Yohimbine, an alkaloid derived from the bark of the Pausinystalia yohimbe tree, has a history of use as an aphrodisiac in traditional West African medicine. Its modern use in supporting the male reproductive system, particularly for the treatment of erectile dysfunction (ED), is supported by several clinical studies. Yohimbine acts primarily as an alpha-2 adrenergic receptor antagonist, which increases sympathetic nervous system activity and promotes the release of norepinephrine, resulting in enhanced blood flow to the penile tissues.

Multiple randomized controlled trials from the 1980s and 1990s have shown that yohimbine can produce modest improvements in erectile function compared to placebo, particularly in cases of psychogenic ED. The American Urological Association Guidelines (1996) mentioned yohimbine as a potential therapy for ED before the advent of phosphodiesterase-5 inhibitors (like sildenafil). However, more recent meta-analyses note that while there is some efficacy, the effect size is relatively small, and safety concerns, such as increased blood pressure, anxiety, and cardiac arrhythmias, limit its widespread use.

Overall, yohimbine’s use for male reproductive support, specifically for ED, has both traditional and scientific roots. Its evidence base is moderate (rated 3/5), as it is less effective and less safe than modern medications but is still recognized for having a real, if limited, pharmacological effect.