Erectile Dysfunction

Why it works: NO–cGMP pathway: L-arginine is the substrate for nitric-oxide synthase, which makes nitric oxide (NO). NO activates guanylate cyclase → raises cGMP → relaxes penile smooth muscle →...

Instructions: Dose used in trials:. • 1.5–5 g/day total (often split 2–3 doses) for 6–12 weeks. ScienceDirect. • Examples: 5 g/day for 6 weeks (double-blind RCT) and 6 g/day for 3 months (double...

Warnings: Do not use after a recent heart attack: Post-MI patients given L-arginine had worse outcomes in the...

Studies: Systematic review & meta-analysis (2019): 10 RCTs; L-arg...

Why it works: May influence nitric-oxide (NO) signaling and arousal circuits (animal data). In sexually sluggish male rats, damiana extract increased sexual motivation/performance; follow-up wor...

Instructions: Tea (infusion): ~1 g dried leaf in 250 mL boiling water, steep 10–15 min; up to three cups daily. PeaceHealth. • Tincture: 2–3 mL, three times daily. PeaceHealth. • Capsules/tablet...

Warnings: Pregnancy & breastfeeding: Avoid—insufficient safety data. (Common monographs and consumer health so...

Studies: Human evidence specific to damiana:No robust randomized cont...

Why it works: Endothelial function & blood flow. Erections depend on healthy endothelium and vasodilation mediated by nitric oxide (NO). Garlic (especially aged garlic extract, “AGE”) has been s...

Instructions: Practical options drawn from human vascular trials (not ED-specific):. • Aged garlic extract (AGE): Formulations like Kyolic have been used in RCTs at ~1,200 mg/day (e.g., 4 × 300...

Warnings: Bleeding risk / surgery: Garlic supplements can increase bleeding risk. Use caution if you take warf...

Studies: Garlic + tadalafil (pilot RCT, 2024): Prospective, randomize...

Why it works: Vasodilation / blood-flow effects. Standardized Ginkgo leaf extracts (e.g., EGb 761) can influence endothelial function and nitric oxide (NO) pathways in blood vessels—mechanisms c...

Instructions: Typical studied ranges (for standardized leaf extract, usually 24% flavone glycosides/6% terpene lactones such as EGb 761): total 120–240 mg/day, often split into 2–3 doses with fo...

Warnings: Bleeding risk / drug interactions. Ginkgo may increase bleeding—especially with warfarin, antiplatel...

Studies: AISD randomized controlled trials (adults; mixed sexes): • K...

Why it works: Boosts nitric-oxide (NO) signalling in penile tissue. Ginsenosides (notably Rg1/Rg3) can increase endothelial NO synthase activity and cGMP signalling, which relaxes corpus caverno...

Instructions: There’s no universally accepted “medical” dose. Typical trial regimens used:. • Korean red ginseng extract 900 mg three times daily (TID) for 8 weeks in a double-blind, placebo-con...

Warnings: Common/expected effects. • Insomnia, nervousness, headaches, GI upset; consider morning dosing. WebM...

Studies: Systematic reviews (most informative):Cochrane Review (2021)...

Why it works: Possible mechanisms (still not fully defined):. • Maca contains unique fatty acid amides (“macamides”/macaenes) and other phytochemicals that have been proposed to influence sexual...

Instructions: Dose range used in RCTs. • 1.5–3.0 g/day of gelatinized maca powder or equivalent capsules for 12 weeks in healthy men (sexual desire outcomes). Drugs.com. • 2.4 g/day of maca dry...

Warnings: General safety: Reviews and monographs consider maca generally well-tolerated short-term at up to 3...

Studies: Men with mild EDZenico et al., Andrologia 2009 — 50 men with...

Why it works: Possible nitric-oxide (NO) pathway effects. Laboratory work suggests TT (especially its saponin protodioscin) can relax corpus cavernosum tissue via the NO/NO-synthase pathway—i.e....

Instructions: Standardized extract (Tribestan®) regimen used in an RCT: 500 mg three times daily for 12 weeks (adult men with mild–moderate ED). This is the best-described single-herb protocol t...

Warnings: Liver & kidney toxicity (rare case reports). Acute hepatitis, renal injury, and even liver failure h...

Studies: Positive RCT: In 180 men with mild–moderate ED, Tribestan® f...

Why it works: TCM rationale. In traditional theory, many cases of ED map to Kidney Yang deficiency (low libido, cold limbs, low back/knee soreness, fatigue). You Gui Wan is a classic Ming-era fo...

Instructions: Classical preparation/dose (textbook-style): Powdered into honey pills; typical traditional instructions cite ~9–15 g, 2–3×/day (pills), adjusted if prepared as a decoction. Sacred...

Warnings: Because You Gui Wan contains processed aconite (Zhi Fu Zi) and often deer antler components, safety...

Studies: Narrative/overview reviews of TCM in ED mention Yougui pill...

Why it works: TCM rationale (pattern-based):. Jin Gui Shen Qi Wan is a classic formula that “warms and tonifies Kidney-Yang.” In TCM, a subset of erectile dysfunction maps to Kidney-Yang deficie...

Instructions: 1) Get the pattern right (most important):. Jin Gui Shen Qi Wan is not a general ED pill; it’s intended for Kidney-Yang deficiency presentations. Using it when there’s Yin deficien...

Warnings: 1) Aconite (Fu Zi; Zhi Fu Zi) content—potentially serious cardiotoxicity if misused:. • Aconitum alk...

Studies: Direct, high-quality RCTs of Jin Gui Shen Qi Wan for ED in h...

Why it works: Traditional indication. In TCM, Wu Zi Yan Zong Wan “tonifies Kidney essence (jing)” and is used for male infertility, decreased libido, spermatorrhea, premature ejaculation, and so...

Instructions: Because proprietary products differ, follow the labeled instructions of the product you actually buy. For a widely distributed example (Beijing Tong Ren Tang water-honey pills):. •...

Warnings: Quality/adulteration & contamination risks. • Some sexual-enhancement “herbals” are adulterated with...

Studies: For erectile dysfunction specifically:No robust human trials...

Why it works: Mechanism: Epimedium’s signature flavonoid icariin can weakly inhibit the enzyme PDE-5, the same pathway targeted by prescription ED drugs; lab work also suggests effects on nitric...

Instructions: Forms you’ll see: capsules/tablets, teas, and extracts standardized to “icariins.” There is no established, evidence-based dose for ED specifically. Authoritative consumer monograp...

Warnings: Interactions & conditions:. • May lower blood pressure → caution with antihypertensives; avoid with...

Studies: Epimedium alone for ED: There are no high-quality randomized...

Why it works: Restores nitric-oxide (NO) supply to the penis. Penile erection depends on NO-mediated relaxation of cavernosal smooth muscle; low NO bioavailability is a core pathway in many case...

Instructions: Monotherapy for mild ED. • Dose used: 1.5 g/day of L-citrulline (elemental, not citrulline malate) for 1 month.. • Outcome measures: Erection Hardness Score (EHS), intercourse freq...

Warnings: Drug interactions / additive hypotension. • Antihypertensives: Citrulline may add to BP-lowering eff...

Studies: Pilot RCT (monotherapy): 24 men with mild ED crossed over be...