Male Enhancement Supplements: Are you willing to risk your career? Or your life?

Male enhancement products are everywhere; on the radio, in the newspaper, and online. Dietary supplements marketed as “a male enhancement” pose a risk to your health and eligibility if you are an athlete. A web search for “male enhancement products” will yield hundreds of hits including many products containing unlisted, and potentially life threatening, ingredients.

Multiple recalls of male enhancement products, often for containing undeclared drugs or ingredients, have occurred in 2010. Recent recalls include a large group of products from Novacare LLC (Stiff Nights, Size Matters, Erex, Mojo, etc.). These products were found to contain an analogue of Sildenafil, an approved FDA drug, that was not listed on the product labels. This could be dangerous as the drug interacts with certain prescription drugs used to treat diabetes, high blood pressure, high cholesterol, and heart disease. A few days prior to this recall, Revivexxx Extra Strength was recalled for containing the undeclared drug Tadalafil, another FDA approved drug that can interact with prescription medications.

There are countless more male enhancement products that have been recalled over the last 2 years, most for containing undeclared drugs. (To find the FDA releases on these products, visit the REC Facebook page. "Like" the page to stay updated on new supplement recalls.) The FDA has issued many warnings to consumers regarding all male enhancement products because of the high probability that they contain unlisted or dangerous ingredients.

Male enhancement products have often been blamed for positive drug tests. Recently, a USATF Olympic hurdler noted he had taken ExtenZe prior to his drug test. ExtenZe lists DHEA (Dehydroepiandrosterone); DHEA is an anabolic agent that is commonly found in testosterone boosting products. The NCAA also recently sent out a memo specifically warning member institutions of the possibility of positive tests related to the use male enhancement products and asking that this info be passed on to student-athletes.

The REC encourages athletes to be careful when taking male enhancement dietary supplements. Many of these products pose health concerns and claim to increase your testosterone levels. In the NCAA, high testosterone levels can cause a positive drug test. The REC recommends that you do not use these products, as the risk is not worth the perceived reward.

Be aware, when considering dietary supplements: If someone can gain from your decision, check it out thoroughly before you use. Research the product you are considering and look for any peer-reviewed research that proves it can have the results it says it can. Remember, the product manufacturer is trying to market and sell their product and will use images and words that prey on your insecurities to do so.

WebMD suggests opening up to your doctor about any persistent concerns. Not only are most non-medication methods for male enhancement untested, but some are downright dangerous. Also, some problems are early warning signs of serious health problems; share your concerns with your doctor. They may be able to prescribe something that can really help or give you perspective on what “normal” is.

BE EXTRA CAUTIOUS WHEN CONSIDERING MALE ENHANCEMENT PRODUCTS. The REC recommends that you steer clear of all dietary supplements, but be especially careful of those categories that are recalled often or have been known to contain banned ingredients.

Recent recalls:
FDA MedWatch Reference Available
FDA MedWatch Reference Available
FDA MedWatch Reference Available
FDA MedWatch Reference Available
FDA MedWatch Reference Available
FDA MedWatch Reference Available
FDA MedWatch Reference Available
FDA MedWatch Reference Available

The FDA advises consumers who have experienced any negative side effects from sexual enhancement products to consult a health care professional and to safely discard the product. Consumers and health care professionals should report adverse events to the FDA's MedWatch program at 800-FDA-1088 or online. You can also contact the REC and we will submit your adverse reaction.

Check out the special PDF document on male enhancement supplements released by the FDA: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm048386.htm

Remember To Hydrate and Refuel as Fall Sports Report

Fall sports are starting up, bringing thousands of collegiate athletes back to campus for early morning workouts and hot two-a-days. With temperatures in the 90’s, even in the early morning, there is a serious risk for heat cramps, heat exhaustion, and heat stroke. Even in a gymnasium, high temperatures can still affect athletes. Staying hydrated is essential to combat these serious dangers, as well as aid in performance. Dehydration has other negative effects on health and performance such as: increased heart rate, impaired ability to regulate body temperature, fatigue, increased perceived effort, and decrease in attention.

Many student-athletes arrive at the field or gym already dehydrated. Student-athletes may be dehydrated for many reasons, including: stomach fullness they associate with drinking too much, accessibility to beverages, drinking sugary beverages, taste preferences, and many more. Mistakenly, many believe they only need to drink when thirsty, however this amount of fluid intake is not sufficient to meet most student-athlete needs, especially during physical activity.

Student-athletes should be aware that alcohol acts as a diuretic and even consumption after workouts can have a negative effect on hydration levels. They should avoid drinking alcohol as this contributes to dehydration. Caffeine acts as a stimulant and can be especially dangerous if consumed in high temperatures close to or during exercise. Both of these liquids should be avoided, especially when excessive heat is a factor.

Weight loss supplements also typically contain one or more stimulants. Stimulants often speed metabolism, heart rate, and blood pressure; the increased activity in the body produces extra heat (especially in hot and humid conditions). Under these conditions the blood vessels in the skin constrict, preventing the body from cooling itself efficiently. These products should be avoided as well.

How does a student-athlete know if they are hydrated or not? Urine color is a good indicator of hydration level. A light yellow color is an indicator of proper fluid levels; a dark color is a sign of dehydration.

What can athletic trainers, coaches, and other athletic staff do to make sure student-athletes are hydrated? First of all, the staff needs to be committed to keeping student-athletes hydrated. This means encouraging frequent water breaks, having water and sports drinks readily available on the sidelines, and educating student-athletes about proper hydration.

In her book, Sport Nutrition for Coaches, Lesli Bonci suggests the following rules to keep your athletes hydrated:

Rule 1: Players must drink 20 ounces of fluid, one hour before practice or games, so that fluid has time to be absorbed into the body and the student-athlete doesn’t feel full or bloated once practice begins.

Rule 2: Players must drink 14-40 ounces of fluid (depending on sweat rate) per hour of exercise. Be sure athletes are drinking the fluids and not pouring them on their heads or swishing and spitting them out.

Rule 3: After exercise, players must drink 24 ounces of fluid for every pound of weight lost during exercise. To find out this number, have student-athletes weigh themselves before and after practices for a few days to find out approximately how much weight they lose in sweat during exercise.

Rule 4: Have athletes figure out their sweat rate so they know how much to drink per hour during exercise and have them bring a water bottle. To figure out hourly sweat rate, take weight before exercise-weight after exercise+fluid intake during exercise and divide it by number of hours spent exercising. This will give the hourly sweat rate and the amount of fluid the student-athlete should intake per hour of activity.

Share information on hydration with your student-athletes, warn them of the dangers of exercising dehydrated, and make a commitment as a team to watch for any signs of heat exhaustion before it turns into heat stroke. Most importantly, always encourage student-athletes to drink during practices and games.

Many times, heat workouts cause student-athletes to be less hungry. It is equally important for student-athletes to refuel with food following workouts as well as eating before workouts. The increase in workout frequency and intensity will require that athletes eat plenty as they are burning more calories. If athletes do not eat enough, they will end up feeling fatigued. Remind your athletes that proper nutrition and hydration have an effect on energy levels and performance.

Also, as student-athletes begin reporting for fall sports, remind them to check all supplements with the REC.


Source: Leslie Bonci, MPH, RD, CSSD. "Sport Nutrition for Coaches." 2009.