This multi-million dollar business is driven by various psychological factors that many men may be too embarrassed to ask their primary care for ED treatment, they may have experienced side-effects after using Sildenafil or Tadalafil or they may have a large co-payment attached to their prescription for erectile medication. Consumer request has created a huge demand for these products and has led to sales in the hundreds of million to billions of dollars in the US and world-wide The FDA has identified more than 350 different supplements marketed for sexual enhancement and found to be tainted with prescription medication of which the quality and quantity is questionable due to lack of oversight in these products. In recent years the Food Drug Administration FDA has noted an emerging trend where dietary supplements used for sexual enhancements have untested pharmaceutically active ingredients leading to harmful consequences. Inadequate regulatory measures, weak quality control system and uncontrolled distribution by various vendors are some of the reasons that has augmented herbal supplements market. It is difficult to analyze the herbal products that cause adverse events due to insufficient information, lack of expertise. These products are marketed as supplements and are not currently under the regulations of the Food and Drug Administration (FDA) and are thus released to the general public containing unknown amounts of medications or drugs that are normally available by prescription only in the USA. These products are accessible for purchase from local food, drug stores and the internet. The safety of herbal supplements has become a globally major concern in national and international health authorities due to increasing adverse events and adulterations associated with usage of herbal medications.
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Nevertheless, the use of herbal medicines continues to expand rapidly across world and many people perceive usage of herbal medication as a safe and reliable way to improve health outcome. Safety and quality concerns regarding over the counter sexual enhancement products sold in the USA market pose a major health risk to the general public. We present a case report of an individual with bipolar disorder and hypersexual behavior who became victim to over the counter sexual enhancement products/supplements which caused serious health and life threatening consequences. Patients who are prone to impulsive hypersexual behavior such as patients with bipolar disorder, substance use, borderline personality disorder and those who may feel adamant to discuss erectile dysfunction with their physicians are more likely to become the victims of using illicit medications/ drugs with serious health risks consequences. These sexual enhancement products are being sold as safe and natural with false hopes to resolve erectile dysfunction. These products keep the consumer in the dark in terms of the quantity, ingredients, effectiveness and possible side effects. The types of chemicals found in these medications are making it harder for regulatory authorities to track them down.
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These Erectile Dysfunction (ED) pills may contain Sildenafil, the active ingredient of Viagra in much higher quantity then legally prescribed by a licensed physician or they may contain unknown quantities of Thiosildenafil, the active ingredient in Cialis. These non FDA approved products with unknown ingredients are widely accessible for purchase ranging from local food, drug stores and to the internet.
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