African Traditional Medicine
Yohimbe (Pausinystalia yohimbe), Yohimbine & West/Central African practices
Evidence grade 2 of 5, Thin. Read how the Atlas grades evidence.
The written rationale for this grade is still being prepared.
- FDA
- Yohimbine HCl was a marketed prescription drug for ED in the pre-PDE5 era (grandfathered, never formally approved via a modern efficacy review); crude yohimbe bark is an unapproved supplement
Reference only. Not medical advice.
What can go wrong
Yohimbine raises heart rate and blood pressure and can cause anxiety, panic, insomnia, and, in overdose, hypertensive crisis and arrhythmia. It is contraindicated with MAO inhibitors and risky in cardiovascular disease and anxiety disorders. Crude yohimbe bark supplements have been associated with poison-control calls due to unpredictable dosing. The FDA has flagged yohimbe-containing supplements for inaccurate labeling.
This is something to take to a clinician. The Atlas can tell you what is known about african traditional medicine in general. It cannot tell you what is happening in your body, and the difference matters most for exactly the symptoms that bring people to this page.
Yohimbe is the bark of Pausinystalia yohimbe, a tree of the rainforests of Cameroon, Gabon, Nigeria, and the Congo Basin, used in Central and West African traditional practice as a stimulant and aphrodisiac. Its alkaloid yohimbine is an alpha-2 adrenergic antagonist; yohimbine HCl (sold under brand names such as Yocon and Aphrodyne) was a prescription drug for erectile dysfunction in the pre-PDE5 era. It was a grandfathered/old drug that never went through a modern FDA efficacy-approval review, so calling it cleanly 'FDA-approved' overstates its regulatory status. After sildenafil's 1998 arrival, yohimbine faded from prescribing and the crude bark is now sold as a loosely regulated supplement with inconsistent alkaloid content. Evidence for crude yohimbe is weak (grade 2); standardized yohimbine had modest RCT support.
The traditional African botanical whose alkaloid became a pre-Viagra prescription ED drug.
What people take it for
These are the reasons people give for taking it. They are not effects it has been shown to have.
How it is supposed to work
Yohimbine blocks alpha-2 adrenergic receptors, increasing noradrenergic outflow and reducing sympathetic tone that otherwise inhibits erection; it may also increase penile blood inflow. This pharmacology is real and reproducible. The problem is the crude bark: supplement testing shows wildly variable, often near-zero or unexpectedly high yohimbine content, making the traditional preparation unpredictable.
What people get wrong
Often saidYohimbe bark equals the prescription drug yohimbine
ActuallyCrude bark has highly variable and often mislabeled alkaloid content; it is not a reliable substitute for standardized yohimbine HCl.
Often saidIt is purely traditional with no pharmaceutical history
ActuallyYohimbine HCl was a genuine prescription ED drug (e.g., Yocon, Aphrodyne) for years before PDE5 inhibitors displaced it, though as a grandfathered drug it predates modern FDA efficacy approval.
Who profits, and who pushes back
Nobody is named here yet, because we have not done that work on this entry. Read that as unfinished. Somebody almost certainly sells this, and somebody almost certainly disputes it. Assume both until we have checked.
How we got here
Pausinystalia yohimbe is indigenous to the Atlantic-coast rainforests of Central and West Africa; its bark has documented use among peoples of the Cameroon and Congo Basin regions as a stimulant and aphrodisiac. European colonial naturalists recorded the use in the 19th century, and yohimbine was isolated from yohimbe bark by the German chemist Leopold Spiegel around 1896 (the same alkaloid Otto Hesse had earlier isolated from quebracho). Through the 20th century yohimbine became a Western prescription agent for impotence; products such as Yocon and Aphrodyne were marketed as grandfathered/old drugs rather than via a modern FDA efficacy approval. The 1998 launch of sildenafil rendered it largely obsolete in medicine, after which it migrated to the supplement aisle.
- 19th c.European naturalists record West/Central African aphrodisiac use
- ~1896Yohimbine alkaloid isolated from yohimbe bark (Spiegel)
- 1980sYohimbine HCl (e.g., Yocon, Aphrodyne) marketed as a prescription ED drug (grandfathered, not via modern efficacy approval)
- 1998Sildenafil launches; yohimbine prescribing collapses
- 2010sFDA warnings on mislabeled crude yohimbe supplements
The people taking it
In its native region, yohimbe bark remains part of traditional practice. Globally, crude yohimbe and yohimbine extracts are sold as ED and fat-loss supplements, especially in the United States and Europe, where labeling accuracy is poor.
What we do not know
- Can crude yohimbe ever be dosed safely given content variability?
- What is the real cardiovascular event rate with supplement-grade yohimbe?
- Is wild harvesting threatening the species?
The market for this
What follows describes how this is bought and sold. It is not a buying guide and it is not an endorsement of any seller.
Crude yohimbe supplements are notoriously inconsistent; independent analyses have found actual yohimbine content ranging from negligible to far above label. Unsustainable bark harvesting is also a conservation issue for the wild tree.
Cameroon / Congo BasinBark wild-harvested, sometimes unsustainably, raising conservation concern for the speciesExport processorsBark dried and shipped for extractionWestern supplement makersVariable, frequently mislabeled finished products
At a glance
- Tree
- Pausinystalia yohimbe, Rubiaceae family
- Range
- Cameroon, Gabon, Nigeria, Congo Basin
- Active alkaloid
- Yohimbine (alpha-2 antagonist)
- FDA drug era
- Yohimbine HCl marketed as a grandfathered Rx for ED; eclipsed by sildenafil 1998
What this entry does not yet cover
What follows is unfinished work on our side, not a finding about African Traditional Medicine. A short entry is not a safe entry.
- Cost and market. We have not documented what it sells for or who sells it.
- Who uses it. We have not documented the user groups.
- What could change. No forward-looking summary yet.
- How it compares. We have not set it against the alternatives.
- Children and teenagers. We have not checked what is known about younger people.
- Where we land. We have not taken a position on this yet.
Sources
The studies below are named and described, but not linked. You cannot open them from here and check our reading against them, which means this page is our summary of the literature rather than a document you can verify. Weigh it accordingly until the links exist.
The studies that matter
Ernst & Pittler meta-analysis of yohimbine for ED1998
Pooled RCTs found yohimbine modestly superior to placebo for organic and non-organic ED
Yohimbine for SSRI-induced sexual dysfunction1990s-2000s
Small trials suggested possible benefit; evidence limited