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
- 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.
- 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.
- McKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence. Altern Med Rev 2004; 9(1):4-16.
- Murphy LL, Lee TJ. Ginseng, sex behavior, and nitric oxide. Ann N Y Acad Sci 2002; 962:372-377.
- 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.
- 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.
- 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.
- 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.
- Gokce N. L-Arginine and hypertension. J Nutr 2004;134:2807S-2811S.
- Kabat A and Dhein S. L-Arginine supplementation prevents the development of endothelial dysfunction in hyperglycemia. Pharmacology 2005;76:185-91.
- Dennehy CE, Tsournounis, Miller AE. Evaluation of herbal dietary supplements marketed on internet for recreational use. Am Pharmacother 2005;39:1634-9.
- Product web site. www.arginmax.com . Accessed May 11, 2011.
- 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)
Last updated: December 19, 2011
arousal (uh-ROW-zul)
The state of being alert and ready to respond, or waking from sleep.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)asthma (AZ-muh)
A chronic disease in which the bronchial airways in the lungs become narrowed and swollen, making it difficult to breathe. Symptoms include wheezing, coughing, tightness in the chest, shortness of breath, and rapid breathing. An attack may be brought on by pet hair, dust, smoke, pollen, mold, exercise, cold air, or stress.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)baseline (BAYS-line)
An initial measurement that is taken at an early time point to represent a beginning condition, and is used for comparison over time to look for changes. For example, the size of a tumor will be measured before treatment (baseline) and then afterwards to see if the treatment had an effect.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)biological (BY-oh-LAH-jih-kul)
Pertaining to biology or to life and living things. In medicine, refers to a substance made from a living organism or its products. Biologicals may be used to prevent, diagnose, treat or relieve of symptoms of a disease. For example, antibodies, interleukins, and vaccines are biologicals. Biological also refers to parents and children who are related by blood.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)blood pressure (blud PREH-sher)
The force of circulating blood on the walls of the arteries. Blood pressure is taken using two measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Blood pressure is written with the systolic blood pressure first, followed by the diastolic blood pressure (for example 120/80).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)blood sugar (blud SHUH-ger)
Glucose (a type of sugar) found in the blood. Also called glycemia.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)chemotherapy (KEE-moh-THAYR-uh-pee)
Treatment with drugs that kill cancer cells.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)circulation (ser-kyoo-LAY-shun)
In the body, the flow of blood through the heart and blood vessels, and the flow of lymph through the lymph vessels.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)diabetes (dy-uh-BEE-teez)
Any of several diseases in which the kidneys make a large amount of urine. Diabetes usually refers to diabetes mellitus in which there is also a high level of glucose (a type of sugar) in the blood because the body does not make enough insulin or use it the way it should.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)dysfunction (dis-FUNK-shun)
A state of not functioning normally.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)erectile dysfunction (eh-REK-tile dis-FUNK-shun)
An inability to have an erection of the penis adequate for sexual intercourse. Also called impotence.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)ginkgo (GING-koh)
A tree native to China. Substances taken from the leaves and seeds have been used in some cultures to treat certain medical problems. Ginkgo has been studied in the prevention and treatment of Alzheimer disease, dementia, certain blood vessel diseases, and memory loss. It may cause bleeding or high blood pressure when used with certain drugs. Also called ginkgo biloba and maidenhair tree.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)ginseng (JIN-seng)
An herb with a root that has been used in some cultures to treat certain medical problems. It may have anticancer effects.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)herbal (ER-bul)
Having to do with plants.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)hormone (HOR-mone)
One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)L-arginine (… AR-jih-neen)
One of the twenty common amino acids (building blocks of proteins). L-arginine is being studied as a nutritional supplement in the treatment and prevention of cancer and other conditions. Also called arginine.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)menopause (MEH-nuh-pawz)
The time of life when a woman’s ovaries stop producing hormones and menstrual periods stop. Natural menopause usually occurs around age 50. A woman is said to be in menopause when she hasn’t had a period for 12 months in a row. Symptoms of menopause include hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)orgasm (OR-ga-zum)
The final part of the sex act, which involves contraction of sexual organs and a sudden release of endorphins, leading to a feeling of pleasure. In males, orgasm usually occurs with release of semen.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)oxide (OK-side)
A type of chemical substance that is a combination of oxygen and another substance. Oxides are found in essential oils.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)perimenopausal (PAYR-ee-MEH-nuh-PAW-zul)
Describes the time in a woman’s life when menstrual periods become irregular as she approaches menopause. This is usually three to five years before menopause and is often marked by many of the symptoms of menopause, including hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)physical examination (FIH-zih-kul eg-ZA-mih-NAY-shun)
An exam of the body to check for general signs of disease.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)physician (fih-ZIH-shun)
Medical doctor.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)placebo (pluh-SEE-boh)
An inactive substance or treatment that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)postmenopausal (post-MEH-nuh-PAW-zul)
Having to do with the time after menopause. Menopause (“change of life”) is the time in a woman's life when menstrual periods stop permanently.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)premenopausal (pree-MEH-nuh-PAW-zul)
Having to do with the time before menopause. Menopause ("change of life") is the time of life when a woman's menstrual periods stop permanently.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)prescription (prih-SKRIP-shun)
A doctor's order for medicine or another intervention.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)psychological (SY-koh-LAH-jih-kul)
Having to do with how the mind works and how thoughts and feelings affect behavior.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)radiation (RAY-dee-AY-shun)
Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)randomized
Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments.
(http://www.cancer.gov/dictionary)sensitivity (SEN-sih-TIH-vih-tee)
When referring to a medical test, sensitivity refers to the percentage of people who test positive for a specific disease among a group of people who have the disease. No test has 100% sensitivity because some people who have the disease will test negative for it (false negatives).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)significant (sig-NIH-fih-kunt)
In statistics, describes a mathematical measure of difference between groups. The difference is said to be significant if it is greater than what might be expected to happen by chance alone. Also called statistically significant.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)stress (stres)
The response of the body to physical, mental, or emotional pressure. This may make a person feel frustrated, angry, or anxious, and may cause unhealthy chemical changes in the body. Untreated, long-term stress may lead to many types of mental and physical health problems.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)supplementation (SUH-pleh-men-TAY-shun)
Adding nutrients to the diet.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)surgery (SER-juh-ree)
A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)therapy (THAYR-uh-pee)
Treatment.
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)vaginal (VA-jih-nul)
Having to do with the vagina (the birth canal).
Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)
