Summary of risk of bias for individual studies. Among all the interventions, Hochu-ekki-to and W. (2017) Traditional Chinese Medical Therapy for Erectile Dysfunction. Let’s move on to see which Chinese herbal formulas can help improve these and other imbalances. But imbalances—whether caused by stress, aging, or lifestyle—can lead to fatigue, poor libido, or even chronic health issues. In TCM, supporting men’s health means maintaining balance across the body’s systems. While Western approaches to care can be effective, they also often come with unwanted side effects. Asian ginseng grows in East Asian mountains, while American ginseng is an endangered species that grows in deciduous forests of the west half of North America. Over twelve ginseng species were identified, although mainly Asian or Korean ginseng (P. ginseng) and American ginseng (P. quinquefolius) have been used for their therapeutic properties. In 2014, Singh et al. reported a cross-sectional survey investigating the correlation between frequency and quantity of kratom consumption, and the risk of addiction development and the severity of withdrawal symptoms and craving in regular user . Data showed that low kratom doses (1–5 g) induce stimulating effects, involving the release of neurotransmitters by reversible blockade of calcium channels. In modern times, meanwhile, there have been only a few studies on the application of Sang-Piao-Xiao-San for nocturnal enuresis15 and interstitial cystitis.16These mild effects were not anticipated, considering the mechanism of action of these plants.The effects of tomato juice on male infertility.The risks of buying male enhancement pills over the counter apply to online purchases as well, because these are sold as herbal supplements, and not regulated by the FDA like drugs are.Studies are beginning to uncover how these natural remedies work to improve energy, balance hormones, and target specific health challenges like erectile dysfunction, fertility, and prostate health.Thereby, kidney and liver are two important organs with a wide range of functions in TCM. It’s considered safe when taken under medical supervision, making it a valuable addition to your treatment plan. While generally safe for short-term use, Panax ginseng may cause insomnia, headaches, and vertigo. If you’re looking for a natural way to boost your hormonal health, DHEA could be a promising option. Additionally, DHEA is considered safe when taken at low doses, although it may cause side effects like acne. In my guide to Chinese herbs for male enhancement, I focus on the herbs that are most popular in Asian culture. In my experience, the best herbs for male enhancement come from Asia, then South America. While herbal remedies may offer some benefits, medical treatments are the gold standard for addressing ED. Its ability to boost energy and improve blood flow may enhance erectile function and address mild to moderate ED. Studies suggest that high doses of L-arginine can enhance erectile function. In 2010, in the United States, approximately 29% of 428 infertile couples had utilized an alternative treatment after 18 months of observation, 59% of which had taken herbal therapy . In 2007, approximately 56% of infertile couples had sought medical care worldwide and many of these couples had opted for supportive complementary and alternative medicines to treat infertility. In particular, substances of natural origin have been used worldwide for millennia in traditional medicines to boost sexual desire, sexual pleasure, or sexual behavior , and the use of psychoactive and/or stimulant drugs during intercourse, i.e., chemsex, is on the rise . Most of the selected sexual enhancers appeared to be safe at therapeutic doses, although mild to severe adverse effects may occur in cases of overdosing or self-medication with unstandardized products. Sexual enhancers increase sexual potency, sexual pleasure, or libido. Consumption of Iranian herbal medicine by infertile men can improve pregnancy outcome. Obesity, endocrine disruption and male infertility. A unique view on male infertility around the globe. Traditional knowledge reflects the interaction between individuals and societies with nature, and has the potential to contribute significantly to the healthcare of local people, as well as to scientific knowledge and drug discovery through documentation of traditional medicine and local ethnobotany 27,28,29. Pharmacological treatments for DE, anejaculation and anorgasmia, however, remain limited, with few large-scale studies showing limited efficacy and/or significant adverse events , although psychotherapy and addressing underlying causes are recommended . The most common form of EjD in the general population is PE, affecting up to 20–30% of the male adult population 2,3, where RE is considered the second most common type of EjD and an important cause of infertility . Ejaculatory dysfunction (EjD) is a multidimensional psych-neuro-uro-endocrine pathological condition characterized by the disruption of the ejaculatory cascade that results in a failure of normal ejaculation . This improvement in sperm parameters may likely be due to the comprehensive therapy that the control group received. Five studies compared an intervention with control (Ahmad et al., 2010; Mahajan et al., 2012; Peng et al., 2014; Yu et al., 2017; Wang et al., 2020b). Six studies compared an intervention with a placebo (Rege et al., 1997a; Safarinejad et al., 2011; Khoradmehr et al., 2014; Kolahdooz et al., 2014; Park et al., 2016; Kolangi et al., 2019). For example, seminal RANTES is a chemokine and acts as a chemoattractant for WBCs in various genital infections, in which the excess can lead to infertility (Isobe et al., 2002). In Japan, an RCT was conducted to evaluate the effect of tomato juice on male infertility (Yu et al., 2017). The treatment group was given three 500 mg capsules of red ginseng daily for 12 weeks. However, a significant increase in sperm motility was observed. A total of 66 patients were randomly distributed into a treatment group and a control group. After 60 days, a noticeable increase in semen concentration, morphology, and motility was observed in the patients as compared to their baseline parameters. Although there are a variety of CHM-based auxiliary and alternative treatment methods for patients with BPH, the targets of related studies have mostly consisted of single herbs or extracts, while the effects of CHM powders have yet to be sufficiently investigated. This study evaluated the clinical effects of a Chinese herbal medicine (CHM) on patients with BPH. Lastly, only 42 studies were included, which is a small representation of the alternative medicines and herbal remedies used for ED, making any conclusions relatively unclear even for the more prominent interventions investigated. This process, known as neovascularization, significantly improves blood circulation and restores the natural vascular function necessary for strong erections. Furthermore, horny goat weed might also negatively affect heart and respiratory functions. Horny goat weed (Epimedium) has been traditionally used to enhance sexual performance. Additionally, ginkgo may increase the risk of bleeding, especially if you’re taking blood thinners. Following are the details explaining the effects of all the herbs included on sperm parameters. Details about publication year, authors, design of the study, country, sample size, age of the patients, interventions, and outcomes of the study were extracted from each included study. Recently, the European Association of Urology has acknowledged the use of complementary herbal medicines to treat male infertility (Nejatbakhsh et al., 2016). In an effort to find the ultimate erectile dysfunction cure, many men resort to using enhancement pills to help improve their game. It is one of the best herbs that increase testosterone in the market. There are herbs that increase testosterone in men while others act as antioxidants, destroying the free radicals that cause diseases such as prostate cancer. Scientists stumbled upon certain natural gems while trying to get the perfect erectile dysfunction cure. Ginseng is commonly taken by itself or with an herbal formula to enhance sexual performance in traditional Chinese medical practices. Recent evidences on its mechanisms of action that may represent novel therapeutic strategies for the treatment of male reproductive diseases or disorders will be discussed. Ginseng has been reported to have diverse physiological effects in multiple systems, including cardiovascular, immune, and neuronal. Chinese herbal medicine has been used for thousands of years to address men’s health concerns, but modern research is now catching up to this ancient wisdom. TCM offers an alternative route to addressing men’s health concerns, as well as an integrative way to combat the side effects of other treatments. Understand the full picture of male factor infertility and Chinese herbs that help here. I think of astragalus as the vitamin C of Chinese herbs. Unlike cordyceps, astragalus is better to take daily to get the most health benefits. The effects I get from those so-called “nootropics” are nothing compared to a good green tea/cordyceps rush. Cordyceps or “Chinese caterpillar fungus” is hand down the best Chinese herb for male performance enhancement. By following my guide, you’ll stick with the superior herbs that really work. This article is not intended to suggest specific treatments for patients or that any supplements mentioned prevent or cure diseases or problems. Under the guidance of a licensed TCM practitioner, herbal Chinese products may help restore the body’s natural emotional balance and improve cognitive function. Because sexual potency is often linked to masculinity, infertility is another issue men often feel ashamed to discuss. Restoring balance to the male body with natural remedies may help reduce reliance on ongoing medical treatment or pharmaceuticals. Chinese herbs and formulas can be a rewarding way to maintain men’s health, well-being, and vitality. Optimize Your Health, Inside and Out Recently, LaBryer et al. hypothesized that kratom may have restored testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin levels in a patient with hypogonadotropic hypogonadism . The possible stimulant and libido-enhancing effects of mitragynine may be due to the blockade of serotonergic 5-HT2A receptors and the postsynaptic stimulation of α2 adrenergic receptors (α2R) in the CNS . New preparations such as capsules, resins, or tinctures are now available on the Internet and are purchased in Europe and in America for recreational use or as herbal products 209,210. Liver Blood Deficiency By contrast, serum testosterone remained unchanged, suggesting androgen-independent mechanisms . Sexual desire increased significantly from week 8 onward, with a 40% rise in the 1.5 g group and a 42% rise in the 3.0 g group at week 12. Gonzales et al. conducted a 12-week randomized controlled trial (RCT) in 57 healthy In the first trial, Leitão et al. conducted a 6-month, double-blind, placebo-controlled trial with a 2 × 2 factorial design in 45 men with androgen deficiency of aging males. Related theories can be traced back to The Yellow Emperor’s Classic of Internal Medicine, and the symptoms included in the concept of “Long Bi” were approximately similar to the symptoms of BPH, such as anuria, urinary retention, voiding difficulties, and so forth. The post-void residual urine volume test results of the patients before and after taking the CHM formula The uroflowmetry test results of the patients before and after taking the CHM formula Overall, the patients exhibited a significant improvement in terms of the IPSS. Traditional Chinese medicine (TCM), including acupuncture and Chinese herbs, is used as an alternative therapy to increase the curative effect for erectile dysfunction (ED). Along with all the limitations, our systematic review is the first study establishing a comparison among all available herbal interventions regarding male infertility, and this comprises a very significant aspect of this work. This systematic review has demonstrated the efficacy of herbal medicines in the treatment of male infertility. This systematic review is aimed to summarize the results of all the accessible studies that fulfill the inclusion criteria to determine the efficacy parameters of herbal interventions in male infertility. The review focused on selected plants and their active ingredients, which were included after a preliminary screening of the literature. Considering the paucity of data and the frequent co-exposure to other psychoactive substances, conclusions can be hardly drawn regarding the psychiatric/neurological adverse effects of several of the plants included in this article. Although the consumption of these plants appears safe, further studies should be conducted to better understand their positive and negative effects. Moreover, the clinical efficacy of Chinese herbal medicine (CHM) has not been sufficiently demonstrated by evidence-based clinical trials.This, in turn, jeopardizes the extinction of essential medicinal plants which may have stored indispensable compounds that are responsible for addressing the existing global health issues.From each study, we extracted data on study design, participant characteristics, intervention protocols, outcome measures, and adverse events.A total of 137 records were included in the final review; species-by-species search results are detailed in a flow diagram in Figure 1.Some individuals might seek products that could support healthy testosterone levels, while others may gravitate toward blends that are designed to promote vitality and endurance.Many animal experiments have verified that Tribulus terrestris could improve erectile function.Sperm count, however, was increased by 62%. By contrast, a standardized water extract (PHYSTA) enhanced libido and erectile function without altering testosterone, suggesting potential utility when baseline hormones are within normal ranges . Specifically, fenugreek (Testofen) increased total and free testosterone and improved sexual activity indices in aging men, indicating an androgen-dependent effect . Conversely, agents that improved sexual function without altering testosterone, including Maca across randomized trials and the topical SS-cream, suggest androgen-independent or peripheral modulation and can be discussed conceptually in terms of nourishing essence (jing) or regulating qi and blood. These proposed mechanisms suggest a therapeutic profile that combines direct steroidogenic support with enzyme-level modulation, providing complementary pathways for maintaining physiological testosterone concentrations and optimizing sexual function parameters . Although the majority of studies used IELT as a standardized outcome in PE, the available studies are widely heterogenous in the TCAM intervention investigated and comparison groups used.During initial assessment, patient reported he has been abusing over the counter erectile dysfunction (ED) pills since last ten (10) years which he purchased over the internet and from the local grocery stores, with the majority being labeled made in China.It was reported that Shuganyiyang capsule improved the intracavernous pressure in arteriogenic ED in rats by activating the NOS-cGMP pathway and reducing the expression of PDE5 (44).Kate Downes is a Chinese medicine practitioner with a passion for herbal medicine.Performance bias and selection bias were found in only 40% of the studies.These formulas improve erectile function when the root is Liver qi stagnation.The primary outcomes were the significant decreases in the mean IPSS and AMS after the CHM treatment. Two reviewers MRY and TAS screened titles and abstracts extracted from various databases using the well-defined selection criteria. Several plants contain flavonoids and phenolic compounds which are potent antioxidants and are highly effective in improving the quality of sperms (Rekka et al., 1996). In 30–80% of cases, sperm damage is postulated to have resulted from oxidative stress caused by reactive oxidative species (ROS). Western Medicine Etiology This product as per FDA website has the undeclared ingredient “Sildenafil” and FDA has issued warning Patient reported he is also using “Mojo Risen” which has been shown to contain Noracetildenafil as confirmed by FDA laboratory analysis. To list some of these products which the patient took, as confirmed by patient, included “Male Enhancement”, “Extenze” which had the word written “doctor approved”. Those products packaging did not list quantity, ingredients, warning sign or harmful side effects of the products. This was the only herbal medicine investigated as a single herb with a standardized extract (hypericin). (Saint John’s wort) is used traditionally in Chinese, Greek and Islamic medicine systems and is a popular medicinal herb globally, prominently as an anti-depressant treatment 27,28,97. Extractions of herbal medicines contain secondary plant metabolites that can work synergistically or as isolates on human physiology . One study investigated mindfulness meditation as a psycho-neuro technique for PE, where mindfulness meditation with vibrator-assisted start–stop exercises and (VSS+) improved CHEES significantly better compared to only vibrator-assisted start–stop exercises (VSS) and no treatment . Another study found that penile root masturbation (PRM) and Kegel exercise increased IELT and decreased PEDT, where PRM was significantly better than Kegel exercises . Trials addressing different domains of male sexual dysfunction—including erectile dysfunction (ED), late-onset hypogonadism (LOH), and premature ejaculation (PE)—were included to capture the breadth of male sexual health conditions and their potential herbal interventions. The beneficial effects have been scientifically evaluated and confirmed in meta-analyses of randomized clinical trials.6 For example, in a double-blind, placebo-controlled study, 45 men with moderate to severe erectile dysfunction had found improvement in their scores on erectile performance and sexual satisfaction after treated with three times daily doses of 900 mg Korean red ginseng for 8 wk.7 A similar study on 60 men with erectile dysfunction also reported marked improvement in erectile function including rigidity, penetration, and maintenance of erection after taking Korean red ginseng (1000 mg) three times daily for 12 wk.8 In March 2020, Srivatsav et al. reviewed the efficacy and the safety profile of several common aphrodisiacs used in the treatment of erectile dysfunction, but the study was not exhaustive and psychiatric and neurological adverse effects were not addressed . Androgen receptor (AR) is abundantly expressed in male genital tissues and in spermatozoa,56 and its expression is significantly decreased in infertile men.57 Ginsenoside Rb1 and Re have been reported to be AR agonists, through which these ginsenosides stimulate NO production via the activation of NOS.58,59 Ginseng berry extract GB0710, of which ginsenoside Re is the key ingredient, could improve erectile dysfunction in rats by inducing NO production.10 Re-induced NO production in sperm has also been shown to be involved in capacitation and acrosome reaction, and that these effects could be a result of the non-genomic activities of the Re-AR interaction.40 Excessive consumption of carbohydrates, sugars, and fried food may increase the production of Dampness or Phlegm, which may produce sexual dysfunction. Most books, from ancient to modern, teach that an excess of ejaculation will deplete the Kidney Essence and will produce male erectile dysfunction. Insufficiency of Jing or essence will lead to infertility and erectile dysfunction. It is the basis of our sexual function, erectile function in charge of producing sperm in men and ova and menstrual blood in women. Daily treatment of Asian ginseng (25–100 mg/kg) or ginsenoside Rg1 (2.5–10 mg/kg) demonstrates a dose-dependent increase in mounting, intromission, and penis licking in mice which are exposed to estrous females.18 Such effects are not observed in mice treated with ginsenoside Rb1, Rb2, and Ro. In this review, we will summarize the effects of ginseng on male sex performance and spermatogenesis. The pills marketed as safe herbal alternatives to Viagra and other prescription medication for erectile dysfunction exhibits a hidden danger and adverse effects especially among people with pre-existing heart conditions. Their scores on the International Index of Erectile Function-5 (IIEF-5), a standard measure for erectile dysfunction, increased from an average of 11.2 to 17.9. The study revealed that men in the treatment group experienced significant improvements in sexual health compared to those taking a placebo. This condition, affecting middle-aged and older men, is characterised by declining testosterone levels and symptoms such as reduced libido and erectile dysfunction. Studies are beginning to uncover how these natural remedies work to improve energy, balance hormones, and target specific health challenges like erectile dysfunction, fertility, and prostate health. Click here to read more about managing erectile dysfunction with Chinese herbs. Seventy plant species have been reported for the management of erectile dysfunction in Ethiopia. Since the discovery of phosphodiesterase type 5 inhibitors, a significant portion of the patients has solved the issue of erectile dysfunction. Therefore, use of ginseng appears to be important for the development of novel therapeutics or to increase the effectiveness of the current treatment strategies for male reproductive diseases or disorders. Ginseng is a vital constituent of traditional Chinese medicine and has been used to treat various physical conditions for thousands of years, importantly as an aphrodisiac and is used to treat sexual dysfunction as well as to enhance sexual behavior and gonadal functions (Fig. 1). Estrogen is another hormone with profound effects on sexual function of both male and female. Officinarum, a Chinese herbal medicine belonging to the Zingiberaceae family, was studied in Iran through a double-blind RCT (Kolangi et al., 2019). All three studies compared the outcome values with the baseline of the same patients. Also, sperm motility was increased from 32 ± 17% to 39 ± 19%, and a significant increase in seminal plasma soluble Fas (sFas) was observed. Ginseng is one of the most precious herbs in traditional Chinese medicine. In 2010, an estimated 48.5 million couples worldwide were infertile.1 In approximately 40% of these couples, the male partner has been either the sole or a contributing cause of infertility.2,3 Herbal therapy is increasingly popular worldwide as a way to treat infertility. It was concluded by the psychiatric treatment team that the patient’s physical state/seizures like activity was resulting from his continued misuse of over-the counter- ED supplements as self-reported by patient and his friend. Later patient called his friend and request to take him to nearby healthcare facility Patient reported right hemiparesis, unstable gait and imbalance. The availability of these products through the internet and over the counter in local grocery stores places has a huge clinical challenge to health care. Unfortunately, as reported by patient he went home after discharged and he continued to abuse ED supplements. He was found unresponsive in his apartment by his home health aide; he had saliva drooling from the mouth, and was unresponsive to questioning from the admitting physician. Qi Ying Lean However, sexual enhancers of plant origin have gained popularity over recent years, as natural substances are often regarded as a safer alternative to modern medications and are easily acquired without prescription.Many options exist, from medication, counseling, lifestyle changes, surgeries, and vacuum devices to improve erectile function.The tertiary outcomes were the alteration of the mean BCQ score and an obvious increase in the mean IIEF after the CHM treatment.However, not all patients respond to the treatments available, and adverse effects and costs may further limit pharmacological intervention .Furthermore, in a previous uncontrolled pilot study, SS-Cream improved IELT compared to baseline and seemed effective in PE and PE combined with erectile dysfunction .According to a recent study in Ethiopia, plants in the Fabaceae family are the most commonly used traditional medicinal plants .Peng et al. (2014) conducted an RCT in China to assess the extent of the effect of Gushenyutai plaster on male infertility.Andropause, or the gradual decline in testosterone levels, brings challenges like fatigue, brain fog, weight gain, and mood changes.While Western approaches to care can be effective, they also often come with unwanted side effects. Derived from the bark of an African tree, yohimbe has been studied for its effects on ED, particularly in men whose dysfunction is caused by certain antidepressants. While it’s true that ginkgo can enhance circulation, there’s no strong evidence to suggest it improves erectile dysfunction. Known as the “Korean red ginseng,” Panax ginseng has been used in traditional medicine for centuries to improve sexual performance. Research has shown that DHEA supplements can improve erectile function, particularly in men with low testosterone levels. For many men, erectile dysfunction (ED) is a common but sensitive issue that can impact their confidence and relationships. A variety of health factors can cause unexpected changes in the production of testosterone. For men, testosterone is responsible for sexual development, muscle growth and bone density, and sex drive. While testosterone is typically thought of as a male hormone, it is also important for women. However, sexual enhancers of plant origin have gained popularity over recent years, as natural substances are often regarded as a safer alternative to modern medications and are easily acquired without prescription. These pills contain naturally occurring ingredients that are safe and have virtually no side effects. Now, there’s a better alternative in form of natural male enhancement pills. By inhibiting the production of cortisol, garlic promotes the generation of more testosterone and an improved sex drive. Congruent to the present study, the people of Nigeria also traditionally use the root of Asparagus africanus Lam. As a result, these studies highlight the screening of plant species belonging to the Fabaceae family that could be important candidates to bring lead compounds to be used for future optional agents. According to a recent study in Ethiopia, plants in the Fabaceae family are the most commonly used traditional medicinal plants . Combined use of Yidiyin and hypoglycemic drugs could increase patients’ scores on international index of erectile function-5 (IIEF-5) more than the hypoglycemic drug alone. Yidiyin, a Chinese herbal decoction used to treat diabetic ED, was shown to improve the erectile function in diabetic patients and rats. It was reported that intraperitoneal Panax notoginseng saponins injection for 4 weeks improved erectile function in rats with diabetic ED by increasing Akt expression and suppressing oxidative stress in the penis (36). It was shown that Cistanche extract shortened the erectile latency and prolonged the erectile duration in castrated rats. Hence the precise mechanism underlying its pro-erectile property needs to be investigated further. It was reported that osthole had a relaxant effect on strips of rabbit corpus cavernosum, which might involve the release of NO from endothelium and inhibition of phosphodiesterase (16). It has been used basically for treating ringworm, swelling of women’s genitals and male impotence. Moreover, the administration of EGb761 was able to enhance the noncontact erection, a penile erection initiated by brain centers, in male rats by increasing the dopamine contents in some parts of brain (14,15). Herbal remedies and lifestyle changes can support prostate health, alleviate urinary symptoms, and even complement conventional treatments for prostate cancer. In this guide, we’ll explore the most common men’s health concerns, how TCM approaches them, and the best herbs to support your journey to better health. Somnifera, in treating male infertility. Key limitations across the included trials encompass modest sample sizes, heterogeneity of herbal preparations and dosing regimens, short- to medium-term follow-up periods, and limited mechanistic assessment (Table 1). Maca offers an androgen-sparing option when the goal is to improve sexual desire or LOH symptoms without altering testosterone -. The effect of RANTES on human sperm chemotaxis. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors, and the reviewers. This review may have been affected by publication bias (inherited from the trials), as is the case for all medical research practices (Easterbrook et al., 1991). Caution must be exercised, however, in the use of herbs at least until the FDA and WHO approve them. Thereby, the goal of treatment is to restore the balance between Yin and Yang. A large number of studies have been conducted to investigate the effect and mechanism of TCM for treating ED. Importantly, improved diet and exercise should be considered, particularly in patients with obesity or diabetes mellitus. The mechanisms of action remain unclear, but each of these appears to in part increase nitric oxide synthesis. Up to 718 plant species are used in traditional medicine as aphrodisiacs, compounds that increase sexual arousal, libido, potency (erection) and/or sexual pleasure 13,19. Complementary and alternative medicines, including dietary supplements and herbal remedies, are increasingly being used for treatment of ED, particularly through over-the-counter and internet sources 6,13,15,16. However, not all patients respond to the treatments available, and adverse effects and costs may further limit pharmacological intervention . Importantly, ED has a significant negative impact on a man’s quality of life, including loss of self-esteem, avoidance of intimacy, anxiety and depression, which in turn exacerbate sexual dysfunction. This is a common and increasing male sexual health concern, with a prevalence of up to 31% and projected to affect up to 322 million men by 2025 . The patients also experienced improvements in other symptoms affecting their quality of life, such as dry mouth, residual urine sensations, and excessive thirst. Finally, we also chose to include small amounts of Huang Bo (Cortex Phellodendri) and Zhi Mu (Rhizoma Anemarrhenae) in our formula, with both included for the purposes of clearing heat and purging kidney fire, according to TCM theory. Yin Yang Huo (Herba Epimedii) was used, according to TCM theory, to strengthen kidney Yang, increase the libido, and treat impotence. Single Chinese herb or herbal extracts Specifically, this included herbal medicine , yoga and physio-kinesitherapy, biofeedback therapy and electrical stimulation of the perineal floor . However, reporting the adverse events were not consistently mentioned in all the studies included and was not reported at all in four studies 61,66,69,79 (Table 1). Most studies and interventions investigated showed few adverse effects and good short-term safety profiles. The studies included in this review used a variety of different comparison groups. Data were collected using an Excel sheet and included the study design, a description of the patient and control cohorts, the dosage and duration of the intervention used, a report of the outcomes and any adverse effects. Large-scale epidemiologic investigations, including the Massachusetts Male Aging Study and the Multinational Men’s Attitudes to Life Events and Sexuality (MALES) study , have documented an age-dependent increase in prevalence.For example, the administration of standardized ginseng extract (100 mg/kg) daily for 90 d in streptozotocin-induced diabetic rats has been shown to result in a significant improvement of fertility parameters and decrease in testicular pathological signs, such as degenerative changes of the seminiferous tubules.50 Furthermore, the consumption of Korean red ginseng (30 mg/kg, three times a week for 1 mo) can help streptozotocin-induced type 2 diabetic male rats to improve on libido and sexual performance.51 In addition, ginseng has been shown to be able to stabilize diabetes disease progression.For instance, mild gastrointestinal discomfort was occasionally reported, particularly with fenugreek when taken without food .This section collects any data citations, data availability statements, or supplementary materials included in this article.Various treatment modalities including pharmacological and herbal interventions, laboratory methods, and surgical interventions are available to treat male infertility (Sinclair, 2000).Thereby, the goal of treatment is to restore the balance between Yin and Yang.Whether you’re dealing with erectile dysfunction, fertility struggles, or just looking to optimize your health, there’s an herbal solution for you. Her life as a remote herbalist and writer has allowed her to work with a variety of wellness brands, health pioneers, and her wonderful clients. In fact, it was her love for plant and earth medicine that first drew her to study Chinese medicine. Kate Downes is a Chinese medicine practitioner with a passion for herbal medicine. When it comes to supporting these men’s health issues, Chinese medicine has your back. Topical anesthetics, prominently lidocaine and prilocaine, have been widely used as a medical treatment to reduce glans sensitivity for PE . However, the Chinese Medicine Symptoms Score decreased, and the sex life satisfaction score increased significantly more than dapoxetine alone . Although the role of FSH, if any, in ejaculation has not been well investigated, men with PE have been found to have higher levels of FSH compared to healthy controls . EiacuMev® is a polyherbal combination of Satureya montana, Tribulus terrestris, Phyllanthus emblica and Cardamomo, with L-tryptophan, ascorbic acid, vitamins B1, B3 and B6 . Although the role of PGF2α in ejaculation is not clear, administration to boars significantly increased ejaculation time . A web-based systematic research literature search strategy was conducted through various electronic databases including PubMed (Medline), Google Scholar, and grey literature to access the relevant studies. This review was carried out following the recommendations stated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement . The current study was carried out to systematically compile and document the traditional medicinal plants used for the management of ED or impotence in Ethiopia. Around 6500 plant species are reported in the Ethiopian flora; of those, approximately 12% are endemic. It is unclear if the increase in FSH with EiacuMev® is beneficial for patients with EjD, which appears to be a somewhat contradictory result. GJMSHT increased IELT alongside CIPE10 and CIPE5 scores compared to a group with no treatment, with an increased Sexual Partner’s Satisfaction Rate and Wish Fulfillment Rate . Gu-jing-mai-si-ha (GJMSHT) is a traditional Uighur medicine polyherbal combination of Radix anacycli pyrethri, Mastiche, Fructus cardamomi, Rhizoma Cyperi, Stigma Croci, Semen Myristicae, Radix Curcumae, Folium Syringae oblatae, Radix et Rhizoma Nardostachyos, Fructus Tsaoko and Flos Rosae rugosae . Is as effective as SSRIs, with lower side-effects and fewer trial dropouts compared to SSRI treatment groups 98,99, particularly through hypericin and hyperforin as well established active constituents . IELT increased significantly compared to the placebo control for Hypericum perforatum L., and improved intercourse satisfaction and orgasmic function . Combined use of Yidiyin and hypoglycemic drugs could increase patients’ scores on international index of erectile function-5 (IIEF-5) more than the hypoglycemic drug alone.It is difficult to analyze the herbal products that cause adverse events due to insufficient information, lack of expertise.This suggests the reported plant species could be a source of a new class of drugs against ED.The availability of these products through the internet and over the counter in local grocery stores places has a huge clinical challenge to health care.Another study was conducted in Iran, a triple-blind RCT, to compare the effects of W.A safety study found that taking 2,000mg of shilajit daily for 45 days was safe. Patients returned to clinics as scheduled and completing international prostate symptoms scores (IPSS), aging male symptoms score, international index of erectile function, and body constitution questionnaire of traditional Chinese medicine. If you're looking to enhance your sexual performance, there are a few licensed treatments available that are safer alternatives to OTC herbal male enhancement pills and penis enlargement pills that supposedly work wonders. Furthermore, the present review did not consider a single intervention, and numerous different forms of alternative medicines and herbal remedies are reported. STI Rates Surge in UK as Awareness Lags, Study Finds Fenugreek may enhance hypoglycemic effects of diabetes medications,This male sexual dysfunction will need a long time to recover, probably several months.However, the unselective action of radiation therapy can also damage normal cells, leading to side effects.Before we look at these herbs, it’s worth pointing out how they treat this frustrating issue in men.American and Asian ginseng present a good safety profile with a few cases of mild gastrointestinal and sleep disorders.In one study (animal), the mice engaged in more rounds of sex for longer durations each round.This development marks an encouraging step forward in addressing the challenges of male sexual dysfunction. The safest way to buy male enhancement pills is to see a doctor, get yourself checked by them, and buy the pills they prescribe for you, at a certified drugstore. The period for which the effects of the FDA-approved prescription drugs for ED last varies; sildenafil effects last for about 4 hours, vardenafil lasts for about 6 hours, and tadalafil effects last for up to 36 hours with one dose. Talk to your partner openly and discuss how you can improve the quality of your intimacy and sexual relationship. Get a medical checkup to see if there are any underlying health issues and have them treated. Herbal male enhancement pills are touted to be natural alternatives to prescription drugs, but they are not safe. However, EjD is reported in 1.8% of males with infertility, with RE the most common (0.7% males), followed by PE (0.5%) and anejaculation (0.4%) . Controlled clinical trials investigating a cohort of male patients diagnosed primarily with EjD and undergoing any TCAM intervention compared to any comparison group were included. Although psychological and pharmacological treatments are available, traditional, complementary, and alternative medicine (TCAM) is reportedly used. The patients participating in this study were required to fill in questionnaires including the IPSS questionnaire, the Aging Male Symptoms (AMS) scale, the International Index of Erectile Function (IIEF), and the Body Constitution Questionnaire (BCQ) before the trial, at week 4, and after the CHM treatment course at week 8. The treatment duration was 8 weeks, and the patients were asked to take one pack of the medicine three times per day. Data on the epidemiology in the general population of EjD as a heterogenous sexual disorder are scant . The available studies were widely heterogenous in the TCAM intervention investigated and comparison groups used. Quality of the studies was assessed using the Cochrane Risk of Bias tool for randomized controlled trials. We would like to thank Jui-Fang Huang, the statistician performed quality assurance checks on the data and conducted the study analysis. Further rigorous double-blinded clinical trials should be implemented in the future to further confirm and clarify the effects of the CHM formula. This review establishes that all herbal interventions had a significantly positive effect on male infertility. All of these studies reported significant improvement in semen parameters, therefore reinforcing the reported efficacy of the herbal interventions used in the study. A significant increase was observed in sperm parameters of the patients after 6 months, and 17.9% of couples reported pregnancy after treatment. Ginseng is also reported to increase testosterone concentrations, improving erection and increasing copulatory behaviour . Ginseng was further used in a combination herbal formula including KBMSI-2 and VigRX Plus (VXP) , both improving erectile function. In traditional Chinese medicine practice, Panax ginseng (Korean ginseng), particularly the steamed aged root called red ginseng, has been used as an aphrodisiac to improve sexual performance for thousands of years 65,66. This included single and combined herbal interventions, non-herbal nutraceuticals, combined herbal and non-herbal nutraceuticals, acupuncture, lifestyle intervention, and topical herbal applications. A systematic review of the literature for placebo-controlled clinical trials investigating traditional and herbal medicine was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines . To further clarify the effects and clinical application of Chinese herbs and herbal formulas, well-designed RCTs need to be conducted. Animal experiments indicated that administration of Yidiyin increased rats’ erectile function through activating NOS-cGMP pathway (45). In addition, icariin was reported to increase the circulating testosterone level in rats with damaged reproductive system (42). Heart & Gall Bladder Qi Deficiency No significant change was detected in the semen volume and sperm density after 12 weeks. The treatment group was given 150 ml decoction of Qixiong Zhongzi twice a day, while the control group received 1 g of levocarnitine twice a day. The effect of Qixiong decoction, a Chinese medicine, was studied through an RCT in China (Wang et al., 2020b). Sperm motility was increased by 4.6%. An amount of 120 mg/kg DPP powder capsules were given to patients every other day. Terrestris treatment produced mixed results. In total, 24 RCTs, including 2080 patients with ED, were identified. The Botanical Institute does not provide medical advice, diagnosis, or treatment Polysaccharide on testosterone content, substance metabolism and exercise capacity in rats of exercise training. Aqueous extracts and hydrocortisone on the concentration of blood plasma testosterone in mice. Moreover, no study has been conducted to evaluate the efficacy of herbal interventions in the treatment of male infertility. When men face health challenges like erectile dysfunction, low testosterone, or prostate concerns, conventional Western medicine often offers quick, targeted solutions. Somnifera; complementary and alternative medicine; herbal interventions; male infertility; semen parameters; systematic review. The heterogeneity of outcome domains (erectile dysfunction, hypogonadism, premature ejaculation) reflects the breadth of male sexual dysfunction but limits direct comparisons across interventions. Aqueous, chloroform, and alcohol extracts of Gloriosa superba at the dose of 500 mg/kg body weight showed an aphrodisiac effect with an increase in sexual and orientation behavior. The third cited plant, Carissa spinarum L., alike the Ethiopian people, the people of South and Central Benin use its roots for the treatment of sexual weakness. Alike this study, Semenya and Potgieter reported that Fabaceae and Asteraceae were among the commonly used families for ED. As shown in Table 1, the current review reported 70 Ethiopian plant species that have traditionally been used to treat ED. Prostate Cancer Surgery Linked to Lasting Changes in Quality of Life and Sexual Health Later patient called his friend and request to take him to nearby healthcare facility Patient reported right hemiparesis, unstable gait and imbalance.The inclusion criteria were met by 19 studies which comprised 1,398 participants.This is mediated through increased NO in the endothelium and nitrergic nerve endings, inducing vasodilation.Moreover, the administration of EGb761 was able to enhance the noncontact erection, a penile erection initiated by brain centers, in male rats by increasing the dopamine contents in some parts of brain (14,15).Panax notoginseng is planted mainly in Guangxi province and Yunnan province of China.The effect of RANTES on human sperm chemotaxis.Data on the epidemiology in the general population of EjD as a heterogenous sexual disorder are scant . The findings provide hope for men seeking non-hormonal treatment options, particularly those unable to undergo testosterone replacement therapy (TRT) due to health risks. Her goal is to help the public gain a better understanding of the wonders of Chinese herbal medicine so they can be empowered in their own quest for natural, vibrant health. Chinese herbal medicine offers a powerful, natural way to address the root causes of common men’s health issues. Another study published in the Journal of Sexual Medicine found that Maca Root can enhance sexual desire and improve sperm quality. Research shows that its active compound, icariin, helps improve blood flow by inhibiting the enzyme PDE5—similar to how certain pharmaceuticals work for erectile dysfunction. This is a broad definition, incorporating traditional medicine systems and modalities. These treatments also only deal with the symptoms of ED and do not address any underlying pathogenesis . Although generally well tolerated, adverse effects include headaches, dyspepsia, nasal congestion, flushing, syncope, vision loss, priapism, and myocardial infarction . Pharmaceutical treatments for ED are typically phosphodiesterase-5 inhibitors that inhibit the outflow of blood from the penis to induce erection. The IIEF is a validated subjective score with high sensitivity and specificity for ED , and is used as a global standard in the clinical investigation of conventional and surgical interventions for ED 9,10. Although English, Italian and Spanish full-text articles would be included, there is a limitation on other language publications. However, there is some variation in the definition of the cohort for PE and inclusion criteria for the different studies. The keyword search strategy and eligibility were based on the Population, Intervention, Comparison, Outcomes and Study Design (PICOS) framework and aligned with the aim of this study. This systematic review used the PRISMA guidelines to improve validity and reliability. Overall, cordyceps is my favorite natural male enhancement supplement followed by Tongkat Ali and horny goat weed. Out of all the Chinese herbs I’ve tested over the years, these 5 worked the best for me. The first time I took Fo-Ti, I noticed an increase in my energy and a spike in my libido. In one study (animal), the mice engaged in more rounds of sex for longer durations each round. The Chinese believe that goat weed can raise low testosterone levels and boost muscle mass. Eurypeptides (approximately 4.3 kDa) have been described as putative “phytoandrogens”, potentially facilitating enhanced testosterone biosynthesis in Leydig cells through direct steroidogenic stimulation . In addition, morning erection frequency and sexual activity levels improved compared to placebo . Building on this, Rao et al. evaluated Testofen in 111 healthy aging men for 12 weeks. Fenugreek extracts have shown promising results across two studies. Gushenyutai plaster is made from 23 herbs and serves as a transdermal patch. A total of 18.75% of couples became pregnant in the treatment group compared to 3.3% in the control. However, an insignificant change in sperm morphology was observed. Whether you’re suffering from erectile dysfunction or just want a performance boost, Chinese herbs get the job done. Low testosterone can lead to reduced sexual function and vitality, and TRT helps reverse these effects. Although it is increasingly investigated for medical application, hyaluronic acid is not reported as a conventional treatment for PE and is included as a TCAM treatment in this review. Furthermore, in a previous uncontrolled pilot study, SS-Cream improved IELT compared to baseline and seemed effective in PE and PE combined with erectile dysfunction . However, the included studies generally showed improved outcomes intra-group and when compared to placebo. Therefore, this study aims to systematically review human clinical trials investigating the use of TCAM to treat EjD. In conclusion, this trial indicated that the add-on CHM formula (VGHBPH0) consisting of Ji-Sheng-Shen-Qi-Wan, Sang-Piao-Xiao-San, Wu Yao, Yi Zhi Ren, Dan Shen, Yin Yang Huo, Fu Pen Zi, Huang Bo, and Zhi Mu might be a potential treatment for improving the lower urinary tract symptoms of BPH patients. After the combined therapy consisting of the investigated CHM formula and various Western medicines, the patients with BPH showed significant improvement in terms of their LUTS, especially with respect to their voiding and incomplete emptying symptoms. In addition to Ji-Sheng-Shen-Qi-Wan, Sang-Piao-Xiao-San (Mantis Formula), which was first prescribed by Tsong-Shi Ko in AD 1116 and is composed of eight herbs, was a formula that was commonly prescribed by TCM physicians for patients with BPH in Taiwan (Table 3). Not specified in the study Fenugreek may enhance hypoglycemic effects of diabetes medications, However, evidence is limited to interventions of 6 months or less, with little data on long-term safety beyond this timeframe. The evaluation of infertility. Efficacy of aphrodisiac plants towards improvement in semen quality and motility in infertile males. Phytomedicine 21 (6), 901–905. Although the mechanisms of action of SS-Cream have yet to be determined, it is proposed that the active constituents of the included herbs act as desensitizing agents on the glans penis, smooth muscle relaxation and increased local blood flow that may be mediated through the activation of NO/guanosine monophosphate pathways . Furthermore, QSF has been shown to increase low baseline levels of NO and serotonin and decrease high baseline levels of testosterone and oxytocin in PE patients, with no effect on FSH, LH, prolactin and thyroid-stimulating hormone . IELT increased significantly, and PEDT decreased significantly for EiacuMev® compared to counselling and sexual behavioral treatment, with no change in MSHQ-EjD . NO levels are reduced in males with PE, where increased NO secondary to SSRI treatment improves ejaculation latency through a central mechanism . This formula is proposed to increase testosterone, dopamine, serotonin and nitric oxide (NO), and inhibit phosphodiesterase-5, although these mechanisms were not investigated in this study . What are male enhancement pills? Park et al. (2016) conducted a double-blinded RCT to assess the efficacy of red ginseng in male infertility. A total of 62 patients were distributed into a treatment group and a placebo group in an experimental study (Khoradmehr et al., 2014). After the treatment period, no comparable improvement was noticed in semen parameters and hormones, therefore showing saffron to be ineffective in treating male infertility. Sperm density and motility along with serum FSH, LH, and testosterone were significantly elevated after treatment in the patients as compared to their baseline. A total of 20 oligozoospermic patients were equally divided into the treatment group and the control group. The researchers found that shilajit increased levels of total testosterone, free testosterone, and dehydroepiandrosterone (DHEAS) compared to the group that received a placebo. Although shilajit may work to benefits for women, various clinical trials have looked at the benefits of shilajit for men’s health, particularly for testosterone support. In traditional Ayurvedic medicine, Shilajit was known as a “Rasayana”, that is, a herb that works to rejuvenate the body, increase longevity, and helps to slow the aging process. This section collects any data citations, data availability statements, or supplementary materials included in this article. Administration of Hochu-ekki-to and Withania somnifera resulted in an improvement in sperm motility and concentration and a decrease in cytokines and an improvement in the primary endpoints of semen, respectively. The compound herbal remedy comprised Allium cepa, Cinnamomum verum, Zingiber officinale, Ocimum basilicum, Citrullus lanatus, peel of Citrus sinensis, and seeds of Daucus carota (Ouladsahebmadarek et al., 2016). Topalaf is a powdered blend of various herbs including Tribulus terrestris, Orchis mascula root, pollen of Phoenix dactylifera, the seed of Allium ampeloprasum, and the seed of Lepidium sativus, Amygdalus communis, and Ficus carica. However, the uses of these interventions are limited to specific patient populations or have certain side effects that interfere with patient quality of life. The current Western medicine treatment options for benign prostatic hyperplasia (BPH) have various degrees of documented effectiveness. The risks of buying male enhancement pills over the counter apply to online purchases as well, because these are sold as herbal supplements, and not regulated by the FDA like drugs are. Very often, the actual composition and strength of the ingredients in the herbal pills are also not known, so it is impossible to determine how long their effects last, or the entire gamut of side effects. Erectile dysfunction and premature ejaculation can be treated appropriately by a specialist.