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Impotence, or erectile dysfunction, is a problem getting or keeping an erection of the penis. The penis is then not firm enough to have sex.

It is treated with medicine and healthy habits. Some people may need to use devices. Others may need surgery. Natural therapies have been used to get or keep an erection.

Natural Therapies

Likely Effective

Ginseng is a plant with roots that are taken as a supplement. It is likely to help maintain an erection.A3, A12

May Be Effective

These therapies may benefit erectile function:

  • Alga ecklonia bicyclis, tribulus terrestris, and glucosamine oligosaccharide A7
  • Alpha-lipoic Acid A11
  • S-Adenosylmethionine (SAMe) A14
  • Testosterone supplements A8, A10
  • Tongkat ali A4

May Not Be Effective

These therapies may not benefit erectile function;

  • Acupuncture B1
  • Chinese herb formula A11

Not Enough Data to Assess

  • French maritime pine bark ( Note : It should not be taken by people who have problems with their immune system.)A1, A6, A13
  • Maca A15
  • Saffron A5, A16
  • Tribulus terrestris A2, A9

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse. For example, French maritime pine bark may make the immune system more active. Talk to your doctor before taking it if you have problems with your immune system.



Herbs and Supplements

A1. Ledda A, Belcardo G, et al. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU Int. 2010;106(7):1030-1033.

A2. Kamenov Z, Fileva S, et al. Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction-A prospective, randomized, double-blind, placebo-controlled clinical trial. Maturitas. 2017;99:20-26.

A3. Borrelli F, Colalto C, et al. Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis. Drugs. 2018;78(6):643-673.

A4. Kotirum S, Ismail SB, et al. Efficacy of Tongkat Ali (Eurycoma longifolia) on erectile function improvement: systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2015 Oct;23(5):693-698.

A5. Mohammadzadeh-Moghadam H, Nazari SM, et al. Effects of a Topical Saffron (Crocus sativus L) Gel on Erectile Dysfunction in Diabetics: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled Trial. J Evid Based Complementary Altern Med. 2015 Oct;20(4):283-286.

A6. Stanislavov R, Rohdewald P. Improvement of erectile function by a combination of French maritime pine bark and roburins with aminoacids. Minerva Urol Nefrol. 2015 Mar;67(1):27-32.

A7. Sansalone S, Leonardi R, et al. Alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide improve erectile function, sexual quality of life, and ejaculation function in patients with moderate mild-moderate erectile dysfunction: a prospective, randomized, placebo-controlled, single-blinded study. Biomed Res Int. 2014;2014:121396.

A8. Corona G, Isidori AM, et al. Testosterone supplementation and sexual function: a meta-analysis study. J Sex Med. 2014 Jun;11(6):1577-1592.

A9. Santos CA Jr, Reis LO, et al. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study. Actas Urol Esp. 2014 May;38(4):244-248.

A10. Mitkov MD, Aleksandrova IY, et al. Effect of transdermal testosterone or alpha-lipoic acid on erectile dysfunction and quality of life in patients with type 2 diabetes mellitus. Folia Med (Plovdiv). 2013 Jan-Mar;55(1):55-63.

A11. Xiong G, Li B, et al. Chinese herb formulae for treatment of erectile dysfunction: a systematic review of randomised controlled clinical trials. Andrologia. 2014 Apr;46(3):201-223.

A12. Choi YD, Park CW, et al. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study. Int J Impot Res. 2013 Mar-Apr;25(2):45-50.

A13. Schoonees A, Visser J, et al. Pycnogenol® (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane Database Syst Rev. 2012 Apr 18;(4):CD008294.

A14. Dording CM, Mischoulon D, et al. SAMe and sexual functioning. Eur Psychiatry. 2012 Aug;27(6):451-454.

A15. Shin BC, Lee MS, et al. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44.

Safarinejad MR, Shafiei N, et al. An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatment. Int J Impot Res. 2010 Jul-Aug;22(4):240-250.


B1. Cui X, Zhou J, et al. Acupuncture for Erectile Dysfunction: A Systematic Review. Biomed Res Int. 2016;2016:2171923.

Last reviewed November 2019 by EBSCO NAT Review Board Eric Hurwitz, DC