Health Care Professional Information

Clinical Summary

ArginMax is a nutritional supplement comprised of Gingko biloba, Panax ginseng, American Ginseng, Damiana, L-Arginine, Vitamins A, C, E, B-complex, Zinc and Selenium. It is being promoted to help both female sexual dysfunction and erectile dysfunction in men. Sexual dysfunction may involve loss of sexual desire, difficulty in maintaining arousal, painful intercourse, or difficulty in achieving orgasm. It can result from factors such as stress, hormonal imbalances, cancer treatment involving surgery, radiation, chemotherapy or hormone therapy, use of antidepressants, or menopause.
ArginMax is thought to enhance blood circulation and muscle relaxation resulting in increased sexual satisfaction. It was shown in pilot studies to improve sexual function in women with sexual dysfunction (1) (13) and in men with erectile dysfunction (2).
This product contains ginseng that was shown to have estrogenic effects (6) although there are conflicting data from another study (7).
L-Arginine may worsen symptoms in people with allergen-induced asthma (8) and reduce blood pressure (9). It may also affect blood sugar levels (10) and should be used with caution in patients with diabetes. ArginMax has not been studied in cancer patients.

Purported Uses
  • Erectile dysfunction
  • Female sexual dysfunction
Constituents

ArginMax for Women

  • Asian Ginseng (Panax ginseng)
  • Gingko (Ginkgo biloba)
  • Damiana (Turnera diffusa)
  • L-Arginine
  • Vitamins A, C, E, and B-complex
  • Calcium
  • Iron
  • Zinc
  • Selenium

ArginMax for Men

  • Ginkgo (Ginkgo biloba)
  • Asian Ginseng (Panax ginseng)
  • American Ginseng (Panax quinquefolius)
  • L-Arginine
  • Vitamins A, C, E, and B-complex
  • Zinc
  • Selenium
    (12)
Mechanism of Action

The main ingredient in ArginMax is L-Arginine, an essential amino acid and a precursor to nitric oxide that may modulate vaginal blood supply and smooth muscle relaxation (3). Ginsenoides, compounds present in Ginseng, have been shown to increase nitric oxide production (4). Gingko is believed to facilitate microvascular circulation (5). Damiana has been promoted as an aphrodisiac (11) but scientific evidence is lacking.

Warnings

Sexual dysfunction could be a result of other complex underlying physical, biological, or psychological disorders. Patients should consult and be monitored by a physician when using this product.

Contraindications
  • Pregnancy
  • Nursing
  • Sensitivity to any of the constituents
  • Hormone sensitive cancer as ginseng has been shown to have estrogenic activity
  • Diabetes as L-Arginine may affect blood sugar levels (10)
  • Asthma as L-Arginine may worsen symptoms(8)
Herb-Drug Interactions
  • Anticoagulants: Ginkgo may have additive effects with blood thinning drugs while Ginseng can antagonize their effects.
  • Antihypertensive and Hypoglycemic drugs: L-arginine may have additive effects with antihypertensive (9) and hypoglycemic (10) drugs.
Literature Summary and Critique

Ito TY, Trant AS, Polan ML. A double-blind placebo-controlled study of ArginMax, a nutritional supplement for enhancement of female sexual function. J Sex Marital Ther 2001; 27(5):541-9.
Seventy-seven women (aged 24-71 years) with sexual dysfunction were randomly assigned to daily supplementation with Arginmax or placebo for four weeks. Physical examination, blood pressure and Female Sexual Function Index (FSFI) were used at baseline and at four weeks. Researchers observed an improvement in sexual desire in women in the ArginMax group. Large scale studies are needed to verify these results.

Ito TY, Polan ML, Whipple B, Trant AS. The enhancement of female sexual function with ArginMax, a nutritional supplement, among women differing in menopausal status. J Sex Marital Ther. 2006 Oct-Dec;32(5):369-78.
One hundred eight (108) women, ages 22-73 years, reporting lack of sexual desire, were randomized to receive ArginMax or placebo. The women self-reported as 59 premenopausal (PRE); 20 perimenopausal (PERI), and 29 postmenopausal (POST). After 4 weeks, PRE women on ArginMax reported significant improvement in level of sexual desire (72%; p = 0.03) and satisfaction with overall sex life (68%; p = 0.007), compared with placebo group, according to the Female Sexual Function Index (FSFI; Kaplan et al., 1999) scales. Frequency of sexual desire (60%; p = 0.05) and frequency of intercourse (56% p = 0.01) also increased among the PRE women. Among PERI women, primary improvements were reported for frequency of intercourse (86%; p = 0.002), satisfaction with sexual relationship (79%; p = 0.03), and vaginal dryness (64%; p = 0.03) compared with placebo group. POST women primarily showed an increase in level of sexual desire, with 51% showing improvement, compared with only 8% in the placebo group (p = 0.008).
Additional studies are needed to confirm these observations.

Dosage (Inside MSKCC Only)
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References
  1. Ito TY, Trant AS, Polan ML. A double-blind placebo-controlled study of ArginMax, a nutritional supplement for enhancement of female sexual function. J Sex Marital Ther 2001; 27(5):541-549.
  2. Ito T, Kawahara K, Das A, Strudwick W. The effects of ArginMax, a natural dietary supplement for enhancement of male sexual function. Hawaii Med J 1998; 57(12):741-744.
  3. McKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence. Altern Med Rev 2004; 9(1):4-16.
  4. Murphy LL, Lee TJ. Ginseng, sex behavior, and nitric oxide. Ann N Y Acad Sci 2002; 962:372-377.
  5. Boelsma E, Lamers RJ, Hendriks HF, van Nesselrooij JH, Roza L. Evidence of the regulatory effect of Ginkgo biloba extract on skin blood flow and study of its effects on urinary metabolites in healthy humans. Planta Med 2004; 70(11):1052-1057.
  6. Lee YJ, et al. Ginsenoside-Rb1 acts a weak phytoestrogen in MCF-7 human breast cancer cells. Arch Pharm Res 2003; 26(1):58-63.
  7. Polan ML, et al. Estrogen bioassay of ginseng extract and Arginmax, a nutritional supplement for the enhancement of female sexual function. J Womens Health 2004; 13(4):427-430.
  8. Takano, et al. Oral administration of L-Arginine potentiates allergen-induced airway inflammation and expression of interleukin-5 in mice. J Pharmacol Exp Ther 1997; 286(2):767-71.
  9. Gokce N. L-Arginine and hypertension. J Nutr 2004;134:2807S-2811S.
  10. Kabat A and Dhein S. L-Arginine supplementation prevents the development of endothelial dysfunction in hyperglycemia. Pharmacology 2005;76:185-91.
  11. Dennehy CE, Tsournounis, Miller AE. Evaluation of herbal dietary supplements marketed on internet for recreational use. Am Pharmacother 2005;39:1634-9.
  12. Product web site. www.arginmax.com . Accessed May 11, 2011.
  13. Ito TY, Polan ML, Whipple B, Trant AS. The enhancement of female sexual function with ArginMax, a nutritional supplement, among women differing in menopausal status. J Sex Marital Ther 2006;32(5):369-78.

Consumer Information

How It Works

Bottom Line: ArginMax was shown in small studies to improve sexual performance in both women and men.

ArginMax is a dietary supplement that contains Gingko biloba, Panax ginseng, American Ginseng, Damiana, L-Arginine, Vitamins A, C, E, B-complex, Zinc and Selenium. The manufacturers of ArginMax claim that it helps improve sexual performance in both men and women. Sexual dysfunction may involve loss of sexual desire, arousal, difficulty in maintaining arousal, painful intercourse, or difficulty in achieving orgasm. The factors responsible include stress, hormonal imbalance, use of antidepressants, menopause, and cancer treatments among others. The herbal components of ArginMax are thought to improve sexual satisfaction by increasing blood flow and by promoting muscle relaxation. Patients with hormone sensitive cancers should be careful as ginseng has estrogenic effects. The L-Arginine can make symptoms worse in people with asthma. It can also affect blood sugar therefore diabetics should be careful when using this product. Ginseng and ginkgo can cause interactions with other prescription drugs. ArginMax has not been studied in cancer patients.

Purported Uses
  • Female Sexual Dysfunction
    A small study showed that ArginMax improved sexual satisfaction in women with sexual dysfunction
  • Erectile Dysfunction
    ArginMax improved the overall sex life in men with erectile dysfunction
Research Evidence

Female Sexual Dysfunction:
In this study, 77 women (aged 24-71) with sexual dysfunction were given either ArginMax or placebo daily for four weeks. A Female Sexual Function Index (FSFI) was used to measure any changes. More women in the ArginMax group reported improvement in sexual desire compared to those on placebo.

One hundred and eight women, aged 22-73 years, reporting lack of sexual desire, received either ArginMax or placebo. The women self-reported as 59 premenopausal (PRE); 20 perimenopausal (PERI), and 29 postmenopausal (POST). After 4 weeks, PRE women on ArginMax reported significant improvement in level of sexual desire and satisfaction with overall sex life, compared with placebo group. Frequency of sexual desire and frequency of intercourse also increased among the PRE women. Among PERI women, primary improvements were reported for frequency of intercourse and satisfaction with sexual relationship, compared with placebo group. POST women primarily showed an increase in level of sexual desire.
Additional studies are needed to confirm these observations.
 

Patient Warnings

Sexual dysfunction could be a result of other complex underlying physical, biological, or psychological disorders. Patients should consult and be monitored by a physician when using this product.

Do Not Take If
  • You are pregnant
  • You are nursing
  • You have diabetes (L-arginine may affect the blood sugar level)
  • You have asthma (L-arginine may worsen the symptoms)
  • You have hormone sensitive cancer (ginseng has estrogenic effects)
  • You are taking prescription drugs (the herbal components of ArginMax may interact with the drugs)
E-mail your questions and comments to aboutherbs@mskcc.org.