Virility to Fertility: An Evidence-Based Study on Traditional Herbal Aphrodisiacs

More than 60% of people globally rely on herbal medicines as a source of healthcare. Traditional herbal preparations can be traced back to ancient literature, folk knowledge, and ethnic practices. Traditional herbal products are preferred over synthetic drugs since these are considered more accessible, affordable, culturally acceptable, non-toxic, and sustainable. Globally 15% of couples are affected with infertility, 20-30% of which are attributed to the male factor. Fertility-enhancing drugs and hormonal methods such as testosterone replacement therapy (TRT) increase testosterone levels in males but may result in other side effects. Assisted reproductive technology (ART) remains expensive medicare throughout the world despite its widespread use, and its success rate also varies with the age of the partner, apart from other complexities. Aphrodisiacs (Greek - Aphrodisiakos: sexual) are agents that provoke sexual desire and increase performance. Aphrodisiac herbs have been in use for thousands of years by various civilizations worldwide involving the traditional healers and have been mentioned in different ancient literatures, including Ayurveda, Unani, Siddha, and Chinese Pharmacopoeia. Apart from increasing sexual desire and performance, these herbs have perceived roles in enhancing fertility. Physiologically, herbal aphrodisiacs induce virility and reproductive wellbeing of men by modulating gonadal as well as neuro-endocrine systems through the interplay of hormones and biogenic substances. Unfortunately, sometimes the marketed herbal aphrodisiacs are adulterated with synthetic compounds, which necessitates further studies and validation of such preparations for widespread clinical use in the workup algorithm of patients, particularly in cases of idiopathic male infertility and erectile dysfunction. Confirmatory laboratory studies, human clinical trials and case studies will be of paramount use in validating the role of such traditional herbal medicines as aphrodisiacs in restoring virility and fertility of men who may be in need.