Pausinystalia Yohimbe Extract
Also known as: Corynanthe yohimbe, Yohimbe bark extract, Yohimbine, Yohimbine hydrochloride, Pausinystalia yohimbe
Overview
Pausinystalia yohimbe is a West African evergreen tree whose bark contains the alkaloid yohimbine, traditionally used as an aphrodisiac and stimulant. The extract, primarily yohimbine, is most notably used for treating erectile dysfunction (ED). It functions pharmacologically as an α2-adrenergic receptor antagonist, increasing sympathetic nervous system activity. While also explored for athletic performance and weight loss, these applications have less robust scientific support. Research on yohimbine's efficacy for ED is supported by several randomized controlled trials and meta-analyses, indicating a moderately mature evidence base with variable but generally adequate quality.
Benefits
Yohimbine has demonstrated significant benefits for erectile dysfunction (ED). Systematic reviews and meta-analyses show it improves erectile function compared to placebo, with one meta-analysis reporting an odds ratio (OR) of 3.85 (95% CI 2.22 to 6.67) favoring yohimbine. Another meta-analysis found yohimbine alone improved erectile function with OR = 2.08 (95% CI 1.30–3.32, p=0.002), and even greater efficacy when combined with other supplements (OR = 6.35). While yohimbine alone did not significantly improve overall sexual function (p=0.07), combined treatments did (OR = 2.65, p=0.002). Mechanistically, it relaxes corpus cavernosum smooth muscle, similar to PDE5 inhibitors, potentially via α1-adrenoceptor antagonism and nitric oxide (NO) mediated pathways. These benefits are particularly noted in men with organic impotence and diabetic ED, offering a valuable treatment option for these populations.
How it works
Yohimbine primarily acts by blocking presynaptic α2-adrenergic receptors, which leads to an increased release of norepinephrine. This enhances sympathetic outflow and promotes vasodilation in penile tissue. Additionally, it antagonizes α1-adrenoceptors in the corpus cavernosum smooth muscle, causing relaxation and improved blood flow. The extract may also increase nitric oxide (NO) release from endothelial cells, further enhancing cGMP-mediated smooth muscle relaxation, a mechanism similar to that of PDE5 inhibitors. Yohimbine is absorbed orally, with its bioavailability potentially varying, and is often administered as yohimbine hydrochloride for consistent dosing.
Side effects
Yohimbine is generally considered safe at therapeutic doses but possesses a narrow therapeutic window, meaning the difference between an effective dose and a toxic dose is small. Common side effects, affecting more than 5% of users, include increased heart rate, elevated blood pressure, anxiety, and gastrointestinal discomfort. Less common side effects (1-5%) include headache, dizziness, and insomnia. Rare but serious side effects (less than 1%) can involve severe hypertension, tachyarrhythmias, and psychiatric symptoms. It is crucial to exercise caution with drug interactions, particularly with antihypertensives, stimulants, and MAO inhibitors, due to potential additive cardiovascular and central nervous system effects. Contraindications include pre-existing cardiovascular disease, psychiatric disorders, and pregnancy. There is a notable incidence of adverse events requiring hospitalization associated with yohimbe supplements, often attributed to variability in product purity and inconsistent dosing.
Dosage
The minimum effective dose for erectile dysfunction (ED) is approximately 5.4 mg of yohimbine hydrochloride daily. Optimal dosing ranges from 5 to 15 mg per day, typically divided into 2-3 doses. The maximum safe dose is generally considered to be around 20 mg per day; exceeding this significantly increases the risk of adverse effects. For acute use, it is usually taken orally 30-60 minutes before sexual activity. Standardized yohimbine hydrochloride is the preferred form for consistent and reliable dosing. Absorption may be influenced by food intake, with fasting potentially improving bioavailability. No specific cofactors are required, but medical supervision is advised when combining with other medications.
FAQs
Is yohimbe effective for ED?
Yes, meta-analyses confirm yohimbe's efficacy is superior to placebo, particularly for organic erectile dysfunction, by improving erectile function.
Is it safe?
Yohimbe is safe within recommended doses, but it has a narrow safety margin. Adverse effects can be serious, so careful adherence to dosage is crucial.
When should I take yohimbe?
It is typically recommended to take yohimbe 30-60 minutes before anticipated sexual activity for acute effects.
How soon do benefits appear?
Effects can be observed acutely, often within an hour of dosing, due to its rapid mechanism of action.
Is yohimbe a stimulant?
Yes, yohimbe acts as a stimulant due to its mechanism of increasing sympathetic nervous system activity.
Research Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9612744/ – This systematic review and meta-analysis by Wibowo et al. (2022) included 8 RCTs and found that yohimbine alone significantly improved erectile function (OR=2.08) and even more so when combined with other treatments (OR=6.35). The study highlights the efficacy of yohimbine for ED, despite some heterogeneity in dosing and combination therapies across studies.
- https://www.auajournals.org/doi/10.1016/S0022-5347(01)63942-9 – Kloner et al. (1998) conducted a meta-analysis of 7 RCTs, concluding that yohimbine was superior to placebo for ED treatment (OR=3.85). The study noted that serious adverse events were rare and reversible, supporting yohimbine as a reasonable initial pharmacologic option for erectile dysfunction.
- https://www.scirp.org/journal/paperinformation?paperid=23076 – An experimental study by Olabiyi et al. (2014) demonstrated that a methanolic extract of P. yohimbe relaxed rabbit corpus cavernosum smooth muscle comparably to sildenafil. This in vitro research suggests that yohimbe may act through PDE5 inhibition and nitric oxide-mediated pathways, providing a mechanistic basis for its use in ED, though direct clinical extrapolation is limited.
- https://www.mskcc.org/cancer-care/integrative-medicine/herbs/yohimbe – This source from Memorial Sloan Kettering Cancer Center provides a comprehensive overview of yohimbe, including its traditional uses, active compounds, and potential side effects. It emphasizes the importance of caution due to its narrow therapeutic window and potential for adverse reactions, especially with variable product purity.
- https://www.healthline.com/nutrition/yohimbe – Healthline offers a general overview of yohimbe, discussing its purported benefits for ED, weight loss, and athletic performance, while also highlighting the associated risks and side effects. It underscores the need for careful consideration and medical consultation before use due to safety concerns.
- https://www.drugs.com/npp/yohimbe.html – Drugs.com provides detailed information on yohimbe, focusing on its pharmacological actions, indications, contraindications, and potential drug interactions. This resource is valuable for understanding the clinical aspects and safety profile of yohimbe as a supplement.
