The Burden of Male Infertility and the Role of Herbal Medicine

Infertility is a global health challenge affecting an estimated 8–12% of couples worldwide, with male factors contributing to nearly 30–40% of cases. In Nigeria, studies indicate that infertility rates may be as high as 20–45% in some regions, and more than three out of every ten Nigerian men report experiencing erectile dysfunction or other sexual problems.

The World Health Organization (WHO) reports that one in six people globally is affected by infertility, and in Nigeria, approximately 75–80% of both rural and urban populations rely on traditional medicine as their primary form of healthcare. This reliance is driven by several factors:

• Accessibility: Herbal medicines are often more readily available than conventional pharmaceuticals, especially in rural communities
• Affordability: Traditional remedies are generally less expensive than fertility treatments or prescription medications
• Cultural acceptance: Herbal medicine is deeply embedded in Nigerian cultural practices and belief systems
• Perceived safety: Many believe natural products have fewer side effects than synthetic drugs

The WHO encourages nations to exploit natural and indigenous resources as sources of pharmaceutical raw materials, and Nigeria’s rich biodiversity offers tremendous potential for developing evidence-based herbal treatments for male reproductive health.

Mechanisms of Action: How Herbal Medicines Enhance Male Fertility

A systematic review of 25 randomized controlled trials from Central and West African countries (80% conducted in Nigeria) identified three primary mechanisms through which medicinal plants enhance male fertility:

Mechanism	Description	Key Biomarkers Affected
Antioxidant activity	Reducing oxidative stress that damages sperm DNA and membranes	SOD (superoxide dismutase), CAT (catalase), GPx (glutathione peroxidase), reduced malondialdehyde (MDA)
Anti-inflammatory effects	Decreasing chronic inflammation that impairs testicular function	Inflammatory cytokines, nitric oxide modulation
Hormonal modulation	Regulating reproductive hormone levels	Testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH)

Treatment with these plant extracts has been associated with:

• Increased sperm count
• Improved sperm motility and viability
• Enhanced testicular histoarchitecture (improved structural integrity of the testes)

Indigenous Nigerian Herbs for Male Libido and Fertility

The following herbs are native to Nigeria and West Africa, with documented traditional use and emerging scientific evidence supporting their reproductive benefits.

1. Fadogia agrestis
2. Local names: Daddajo (Hausa), Bakin gida, Afang (various regions)
3. Plant part used: Roots (most common), stems
4. Traditional use: Aphrodisiac, treatment of erectile dysfunction, low libido, and low sperm count
5. Evidence status: Highest frequency of citation (18.18%) in Jos North ethnobotanical survey for male infertility

Fadogia agrestis is the most frequently cited plant for male infertility treatment in Plateau State, Nigeria . Traditional medicine practitioners recommend it for enhancing sexual desire, improving erectile function, and increasing sperm production. The roots are typically prepared as a decoction (boiled in water) or infusion.

Preparation method according to traditional practitioners: The roots are washed, cut into small pieces, boiled in water for 15-20 minutes, strained, and consumed as a tea. Some practitioners combine it with other herbs for synergistic effects.

• Khaya ivorensis (African Mahogany)
• Local names:  Oganwo (Yoruba), Ono (Igbo), Madaci (Hausa)
• Plant part used:  Stem bark, roots
• Traditional use:  Low sperm count, erectile dysfunction, general male vitality
• Evidence status  Second highest frequency of citation (9.09%) in Jos North survey

Khaya ivorensis is a large forest tree whose bark is highly valued in traditional medicine. It is typically prepared as a decoction and consumed orally. The plant contains limonoids and other bioactive compounds with potential antioxidant and anti-inflammatory properties .

• Cassia sieberiana (African Laburnum)
• Local names:  Gando (Hausa), Ewe agunfun (Yoruba)
• Plant part used:  Roots
• Traditional use : Common aphrodisiac in Northern Nigeria for enhancing sexual function and treating erectile dysfunction
• Evidence status:  Safety and toxicity evaluated in recent study 

Cassia sieberiana is widely used as an aphrodisiac in Northern Nigeria. A recent toxicity study evaluated the safety of this plant:

Key findings from toxicity study:

• LD50 > 5000 mg/kg – considered safe with a high margin of safety
• No significant alterations in liver function parameters, body weight, or organ weights at tested doses (100, 200, and 400 mg/kg)
• Treated rats showed a significant reduction in serum potassium ions at lower doses
• The extract demonstrated antioxidant properties and did not induce lipid peroxidation
• Conclusion: C. sieberiana ethanolic extract can be considered safe for oral use

The roots are typically prepared as a decoction or infusion, often combined with other herbs such as ginger or honey. Traditional practitioners recommend it for improving libido, erectile function, and overall sexual performance.

• Corchorus olitorius (Jute Mallow / Ewedu)
• Local names:  Ewedu (Yoruba), Rama (Hausa), Achingbara (Igbo)
• Plant part used:  Leaves, stems
• Traditional use:  Nutritional vegetable with anecdotal aphrodisiac claims
• Evidence status:  Scientific validation in 2025 study 

Beyond its well-known role as a nutritious soup vegetable (ewedu), Corchorus olitorius has been traditionally used as an aphrodisiac in some Nigerian communities. A 2025 study scientifically evaluated these claims.

Key findings from the 2025 aphrodisiac study:

Parameter	Effect at 500 mg/kg	Effect at 1000 mg/kg
Mount frequency	Significant increase	Significant increase
Intromission frequency	Significant increase	Significant increase
Ejaculation frequency	Significant increase	Significant increase
Ejaculation latency	Significant increase	Significant increase
Post-ejaculatory interval	Significant decrease	Significant decrease

Conclusion: Both leaf and stem extracts of Ewedu significantly enhanced sexual desire and copulation performance, with effects comparable to sildenafil citrate (Viagra). The plant demonstrates potential for improving libido, potency, and sexual pleasure .

Preparation: The leaves are typically cooked as a soup, but for medicinal purposes, the study used ethanolic extracts. Traditional users consume the cooked vegetable regularly or make infusions from dried leaves.

• Tetracarpidium conophorum (African Walnut)
• Local names:  Ukpa (Igbo), Awusa (Yoruba), Kasu da zawa (Hausa)
• Plant part used:  Seeds
• Traditional use:  Fertility enhancement, treatment of infertility
• Evidence status:  Multiple studies from Nigeria 

African walnut is a climbing shrub whose seeds are consumed as snacks. Two Nigerian studies have investigated its effects on male fertility:

Study 1 (Akomolafe et al., 2015): Aqueous extract of Tetracarpidium conophorum was administered to rats with ethanol-induced infertility. The extract protected against ethanol-induced testicular damage and improved sperm parameters.

Study 2 (Akomolafe et al., 2017): The same plant demonstrated protective effects on sperm quality and testicular histology in rats exposed to alcohol-induced reproductive toxicity.

Mechanism: The plant’s high antioxidant content (flavonoids, phenolic compounds) reduces oxidative stress in testicular tissue, protecting sperm-producing cells from damage.

• Plukenetia conophora (African Walnut Vine)
• Local names:  Ukpa (Igbo – sometimes confused with Tetracarpidium)
• Plant part used:  Seeds, leaves
• Traditional use:  Treatment of testicular damage, fertility enhancement
• Evidence status:  Studied for cadmium-induced testicular damage 

A Nigerian study (Olaniyan et al., 2018) investigated the methanol extract of Plukenetia conophora in rats with cadmium chloride-induced testicular damage (a model for environmental toxin exposure). The extract demonstrated protective effects on testicular tissue and improved reproductive outcomes .

• Carpolobia alba (White Carpolobia)
• Local names:  Agba (Yoruba), Ichekwa (Igbo)
• Plant part used:  Roots
• Traditional use: Widely used in sub-Saharan Africa (especially Nigeria) for perceived sexual stimulatory effects
• Evidence status:  Recent 2025 study shows complex effects 

Carpolobia alba is widely used as a traditional aphrodisiac across Nigeria. However, a very recent 2025 study has raised important safety considerations.

Key findings from the 2025 study:

Finding	Implication
Significantly increased sexual activity and mating behavior across all treated groups	Confirms traditional aphrodisiac use
Weak immunoexpression of Bcl-2 (anti-apoptotic protein) in testicular sections	Indicates increased apoptotic (cell death) activity in the testes
Strong PCNA expression (proliferating cell nuclear antigen)	Indicates increased cell proliferation (compensatory mechanism)

Conclusion: Despite its traditional use as an aphrodisiac, Carpolobia alba exhibits potential anti-fertility effects following sub-acute (30-day) exposure, as evidenced by disrupted testicular cell regulation. The increased apoptotic activity in testicular tissue raises concerns about its long-term reproductive safety.

Important safety note: This finding highlights a crucial principle in herbal medicine – an herb that enhances libido may not necessarily improve fertility, and in some cases, could be detrimental to long-term reproductive health. Users should exercise caution and avoid prolonged use without professional guidance.

• Parquetina nigrescens
• Plant part used:  Leaves
• Traditional use:  Treatment of reproductive toxicity
• Evidence status:  Studied for d-galactose-induced reproductive toxicity 

A Nigerian study (Ajayi et al., 2021) evaluated the hydroethanolic leaf extract of Parquetina nigrescens in rats with d-galactose-induced reproductive toxicity. The plant demonstrated protective effects on reproductive parameters.

• Senecio biafrae
• Plant part used:  Leaves
• Traditional use:  Treatment of tetracycline-induced reproductive toxicity
• Evidence status:  Studied in Nigeria 

Senecio biafrae (often spelled Seneciobiafrae) was studied for its ability to protect against tetracycline-induced reproductive toxicity in male rats. The aqueous crude leaf extract demonstrated protective effects on testicular function.

1. Other Nigerian Plants Documented in Ethnobotanical Survey

The ethnobotanical survey in Jos North LGA documented 21 plant species from 18 families used for male infertility treatment. Key plants include :

Plant Species	Family	Plant Part Used	Preparation Method
Fadogia agrestis	Rubiaceae	Roots	Decoction
Khaya ivorensis	Meliaceae	Stem bark, roots	Decoction
Cassia sieberiana	Fabaceae	Roots	Decoction/infusion
Carpolobia alba	Polygalaceae	Roots	Decoction
Anogeissus leiocarpus	Combretaceae	Stem bark	Decoction
Parkia biglobosa	Fabaceae	Stem bark	Decoction
Securidaca longipedunculata	Polygalaceae	Roots	Decoction
Ziziphus abyssinica	Rhamnaceae	Roots	Decoction
Detarium microcarpum	Fabaceae	Roots	Decoction
Piliostigma thonningii	Fabaceae	Stem bark	Decoction

General preparation methods according to traditional practitioners:

• Decoction (38%) : Boiling plant material in water until the volume reduces
• Infusion (31%) : Steeping plant material in hot water without boiling
• Cold maceration (31%) : Soaking plant material in cold water for extended periods

The roots are the most commonly used plant part (48%), and the only route of administration reported was oral .

Introduced Herbs Now Available in Nigeria

Globalization and increased trade have brought several internationally recognized aphrodisiac and fertility-enhancing herbs to the Nigerian market. These are now available through health food stores, online retailers (such as HealthPlus Nigeria, Comilmart, and Jumia), and some pharmacies.

1. Tongkat Ali (Eurycoma longifolia)
2. Origin:  Southeast Asia (Malaysia, Indonesia, Thailand)
3. Traditional use:  Male aphrodisiac, testosterone booster, fertility enhancer
4. Availability in Nigeria:  Available as supplements through HealthPlus Nigeria and other retailers 
5. Suggested benefits:  Supports sexual drive and libido, maintains hormonal health, enhances endurance and stamina 

Mechanism: Tongkat Ali is believed to increase testosterone levels by stimulating the release of luteinizing hormone (LH) from the pituitary gland, which in turn signals the testes to produce more testosterone.

Nigerian availability: Swanson brand Tongkat Ali (400 mg, 120 capsules) is available in Nigeria through HealthPlus Pharmacy. Other brands are available through Comilmart and various online platforms.

Dosage recommendations (from supplement labels): Typically 200-400 mg daily, but users should follow product-specific instructions.

• Tribulus terrestris (Puncture Vine)
•  Origin:  Temperate and tropical regions worldwide (now naturalized in many areas)
•  Traditional use:  Aphrodisiac, testosterone booster
•  Availability in Nigeria:  Available as supplements through Comilmart and other retailers 
•  Proposed mechanism:  May increase LH and subsequently testosterone

Note on evidence: While widely marketed for testosterone enhancement, research on Tribulus is mixed. Some studies show libido benefits, while others show minimal effect on actual testosterone levels.

• Ashwagandha (Withania somnifera)
• Origin:  India and North Africa
• Traditional use:  Adaptogen (stress reducer), vitality enhancer, sexual tonic
• Availability in Nigeria:  Available as supplements through Comilmart 
• Mechanism:  Reduces cortisol (stress hormone), which can suppress libido and testosterone

Ashwagandha is classified as an adaptogen – herbs that help the body resist physical and mental stress. By reducing cortisol levels, Ashwagandha may indirectly support testosterone production and libido.

• Ginseng (Panax ginseng)
•  Origin:  Eastern Asia (Korea, China)
•  Traditional use:  Energy booster, adaptogen, aphrodisiac
•  Availability in Nigeria:  Available as supplements through Comilmart 
•  Mechanism:  Improves circulation, reduces fatigue, supports nitric oxide production

Ginseng is one of the most studied herbs for erectile dysfunction. It works by improving blood flow and reducing oxidative stress .

• Horny Goat Weed (Epimedium species)
• Origin:  China and other parts of Asia
• Traditional use:  Treatment of erectile dysfunction, libido enhancement
• Availability in Nigeria:  Available as supplements through Comilmart 
• Active compound:  Icariin, which inhibits PDE5 (similar mechanism to sildenafil/Viagra)

Horny Goat Weed contains icariin, a compound that works similarly to prescription PDE5 inhibitors (like Viagra) by increasing blood flow to the penis .

• L-Arginine (Amino Acid, not an herb but common in herbal formulas)
• Source:  Often derived from pine bark or synthesized; commonly added to herbal formulations
• Mechanism:  Precursor to nitric oxide, which relaxes blood vessels and improves erections
• Availability in Nigeria:  Available in many combination herbal products 

L-Arginine is often included in men’s health formulations because it directly supports the physiological process of erection through nitric oxide production .

Traditional Formulations and Combination Products

 Opa eyin Herbal Concoction

•  Origin:  South Western Nigeria
•  Traditional use:  Aphrodisiac and reproductive health tonic
•  Evidence status:  Recently studied for antioxidant and reproductive benefits 

A 2025 study investigated the phytochemical composition and antioxidant properties of Opa eyin, a traditional herbal concoction used in South Western Nigeria .

Phytochemical profile of Opa eyin:

Phytochemical	Concentration (mg/100g)	Significance
Anthocyanins	109.91	Strong antioxidant, anti-inflammatory
Flavonoids	98.82	Antioxidant, improves blood flow
Steroids	58.39	Hormonal modulation (precursors to sex hormones)
Alkaloids	56.55	Bioactive compounds with varied effects

Key findings:

• Demonstrated significant dose-dependent in vitro antioxidant activity through:
• DPPH radical scavenging
• Reducing power assays
• Nitric oxide scavenging assays
• In vivo experiments on Wistar rats showed dose-dependent antioxidant effects in the liver, kidney, and testes
• Opa eyin improved reproductive health in exposed animals, evidenced by reduced oxidative stress in the testes, suggesting potential benefits for fertility
• The study concluded that these findings “validate its traditional use” as a reproductive tonic

Caution: The study recommended further research to elucidate long-term safety and efficacy.

Part 4: Safety Considerations and Contraindications

While herbal medicines offer promising benefits for male reproductive health, safety considerations are paramount.

Documented Safety Profiles of Nigerian Herbs

Plant	Safety Status	Key Findings
Cassia sieberiana	Considered safe	LD50 > 5000 mg/kg; no significant organ toxicity in sub-acute study
Carpolobia alba	Potential risk	Increases libido but may have anti-fertility effects with prolonged use
Opa eyin	Undergoing evaluation	Demonstrates benefits but long-term safety requires further study

General Safety Guidelines

Before using any herbal remedy:

1. Consult a healthcare provider – Especially if you have underlying medical conditions (diabetes, hypertension, liver or kidney disease) or are taking prescription medications
2. Source quality products – Purchase from reputable vendors to ensure product authenticity and reduce contamination risks
3. Start with low doses – Begin with the lowest recommended dose to assess individual tolerance
4. Monitor for side effects – Discontinue use and seek medical attention if you experience:
5. Nausea, vomiting, or abdominal pain
6. Dizziness or palpitations
7. Signs of allergic reaction (rash, difficulty breathing)
8. Unusual changes in urinary or sexual function
9. Disclose use to your doctor – Herbal medicines can interact with prescription drugs, including:
10. Blood thinners (warfarin, aspirin)
11. Antihypertensive medications
12. Diabetes medications
13. Antidepressants

Important Warning Signs – When to See a Doctor

Do not rely solely on herbal remedies if you experience:

• Sudden onset of erectile dysfunction (especially after trauma)
• Testicular pain, lump, or swelling
• Blood in semen (hematospermia)
• Inability to conceive after 12 months of unprotected intercourse (6 months if over 35)
• Signs of low testosterone (fatigue, depression, loss of muscle mass, decreased body hair)

 Part 5: Practical Guide to Using Herbal Remedies

 Preparation Methods According to Traditional Practices

Method	Description	Common For
Decoction	Boiling plant material in water (typically roots or bark) for 15-30 minutes, then straining	Fadogia agrestis, Khaya ivorensis, Cassia sieberiana
Infusion	Steeping plant material in hot water (like tea) for 5-10 minutes	Leaves and flowers
Cold maceration	Soaking plant material in cold water for several hours or overnight	Delicate plant parts or when preserving volatile compounds
Powdered form	Dried plant material ground into powder, often mixed with honey or water	Various plants
Tinctures	Alcohol-based extracts (less common in traditional Nigerian practice but available commercially)	Commercial products

Combination Approaches for Optimal Results

Based on traditional practices and evidence, a multimodal approach may yield the best results:

1. Dietary foundation: Incorporate fertility-supporting foods like:
2. Ewedu (Corchorus olitorius) as a regular vegetable
3. African walnuts (Tetracarpidium conophorum) as snacks
4. Zinc-rich foods (oysters, beef, pumpkin seeds)
5. Antioxidant-rich fruits and vegetables
6. Targeted herbal therapy: Select herbs based on specific concerns:

Primary Concern	Recommended Herbs (Nigerian)	Introduced Options
Low libido/desire	Fadogia agrestis, Cassia sieberiana, Ewedu	Tongkat Ali, Ashwagandha
Erectile dysfunction	Cassia sieberiana, Ewedu	Ginseng, Horny Goat Weed, L-Arginine
Low sperm count/quality	Khaya ivorensis, Tetracarpidium conophorum	Tongkat Ali
Stress-related sexual issues	Adaptogens in general	Ashwagandha

• Lifestyle modifications:
• Regular exercise (improves blood flow and hormone levels)
• Stress reduction techniques (meditation, adequate sleep)
• Avoidance of smoking, excessive alcohol, and recreational drugs
• Maintaining healthy body weight

Part 6: Research Limitations and Future Directions

While the evidence for Nigerian medicinal plants in male reproductive health is promising, several limitations must be acknowledged:

Limitation	Current Status	Recommended Action
Study designs	All 25 studies in the systematic review used animal models; human clinical trials are lacking	Human trials are urgently needed
Chemical characterization	Only a few studies characterized the chemical composition of plants (GC-MS: 12%, HPLC: 8%)	Proper chemical characterization recommended
Long-term safety	Most studies evaluated short-term (21-60 days) effects; chronic use safety unknown	Chronic toxicity studies required
Standardization	No standardized dosing or quality control	Development of quality standards needed
Drug interactions	Largely unstudied	Pharmacokinetic interaction studies required

Conclusion

Nigeria possesses a rich heritage of medicinal plants with demonstrated potential for improving male libido and fertility. Herbs such as Fadogia agrestis, Cassia sieberiana, Corchorus olitorius (Ewedu), and Tetracarpidium conophorum have shown promise in scientific studies, with mechanisms involving antioxidant activity, hormonal modulation, and anti-inflammatory effects.

Additionally, introduced herbs including Tongkat Ali, Ashwagandha, Ginseng, and Horny Goat Weed are now available in Nigeria and offer alternative or complementary options.

Key takeaways:

1. Evidence supports traditional use – Multiple Nigerian plants demonstrate scientifically validated benefits for male reproductive health
2. Safety varies by plant – While some plants (e.g., Cassia sieberiana) have favorable safety profiles, others (e.g., Carpolobia alba) may pose risks with prolonged use
3. Libido enhancement ≠ fertility improvement – Some plants that increase sexual desire may not improve (and could impair) actual fertility
4. Consultation is essential – Herbal remedies should be used under the guidance of qualified traditional medicine practitioners or healthcare providers
5. More research is needed – Human clinical trials and long-term safety studies are urgently required to establish standardized, evidence-based recommendations

As the WHO encourages the integration of traditional and complementary medicine into national healthcare systems, this documentation and scientific validation of Nigerian medicinal plants for male reproductive health represents an important step toward preserving cultural heritage while improving health outcomes.

 References

1. Adenekan, S. (2025). Antioxidant properties and reproductive health benefits of Opa eyin Herbal Concoction: In vitro and In vivo Evaluation. African Journal of Online Libraries.
2. (2025). Evaluation of the Acute and Sub-acute Toxicity of the Ethanolic Extract of Cassia sieberiana Root in Male Wistar Rats. Zenodo.
3. Exploring the male fertility potential of medicinal plants from central and West African countries: A systematic review. (2025). Phytomedicine Plus, 5(2), 100786.
4. Herbal Men Enhancement in Nigeria. (2025). Comilmart.
5. Ohemu, T. L., Okwori, V. A., Azila, J. J., & Nwobodo, C. A. (2024). Ethnobotanical Survey of Medicinal Plants Used to Treat Male Infertility in Jos North Local Government Area of Plateau State, Nigeria. Journal of Herbal Medicine, 100825.
6. Oluwatunase, G. O., et al. (2025). Anti-fertility and Sexual Behavioral Effects of Sub-Acute Administration of Carpolobia Alba (G. Don) Root Extract in Male Wistar Rats: an Immunohistochemical Study. Research Square.
7. (2025). Evaluation of Aphrodisiac Potentials of Corchorus Olitorius Leaves and Stem Ethanolic Extracts in Male Wistar Rats. Zenodo.
8. Swanson Passion Tongkat Ali 400 mg. HealthPlus Nigeria.

This comprehensive guide is for educational purposes. Always consult with a qualified healthcare provider or traditional medicine practitioner before starting any herbal regimen.