 

  5. Laumann EO, Paik A, Rosen RC . Sexual dysfunction in the United States: prevalence and predictors. J Am Med Assoc 1999; 281: 537–544.

    Article  CAS  Google Scholar 

  6. Pfizer Global Study of Sexual Attitudes and Behaviours. Pfizer Sexual Health Summit, London, February 20, 2002, http://www.pfizerglobalstudy.com/.

  7. Pew Internet and American Life Project. The Online Health Care Revolution: How the Web helps Americans take Better Care of Themselves, 2001, http://www.pewinternet.org.

  8. Morris CA . Internet marketing of herbal products. JAMA 2003; 290: 1505–1509.

    Article  CAS  Google Scholar 

  9. Barnes J . Quality, efficacy and safety of complementary medicines: fashions, facts and the future. Part 1. Regulation and quality. Br J Clin Pharmacol 2003; 55: 226–233.

    Article  Google Scholar 

  10. Editorial. Viagra's licence and the internet. Lancet 1998; 352: 751.

  11. Health on the Net Foundation. http://www.hon.ch.

  12. Mitretek Working Group—Criteria for Assessing Quality of Health Information on the Internet, October 14, 1997, http://www.hitiweb.mitretek.org/docs/criteria.html.

  13. European Commission Information Society Directorate-General Quality (ECISDQ) Criteria for Health Related Websites—Draft Guidelines, 2002, http://www.europa.eu.int/information_society/eeurope/ehealth/quality/draft_guidelines/index_en.htm.

  14. Bedell SE, Agrawal A, Petersen LE . A systematic critique of diabetes on the World Wide Web for patients and physicians. Int J Med Inform 2004; 73: 687–694.

    Article  Google Scholar 

  15. Croft DR, Peterson MW . An evaluation of the quality and contents of the asthma education on the World Wide Web. Chest 2002; 121: 1301–1307.

    Article  Google Scholar 

  16. Doupi P, Van der Lei J . R-x medication information for the public and the WWW: quality issues. Med Inform Internet Med 1999; 24: 171–179.

    Article  CAS  Google Scholar 

  17. Latthe M, Latthe PM, Charlton R . Quality of information on emergency contraception on the Internet. Br J Fam Plann 2000; 26: 39–43.

    CAS  PubMed  Google Scholar 

  18. Sandvik H . Health information and interaction on the internet: a survey of female urinary incontinence. BMJ 1999; 319: 29–32.

    Article  CAS  Google Scholar 

  19. Hellawell GO, Turner KJ, Monnier KJ, Brewster SF . Urology and the internet: an evaluation of internet use by urology patients and of information available on urological topics. Br J Urol Int 2000; 86: 191–194.

    Article  CAS  Google Scholar 

  20. Impicciatore P, Pandolfini C, Casella N, Bonati M . Reliability of health information for the public on the World Wide Web: systematic survey of advice on managing fever in children at home. BMJ 1997; 314: 1875–1879.

    Article  CAS  Google Scholar 

  21. Eysenbach G, Powell J, Kuss O, Sa E-R . Empirical studies assessing the quality of health information for customers on the World Wide Web: a systematic review. JAMA 2002; 289: 2786.

    Google Scholar 

  22. Rowland DL, Tai W . A review of plant-derived and herbal approaches to the treatments of sexual dysfunctions. J Sex Marital Therapy 2003; 29: 185–205.

    Article  Google Scholar 

  23. Mitka M . FDA issues warning on ‘All-Natural’ herbal product found to contain Viagra. JAMA 2003; 289: 2786.

    Article  Google Scholar 

  24. Wooltorton E . Hua Fo tablets tainted with sildenafil-like compound. CMAJ 2002; 166: 1568.

    PubMed  PubMed Central  Google Scholar 

  25. Ernst E, Pittler MH . Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. J Urol 1998; 159: 433–436.

    Article  CAS  Google Scholar 

  26. Riley AJ . Yohimbine in the treatment of erectile disorder. Br J Clin Pract 1994; 48: 133–136.

    CAS  PubMed  Google Scholar 

  27. Bratman S, Girman A . Mosby's Handbook of Herbs and Supplements and their Therapeutic Uses. Mosby Inc.: St Louis, MO, 2003; 976–978.

    Google Scholar 

  28. Choi YD, Xin ZC, Choi HK . Effect of Korean red ginseng on the rabbit corpus cavernosal smooth muscle. Int J Impot Res 1998; 10: 37–43.

    Article  CAS  Google Scholar 

  29. Choi HK, Seong DH, Rha KH . Clinical efficacy of Korean red ginseng for erectile dysfunction. Int J Impot Res 1995; 7: 181–186.

    CAS  PubMed  Google Scholar 

  30. Hong B, et al. A double-blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol 2002; 168: 2070–2073.

    Article  CAS  Google Scholar 

  31. Paick JS, Lee JH . An experimental study of the effect of Ginkgo biloba extract on the human and rabbit corpus cavernosum tissue. J Urol 1996; 156: 1876–1880.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R Thurairaja.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Thurairaja, R., Barrass, B. & Persad, R. Internet websites selling herbal treatments for erectile dysfunction. Int J Impot Res 17, 196–200 (2005). https://doi.org/10.1038/sj.ijir.3901282

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901282

Keywords

This article is cited by

Search

Quick links