Royal honey: Does it work, and is it safe?

Royal honey may seem to work, but some products have contained hidden sildenafil or tadalafil, which makes them potentially unsafe. In 2024, the FDA flagged 18 honey based sexual enhancer products in one warning cycle, and some “royal honey” products have tested positive for hidden sildenafil or tadalafil, the same prescription ingredients used for erectile dysfunction.

Key takeaways

• The FDA has repeatedly warned that some royal honey and other honey based sexual enhancer products contained hidden sildenafil or tadalafil, including products such as “Royal Honey for Him,” “X Rated Honey for Men,” and “Kingdom Honey Royal Honey VIP.”
• Approved erectile dysfunction drugs are prescribed at known doses, such as sildenafil 25 mg, 50 mg, or 100 mg, and tadalafil 5 mg, 10 mg, or 20 mg. A tainted supplement gives you no reliable dose, no screening for drug interactions, and no medical follow up.
• In the Massachusetts Male Aging Study, 52% of men ages 40 to 70 reported some degree of erectile dysfunction, and complete erectile dysfunction affected about 10%.^[1]
• A 2011 meta analysis linked erectile dysfunction with a 44% higher risk of cardiovascular events, which is why persistent erection problems should not be brushed off as a supplement issue alone.^[2]
• For men with symptoms of low testosterone, Veedma uses morning testing and decision thresholds of total testosterone below 350 ng/dL or free testosterone below 100 pg/mL, plus LH and FSH, because a low number alone does not diagnose hypogonadism.^[5]

Why royal honey gets linked to erections

Royal honey is not an approved treatment for erectile dysfunction, and when men say it “works,” the effect may come from undeclared prescription drug ingredients rather than honey itself.

An erection depends on blood flow, nerve signaling, and nitric oxide. Nitric oxide relaxes smooth muscle in penile tissue, which lets more blood enter and stay trapped long enough for rigidity. Phosphodiesterase type 5, usually shortened to PDE5, is the enzyme that breaks down that signal. Sildenafil and tadalafil work by blocking PDE5, which is why they can improve erections during sexual stimulation.^[4]

That physiology matters because many honey packets marketed as a sexual enhancer promise fast results that plain honey and herbs have never proven in major urology guidelines. According to the FDA, laboratory testing has found sildenafil or tadalafil in some products sold as honey based male performance aids, including products sold online and through major marketplaces.

There is also a bigger clinical point. Erectile dysfunction can be an early clue to vascular disease, diabetes, medication effects, anxiety, sleep problems, pelvic surgery, or hypogonadism. So even if a packet seems to help, it can still mask the real diagnosis.^{[2] [3] [5]}

How it works, or seems to

Royal honey products are usually marketed as multi ingredient supplements, not as plain food honey.

It is usually a blend, not just honey

Many products marketed as royal honey list add ons such as tribulus terrestris, tongkat ali, and ginseng beside honey. Those ingredients are often sold in testosterone boosters and sexual enhancer formulas, but major erectile dysfunction guidelines do not recommend royal honey as a standard treatment because evidence for branded honey packets is weak and product contents are inconsistent.

If it seems to work quickly, a hidden PDE5 inhibitor is the most plausible explanation

PDE5 means phosphodiesterase type 5, the enzyme that dampens the blood flow signal needed for an erection. Approved PDE5 inhibitors such as sildenafil and tadalafil have strong evidence from randomized trials and meta analyses, but they are meant to be prescribed at known doses after screening for contraindications and side effects.^[4]

That is why “does it work” is the wrong first question with royal honey. The better question is “what is actually in it?” because a hidden drug can create a real effect for a dangerous reason.

The biggest problem is dose uncertainty

With prescription erectile dysfunction drugs, the dose, timing, and warnings are explicit. With tainted supplements, the consumer does not know whether he took a low dose, a high dose, or a PDE5 analogue that was never clinically tested, and the FDA has repeatedly warned that some royal honey products contained undeclared sildenafil or tadalafil.

That matters because sildenafil and tadalafil can cause headache, flushing, nasal congestion, dyspepsia, back pain, or visual symptoms even when properly prescribed. If the drug is hidden, there is no informed consent and no safe dosing plan.^[4]

The most serious risk is drug interaction, especially with nitrates

Nitrates are heart medicines such as nitroglycerin that widen blood vessels. PDE5 inhibitors can dangerously amplify that effect and drop blood pressure to unsafe levels, which is why major guidelines and drug labeling treat nitrates as a contraindication.

The biggest interaction risk is in men who use nitrates such as nitroglycerin, and caution is also needed with some alpha blockers and cardiovascular conditions.

Persistent erectile dysfunction still needs a real workup

Erectile dysfunction is a symptom, not a final diagnosis. For men who also report low libido, fatigue, reduced morning erections, or fertility concerns, testosterone testing should be done with morning blood work from 07:00 to 11:00, and LH and FSH must be measured alongside testosterone to tell whether the problem is primary or secondary hypogonadism.^[5]

LH and FSH are pituitary hormones that signal the testes to produce testosterone and sperm. At Veedma, persistent symptoms combined with total testosterone below 350 ng/dL or free testosterone below 100 pg/mL guide next steps, and free testosterone is measured directly by Equilibrium Dialysis with LC MS/MS rather than inferred from SHBG calculations.^[5]

What erectile dysfunction can be linked to

Erectile dysfunction is often a vascular or metabolic warning sign, not just a bedroom problem.

Cardiovascular disease. A 2011 meta analysis in the Journal of the American College of Cardiology found that erectile dysfunction was associated with a 44% higher risk of cardiovascular events, a 25% higher risk of all cause mortality, a 62% higher risk of myocardial infarction, and a 39% higher risk of cerebrovascular events.^[2] That is one reason doctors ask about erections during preventive visits.

Diabetes. A 2017 systematic review and meta analysis covering 145 studies and 88,577 men found that erectile dysfunction affected about 52.5% of men with diabetes, and diabetes increased the odds by roughly 3.5 fold versus men without diabetes.^[3] High blood sugar damages blood vessels and nerves, both of which are essential for normal erections.

Age related prevalence. In the Massachusetts Male Aging Study, 52% of men ages 40 to 70 reported some degree of erectile dysfunction, with about 17% mild, 25% moderate, and 10% complete.^[1] Age raises risk, but age does not make unexplained symptoms “normal.”

Hypogonadism and endocrine causes. Low testosterone does not explain every erection problem, but it becomes more relevant when erectile dysfunction appears together with reduced sexual desire, fewer spontaneous morning erections, infertility, lower energy, or loss of muscle. In those cases, morning total and free testosterone should be checked, and LH plus FSH are mandatory to classify the cause correctly.^[5]

Symptoms and warning signs to watch for

Trouble getting or keeping an erection often deserves evaluation when it becomes repetitive, bothersome, or clearly different from your baseline.

• You get hard enough for foreplay, but lose firmness before penetration or within a few minutes.
• You notice fewer morning erections than you used to, especially when the change lasts for weeks.
• You can sometimes get a partial erection during masturbation, but partner sex is consistently harder than it was before.
• You used royal honey or another sexual enhancer and then developed headache, facial flushing, stuffy nose, heart pounding, indigestion, back pain, or a blue tinged change in vision.^[4]
• You felt dizzy, faint, weak, or unusually lightheaded after taking a honey product, especially if you also use nitroglycerin or another nitrate medicine.
• Your sex drive dropped along with your erection quality, which raises the possibility of hormonal involvement and makes testosterone, LH, and FSH testing more relevant.^[5]
• You have diabetes, high blood pressure, high cholesterol, obesity, sleep apnea, or you smoke, all of which increase the odds that erectile dysfunction reflects blood vessel disease rather than performance anxiety alone.^{[2] [3]}
• You had chest pain, severe shortness of breath, or an erection that lasted more than 4 hours after using a supplement. That is an emergency. Go to the ER or call 911.

Myth vs fact

Myth: If royal honey is sold online, it must be FDA approved

Fact: Dietary supplements are not FDA approved for safety or effectiveness before sale, and the FDA has repeatedly identified tainted sexual enhancement products after they were already on the market.

Myth: If royal honey works, the honey itself is treating erectile dysfunction

Fact: The effect some men report is more plausibly explained by undeclared sildenafil or tadalafil than by honey. Approved PDE5 inhibitors have robust trial data. Royal honey does not appear in major erectile dysfunction guidelines as a recommended therapy.^[4]

Myth: A natural sexual enhancer cannot cause serious side effects

Fact: Hidden PDE5 inhibitors can cause the same side effects and interactions as prescription erectile dysfunction drugs, including dangerous hypotension with nitrates. “Natural” on the packet does not neutralize a hidden drug.

Myth: Erectile dysfunction is only a sex issue

Fact: Erectile dysfunction is associated with higher cardiovascular risk and is common in men with diabetes. It can be an early signal of blood vessel disease years before a cardiac event.^{[2] [3]}

Myth: Erectile dysfunction always means low testosterone

Fact: Male hypogonadism is a clinical syndrome that requires both persistent symptoms and biochemical evidence. Total and free testosterone should be interpreted with LH and FSH, because without gonadotropins you cannot tell primary from secondary hypogonadism or choose the right treatment.^[5]

What to do if you used royal honey

If you used royal honey and had side effects, the safest move is to stop the product and treat the situation like a possible hidden drug exposure.

1. Step 1: Stop using the product now, and keep the packet, box, lot number, and purchase receipt if you still have them. Check the FDA tainted products list and recall notices for the exact product name because similar sounding honey brands are easy to confuse.
2. Step 2: Get urgent medical help if you had chest pain, fainting, severe dizziness, shortness of breath, vision loss, or if you take nitrates such as nitroglycerin. Tell the clinician you may have taken an undeclared erectile dysfunction drug so they know to think about hypotension and interactions.
3. Step 3: If the real issue is ongoing erectile dysfunction, get evaluated instead of self experimenting. A proper visit should review medications, cardiometabolic risk, sleep, mental health, urinary symptoms, and sexual history. If low testosterone symptoms are present, morning total testosterone, directly measured free testosterone, LH, and FSH should be part of the workup.^{[2] [3] [5]}

Veedma offers a thorough diagnostic workup for men across the U.S., including an advanced lab panel measured by LC MS/MS or a review of existing results you already have, including uploads from services like Function Health. The medical team builds individualized treatment plans, with Enclomiphene as first line for eligible men with secondary or functional hypogonadism, and the Enclomiphene plus Tadalafil combination tablet when erection or urinary symptoms are also present. Licensed providers then monitor response, side effects, CBC, Comprehensive Metabolic Panel, PSA when age appropriate, and hormone markers over time so the protocol can be adjusted safely.

Bottom line

Royal honey may seem to work, but that apparent effect can come from undeclared erectile dysfunction drugs rather than from honey or herbs. As a sexual enhancer, it is unreliable, unregulated, and potentially unsafe, especially for men taking nitrates or those ignoring the bigger medical causes of erectile dysfunction.

References

1. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. The Journal of urology. 1994;151:54-61. PMID: 8254833
2. Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. Journal of the American College of Cardiology. 2011;58:1378-85. PMID: 21920268
3. Kloner RA, Burnett AL, Miner M, et al. Princeton IV consensus guidelines: PDE5 inhibitors and cardiac health. The journal of sexual medicine. 2024;21:90-116. PMID: 38148297
4. Goldstein I, Lue TF, Padma-Nathan H, et al. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. The New England journal of medicine. 1998;338:1397-404. PMID: 9580646
5. Salonia A, Capogrosso P, Boeri L, et al. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2025 Update on Male Hypogonadism, Erectile Dysfunction, Premature Ejaculation, and Peyronie’s Disease. European urology. 2025;88:76-102. PMID: 40340108