Sexual prowess from nature: A systematic review of medicinal plants used as aphrodisiacs and sexual dysfunction in sub-Saharan Africa

South African Journal of Botany Available online 19 September 2018 In Press, Corrected ProofWhat are Corrected Proof articles? Review Author links open overlay panelA.A.AjaoN.P.SibiyaA.N.Moteetee https://doi.org/10.1016/j.sajb.2018.08.011 Get rights and content Highlights • A review on aphrodisiac medicinal plants used in sub-Sahara Africa is compiled. • 206 plant species documented, family Fabaceae has the most utilized species. • 46 species have been tested scientifically, toxicology was reported for 75 plants. • Roots are the most utilized parts, decoctions are the most preferred dosage form. • Some species have been shown to have toxicity associated with vital organs. Abstract Sexual dysfunction is a serious health challenge characterized by inability to achieve, keep, and maintain penile erection enough for stimulating coitus. Literature suggests that many people suffering from sexual dysfunction continue to explore aphrodisiac plants as alternative therapy. However, the extent to which these plants are used across the sub-Saharan region is not known. The aim of this paper is therefore to present a review of aphrodisiac medicinal plants used for the treatment of sexual dysfunction in order to identity existing gaps regarding the indigenous knowledge, ethnopharmacology, and toxicology of the implicated plants in the region. The information used was sourced from books, published and unpublished dissertations and theses, as well as published articles using online databases. This review presents a total of 209 plant species belonging to 73 families used in sub-Saharan Africa to treat sexual dysfunction.The families Fabaceae (28), Rubiaceae (16), Euphorbiaceae (11), Apocynaceae (10), Asteraceae (9), and Rutaceae (7) dominated the plant species used in the treatments.South Africa (75), Uganda (32) and Nigeria (28) are the countries with the highest recorded number of plant species, with the roots being the most used plant parts, and decoctions the most preferred method of preparation.Forty-eight plant species including Gloriosa superba, Mucuna pruriens, Sphenocentrum jollyanum, and Morella serrata have previously been evaluated scientifically, thus lending credence to the folkloric usage of the plants. Regarding the toxicity, the review reveals that only 77 plant species have been evaluated, of which 25 exhibited varying degrees of toxicity in test animals, for example,Bulbine natalensis and Callilepsis laureola are reported to be toxic to the liver. Overall, this review demonstrates the need for further studies including ethnopharmacology and toxicology of the documented plants, so that they can be properly utilized for traditional treatment and harnessed for drug discovery processes. Keywords Erectile dysfunction Impotence Sexual dysfunction Medicinal plants 1. Introduction The term ‘Aphrodisiac’ takes its roots from the word ‘Aphrodite’, the Greek goddess of beauty and love. Scientifically, an aphrodisiac is any natural agent or substance that can boost sexual performance (Shamloul, 2010) and can be of animal, plant, or mineral origin (Kotta et al., 2013). The undaunted and continuous search for substances that can boost sexual prowess is historically known in the Chinese, Egyptian, Hindu and Roman cultures (Shah, 2002). Looking back in history, the Chinese and the Indians shared the same aphrodisiac idiosyncrasy as the Romans in believing that consumingan animal's sexual organ, for example goat testicles, can boost man's sexual ability (Shah, 2002). On the contrary, primeval Egyptians were known for aphrodisiac medications which involved the application of oiled baby crocodile heart to the penis or an ingestion of a combination of 37 ingredients which included pine, salt, and water melon (Smith, 1974; Nunn, 1996). Based on the therapeutic activity of the substance, aphrodisiacs can be classified into three groups: (i) those that increase sexual arousal and desire; (ii) those that increase sexual potency through effectiveness of an erection; and (iii) those that increase sexual pleasure (Sandroni, 2001; Kotta et al., 2013). Sexual dysfunction or sexual disorder is a serious medical condition that affects both men and women and can be caused by physiological or psychological factors (Malviya et al., 2016). Erectile dysfunction (ED) is a form of sexual dysfunction, which is the main reason for male impotence. ED is the incapacity to achieve and sustain an erection sufficient for satisfactory sexual performance (Joseph et al., 2015). Globally, the prevalence of ED is quite high and with an estimated incidence ranging from 2% in men younger than 40 years to 86% in men 80 years or older (Prins et al. 2002), it is considered to be on the increase at a similar rate as diabetes mellitus. In a study by Aytac et al. (1999), the estimated worldwide prevalence of ED in men was 152 million in 1995 and it is projected to be 322 million in 2025, an increase of 111%, much of which occurs in developing countries (Aytac et al., 1999).The prevalence varies from country to country and this may be attributed to different risk factors and conditions such as obesity, diabetes mellitus, dyslipidemia, metabolic syndrome, and unhealthy lifestyles such as lack of exercise, and smoking (Salonia et al., 2012).According to Global Online Sexuality Survey, the prevalence is 45.1% in the Middle East and 37.7% in the United States (Wang et al., 2017). Among Russian men, it was found to be 48.9% while that of Urban Malaysian men is 25% (Arasalingam et al., 2016, Korneyev et al., 2016). Furthermore, the estimated rates of ED among men attending primary care clinics was found to be 57.4% in Nigeria, 63.6% in Egypt, and 80.8% in Pakistan (Shaeer et al., 2003; Oyelade et al., 2016). According to Kemp and Rheeder (2015), a study carried out in 1980 revealed that the prevalence of ED in diabetic men stood at 35% in South Africa. ED and premature ejaculation are the commonest complaints of male patients with sexual dysfunction that requires intervention of aphrodisiac agents (Lindau et al., 2007). People suffering from ED have continued to explore aphrodisiac plants as alternative therapy because of their efficacy, accessibility, affordability, and minimal side effects (Sabiu et al., 2016, Sabiu and Ashafa, 2017). Modern aphrodisiac drugs such as sildenafil citrate have been reported to elicit side effects such as stomach disorder, nasal congestion, loss of accommodation due to blurred vision, and urinary tract infections (Kulkarni and Reddy, 1998, Lue, 2000).Numerous plants have been traditionally used to treat ED, for example,Crocus sativus L., Mondia whitei (Hook.f.) Skeels, Panax ginseng C.A.Mey., Phoenix dactylifera L., and Tribulus terrestris L., all of which have been scientifically proven to have aphrodisiac properties (Kotta et al., 2013). Despite the cosmopolitan usage of medicinal plants to solve this problem, studies on the commonly used aphrodisiac medicinal plants in Africa are limited. In sub-Saharan Africa, large volumes of information pertaining to plant use, whether in general or for a specific ailment, have been published, with every country boasting several ethnobotanical surveys. However, we could find only a few articles either reviewing published literature or reporting results of ethnobotanical surveys conducted specifically on this subject. A study by Noumi et al. (1998) revealed that 69 species of plants are used as aphrodisiacs in Cameroon. In a review by Abdillahi and Van Staden (2012), it was reported that 61 species are used for male impotence or as aphrodisiacs in South Africa. A survey carried out in western Uganda (Kamatenesi-Mugisha and Oryem-Origa, 2005) showed that 31 species are used for treatment of impotence and ED. Some studies have reviewed aphrodisiac uses and/or evaluated aphrodisiac efficacy (including androgenic, erectogenic, etc.), for example, Vangueria agrestis (Schweinf. ex Hiern) Lantz (Yakubu et al., 2005), Eriosema kraussianum Meissner (Ojewole, 2007), Aloe excelsa A.Berger, Cucurbita pepo L., Ekebergia capensis Sparrm. (Gundidza et al., 2009), Mondia whitei (e.g., Watcho et al., 2007; Lampiao et al., 2008; Gundidza et al., 2009, Martey and He, 2010, Oketch-Rabah, 2012), Bulbine natalensis Baker (Yakubu and Afolayan, 2009), Clerodendron capitatum (Abdelwahab, et al., 2012), and several others. Some of these studies have further provided scientific evidence corroborating the aphrodisiac activity of some of these plants. Mondia whitei seems to have particularly attracted considerable attention. The species occurs across the whole of Africa except for the northern parts (Aremu et al., 2011), and is used widely for several other medicinal purposes. This paper presents a comprehensive review detailing the extent to which medicinal plants are used as aphrodisiac agents in sub-Saharan Africa. It also identifies existing gaps on the research done to test the efficacy of these plants (as well as their toxicity) in order to validate their traditional uses as aphrodisiacs. It is a well-known fact that ethnobotanical knowledge has been promoted as an important line of thought required for drug discovery. 2. Material and methods Published literature in the form of published and unpublished dissertations and theses, books, and journal articles downloaded from databases such as PubMed, Scopus, Science Direct, Wiley Online Library, and Google scholar using keywords such as aphrodisiac, sterility, impotent, libido, and traditional medicinal plant, were used as sources of information. 3. Results and discussion The list of the plants implicated for the treatment of sexual dysfunction, their habits, parts used, mode of administration, countries where they are used, toxicity, and ethnopharmacology are presented in Table 1. The correct names and authorities were listed according to International code of botanical nomenclature using websites such as the plant list (www.theplantlist.org), JSTOR (http://plants.jstor.org), and Tropicos (www.tropicos.org). Table 1. Aphrodisiac medicinal plant used in sub-Saharan Africa, their habits, parts used, mode of administration, countries where they are used, toxicity, and ethnopharmacology. Family Name of the plant Habit Part(s) used Mode of administration Toxicity studies Scientific validation Country Acanthaceae Acanthus pubescens (T.Thoms.) Engl. Shrub Leaves Decoction of the leaves is drunk in local brew called ‘Tontoe’ (Ssegawa and Kasenene, 2007) Not toxic (Nondo et al., 2015) No records Uganda Acanthaceae Duosperma kilimandscharicum (C.B.Clarke) Dayton Shrub Leaves, roots Leaves and roots are taken together with goat blood or extract from goat meat (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Amaryllidaceae Ammocharis coranica(Ker Gawl.) Herb. Herb Roots Root decoction boiled for 10mins taken orally (Semenya and Potgieter 2013) No records No records South Africa Amaryllidaceae Allium cepa L. Herb Bulbs leaves, roots Chewing, infusion of the bulbs, leaves and root is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records Enhances copulatory behaviour in male rats (Allouh et al., 2014) Uganda Amaryllidaceae A. sativum L. Herb Bulbs, roots, leaves Chewing or infusion of the bulbs, leaves and root is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) Not toxic up to 2200 mg/kg dosage (Mikail, 2010) Increased weight of seminal vesicles and epididymides in male rats (Al-Bekairi et al., 1990) Uganda Annonaceae Artabotrys brachypetalus Benth. Tree Roots Infusion of the roots taken orally (Mabogo, 1990) Methanolic and DCM extracts toxic at 0.5mg/mL (Makhuvele et al., 2018) No records South Africa Anarcadiaceae Ozoroa insignis ssp. reticulata (Baker f.) J.B.Gillett Tree Roots Root decoction taken orally (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania, Somalia, South Africa Anarcadiaceae O. sphaerocarpa R.Fern. & A.Fern. Tree Stem bark The bark is pounded and taken with soft Porridge (Semenya and Potgieter, 2013) No records No records South Africa Anacardiaceae Pistacia vera L. Tree Nuts Nuts are chewed (Ajibesin et al., 2012) No toxic effect on normal cells (Seifaddinipour et al., 2018) No records Nigeria Anacardiaceae Rhus vulgaris Meikle Shrub Whole plant Chewing and oral administration of whole plant (Watt and Breyer-Brandwijk, 1962) No records No records Uganda Anacardiaceae Spondias mombin L Tree Leaves Decoction of the leaves is taken orally (Ajibesin et al., 2012) Relatively safe, but prolonged use can lead to renal and hepatic toxicity (Asuquo et al., 2012) Increased levels of serum testosterone (Oloye et al., 2017) Nigeria Apiaceae Heteromorpha arborescens (Spreng.) Cham. & Schltdl. Tree Roots Infusion of the root taken orally or 1 teaspoon of the leaves powder is mixed in 500 ml milk, boiled and twice a day (Mabogo, 1990, Pujol, 1990) No records No records South Africa Apocynaceae Acokanthera schimperi (A.D.C)Schweinf Tree Roots Hot infusion of the pounded root is taken orally (Schmelzer, 2008) No records No records Kenya and Tanzania Apocynaceae Carissa edulis Vahl. Shrub Roots No details provided (Watt and Breyer-Brandwijk, 1962) Low toxicity levels (Dzoyem et al., 2014) No records Ghana Apocynaceae Ancylobothrys capensis Oliv. Climber Fruits The fruit is used with another plant in making an aphrodisiac decoction taken only by African men (Watt and Breyer-Brandwijk, 1962) No records No records Africa Apocynaceae Gomphocarpus fruticosus (L) W.T.Aiton subsp. fruticosus Shrub Roots Decoction of the root is boiled for 15 min and taken orally (Semenya and Potgieter, 2013) No records No records South Africa Apocynaceae Mondia whitei (Hook. f.) Skeels Climber Root bark The root is chewed and decoction is taken orally or made into tea or pounded with food (Watt and Breyer-Brandwijk, 1962, Gelfland et al., 1985, Schmelzer and Gurib-Fakim, 2008; Noumi et al., 2008; Gundidza et al., 2009) Low toxicity levels (Joseph et al., 2015) Increase in sexual arousability, copulatory efficiency, improved sexual sensation (Gundidza et al., 2009) Benin, Cameroon, Kenya, Nigeria, South Africa, Uganda, Zimbabwe Apocynaceae Picralima nitida (Stapf) T.Durand and H.Durand Tree Stem bark, fruits No details provided (Adjanohoun et al., 1996, Kuete et al., 2011) No toxicity (Otoo et al., 2015) Androgenic effect and estrogenic activity (Otoo et al., 2015) Cameroon Apocynaceae Rauwolfia vomitoria Afze Tree Leaves, roots Leaves juice is taken orally; the crushed root is infused in warm water and taken orally (Afolayan and Yakubu, 2009, Ajibesin et al., 2012, Van Andel et al., 2012a) Poor liver and kidney function (Eteng et al., 2009) No records Ghana, Nigeria Apocynaceae Strophanthus hispidus DC. Climber Roots No details provided (Watt and Breyer-Brandwijk, 1962) 1000 mg/kg body weight of stem bark slightly toxic (Osibemhe et al., 2016) No records West Africa Apocynaceae Tabernanthe iboga Baill. Shrub Leaves Leaf decoction is taken orally (Schmelzer, 2008) Behavioural changes observed in mice with higher doses of the alkaloids ibogaine (400mg/kg) and noribogaine (500mg/kg) No records Gabon Apocynaceae Wrightia natalensis Stapf Tree Stem bark, roots Mixture of root and bark powder mixed with beer (Mabundu) and water taken orally immediately or within two days of preparation (Mabogo, 1990) No records Relaxed the corpus cavernosal smooth muscle (Rakuambo et al., 2006) South Africa Arecaceae Acorus calamus L. Herb Rhizomes Details not provided (Mabogo, 1990, Hutchings et al., 1996) No toxicity on acute and chronic administration in rats (Shah et al. 2012) No records South Africa Arecaceae Cocos nucifera L. Tree Fruits Fruit consumption by men (Lima et al., 2015) Low toxicity in rats and mice (Costa et al., 2011) Improves sexual behaviour in rats (Prakash et al., 2015) Mozambique Arecaceae Phoenix reclinata Jacq. Shrub Leaves, roots Decoction of the leaves and root is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Asclepiadaceae Ceropegia purpurascens K. Schum. subsp. purpurascens Climber Roots Root decoction boiled for 10 mins taken orally (Semenya and Potgieter, 2013) No records No records South Africa Asclepiadaceae Cryptolepis obtusa N.E.Br. Shrub Roots In Tanzania, root decoction drunk is as aphrodisiac while the root is chewed in Kenya (Schmelzer and Gurib-Fakim, 2008) No records No records Kenya, Tanzania Asclepiadaceae Pachycarpus robusta (A.Rich.) Bullock Herb Roots Details not provided (Watt and Breyer-Brandwijk, 1962) No records No records Congo, East Africa Asclepiadaceae Parquetina nigrescens Afzel Climber Roots Root decoction is taken once in the evening (Kokwaro, 1993) No toxicity (Adu-Amoah et al., 2014) The extracts improve sexual activity, behaviour and competence through improving sexual hormone secretion (Oyelowo et al., 2012; (Kayode and Yakubu, 2017). Kenya Asclepiadaceae Dregea rubicunda K.Schum Climber Roots Fresh root is chewed (Kokwaro, 1993) No records No records Tanzania Asphodelaceae Aloe vera (L.) Burm.f. (= Aloe barbadensis) Mill. Herb Roots Extract from the root is taken orally (Erhabor and Idu, 2017) No acute behavioural changes (Erhabor and Idu, 2017) Increased sexual behaviour parameter (Erhabor and Idu, 2017) Nigeria Asphodelaceae A. dichotoma Masson Tree Roots Root powder is stirred in water and the resulting foam is drunk (Watt and Breyer-Brandwijk, 1962) No records No records Zimbabwe Asphodelaceae A. excelsa A. Berger Shrub Leaves Details not provided (Gundidza et al., 2009) No records Increased sexual sensation and copulatory efficiency (Gundidza et al., 2009) Zimbabwe Asphodelaceae Bulbine natalensis Baker Herb Stem The powder from the stem is mixed with milk and taken orally (Yakubu and Afolayan, 2009) Toxic on liver but not kidney functionality in rats (Yakubu and Afolayan, 2009) Increased hormone levels (Yakubu and Afolayan, 2009) South Africa Asphodelaceae Aspidoglossum biflorum E.Mey. Herb Roots Details not provided (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Asteraceae Artemisia annua L. Herb Roots Root boiled in water for 20 mins is taken orally (Semenya and Potgieter, 2013) No records No records South Africa Asteraceae Athrixia phylicoides DC. Shrub Leaves, stalks Leaves and stalks are brewed in the form of a tea and taken orally (Mabogo, 1990, Hutchings et al., 1996, Van Wyk and Gericke, 2000) Aqueous extracts had no toxic effects on brine shrimp (McGaw et al., 2007) No records South Africa Asteraceae Callilepsis laureola DC. Herb Tubers Decoction from the tuber boiled in water for 5 mins is taken orally (Semenya and Potgieter, 2013) Toxic to liver and Hep G2 cells in vitro (Popat et al., 2001) No records Asteraceae Cyanthillium cinereum (L.) H.Rob. (Vernonia cinerea Shrubs Leaves, roots Decoction of the leaves and roots is taken orally. Roots are also chewed (Kamatenesi-Mugisha and Oryem-Origa, 2005) No toxic effects on mice and brine shrimp (Latha et al., 2010) Restored sperm motility and testosterone concentrations (Pomjunya et al., 2017) Uganda Asteraceae Helichrysum caespititium (DC) Harv. Herb Root Extract from the root is used (Moffett, 2010) Non-toxic (Mamabolo et al., 2017) No records South Africa Asteraceae Helichrysum platypterum DC Herb Root Decoction of the root is orally taken (Moffett, 2010) No records No records South Africa Asteraceae Vernonia microcephala DC. Shrub Roots Boiled root infusion drunk twice a day (Kokwaro, 1993) No records No records Kenya Asteraceae Microglossa pyrifolia (Lam.) Kuntze. Herb Leaves No details provided (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Asteraceae Sonchus schweinfurthii Oliv. & Hiern Herb Roots Decoction of the root is taken orally (Kitula, 2007) No records No records Tanzania Boraginacaeae Ehretia cymosa Thonn. Shrub Leaves, roots Leaves decoction and root taken orally (Kokwaro, 1993) No records No records Kenya Bignoniaceae Kigelia africana (Lam.) Benth. Tree Fruits, seeds Fruit boiled with milk, cooled and taken orally in Botswana and Nigeria. Roasted seed or fruit are macerated in beer in Ethiopia while bark decoction is drunk in Tanzania (Setshogo and Mbereki, 2011, Neuwinger, 1996) No organ toxicity (Nyarko et al., 2005) Increases sperm count, motility, and fertilization ability in African Catfish (Adeparusi et al., 2010); increase in testicular weight, body weight, testosterone levels and follicle-stimulating hormone (Azu et al., 2010) Botswana, Nigeria, Ethiopia Brassicaceae Lepidium sativum L. Herb Leaves Ground leaves mixed with lemon juice and water is taken orally (Fullas, 2001) Leaves edible, not toxic, but seeds in high quantities (50% of diet); lethal in rats (Adam, 1999) No records Ethiopia Brassicaceae Nasturtium officinale R. Br Herb Leaves Decoction of the leaves is taken orally (Ajibesin et al., 2012) LD50 of ˃5g/kg in rats (Sadeghi et al., 2014) No records Nigeria Buddlejaceae Nuxia floribunda Benth. Tree Roots Decoction of the root taken orally (Kitula, 2007) No records No records Tanzania Cannabaceae Cannabis sativa L. Shrubs Leaves Leaves are chewed and Inhaled through smoking (Kamatenesi-Mugisha and Oryem-Origa, 2005) Prolonged use can affect several physiological processes (Sailani and Moeini, 2007) Reduces epididymal sperm count in rats (Sailani and Moeini, 2007) Uganda Canellaceae Warburgia salutaris (Bertol. f.) Chiov Tree Stem bark Details not provided (Mabogo, 1990) No records No records South Africa Canellaceae W. ugandensis Sprague Tree Stem bark, leaves, roots Orally taken as tea or in porridge (Kamatenesi-Mugisha and Oryem-Origa, 2005) No toxicity in rats (Karani et al., 2013) No records Uganda Capparaceae Cleome gynandra L. Herbs Leaves, roots Roots are chewed and leaves are cooked as food (Kamatenesi-Mugisha and Oryem-Origa, 2005) No toxicity in brine shrimp (Sango et al., 2016) No records Uganda Capparaceae C. usambaricaPax Herbs Roots Roots are mixed with roots of Macaranga usambarensis and put in a bottle of water to infuse for one hour, after which the infusion is well shaken and a cupful is taken before food twice a day (Kokwaro, 1993) No records No records Kenya Capparaceae Capparis tomentosa Lam. Shrub Roots Decoction of the root is done with roots of Cyperus species and taken orally (Hutchings et al., 1996) No toxic effects on brine shrimp, but other reports indicate toxic effects on goats and that goats and camels die instantly if consumed (Hurinanthan, 2009) No records South Africa Caricaceae Carica papaya L. Tree Roots Pounded root is orally taken with soft porridge (Semenya and Potgieter, 2013 No records No records South Africa Celastraceae Catha edulis(Vahl) Endl. Tree Leaves, stem, roots Chewing oral by chewing Miira (SW) fresh leaves and young st chewing oral by chewing Miira (SW) fresh leaves and young stem em In Uganda, young leaves and stems are chewed (Kamatenesi-Mugisha and Oryem-Origa, 2005). Decoction from the root that is boiled for 5mins is taken orally in South Africa (Semenya and Potgieter, 2013) No toxicity at 200 mg/kg in rats and mice (Sharma et al., 2014) Increase in plasma testosterone levels (Sharma et al., 2014) South Africa, Uganda Celastraceae Gymnosporia senegalensis (Lam.) Loes Shrub Roots, leaves Roots and Leaves are boiled for 20 mins and taken orally(Semenya and Potgieter, 2013) No records No records South Africa Celastraceae Pristimera andogensis var. volkensii (Loes.) N.Hallé Climber Roots Large roots soaked in water and the liq arge roots soaked in water and the liquid uid Root is infused in water and taken orally (Kokwaro, 1993) No records No records Kenya Celastraceae Salacia leptoclada Tul. Climber Roots nN N Na a No details provided (Palmer and Pitman (1972) No records No records South Africa Celastraceae Maytenus buchananii (Loes) Wilczek Shrub Roots The chopped root is infused in beer and taken orally (Iwu, 1993) No records No records Zambia Combretaceae Combretum constrictum (Benth.) Laws. Climber Roots Fresh roots are chewed or boiled with a little salt and a cupful is drunk twice a day (Kokwaro, 1993) No records No records Kenya Combretaceae C. pentagonum Laws. Climber Roots Roots chewed fresh or boiled with a little salt and the liquid drunk two or three times a day as an aphrodisiac. (Kokwaro, 1993) No records No records Kenya Combretaceae Terminalia catappa L. Tree Kernel An infusion of the kernel is taken orally a few minutes before sexual intercourse (Afolayan and Yakubu, 2009) No acute or chronic toxicity on the parameters studied (Arjariya et al., 2013) 1,500 mg/kg dose resulted in prolongation of ejaculation latency, but no effect on libido, sexual vigour or sexual performance (Ratnasooriya and Dharmasiri, 2000) Nigeria Colchicaceae Gloriosa modesta (Hook.) J.C.Manning & Vinn. Climber Corms Details not provided (Gerstner, 1938, Hutchings et al., 1996) Should be regarded as toxic, all parts contain colchicine No records South Africa Colchicaceae G. superba L. Climber Corms Corms in powdered form are taken orally (Bryant, 1966, Hutchings et al., 1996) Highly poisonous to animals and humans, however no clinical toxicity symptoms observed in rats (Pare et al., 2014) Increased testosterone levels and sexual performance (Pare et al., 2014) South Africa Clusiaceae Allanblackia floribunda Oliv. Tree Stem bark Details not provided (Brusotti et al., 2016) Aqueous extract not toxic orally, but very toxic via the intraperitoneal route (Lembé et al., 2013) Decreased ejaculation (Sanda et al., 2013) Cameroon Clusiaceae Garcinia buchananii Baker Tree Fruits Ripe fruits are eaten as aphrodisiac (Chigora et al., 2007) No records No records Zimbabwe Clusiaceae G. livingstonei T. Anders Tree Roots Powdered roots are taken orally (Mabogo, 1990, Pooley, 1993) No records No records South Africa Cucurbitaceae Cucurbita pepo L. Climber Seeds No details provided (Gundidza et al., 2009) No known toxicity, however symptoms of paralysis have been reported in domestic stock and poultry (Watt and Breyer-Brandwijk, 1962) Increased sexual sensation and copulatory efficiency (Gundidza et al., 2009) Zimbabwe Cucurbitaceae Momordica balsamina L. Climber Roots No details provided (Hutchings, et al., 1996) No toxic clinical signs in rats given aqueous extracts orally (Karumi et al., 2006) No records South Africa Cyperaceae Cyperus esculentus L. Herb tubers Eaten raw, roasted, dried, baked or made into a refreshing beverage called ‘kunnu’ (Sabiu and Ashafa, 2017) Methanol extract non-toxic (Oyelade et al., 2016) Improved sexual performance, increased serum testosterone levels (Allouh et al., 2014) Nigeria Dracaenaceae Dracaena mannii Baker Tree Roots Mixture of its roots with palm wine taken orally (Noumi et al., 1998) No records No records Cameroon Euphorbiaceae Acalypha villicaulis Hochst. ex A.Rich. Herb Roots Infusion of the root is taken orally (Kokwaro, 1993, Schmelzer, 2008) No records No records Kenya, Zimbabwe Euphorbiaceae Alchornea cordifolia (Schum. & Thonn.) Müll.-Arg. Shrub Roots Roots are mixed with the root of Tabernanthe iboga Bail and taken orally with water (Schmelzer and Gurib-Fakim, 2008) Safe at doses lower than 400 mg/kg; higher doses can cause liver and renal damage (Ajibade and Olayemi,, 2009) Increase in testicular weight, sperm count and motility and serum testosterone levels at amounts lower than 400 mg/kg (Ajibade and Olayemi, 2009) Gabon Euphorbiaceae A. floribunda Mull.Arg. Shrub Roots Maceration of the root cortex infused in palm wine for several days is orally administered (Neuwinger, 1996, Schmelzer, 2008) For acute toxicity test, no mortality or obvious sign of toxicity was observed in rats and mice No records Cote d’Ivoire, DR Congo, Gabon, Euphorbiaceae Androstachys johnsonii Prain Tree Roots Root extract is taken orally (Chigora et al., 2007) No records No records Zimbabwe Euphorbiaceae Bridelia cathartica G. Bertol Shrub Roots Roots extract is drunk (Gelfland et al., 1985, Maroyi, 2011) No records No records South Africa, Zimbabwe Euphorbiaceae Euphorbia tirucalli L. Tree Latex, Juice Latex is used in South Africa and the Juice is used in Tanzania (Watt and Breyer-Brandwijk, 1962, Abdillahi and Van Staden, 2012) Toxic (LC50 = 23.10 ppm) (Brasileiro et al., 2006) No records South Africa, Tanzania Euphorbiaceae Flueggea virosa (Willd.)Voigt Shrub Leaves, root Decoction of the root and leaves is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) Acute testing showed non-toxicity (Ezeonwumelu et al., 2013) No records Uganda Euphorbiaceae Jatropha curcas L. Shrub Roots Root is boiled in water for 5min and the decoction is taken orally (Semenya and Potgieter, 2013) No records No records South Africa Euphorbiaceae Macaranga capensis (Baill.) Benth. ex Sim Tree Roots Root decoction is drunk (Chigora et al., 2007) No records No records Zimbabwe Euphorbiaceae Pseudolachnostylis maprouneifolia Pax Tree Stem bark Stem powder in taken as porridge and bark is infused in beer and taken orally (Motlhanka and Nthoiwa, 2013) No records No records Botswana Euphorbiaceae Tragia brevipes Pax. Climbers Leaves Leaf decoction is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Fabaceae Abrus precatorius L. Shrub Seeds, leaves Leaf powder mixed with honey taken orally in Cameroon; The seed powder is taken orally either alone or with the seed extract/powder of Indigofera cordifolia or stem powder of Tinospora cordifolia; root is also chewed (Kokwaro, 1993, Jain et al., 2004, Williams, 2012) “reasonable safety profile” (Mondal et al., 2017) No records Cameroon, Kenya, Tanzania Fabaceae A. schimperi Hochst. ex Benth. Shrub Roots Fresh root is chewed as aphrodisiac (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Fabaceae Afrormosia angolensis Harms Tree Wood Decoction of the splinters of the wood is taken orally (Watt and Breyer-Brandwijk, 1962) No records No records Angola, Zambia Fabaceae Albizia antunesiana Harms Tree Roots Oral administration of the root extract (Maroyi, 2011) No records No records Zimbabwe Fabaceae Cassia abbreviata Oliv Shrub Roots Root extract drunk as aphrodisiac (Maroyi, 2011) No records No records Zimbabwe Fabaceae C. didymobotrya Fresen. Shrub Leaves, roots Chewing and oral administration of the decoction of leaves and root (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Fabaceae C. petersiana Bolle (= Senna petersiana (Bolle) Lock Tree Roots Details not provided (Watt and Breyer-Brandwijk, 1962, Mabogo, 1990) No records No records South Africa Fabaceae C. occidentalis L. Herb Leaves, root Chewing and oral administration of leaf and root decoction (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Fabaceae Desmodium gangeticum (L) DC. Herb Roots Root is chewed (Vedpal et al., 2016) No records No records Nigeria Fabaceae Dichrostachys cinerea (L.) Wight & Arn. Tree Stem bark, roots Oral administration of the bark in used in Uganda. In Tanzania, the root is crushed and mixed with maize or taken as a decoction (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Tanzania, Uganda Fabaceae Elephantorrhiza burkei Benth. Shrub Roots Details not provided (Mabogo, 1990) No records No records South Africa Fabaceae E. cordatum E.Mey. Shrub Roots Root infusions in milk or decoction of the chopped roots is taken orally (Hulme, 1954, Bryant, 1966) No records No records South Africa Fabaceae E. elephantina (Burch.) Skeels Shrub Roots Details not provided (Gelfland et al., 1985) Low toxicity (Maphosa et al., 2010) No records South Africa Fabaceae Eriosema kraussianum Meisn. Herb Roots Decoction of the root is taken orally (Hutchings et al., 1996) No information available It improves the relaxation of carvenosal penile smooth muscle (Drewes et al., 2002) South Africa Fabaceae E. salignum E.Mey. Herb Roots, root bark Oral administration of hot milk infusions of roots or infusions of root bark in cold water. The preparations are to be taken in small doses in the morning and night (Hulme, 1954) No records 75% activity in erectile dysfunction test on rabbit penile smooth muscle (Sharma et al., 2014) South Africa Fabaceae Griffonia simplicifolia (Vahl ex DC.) Baill Climber Leaves Decoction of the leaves is orally administered (Schmelzer, 2008) No records No records Cote d’Ivoire, Nigeria Fabaceae Indigofera flavicans Baker Herb Roots Roots are infused in beer and orally administered (Motlhanka and Nthoiwa, 2012) No records No records Botswana Fabacaeae Macrotyloma axillare (E.Mey.) Verdc. Climber Tubers, leaves Decoction of the root tuber and leaves is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Fabaceae Mucuna pruriens (L.) DC. Climber Seeds Hot water extract of seed is taken orally in Guinea-Bissau, Nigeria and Mozambique; decoction of water extract of the seed is taken orally or 12gm/ seed in 1 litre of milk in Madagascar (Ross, 2003) No toxicity (Shukla et al., 2009, Suresh et al., 2009 Recovery from spermatogenic loss, reduces sperm damage as a result of ageing, regulates steroidogenesis and improves semen quality, it also increases sexual activities (Shukla et al., 2009, Suresh et al., 2009, Suresh et al., 2010, Singh et al., 2013) Guinea-Bissau, Nigeria, Madagascar, Mozambique Fabaceae Mundulea sericea (Willd.) A. Chev. Shrub Roots Fresh roots or root bark is masticated or chewed as aphrodisiac (Kokwaro (1976); Mabogo, 1990) No records No records South Africa Fabaceae Peltophorum africanum Sond. Tree Roots, stem bark Decoction of root or bark is taken orally (Pooley, 1993). The bark may also be pounded and taken orally with warm water (Semenya and Potgieter, 2013) No records No records South Africa Fabaceae Senegalia ataxacantha DC. Tree Roots Details not provided (Mabogo, 1990) No records No records South Africa Fabaceae S. brevispica (Harms) Seigler & Ebinger Tree Roots, stem Details not provided (Delbanco et al., 2017) No records No records Kenya Fabaceae S. polyacantha (Willd.) Seigler & Ebinger subsp. campylacantha Hochtst. ex. A.Rich.) Kyal. & Boatwr. Tree Whole plant Details not provided (Watt and Breyer-Brandwijk, 1962) No records No records Congo Fabacaeae Tamarindus indica L. Tree Stem bark Bark pieces are mashed and added to porridge (Kerharo and Bouquet, 1950, Fandohan, 2007) No toxicity (Rai et al., 2018) It possesses aphrodisiac and spermatogenic activities (Rai et al., 2018) Benin, Cote d’voure Fabaceae Vachellia. karroo (Hayne) Banfi & Glasso Tree Roots Root decoction is taken orally (Chigora et al., 2007) No records No records Zimbabwe Fabacaeae V. nilotica (L.) P.J.H.Hurter & Mabb. Tree Stem bark, roots Decoction of the bark and roots is taken as aphrodisiac (Kokwaro, 1993, Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Fabaceae V. sieberiana Tree Stem bark Decoction of the root is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Fabaceae V. sieberiana (DC.) Kyal. & Boatwr var. vermoesenii (De Wild.) Keay & Brenan Tree Roots Decoction of the root is taken orally (Watt and Breyer-Brandwijk, 1962) No records No records Somalia, Tanzania Flacourtiaceae Xylotheca tettensis (Klotzsch) Gilg Shrub Roots Roots is either chewed or it’s decoction is orally administered (Kokwaro, 1993) No records No records Kenya Geraniaceae Monsonia angustifolia E.Mey. ex A.Rich. Herb Stem, leaves Decoction prepared from crushed dried leaves and stems is taken orally. (Fouche et al., 2015) No toxicity (Adedara and Farombi, 2012) Improvement in spermatozoa quantity and quality (Adedara and Farombi 2012). Enhancement of sexual activity by increasing the testosterone level (Ralebona et al., 2012). No activity (Yakubu, and Quadri, 2012) South Africa Guttiferaceae Garcinia kola Heckel Tree Fruit, roots The decoction of the fruits or roots is taken orally at a dose of one cup twice daily (Afolayan and Yakubu, 2009) No records No significant sexual enhancing effect (Yakubu, Quadri, 2012) Nigeria Guttiferaceae G. huillensis Welw. ex Oliv. Tree Stem bark An infusion of the bark is taken orally (Watt and Breyer-Brandwijk, 1962) No records No records Zambia Heteropyxidaceae Heteropyxis natalensis Harv. Tree Stem bark Details not provided (Hutchings et al., 1996) No records No records South Africa Hyacinthaceae Drimia elata Jacq. Herb Bulbs Bulbs are boiled in water and taken orally (Semenya and Potgieter, 2013) No records No records South Africa Hyacinthaceae Eucomis pallidiflora subsp. pole-evansii (N.E.Br.) Reyneke ex J.C.Manning, Herb Bulbs Bulbs are boiled in water and the decoction is taken orally (Semenya and Potgieter, 2013) No records No records South Africa Hyacinthaceae Urginea altissima (L.f.) Baker Herb Bulbs Details not provided (Gelfand et al., 1985; Hutchings et al., 1996) No records No records South Africa Hypoxidaceae Hypoxis colchicifolia Baker Herb Corms Details not provided (Bryant, 1966) No records No records South Africa Hypoxidaceae H. hemerocallidea Fish., C.A. Mey. & Ave-Lall Herb Tubers The tuber is boiled in water for 5 mins and decoction taken orally (Semenya and Potgieter, 2013) Toxic (Musabayane et al., 2005) It improves sexual function and fertility parameters and may protect the testes from oxidative damage (Tiya et al., 2017) South Africa Hypoxidaceae H. obtusa Burch. ex Ker Gawl. Tree Tubers Tuber is Pounded and mixed with E. pallidiflora (bulb) taken with warm water (Semenya and Potgieter, 2013) No records No records South Africa Icacinaceae Pyrenacantha scandens Planch. ex Harv. Climber Roots Details not provided (Gerstner, 1941) No records No records South Africa Iridaceae Gladiolus ludwigii Pappe Herb Corms Decoction of the corm is taken orally (Watt and Breyer-Brandwijk, 1962) No records No records South Africa Lamiaceae Clerodendrum myricoides R. Br. Shrub Root bark Details not provided (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Liliaceae Agapanthus orientalis Leighton Herb Bulbs Details not provided (Watt and Breyer-Brandwijk, (1962) No records No records South Africa Liliaceae Asparagus africanus Lam. Shrub Roots The powdered root is taken with honey (Afolayan and Yakubu, 2009) No records No records Nigeria Loganiaceae Strychnos cocculoides Baker Tree Roots Root extract is taken orally (Maroyi, 2011) No records No records Zimbabwe Loganiaceae S. spinosa Lam. Roots Details not provided (Gelfland et al., 1985) No records No records South Africa Malvaceae Glyphaea brevis (Spreng.) Monach Climber Leaves, stem, roots Decoction of the leaves, stems, and roots is taken orally (Ajibesin et al., 2012) No records No records Nigeria Malvacae Grewia microthyrsa K. Schum. ex Burret Shrub Root Decoction of the root is taken orally (Mabogo, 1990, Corrigan et al., 2011) No records No records South Africa Malvaceae G. similis K. Schum Shrub Whole plant Decoction of the whole plant is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Melastomaceae Dissotis princeps Triana Shrub Roots Root is chewed (Watt and Breyer-Brandwijk, 1962) No records No records Zimbabwe Meliaceae Ekebergia capensis Sparrm Tree Roots, leaves Decoction of the leaves, stems and roots is taken orally (Gundidza et al., 2009, Ndukui et al., 2012) No records Alleviation of sexual dysfunction through increase in mounting frequency (Ndukui et al., 2012) Uganda, Zimbabwe Melianthaceae Bersama lucens (Hochst.) Szyzyl. Tree Stem bark Details not provided (Watt and Breyer-Brandwijk, 1962, Bryant, 1966) No records No records No records Melianthaceae B.stayneri Phill Tree Stem bark Details not provided (Hutchings et al. (1996) No records No records South Africa Melianthaceae B. swinnyi Phill. Tree Stem bark Details not provided (Hutchings et al., 1996) No records No records South Africa Melianthaceae B. tysoniana Oliv. Tree Stem bark Details not provided (Hutchings et al., 1996) No records No records South Africa Melianthaceae Xylocarpus benadirensis Mattei Tree Unripe fruits The fluid which exudes from the crushed unripe fruit is taken orally (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Menispermaceae Sphenocentrum Jollyanum Pierre Shrub Roots The root is chewed in Ghana and used as tonic in Côte d’Ivoire (Owiredu et al., 2007, Schmelzer, 2008) No toxicity (Nafui, 2008) It stimulates sexual behaviour due to increase in testosterone level (Owiredu et al., 2007) Cote d’Ivoire, Ghana Moraceae Morus mesozygia Stapf Tree Roots The root boiled in cow's or goat's milk and taken orally (Kokwaro, 1993) No records No records Kenya Musaceae Musa paradisiaca L Tree Roots, stem, fruits Infusion of the root and stem as juice or juice from the fruit or decoction of the unripe fruit is taken orally (Afolayan and Yakubu, 2009, Ajibesin et al., 2012) No toxicity (Mallick et al. 2006) Stimulation of the normal functioning of the testes through androgenic activity (Yakubu et al., 2013) Nigeria Myricaceae Morella serrata (Lam.) Killick Shrub Roots Decoction of the root is taken orally (Moffett, 2010); Sabiu and Ashafa, 2017) No toxicity (Sabiu and Ashafa, 2016) Increase in sexual behaviour such as erection, quick flips, long flips and total penile reflexes (Sabiu and Ashafa, 2017) South Africa Myricaceae Myrica salicifolia Hochst. ex A.Rich Shrub Root bark Oral administration of the decoction of the root bark (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Myrothamnaceae Myrothamnus flabellifolius Welw. Herb Whole plant Whole plant is pounded and orally taken with warm water (Semenya and Potgieter, 2013) No records No records South Africa Nymphaceae Nymphaea nouchali caerulea(Savigny) Verdc. Herb Flowers Decoction of the flower is taken orally (Watt and Breyer-Brandwijk, 1962) No records No records West Africa Nymphaceae N. lotus L Herb Flowers Details not provided (Noumi et al., 1998, Mireille et al., 2017) No toxicity (Sharaibi et al., 2015) It possess androgenic properties by increasing the index of libido, sperm motility and viability (Mireille et al., 2017) Cameroon Olacaceae Ximenia caffra Sond. Tree Roots Root extract is drunk in Zimbabwe; Root powder is taken with beer in Botswana (Maroyi, 2011; Motlhanka and Nthoiwa, 2012) No records No records Botswana, Zimbabwe Orchidaceae Ansellia africana Lindl. ( = A. gigantea Reichb. f) Climber Stems Decoction of the stem (Watt and Breyer-Brandwijk, 1962) No records No records South Africa Orchidaceae Eulophia cucullata (Afzel. ex Swartz) Steud. Herb Roots A tablespoon of liquid from slightly boiled bulbous roots is taken (Hulme, 1954, Bryant, 1966) No records No records South Africa Orchidaceae Lissochilus arenarius Lindl. Herb Roots Decoction of the root (Watt and Breyer-Brandwijk, 1962) No records No records South Africa Orchidaceae L. krebsii Reichb. f. Herb Stems The stem is chewed and the juice is swallowed or the juice is mixed with a small amount of cow's or goat's milk and taken orally (Watt and Breyer-Brandwijk, 1962) No records No records South Africa Pedaliaceae Sesamum indicum L. Herb Leaves Details not provided (Watt and Breyer-Brandwijk, 1962) No records It promotes blood testosterone level (Ashamu et al., 2010) Kenya Phytolaccaceae Phytolacca dodecandra L’Herit Shrub Leaves Smearing on ripe banana and roast (Kamatenesi-Mugisha and Oryem-Origa, 2005) No records No records Uganda Piperaceae Piper consanguineum (= C. angustifolium Lam.) Climber Leaves Decoction of the leaves is taken orally (Cambie and Brewis, 1997) No records No records South Africa Piperaceae P. guianense (Klotzsch) C.DC. Climber Fruits The powdered fruit is taken orally with hot pap (Noumi et al., 1998); Afolayan and Yakubu (2009) No Toxicity (Hassan et al., 2010) It promotes the stimulation of the secretions of the testes, epididymis and seminal vesicles (Mbongue et al., 2005) Cameroon, Nigeria Piperaceae P. umbellatum L. Climber Roots The roots are boiled together with Aframomum roots and the liquid strained. A cupful of the preparation is drunk twice a day before food (Kokwaro, 1993) No records No records Kenya Pittosporaceae Pittosporum viridiflorum Sims Shrub Stem bark, roots Details not provided (Gelfland et al., 1985) No records No records South Africa Plumbaginaceae Plumbago zeylanica L. Climber Roots Roots are boiled in water and the decoction is drunk (Motlhanka and Nthoiwam, 2012) No records No records Botswana Polygalaceae Carpolobia alba G.Don Tree Stem bark The decoction of the stem bark is taken orally once daily (Afolayan and Yakubu, 2009) No toxicological effects on all parameters evaluated, including reproductive toxicity (Manfo et al., 2011) Boost male reproductive sexual function by increasing testosterone (Nwidu et al., 2015) Nigeria Polygalaceae C. lutea G.Don Shrub Roots Infusion of the root in water is taken orally (Ajibesin et al., 2012) Acute toxicity studies indicate the median lethal doses of the root > stem > leaves (Nwidu et al., 2015) Restored male sexual behaviour parameters, that is, frequencies of mounting, intromission and ejaculation (Nwidu et al., 2015) Nigeria Polygalaceae Polygala aphrodisiaca Gürke Herb Roots Root is cooked with a young cock and taken orally (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Polygalaceae P. sphenoptera Fresen. Herb Roots Root infusion taken orally (Kokwaro, 1993, Watt and Breyer-Brandwijk, 1962) No records No records Kenya, Tanzania Polygalaceae Securidaca longipedunculata Fresen. Tree Roots In Nigeria, the root bark is chopped into pieces and infused in 350 mL of water for 24 hours, and taken orally. Zimbabweans chew small piece of root and the infusions, decoctions or macerations of the root is taken orally in other countries (Watt and Breyer-Brandwijk, 1962, Afolayan and Yakubu, 2009, Van Wyk and Gericke, 2000; Motlhanka and Nthoiwa, 2012; Van Andel et al., 2012a) Acute toxicity (Mongalo et al., 2015) No records Botswana, Nigeria, South Africa, Zimbabwe Polygonaceae Rumex abyssinicus Jacq. herbs Leaves and stem Leaves and stems are chewed (Ssegawa and Kasenene, 2007) No records No records Uganda Polygonacea R. usambarensis (Dammer) Dammer Herb Leaves Decoction of the leaves is taken orally (Ssegawa and Kasenene, 2007) No records No records Uganda Rosaceae Prunus persica (L.) Batsch var. persica Tree Roots The root is pounded and taken orally with soft porridge (Semenya and Potgieter, 2013) No records No records South Africa Rubiaceae Coffea arabica L. Shrub Seeds Seeds are roasted and chewed; the seeds are also taken orally as beverage (Kamatenesi-Mugisha and Oryem-Origa, 2005) Non-toxic (Do Carmo Carvalho et al., 2011) No records Uganda Rubiaceae C. canephora Pierre ex A.Froehner Tree Roots The roots are chewed, boiled, or cooked with food (Kokwaro, 1993) No records No records Kenya Rubiaceae Craterispermum schweinfurthii Hiern Shrub Roots Roots are chewed or extract from the root are drunk (Kokwaro, 1993) No records No records Kenya Rubiaceae Coddia rudis (E.Mey. ex Harv.) Verdc. Shrub Roots Pounded root decoctions are orally administered (Hulme, 1954) No records No records South Africa Rubiaceae Diodia scandens Sw. Herb Whole plant Water extract of the plant is taken orally (Onuaguluchi and Nwafor, 1999) No records No records Nigeria Rubiaceae Fadogia agrestis Schweinf. Ex. Heirn Shrub Stems The stem may be boiled, powdered, or mixed with spices or eaten with meat or infused with spices to make a drink. An infusion of the stem in water for 2 days may also be taken orally half an hour before sexual intercourse (Afolayan and Yakubu, 2009 No mortality was recorded (Yakubu et al., 2007) The ejaculatory latency was prolonged and there was also a significant increase in serum testosterone concentrations (Yakubu et al., 2005) Nigeria Rubiaceae Fleroya robrostipulata (K.Schum.) Y.f.Deng (= Hallea rubrostipulata(K.Schum.) J.-F. Leroy) Tree Stem bark, root Decoction of bark and root is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) Aqueous extract showed that the extract was safe up to 2000 mg/kg (Ajayi et al., 2012) No records Uganda Rubiaceae Massularia acuminata (G. Don) Bullock ex Hoyl. Shrub Stems The decoction or infusion of the stem is orally administered (Gills, 1992) The saponins caused only functional dysfunction of the organs but not structural and thus not completely ‘safe’ as an oral remedy (Yakubu et al., 2012) The ejaculation latency was significantly prolonged (Yakubu and Akanji, 2011) Nigeria Rubiaceae Morinda lucida Benth. Tree Roots, stems Details not provided (Van Andel et al., 2012a) Relatively safe and non- toxic (Ashafa and Olunu, 2011) No records Ghana Rubiaceae Pausinystalia johimbe (K.Schum.) Pierre ex Beille Tree Stem bark A decoction from the stem bark is given in the dose of one wineglassful thrice a day (Afolayan and Yakubu, 2009) May have some deleterious effects on the kidneys of at varied doses (Yakubu et al., 2003) No records Nigeria Rubiaceae Psychotria capensis subsp. riparia (K.Schum. & K.Krause) Verdc. Shrub Roots Crushed roots are soaked or boiled in water and the infusion or decoction is drunk before bedtime (Kokwaro (1993) No records No records Ethiopia, Kenya Rubiaceae P. cyathicalyx E.M.A.Petit Shrub Roots Decoction of the root is drunk three times a day (Kokwaro, 1993) No records No records Kenya Rubiaceae P. lauracea (K. Schum.) E.M.A.Petit Shrub Roots Decoction of the roots is orally administered (Kokwaro, 1993) No records No records Kenya Rubiaceae Rubia cordifolia L. subsp. conotricha (Gand.) Verdc. Climber Roots Decoction of the root is taken at bedtime (Bryant, 1966) No lethality or toxic reaction (Rajalakshmi et al., 2009) No records South Africa Rubiaceae Coptosperma graveolens (S.Moore) Degreef (= Tarenna graveolens (S.Moore) Degreef Shrub Stems bark, leaves, roots Decoction of the bark, leaves and roots is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) None toxic (Oloro et al., 2015) Improved testosterone levels (Oloro et al., 2016) Uganda Rubiaceae Vangueria infausta Burch. Tree Roots Macerated roots are used as an aphrodisiac (Arnold and Gulumian (1984), Mabogo (1990) Lowest toxicity (Aro et al., 2015) No records South Africa Rutaceae Citropsis articulata (Willd. Spreng.) Swingle & Kellerm. Shrub Stem bark, roots The root and bark chewed and swallowed or taken orally as beverage in tea (Ssegawa and Kasenene, 2007) Slightly toxic (Oloro et al., 2014) Increased level of serum testosterone (Vudriko et al., 2014) Uganda Rutaceae Melicope belahe (Baill.) T.G. Hartley Tree Leaves, stem bark Infusion of leaves and stem bark n alcohol and taken orally (Schmelzer and Gurib-Fakim, 2008 No records No records Madagascar Rutaceae M. madagascariensis (Baker) T.G.Hartley Tree Stem bark Stem bark infused in domestic rum (Schmelzer and Gurib-Fakim, 2008) No records No records Madagascar Rutaceae M. sambiranensis (H. Perrier) T.G. Hartley Tree Leaves, stem bark Infusion of leaves and stem bark in alcohol (Schmelzer and Gurib-Fakim, 2008) No records No records Madagascar Rutaceae Zanthoxylum capense (Thunb.) Harv. Tree Roots Roots are mixed with roots of a Cyperus species (Hutchings et al., 1996) Non-toxic (Amabeoku and Kinyua, 2010) No records South Africa Rutaceae Z. davyi (Verdoorn) Waterm. Tree Roots Details not provided (Mabogo (1990) No records No records South Africa Rutaceae Z. humile (E.A.Bruce) Waterm. Tree Roots Pounded root is taken orally with warm water or soft porridge (Semenya and Potgieter, 2013) No records No records South Africa Santalaceae Osyris lanceolata Hochst. & Steud. Shrub Roots Decoction of the root boiled in water is taken orally (Semenya and Potgieter, 2013) No records No records South Africa Sapindaceae Lecaniodiscus cupanioides Planch. ex Benth. Shrub Roots Decoction of the root is orally administered (Nurudeen et al., 2015) No records No records Nigeria Sapindaceae Pappea capensis Eckl. & Zeyh. Tree Stem bark Decoction and infusion of the bark is taken orally (Watt and Breyer-Brandwijk, 1962, Mabogo, 1990) Non-toxic (Adinortey et al., 2012) No records South Africa Sapindaceae P. capensis Eckl. & Zey. var. radlkoferi Schinz Tree Stem bark Decoction of the bark is taken as aphrodisiac (Watt and Breyer-Brandwijk, 1962) No records No records Tanzania Sapindaceae Paullinia pinnata L. Climber Roots Infusion of the root in mixture of water and alcohol and taken orally (Van Andel et al., 2012b, Mariame et al., 2016) Non-toxic (Adinortey et al., 2012) No records Benin, Ghana, Guinea, Togo Sapotaceae Vitellariopsis marginata (N.E. Br.) Aubrév Tree Roots Decoctions of the root is taken orally (Hutchings et al., 1996) No records No records South Africa Solanaceae Capsicum frutescens L. Herb Fruits Chewing and taken orally in food (Kamatenesi-Mugisha and Oryem-Origa, 2005) Non-toxic (Chen et al., 2003) No records Uganda Solanaceae Withania somnifera (L.) Dunn Shrub Roots The decoction of the root is taken orally at a dose of one to two tablespoonful daily (Afolayan and Yakubu, 2009) Non-toxic (Sharada et al., 1993) Improved overall semen quality (Mahdi et al., 2011) Nigeria Sterculiaceae Cola acuminata (P.Beauv.) Schott & Endl. Tree Fruits Chewed, roasted and taken orally in tea and milk as beverage (Lebbie and Guries, 1995, Lim, 2012) Low level renal toxicity (Oloro et al., 2015) None of the extracts had significant effects on mounting frequency (Oloro et al., 2016) Sierra Leone, Uganda Thymelaceae Synaptolepis kirkii Oliv. Shrub Roots Powder from dry roots taken orally (Chhabra et al., 1993, Hutchings et al., 1996) No records No records South Africa Thyphaceae Thypha capensis (Rohrb.)N.E.Br. Herb Rhizome Decoction of the rhizome is taken orally (Moffett, 2010) Non-toxic (Ilfergane and Henkel, 2018) It stimulated testosterone production (Ilfergane and Henkel, 2018) South Africa Tiliaceae Triumfetta rhomboidea Jacq. Shrub Roots Details not provided (Watt and Breyer-Brandwijk, 1966) Non-toxic (Chen et al., 2003) No records South Africa Urticaceae Urtica massaica Mildbr. Climber Whole plants Decoctions of the whole plant is taken orally (Kamatenesi-Mugisha and Oryem-Origa, 2005) Non- toxic (Sharada et al., 1993) Improved overall semen quality (Mahdi et al., 2011) Uganda Verbenaceae Lippia adoensis Hochst. ex Walp. Herb Leaves Dry leaves are ground and macerated in cold water (Abebe et al., 2003) Low level renal toxicity (Oloro et al., 2015) None of the extracts had significant effects on mounting frequency (Oloro et al., 2016) Ethiopia Vitaceae Cissus populnea Guill. & Perr. Climber Stem bark Infusion of the stem bark in water or gin taken orally (Afolayan and Yakubu, 2009) No records No records Nigeria Zingebaraceae Aframomum citratum (Pereira) K.Schum. Herb Leaves, fruit Details not provided (Tane et al., 2005, Kuete et al., 2011) Non-toxic (Chen et al., 2003) No records Cameroon Zingiberaceae A. melegueta K.Schum. Herb Seeds Details not provided (Van Andel et al., 2012a) Non-toxic (Sharada et al., 1993) Improved overall semen quality (Mahdi et al., 2011) Ghana Zingiberaceae Zingiber officinale Roscoe Herb Rhizomes Rhizome is mixed with honey and taken orally. It can also be taken with tea, porridge and milk (Kamatenesi-Mugisha and Oryem-Origa, 2005) Low level renal toxicity (Oloro et al., 2015) None of the extracts had significant effects on mounting frequency (Oloro et al., 2016) Uganda Zygophyllaceae Tribulus terrestris L. Herb Whole plant The decoction of the whole plant is taken at a dose of three wineglassfuls a day (Afolayan and Yakubu, 2009) No toxicity (Singh et al., 2012 Improvement of sexual behaviour (Singh et al., 2012) Nigeria 3.1. Aphrodisiac medicinal plant in Sub-Saharan Africa Information from the reviewed articles revealed that 209 plant species belonging to 73 families are used in the treatment of sexual dysfunction in sub-Saharan Africa. The highest number of aphrodisiac plants was reported from South Africa (75) followed by Uganda (32), Nigeria (28), Kenya (23), Tanzania (19), and Zimbabwe (17). Other countries such as Benin, Botswana, Cameroon, Gabon, Ghana, Madagascar, Somalia, and Togo, have less than 10 aphrodisiac medicinal plants (Table 1; Fig. 1). It is not surprising that South Africa topped the list since it has the third highest level of biodiversity in the world after Brazil and Indonesia (Light et al., 2005). It is also possible that the highest number of ethnobotanical surveys and reviews have been carried out in South Africa, making the information more accessible. The majority of the recorded plants belong to the families Fabaceae (29), Rubiaceae (16), Euphorbiaceae (11), Apocynaceae (10), Asteraceae (9), and Rutaceae (7). Plant species belonging to the same families have also been reported to have aphrodisiac potential by Semenya and Potgieter (2013). Predominance of aphrodisiac medicinal plants in these families especially Fabaceae and Asteraceae might also be due to extensive range of their distribution across all biomes of the world. In addition, they are the third and first largest flowering plant families, respectively.Furthermore, members of these families are known to contain active metabolites which might also be the reason for their efficacy in the treatment of sexual dysfunction. For example, the Fabaceae is characterized by alkaloids, tannins, and phenolic compounds (Żarnowski et al., 2001), the Euphorbiaceae: alkaloids, terpenoids and phenolic compounds (Mwine and Van Damme, 2011), the Asteraceae: flavonoids, terpenoids, tannins, and saponins (Carvalho et al., 2013), the Rubiaceae: iridoids, anthraquinones, triterpenes, and indole alkaloids (Martins and Nunez, 2015), and Apocynaceae: alkaloids (Mohan et al., 2012).At generic level, the genera Cassia and Bersama (four spp.), are the most speciose genera traditionally used for aphrodisiac purposes, followed by Aloe, Elephantorrhiza, Hypoxis, Piper, and Vachellia (three spp.). Fig. 1 Download high-res image (102KB)Download full-size image Fig. 1. Number of aphrodisiac plants medicinal in different countries. 3.2. Plant habit, part used, and dosage form In terms of the habit of the plant species utilized in the traditional treatment of sexual dysfunction, trees (34%), are mostly used,followed by shrubs (27%), herbs (25%), and climbers (14%),(Table 1; Fig. 2). This result is contrary to the perception suggested by (Ahmad et al., 2009),thatplants withherbaceous life forms are the most commonly used in traditional medicine all over the globe due totheir wide distribution andeasy way of collection. The higher percentage of trees and shrubs used for the treatment of sexual dysfunction might be due to their accessibility throughout the year unlike herbs that may be seasonally available (Tariq et al., 2017). The frequently used plant parts in the preparation of herbal medicine for the treatment of sexual dysfunction in sub-Saharan Africa are roots (122), followed by leaves (40), stem bark (30), stem (12), fruit (12), and whole plant (7). Other parts including flowers, latex, rhizomes, corms, bulbs, seeds, and tubers are also used. This observation is similar to that of Semenya and Potgieter (2013), who reported roots as the most preferred parts for the herbal preparation used by the Bapedi traditional healers of South Africa in the treatment of ED.This might be due to the perception by the traditional healers that greater healing power is contained in the roots when compared to other parts. The efficacy of the root in the treatment of sexual dysfunction might also be due to the fact that it is the most metabolite rich part of the plants (Semenya and Potgieter, 2013; Adnan et al., 2014).It is also important to note that for species in the family Hyacinthaceae, only bulbs are used, in the Polygalaceae only roots (with the exception of Carpolobia alba G.Don) are utilized, while in the Melianthaceae stem bark (with the exception of Xylocarpus benadirensis Mattei.) is used. In the case of the preparation techniques for sexual dysfunction herbal medicine, decoction is the most used method of preparation (40%), followed by chewingand infusion (18%), and pounding (5%),unfortunately the details on the mode of preparation for19% of the plant listed were not provided (Table 1, Fig. 3). This implies that more ethnobotanical surveys should be carried out in order to fill the information gap on the indigenous knowledge regarding medicinal plants used in the treatment of sexual dysfunction in Africa. Decoction, which is the process by which plant material is boiled in hot water until the original volume is reduced to approximately one-fourth has been reported as the most preferred method of preparation of herbal medicine in many cultures (Grønhaug et al., 2008; Simbo, 2010; Daswani et al., 2011). Unlike a decoction, an infusion does not require plant material to be boiled in hot water and thus preserves the volatile and medicinal substances in the plant material than decoction where some of the volatile component might be lost during heating. In South Africa, pounding has been reported as one of the most commonly used methods in medicinal herb preparation, whereby pounded plant materials are taken with soft porridge or warm water (De Wet et al., 2012, Van Wyk et al., 1997).Sometimes, plant materials are infused in gin, rum, palm wine or milk, for example Melicope madagascariensis (Baker) T.G.Hartley is infused in rum, Elephantorrhiza cordatum E.Mey. in milk, while Alchornea floribunda Mull.Arg.is infused in palm wine. Furthermore, two or more plants can be combined together such as Alchornea cordifolia (Schum. & Thonn.) Müll. root that is mixed with the root of Tabernanthe iboga Baill. Fig. 2 Download high-res image (80KB)Download full-size image Fig. 2. Habits of the plant used in the treatment of ED in sub-Saharan Africa. Fig. 3 Download high-res image (123KB)Download full-size image Fig. 3. Mode of the preparation of the plants used in the treatment of ED in sub-Saharan Africa. 3.3. Ethnopharmacology and toxicology One of the shortcomings of herbal medicine is the lack of dosage instructions, so further drug discovery processes such as toxicology, clinical, and lab trials are inevitable to scientifically validate the folkloric usage, as well as to unravel the potential toxicity of the implicated plants (Rai et al., 2011). Out of the 209 species that are used traditionally for the treatment of sexual dysfunction, only 48 were validated scientifically in previous studies, while no information could be found for the remaining 161. This implies that more work still needs to be done on aphrodisiac medicinal plants regarding their ethnopharmacology.Literature indicates that most of the scientifically validated plants displayed their aphrodisiac activities by improving or enhancing sexual performance or androgenic activities through increased testosterone levels, index of libido, prolonged ejaculation latency, sperm motility, and viability erection, quick flips, long flips, penile reflexes, and relaxation of carvenosal penile smooth muscle in test animals. For example, some plants are reported to increase the levels of testosterone in rats in various studies, e.g., Spondias mombin L. (Owiredu et al., 2007) Gloriosa superba L. (Pare et al., 2014), Carpolobia alba G.Don (Nwidu et al., 2015) and Sphenocentrum jollyanum Pierre(Oloye et al., 2017). Other plants are reported to increase the index of libido, sperm motility quick flips, long flips, and total penile reflexes in rats, these include Nymphia lotus L. (Mireille et al., 2017), Lippia adoensis Hochst. ex Walp. (Oloro et al., 2016), Massularia acuminata (G. Don) Bullock ex Hoyl, Yakubu and Akanji, 2011; and Morella serrata (Lam.) Killick (Sabiu and Ashafa, 2017). Extracts from Eriosema kraussianum Meisn. are reported to improve the relaxation of carvenosal penile smooth muscle (Drewes et al., 2002). Surprisingly some plants used traditionally for the treatment of ED, were found not to show significant aphrodisiac activities which thus refute the efficacy of the plants scientifically, for example,Garcinia kola Heckel (Yakubu and Quadri, 2012) and Cola acuminata (P. Beauv.) Schott & Endl. (Oloro et al., 2016).The risk–benefit description of traditional medicine through toxicological investigation of its therapeutic dosage and adverse effects on living organisms is an important parameter to probe into during development of new herbal drugs (Ajao and Moteetee, 2017). Literature shows that the toxicology of only 77 out of 209 species used traditionally for the treatment of sexual dysfunction have been investigated in previous studies, 52 were found to be safe for consumption while the remaining 25 elicited some toxic effects.For example, Bulbine natalensis Baker and Callilepsis laureola DC. were found to be toxic to the liver in male rats (Popat et al., 2001; Yakubu and Afolayan, 2009). A study by Asuquo et al. (2012) showed that prolonged consumption of plants such as Cannabis sativa L. and Spondias mombin L. can result in renal and hepatic toxicity in Wistar rats. The results from toxicological investigation of medicinal plants used in the treatment of sexual dysfunction shows that the toxicological profile of herbal medicines need to be ascertained before being recommended to patients to preventadverse side effects. 4. Conclusion This review presents information on traditional usage, ethnopharmacology, and toxicity of medicinal plants used in the treatment of sexual dysfunction in sub-Saharan Africa. The families Fabaceae, Rubiaceae, Euphorbiaceae, Apocynaceae, Asteraceae, and Rutaceae contain the highest number of aphrodisiac medicinal plants.Also, the genera Cassia and Bersama have the highest number of species for the same purpose.The habit of the most of the aphrodisiac plants is trees, and roots are the most preferred plant parts used in the formulation. Decoction, chewing, and infusion are common methods used in the administration. However, information regarding the mode of administration of some of the plants was not provided which means that significant effort needs to be geared towards the compilation of indigenous knowledge through ethnobotanical surveys of the plants used in the treatment of sexual dysfunction in sub-Saharan Africa.The fact that roots are the most used parts presents a threat to the implicated plant species and can pose some conservation challenges. Out of the 206 plants listed in this review, only 75 have previously been evaluated for their toxicity and 47 for their aphrodisiac activities.This implies that more research needs to be done to validate the folkloric usage of the plants and the associated toxicity.Lastly, this review has identified a number of knowledge gaps regarding the aphrodisiac medicinal plants in sub-Saharan Africa, it is our belief that the data will pave way for future research on herbal drugs for the treatment of sexual dysfunction in the continent. 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