Sex, Bitters, and Broken Bodies: Inside Ghana’s Dangerous Aphrodisiac Craze – Prof. Victor Wutor

Makola. Kejetia. Circle. After 6 p.m., the streets turn into open‑air sex clinics.

“Strong man, sweet woman, last long!” the hawkers shout over Afrobeats.

On shaky wooden tables, beside condoms and painkillers, sit bottles of Vigour Man, African Black Ant, Ogya, sachets of bitters, and jars of honey‑ginger‑garlic floating in gin. Take a shot, chase it with beer or kakai, and “you go perform.”

In a decade, aphrodisiacs (substances believed to increase sexual desire, performance, or pleasure) have quietly grown into a multi-million-cedi informal industry in Ghana, raising serious public health concerns that demand regulatory attention. But behind the jokes and radio jingles is a serious collision of ancient herbal knowledge, aggressive street marketing, and largely unseen‑health risks.

There is no country on planet earth with more aphrodisiacs and bitters than Ghana. Take a look at some of the popular names:

Adonko Bitters, Adutwumwaa Bitters, African Star Anise, Agya Appiah Bitters, Ahenfo Bitters, Alafia Bitters, Amuzu Bitters, Alligator Pepper (Efom Wisa), Alomo Bitters, Amegah Bitters , Atadwe Bitters, Atene Bitters, Barima Nsuo Bitters, Bie Gya Bitters, Big Boss Herbal Gin Bitters, Big Boss Herbal Gin Bitters, Bɔbɔɔbɔ Bitters, Butubutu Bitters, Captains Bitters, Cargo Gin Bitters, Chairman Bitters, Di Ako Bitters, Don Papa Ginseng Bitters , Garlic & Clove, Ginger (Akekaduro), Ginseng Bitter, Hammer Bitters, Happy Man Bitters, Herb Afric Gin Bitters, Hye so Bitters, Joy Dadi Bitters, Joy Sokoo Bitters, Joy Twedee Ginger Bitters, Joy Twedee Ginger Bitters, K 20, Kakai Bitters, Kakanyidi Bitters, Kalahari Bitters, Kasapreko, Kpokɛkɛ Bitters, Kra man koti bitters, Lucky Herbal Bitters, Mahogany Bark (Khaya senegalensis), Mandingo Bitters, Mɛ tu wo twɛ Bitters, Nana Takyi Bitters, Nana Takyi Bitters, Negro Pepper (Hwentia), Obuase Bitters, Odenden Bitters, Odeneho Bitters, Odo aba Bitters, Odo b3ba Bitters, Ogidigidi Bitters, Opeimu Herbal Bitters, Origin Bitters, Pashew Bitters, Piaaw Bitters, Playboys’ Bitters, Prɛkɛsɛ Bitters, Pusher Gin Bitters, Round 2 Bitters, Sei hor Bitters, Shatta/SM Bitters, Soloku Bitters, Target Bitters, Tiger Nuts (Atadwe), To mpa Bitters, Waist and power, Wo ba ada, Wo Twɛ Bɛ Tu Bitters!

This is the story of how “miracle tonics” and “power roots” took over the night — and what they’re really doing to our bodies.

The market has three layers.

1. Traditional Herbal Preparations

The oldest category defends the most. Vendors and registered herbalists sell roots, barks and concoctions: ginseng, kpokpei, akpɛkɛ, moringa, tiger nut, snails in gin, alligator pepper, sarsaparilla. The claim: “cleanse the system”, “boost sperm count”, “improve circulation”, “last 3 rounds”. This knowledge has been passed down for generations.

2. Over-the-Counter "Bitters" & Tonics

Branded products like Alomo, Orijin, and Kasapreko Bitter, and imported brands like Vigour Man and Cobra. Most are 40%+ alcohol and marketed for “energy” and “performance”. They live in bars, kiosks, and even pharmacies.

3. Imported Pills & "Supplements"

African Black Ant, Rhino 69, Viga, Super Viga. Sold discreetly in pharmacies, on WhatsApp, and by roadside vendors. Some are genuine sildenafil. Others are unregistered pills secretly spiked with pharmaceuticals. Price runs from GH₵10 for a sachet to GH₵300+ for a “1-month strong man package”.

Why Is the Demand Booming?
First, cultural pressure. Virility is tied to manhood, and social media has raised expectations.

Second, lifeclass diseases. Diabetes, hypertension, stress, and heavy drinking are causing more cases of erectile dysfunction. Many men would rather buy a tonic than sit in a clinic.

Third, access. It’s easier to grab a “power” sachet at a bus stop than book a doctor. No prescription needed.

And fourth, the silence. Because sex and mental health are still taboo at home and church, people go to herbalists and social media groups instead.

Yes, many plant parts do have pharmacological activity. The problem is what happens when you put 5-15 of them in one bottle. When you boil or infuse roots or combinations of plant parts in 40-50% gin, you create a chemical cocktail with no standard dose. Bottle A from Vendor 1 is not the same as Bottle B from Vendor 2.

Worse, these active ingredients and compounds have real effects and real risks:

1. Drug–herb interactions: Moringa and ginger can lower blood pressure and blood sugar. If you’re already on antihypertensive or diabetic medication, you can faint or develop severe hypoglycemia.
2. Cardiovascular stress: Yohimbine combined with caffeine and alcohol can trigger heart palpitations, anxiety, and dangerous spikes in blood pressure.
3. Blood thinning: Garlic, ginger, and ginseng all thin the blood, increasing bleeding risk before surgery or in people taking warfarin or aspirin.
4. Liver and kidney load: Your liver has to process alcohol, multiple herbs, and often paracetamol for the hangover. Over time, this can lead to liver cirrhosis and kidney damage.
5. Hidden pharmaceuticals: FDA and independent lab tests have found sildenafil, steroids, and painkillers secretly added to supposedly “pure herbal” tonics, underscoring the urgent need for regulation to protect consumers from unlabelled drugs and dangerous adulteration.

When “Power” Meets Alcohol: The Most Dangerous Part

In Ghana, it’s common to wash a pill down with beer because “the alcohol makes it work faster,” But pharmacists warn this practice significantly increases health risks and side effects.

The Big 3 Dangers:

1. Heart and Blood Pressure Crash: Most imported “power pills” contain sildenafil or tadalafil. Alcohol is also a vasodilator. Taken together, your blood pressure can crash, leading to dizziness, fainting, heart attack, or stroke.
2. Liver Damage: Alcohol-based bitters plus beer and herbal toxins create a triple load on the liver.
3. Risky Sex and Poor Judgment: Alcohol lowers inhibitions. Combined with drugs that force a prolonged erection, this leads to condom breakage, sexually transmitted infections, and priapism (an erection lasting more than four hours that can cause permanent damage).

Perspectives of regulatory authorities and health experts

Consumers should verify that products carry a valid FDA registration number. Products that claim instant or three-day results ought to be treated with caution and generally avoided. Any adverse effects should be reported through appropriate channels. Although the FDA conducts enforcement operations, including raids, regulating online sales remains challenging.

Pharmacists emphasize that legitimate erectile dysfunction (ED) medications should be obtained from licensed pharmacies, where patients can receive appropriate counselling. Patients are advised to inform their pharmacists of all medications, supplements, and herbal products they are using.

Every night in Makola, Kejetia, Circle, and a hundred smaller markets, men hand over their last GH₵20 for a quick hit of ‘power’ — in a bottle, sachet, or pill. They trade their cash for a shot that might contain 10 different roots, 40% alcohol, a hidden pharmaceutical, and zero instructions. They walk away laughing, but their livers, hearts, and kidneys are not laughing with them. In the end, this isn’t just a story about sex, shame, or “strong man” bravado. It’s a story about risk — and who pays the price for it.

Our position at the Ghana College of Pharmacists is to “preserve the knowledge but professionalize the practice.” We are advocating for:

1. Systematic testing and standardization of herbal products
2. Structured training of herbal practitioners in dosage, contraindications, and potential interactions
3. Comprehensive labelling, including ingredient lists, possible side effects, and warnings such as “Do not use with alcohol or antihypertensive (blood pressure) medications”
4. Rigorous research and clinical trials focused on Ghanaian medicinal plants

Countries such as China, India, and South Africa have implemented similar measures and now export standardized herbal medicines. Ghana has the potential to follow a comparable trajectory.

We have a choice.
We can keep pretending this is harmless fun — that a little bitters, a little pill, a little kaikai is just part of the nightlife. We can keep boiling unmeasured roots in reused vodka bottles and hope our bodies survive the experiment.

Or we can decide that if Ghanaians are going to chase pleasure and performance, they deserve the same protection as anyone buying blood pressure medicine or antibiotics.

That means rules. Labels. Testing. Real conversations about sex and health in clinics, churches, mosques, and group chats. It means herbalists who are trained and regulated, not chased into the shadows. It means an FDA that can actually keep up with what’s on the street and online.

The herbs are not our enemy. Ignorance is.
A standardized Moringa–Ginger capsule, sold in a pharmacy with a pharmacist who knows your history, is medicine. The same ten roots, drowned in gin, sold from the back of a trotro with no label, is a gamble you may not walk away from.

Strong is not how much you can drink or how long you last. Strong is knowing exactly what you are putting in your body — and refusing to let a cheap bottle decide your fate!

Prof. Victor Wutor
vcwutor@gmail.com

Faculty of Public Health
Ghana College of Pharmacists

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