Do Herbs Really Help Sexual Health? What the Evidence Says
No herb has been proven to treat ED as well as modern medicine, and some 'herbal' products are secretly spiked with ED drugs. Here is the honest evidence.
Key points
- No herb has been proven to treat ED as well as modern medicine; evidence for ginseng, black ginger and others is weak.
- Some 'herbal' products are illegally spiked with sildenafil or tadalafil, which can be deadly with nitrates.
- Exercise, weight loss, stopping smoking and controlling chronic disease have far better evidence.
Many patients have tried herbs or supplements before coming to see me, some for a year or more. I don't see that as wrong; herbal remedies have a long tradition in Thailand. But I want to give you straightforward information. An older article from the clinic said herbs "may help relieve ED to some degree", which is still roughly fair, but it should be clearer about how weak the evidence is and the risks many people don't know about.
Evidence summary for commonly asked-about herbs
| Herb | What is claimed | Latest evidence |
|---|---|---|
| Korean ginseng (Panax ginseng) | Helps erections | A Cochrane review (2021) found it may have a very small effect in mild to moderate ED; certainty of evidence is low |
| Thai black ginger, krachai dam (Kaempferia parviflora) | Boosts performance | Few, small human studies; a 2017 review said no clear clinical conclusion can yet be drawn |
| Tongkat ali, known in Thailand as pla lai phueak (Eurycoma longifolia) | Raises testosterone | A 2022 meta-analysis found it raised total testosterone somewhat, especially in men with low levels, but the studies varied a lot |
| Maca | Increases desire | Few studies with inconsistent results; any effect seems to be on desire rather than erections |
| Horny goat weed (Epimedium) | Works like an ED drug | Its compound icariin has effects in the lab, but there are hardly any good human studies |
Overall, no herb has been proven to treat ED as well as modern medicine, and results vary a great deal from person to person.
Korean ginseng
- May have a very small effect
- Low confidence in evidence (Cochrane 2021)
Black ginger (krachai dam)
- Few, small human studies
- No clear conclusion yet
Tongkat ali
- May raise hormones in some men
- Very varied studies
Maca
- Few studies, inconsistent results
Horny goat weed
- Effects in lab studies
- Almost no good human studies
No herb has been proven to treat ED as well as modern medicines.
Risks many people don't know about
1. Products illegally spiked with drugs
Thailand's Food and Drug Administration (Thai FDA) and the US FDA have repeatedly warned about supplements, coffees and sweets that claim to be herbal but are secretly laced with sildenafil or tadalafil, sometimes at higher doses than the real medicine. Someone taking nitrates for heart disease could be put in mortal danger without knowing it.
Warning signs include adverts saying "works in 30 minutes" or promising instant rock-hard results, or no food registration number that can be verified.
2. No standard control of dose
The amount of active ingredient in herbal products can vary greatly between brands, or even between batches, and they may be contaminated with heavy metals.
3. Side effects and drug interactions
- Palpitations, insomnia and higher blood pressure (seen with ginseng)
- Liver inflammation from some herbs, especially at high doses over long periods
- Ginseng may interact with blood thinners and diabetes medicines
- Don't combine herbal products with PDE5 inhibitors without asking a doctor
Hidden drugs
- Sildenafil/tadalafil secretly added
- Dangerous for nitrate users
No standards
- Active content differs by batch
- May contain heavy metals
Side effects
- Palpitations, higher blood pressure
- Some cause liver inflammation
- Interactions with other drugs
Be suspicious of claims of instant results or no verifiable Thai FDA registration number.
Why you shouldn't rely on herbs alone
ED can be the first sign of diabetes, high blood pressure, high cholesterol or coronary heart disease. Taking herbs indefinitely without being checked may mean missing the chance to find these diseases early. Read more in What causes erection problems, and vascular ED.
If you are interested in your male hormones, a real blood test will tell you far more than guessing. Read Testosterone basics every man should know, and about another group of hormone supplements to be careful with in DHEA and pregnenolone.
What has better evidence than herbs
- Regular aerobic exercise and weight loss
- Stopping smoking and cutting down on alcohol
- Enough sleep, and treating sleep apnoea
- Controlling diabetes, blood pressure and cholesterol
- Looking after stress and your relationship
- Medicine assessed and prescribed by a doctor, when needed
See lifestyle approaches to your hormones in Supporting testosterone with sleep, food and exercise, and for a mineral that is often asked about alongside herbs, read Zinc and men's health.
If you still want to use herbs
- Choose products with a Thai FDA registration number you can verify.
- Avoid products with exaggerated claims.
- Always tell your doctor what you are taking, especially if you have heart disease, high blood pressure, diabetes or liver disease.
- Stop and see a doctor if you get palpitations, chest pain, yellowing of the skin or eyes, or dark urine.
Get advice at Dr. Kris Clinic
You are welcome to bring the products you use for me to look at. We will assess the risks, look for the cause of your sexual problem, and plan care using evidence-based methods, at the clinic in Surat Thani or online, with consultations in English available. For the overall picture of ED treatment, read Erectile dysfunction (ED).
Want help with this? Three simple steps
Reading is a good start. When you are ready, check where you are, see how a consultation works, then book a time that suits you.
1Free 2-minute self-checkSexual-health self-check — see your result instantly and send it to the doctor if you like.Start the self-check →
2See the steps and feesIndividual from 990 THB · couple 1,590 THB · 30–60 minutes, at the clinic or online via MCS Telemedicine.How a consultation works →
3Book with the doctorPick a time online or message us on LINE. Come on your own or with your partner. Payment confirms the booking.Book online →Self-checks are a guide only and do not replace a doctor's assessment. Outcomes vary from person to person, depending on the severity of symptoms, the complexity of the problem and other factors.
Worried about sexual performance?
Talk to a doctor in private. We look at physical, hormonal and vascular causes before choosing the treatment that suits you.
Every medicine and service requires a doctor's assessment first.
Frequently asked questions
Does Thai black ginger (krachai dam) really help erections?
There are only a few small human studies. Some found a small effect, but we cannot conclude that it treats ED, and it should not replace looking for the cause.
Can I take herbs together with tadalafil?
Ask a doctor first, because some herbs, or products secretly spiked with drugs, may add to the effect and cause low blood pressure or more side effects.
How can I tell if a product is spiked with drugs?
It is hard for ordinary consumers to tell. Warning signs are claims of instant results, no Thai FDA number, or sale through channels you cannot verify. Check the registration number with the Thai FDA's system.
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References
- Lee HW, Lee MS, Kim TH, et al. Ginseng for erectile dysfunction. Cochrane Database Syst Rev. 2021;4:CD012654
- Saokaew S, et al. Clinical effects of Krachaidum (Kaempferia parviflora): a systematic review. J Evid Based Complementary Altern Med. 2017;22(3):413-428
- Leisegang K, Finelli R, Sikka S, Panner Selvam MK. Eurycoma longifolia (Jack) improves serum total testosterone in men: a systematic review and meta-analysis of clinical trials. Medicina (Kaunas). 2022;58(8):1047
- US Food and Drug Administration. Tainted Sexual Enhancement Products. Health Fraud Scams
This article is for education and does not replace diagnosis or treatment by a doctor. If you have symptoms or concerns, please see a doctor.
