Herbal dietary supplements for erectile dysfunction: A systematic review and meta-analysis of randomized-controlled...

Interest of herbal supplements as alternatives to conventional treatments for erectile dysfunction (ED) has increased markedly. This systematic review and meta-analysis aimed to evaluate the effectiveness of herbal supplements in treating ED.

Pubmed, Embase, and Cochrane CENTRAL databases were searched for relevant studies published until June 1, 2023. Randomized controlled trials (RCTs) evaluating herbal supplements for ED compared to a placebo or no intervention were eligible for inclusion. The outcomes of interest included erectile function, orgasmic function, sexual desire, subjective satisfaction, and serum testosterone levels.

Fourteen RCTs with a total of 1227 males with ED were included. Mean age of study participants ranged from 35 to 65 years; and follow-up ranged from 1 month to 6 months. Herbal dietary supplements had a significant, positive effect on erectile function (standard mean difference (SMD) = 1.20, 95 % confidence interval (CI): 0.64-1.76), orgasmic function (SMD = 1.09, 95 % CI: 0.34-1.83), sexual desire (SMD = 1.02, 95 % CI: 0.45-1.60), intercourse satisfaction (SMD = 1.48, 95 % CI: 0.83-2.13), overall satisfaction (SMD = 0.93, 95 % CI: 0.45-1.40), and serum testosterone level (SMD = 0.54, 95 % CI: 0.04-1.05) compared to effects in the control groups. Saffron was effective in improving erectile function, orgasmic function, and intercourse satisfaction, while ginseng benefited erectile function, orgasmic function, sexual desire, overall satisfaction, and serum testosterone levels. In contrast, evidence for other agents such as Tribulus terrestris and Maca remains insufficient, underscoring the need for larger, high-quality trials with longer follow-up.