Sildenafil adulteration in herbal aphrodisiacs: a hidden toxicological threat with implications for Sub-Saharan Africa and global health

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Résumé

Herbal aphrodisiacs are widely used across cultures as natural remedies to enhance male sexual performance and fertility. However, the growing adulteration of these products with undeclared pharmaceuticals particularly sildenafil poses serious health threats. This review synthesizes current evidence on the chemical adulteration of herbal aphrodisiacs with sildenafil, emphasizing its toxicological consequences, mechanisms of action, detection strategies, and regulatory gaps. Chronic exposure to such products has been linked to hepatotoxicity, nephrotoxicity, reproductive dysfunction, and oxidative stress. Mechanistically, sildenafil interacts with cytochrome P450 enzymes, disrupts hormonal regulation, and exacerbates endothelial dysfunction. Analytical methods such as HPLC, LC-MS/MS, and portable spectroscopic devices offer detection potential, but access remains limited in low-resource settings. Regulatory oversight is fragmented, particularly in informal markets and online sales platforms. To mitigate risks, this review highlights the urgent need for interdisciplinary interventions encompassing analytical control, policy reform, public awareness, and further research. Addressing this emerging threat requires bridging traditional medicine with modern pharmacovigilance and consumer safety frameworks.

Mots-clés

Sildenafil, herbal aphrodisiacs, adulteration, toxicity, oxidative stress, PDE-5 inhibitors, public health, detection methods