Which aphrodisiacs actually work?

For as long as humans have been mating and reproducing, they've been searching for ways to boost desire, Dr. Michael Krychman, executive director of the Southern California Center for Sexual Health explained to Health. Even today, people are frequently on the hunt for natural solutions, like foods or herbal products to make sex more fun (or as the case may be, more successful).

Take oysters, chocolate, and the ridiculously named horny goat weed, for example—we've all heard these touted as aphrodisiacs, but do they really work?

To find out, Dr. Krychman and his co-author decided to take a look at any and all published research on the subject, looking at 50 previous studies that examined the effects of various foods, herbs, and commercially available supplements. Their analysis, published this month in the journal Sexual Medicine Reviews, found that oysters and chocolate probably don't help (womp, womp).

While these foods contain ingredients that are important for healthy sexual functioning— like zinc and serotonin (in oysters) and caffeine and cannabinoid-like fatty acids (in chocolate), no clinical trials have shown that either actually improve sex drive or performance.

Other supposed aphrodisiacs, like saw palmetto, wild yam, rhinoceros horn, and yep, horny goat weed, also had no evidence to support the marketing claims often associated with them.

The researchers did find that some natural remedies might be helpful, however.

Among the things with "early but promising data behind them," Krychman said: The root vegetable maca and the herbs ginseng, ginkgo biloba, and tribulus terrestris (often sold in supplement form). Ginseng, for example, was shown to be effective at treating erectile dysfunction (ED) in several double-blind, placebo-controlled studies.

Zestra feminine arousal oil, which is essentially lube with a mixture of botanical ingredients including primrose oil and angelica root extract, also appeared to have some benefit among women with various troubles getting and staying aroused in a handful of small studies.

A caveat: While it's exciting (pun intended) to hear that these natural remedies may offer a boost, you still have to be careful buying them in supplement form. The U.S. Food and Drug Administration doesn't test or approve supplements with the same rigor as other products. A 2013 study published in the same journal looked at "natural" supplements claiming to help ED, and found that 74 of 91 products tested were spiked with pharmaceutical ingredients like Viagra. Be sure to buy from trusted sources, and especially if you're taking other prescription medications, talk to your doctor about any supplements you're taking to avoid drug interactions.
Probably the most important findings though is the information about the things that you shouldn't even consider trying. For example, in the case of mad honey (a type of honey made from the nectar of the Rhododendron plant), the authors cite a case study of a married couple who both suffered heart attacks after eating it over the course of a week.

Meanwhile, ingesting Spanish fly (which is made of beetle remains, ick) has been associated with burning of the mouth and throat and inflammation of the urinary tract. These ingredients should be avoided, the authors write, as their risks outweigh their possible benefits.

It's worth noting that because sexuality is complex, there are no magic pills or miracle ingredients to fix every problem, Krychman said. "Many facets, both medical and psychological, can affect both men and women. Men may be more biologically focused, with [sexual problems stemming from] more influence on veins arteries and nerves, but they are also influenced by stress and fatigue. Women, on the other hand, may have more of a psychological influence—but are also subject to hormonal shifts and biological facets as well."

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Currently, pharmaceutical medications for the treatment of sexual problems are only available for men. (These drugs, like Viagra and Cialis, are used to treat erectile dysfunction.) However, the FDA is expected to approve the drug flibanserin in August, for the treatment of low libido in women.

"It will likely be a game-changer for women who have a biological issue that is influencing sexual desire," Krychman said.

For many people experiencing sexual problems, though, there may be something else going on.

"My advice is to get an evaluation," Krychman said. "There maybe an underlying medical issue that is impacting sexuality; some treatable conditions may masquerade as sexual problems." Erectile dysfunction, for example, can be a sign of heart disease or diabetes.

Couples may benefit from improving communication skills, solving marital discord, or addressing testosterone or estrogen imbalances, he adds. Treating vaginal dryness with lubricant may also help, if loss of desire is due to pain during sex.

Overall, Krychman encourages patients to be open with their doctors about all of their symptoms. "You cannot be treated if you do not disclose your concerns."

This article originally appeared on Health.com.

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