L-arginine is an amino acid which gets converted in the body into a chemical called nitric oxide.

Nitric oxide causes blood vessels to open wider for improved blood flow and is essential for achieving an erection. It is therefore believed to have the potential to treat ED and is among the most popular ingredients in male sexual enhancement supplements.

Doses reported for oral administration to improve male sexual function are significantly higher than that supplied by consuming 4 pills of this product. However, there is some early evidence that taking low doses of L-arginine, with other proven ingredients, might improve its effectiveness.

L-arginine is possibly safe for most people for short-term oral administration. It can cause some side effects such as abdominal pain, bloating, diarrhea, gout, allergies, worsening of asthma, and low blood pressure. Caution should be exercised while using arginine containing supplements along with anti-hypertensive medication, nitrates and sildenafil (Viagra).

L-lysine is present at a very high dose of 250 mg per serving of Semenax. Although several nutritional supplement manufacturers claim that lack of lysine causes impotence and supplementing with lysin increases penis volume, no credible research could be found that supports any role for lysine in sperm/semen production or maintenance of erectile function.

L-lysine when taken in combination with vitamin C may help reduce levels of lipoprotein-a (LPA). LPAs carry cholesterol in the blood and contribute to the build-up of plaques that can clog arteries, including the arteries supplying blood to the penis and may thus be contribute to ED. L-lysine is generally considered safe for oral consumption.

T. catigua is a species known as catuaba and used in folk medicine for the treatment of fatigue, stress, impotence and memory deficit.

European herbalists have found that Catuaba may have aphrodisiac properties and can be used to combat sexual weakness. Flavonoids, tannins, alkaloids, saponins, among other phytochemical classes have been identified in the bark extracts of T. catigua.

Enhanced male sexual health has been attributed to a herbal mix containing T. catigua in animal studies. Catuaba use has been known to trigger side effects in some, including headaches, dizziness, and excessive sweating. No information on interactions with other drugs or transdermal dosing could be found.

Epimedium sagittatum leaf extract is present at 150 mg per serving of Semenax. Epimedium or horny goat weed, is an herb used in traditional Chinese medicine to treat fatigue, joint pain, and erectile dysfunction. The herb contains the active moiety icariin.

Lab studies have shown that icariin blocks the effects of the PDE5 enzyme that restricts blood flow to the penis. This activity is similar to that of other clinically used drugs for ED.

In addition to an erectogenic role, it has been suggested that icariin has testosterone-mimetic properties. These effects lend credence to the use of horny goat weed for the management of sexual problems. Early research suggests that it may have properties that can keep bones strong, protect the nerves, and support the immune system.

At this time, there is not enough scientific information to determine an appropriate range of doses for horny goat weed. Products containing this herb should be used with caution if the user is taking anti-hypertensive or anti-coagulant medication.

Safety of the horny goat weed extract has been demonstrated following oral consumption up to a six-month period. Long-term use of horny goat weed might cause dizziness, vomiting, dry mouth, thirst, and nosebleed.

Muira puama (Ptychopetalum olacoides) bark is present at 100 mg per serving in Semenax. Although used in Asia, this ‘potency wood’ is actually the best known Amazonian folk medicine which increases libido and penile hardness. It acts as a nerve stimulant to heighten receptiveness to sexual stimuli as well as physical sensation of sex.

Rich in sterols e.g., sitosterol, campesterol and lupol it activates the body’s receptors for hormones like testosterone to heighten libido and enhance performance. Also present are volatile oils like champor which helps restore sex drive and inner depth of libido and mental ability to be aroused.

Clinical studies have shown muira puama to be effective in improving libido and treating ED. Muira puama extracts have also been reported to have adaptogenic, anti-fatigue, anti-stress, and have beneficial effects on the central nervous system.

Traditionally the roots and stem of this plant have been used to treat neuromuscular disorders, such as paralysis, too. No scientific information on side-effects, interactions or dosing is available for this herb.

Crataegus laevigata or hawthorn berries are present at 50 mg per serving of Semenax. Hawthorn berries, leaves and flowers are used primarily as a tonic to the heart, blood vessels and circulatory system to promote and protect their overall health and to improve or reverse degenerative changes in the heart, blood vessels and circulatory system as we age.

The chief heart and circulatory conditions where Hawthorn can be useful include angina, congestive heart failure, poor heart performance and output, coronary heart disease, high blood pressure, high serum cholesterol and triglycerides, and atherosclerosis or hardening of the arteries.

In addition, Hawthorn is a hepatoprotective herb that improves bile flow and metabolism, and hence lipid and cholesterol metabolism by the liver. As a mild sedative, Hawthorn is of value in the treatment of nervousness and anxiety, as well as mild cases of insomnia.

Hawthorn berries also stimulate the bile and the gastric secretions, thereby having a digestive effect that helps to digest and remove accumulations of stagnant food in the digestive tract, especially high fat and/or high protein foods.

Cranberry seed extract is present at 50 mg per serving. Cranberries have proven efficacy in the prevention and treatment of lower urinary tract infections in men.

The abundance of phenolic compounds in this fruit makes it useful as an antioxidant. Some in vitro studies show that cranberries may have a penile relaxant effect. Although the mechanism of action is not clear this could represent an alternate treatment for ED.

Some forms of ED arise due to accumulation of oxidative products in the erectile tissue and the antioxidant potential of cranberries might prove useful to such patients. Oral use of cranberry extract is generally considered safe.

Cranberries can also precipitate the formation of kidney stones and patients with a history of kidney stones should use products containing cranberries/cranberry extracts with caution. Cranberries might also interfere with the action of certain blood clotting medication.

Tribulus terrestris (vine) is present at 50 mg per serving of Semenax.

T. terrestris, commonly known as Gokshur or Gokharu or puncture vine, has been used for a long time in both the Indian and Chinese systems of medicine.

Its various parts contain a variety of chemical constituents which are medicinally important, such as flavonoids, flavonol glycosides, steroidal saponins, and alkaloids.

It has diuretic, aphrodisiac, immunomodulatory, antidiabetic, absorption enhancing, hypolipidemic, cardiotonic, central nervous system, hepatoprotective, anti-inflammatory, analgesic, antispasmodic, anticancer, antibacterial, anthelmintic, larvicidal, and anticariogenic activities.

T. terrestris has been used for hundreds of years in traditional systems of medicine to treat impotence, venereal diseases, and sexual debility. Its steroidal saponins make it a potent stimulator of testosterone production.

It has been shown to be a sexual enhancer in the management of sexual dysfunction in males. Early research also shows that taking tribulus can improve sexual satisfaction in men with erectile dysfunction.

Side effects are usually mild and uncommon but might include stomach pain, cramping, diarrhea, nausea, vomiting, constipation, excitation, difficulty sleeping. Products containing this herb should be used with caution by patients taking diabetes medication as it is known to reduce blood sugar levels.

Avena sativa extract is present in Semenax at 50 mg per serving. Oat straw extract comes from the stems and leaves of the unripened plant and is high in iron, manganese, and zinc.

Oat straw is widely marketed for enhancing male sexual function. It has been claimed that oat straw works by increasing the amount of free testosterone in the blood.

All that said however, no concrete research was found to substantiate this claim. Its inclusion in this formula might stem from its antioxidant potential. Oral consumption of this extract at the dose present in Semenax should have no side effects.

Sarsaparilla root (Smilax officinalis) is present at a dose of 50 mg per serving of Semenax. The Chinese refer to this herb as ‘khao yen’ and believe strongly in its abilities to act as an aphrodisiac and a sexual stimulant.

It is reported to have a testosterone-like anabolic effect. There are warnings in the literature of gastric irritation and temporary kidney impairment and potential drug interactions with hypnotics, digitalis glycosides, and bismuth.

There are many studies substantiating the anti-inflammatory and antimicrobial properties of this herb, but not many supporting its use to cure impotence and improve sex drive.

Swedish flower pollen is present at a dose of 50 mg per serving of Semenax. Swedish flower pollen promotes healthy urine flow and helps maintain normal prostate cell function.

No literature was found to support its role in semen production or treatment of ED. There is not a large body of evidence to determine safety and adverse reaction profile for swedish flower pollen.

Pumpkin seed is present at 30 mg per serving of Semenax. Men can benefit from the zinc found in pumpkin seeds. Reduced sperm quality and even infertility in men may be associated with low zinc levels. Some reports also suggest that pumpkin seeds might help with lower urinary tract symptoms and prostate hyperplasia.

Doses used in these studies was several fold higher than that found in Semenax. Certain pumpkin seeds (fluted pumpkin seeds) also lead to androgen insufficiency and might have an antispermatogenic activity. The nature of pumpkin seeds used in Semenax is unclear from the label.

Vitamin E (as dl-tocopherol acetate) is present at a dose of 60 IU (international units) per serving of Semenax. Vitamin E treatment has been shown to address symptoms of age-associated symptoms of ED in animal studies.

Vitamin E also supports the biochemical pathways leading to NO release which is important for improving ED symptoms. Vitamin E supplementation should be limited to less than 400 IU per day because of potential adverse long-term health effects of higher doses.

Both vitamin E and zinc have proven anti-oxidant activity which could be an added advantage apart from their role in the maintenance of erectile function. However, there is no study which establishes a direct positive correlation between zinc and vitamin E and increased semen production.

Zinc aspartate (20% elemental zinc) 30 mg is present per serving. Zinc (Zn) is the second most abundant trace element in humans and plays a vital role in a number of physiological processes especially in male fertility.

Studies have established a clear relationship between zinc and testosterone levels. Zinc deficiency can lead to a decrease in testosterone levels and reduced sexual performance. Rodent diet supplemented with 5 mg per day zinc has been shown to greatly improve sexual function.

Zinc deficiency can impede spermatogenesis and is a reason for sperm abnormalities and has a negative effect on serum testosterone concentration.

Inclusion of zinc in this product can have multi-fold benefits for the user such as improved sperm quality, address symptoms of erectile dysfunction (ED), and impart antioxidant activity.

Upto 40 mg zinc taken daily by mouth is completely safe. So the recommended Semenax dose should not be responsible for any side effects. There are no drug interactions described for zinc in the literature.

Butea superba is commonly found in Thai deciduous forests and has the domestic name of “Red Kwao Krua”. Every four capsule serving delivers 500 mg of the B. superba root extract.

The plant tubers have long been consumed as a traditional medicine for the promotion of male sexual vigor. Animal studies showed that a 6-month treatment with B. superba extract resulted in significantly increased sperm concentration and prolonged sperm motility in vitro.

Treated animals also showed no sperm anomalies and testicular damage. The testis weight and sperm count also increased in these animals.

The ethanol extract of B. superba is effective in enhancing penile erection. High doses of this root extract (150 and 200 mg/kg BW/day) can lead to serum testosterone depletion and have serious adverse effects on male sexual function.

The 500 mg dose of B. superba in each serving of Semenax however, is very low compared to the toxic limit for this herb.

L-carnitine is present at a dose of 500 mg per 4 capsules of Semenax. This is an amino acid derived from lysine and methionine, is involved in fat metabolism and exerts a beneficial effect by decreasing free radical production and improving blood flow.

Serum L-carnitine levels are low in patients suffering from ED. The favourable cardiovascular effects of this amino acid have led to studies testing its ability to address symptoms of ED.

The results of these studies suggest that it could possibly be used to treat ED. L-carnitine administered at 2 grams/day was more efficacious than testosterone at treating sexual dysfunction, fatigue, and depressed mood associated with aging. Therefore the recommended dose of L-carnitine for treatment of symptoms of ED is 2 grams per day.

Although, this dose is much higher than the Semenax dose, the ability of L-carnitine to improve blood flow could be beneficial for relieving symptoms of ED. Treatment with carnitine is known to enhance the efficacy of the popular ED drug, sildenafil, in restoring sexual potency following prostate surgery. Oral use of L-carnitine is considered generally safe.

There is a concern that propionyl-L-carnitine might make hypothyroidism worse and increase the incidence of seizures.

Caution should be exercised therefore by users with these symptoms. L-carnitine might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. It may also increase the efficacy of a drug, Sintrom, used to delay clotting and products containing L-carnitine should be used with caution by patients taking Sintrom.

Maca root (400 mg) is present per serving of Semenax. Maca (Lepidium meyenii) is an Andean plant that belongs to the brassica (mustard) family. Maca has been used for centuries in the Andes to enhance fertility and sexual performance in humans and animals.

Traditionally, the herb is also known as an adaptogenic plant, ie, a plant that modulates the body’s response by supporting it in dealing with physiological, biochemical, and psychological stressors.

Maca research shows benefit in the production of sex hormones, enhanced sex drive, stimulation of body metabolism, control of body weight, and increased energy, stress reduction, antidepressant activity, and memory improvement.

Administration of a purified lipid extract from the plant enhanced sexual function in mice and rats as evidenced by an increase in their sexual behaviour. Oral administration of this same extract in in castrated rats showed a decrease in the latent period of erection.

In another study, a hexane maca extract was found to improve sexual performance in rats. Animal experiments suggest that Maca has spermatogenic and fertility-enhancing activities, which are likely due to the phytosterols or phytoestrogens present in the maca. Recent clinical trials have also suggested significant effects of maca for increasing sperm count and mobility and improving sexual function in humans.

Several in vivo studies have shown that maca may improve sexual behaviour and enhance androgen-like effects in rats. The potential bioactive ingredients in maca include macaridine, macamides, macaene, gluosinolates, maca alkaloid, and maca nutrients.

Doses up to 3 grams daily (much higher than the daily Semenax dose) seem to be safe when taken for up to 4 months. Currently there is not much information on adverse drug reactions of Maca and no specific dose is described in the literature.

Pine bark extract (300) and L-arginine HCl (250 mg) are also present in each serving of Semenax.

Clinical studies conducted in Europe and USA have confirmed that the proprietary, patented combination of Larginine aspartate and Pycnogenol ® French maritime pine bark extract can improve mild to moderate erectile dysfunction (ED) and increase quantity and quality of sperms.

It is not clear whether the pine bark extract used in Semenax is the same as the one used in clinical studies above. Moreover, the lowest dose used for this combination that still demonstrates a positive effect on sperm function and erectile function is 690 mg and 60 mg for L-arginine and Pycnogenol, respectively.

The Semenax dose is lower than this reported beneficial dose. Pycnogenol is safe when taken by mouth in doses of 50 mg to 450 mg daily for up to one year.

This substance may aggravate autoimmune disorders and bleeding disorders and caution is advised for such patients. Caution should also be exercised when using products containing this pine bark with diabetes medication and anticoagulants.