Ginseng for erectile dysfunction: will it get you harder?

Ginseng is the root of plants in the Panax family, and the one people usually mean is Panax ginseng, which grows in Korea and north-east China. The knobbly root can look like a tiny human figure, which is partly why it was treated as a whole-body tonic. Panax shares its Greek root with panacea, a cure for everything. No pressure, then.

Red ginseng is that same root after it has been steamed and dried. Raw or air-dried root stays pale and is sold as white ginseng. Steaming turns it a reddish amber and changes some of its active compounds, the ginsenosides, into forms that seem easier to absorb. Most of the sex research uses the red form, so that's the one to buy if you're thinking about ginseng for erectile dysfunction.

You'll also spot American ginseng (Panax quinquefolius) and Siberian ginseng, which isn't true ginseng at all. Different plants, different chemistry, and the erection studies don't apply to them. Read the label before you spend your money.

Ginseng has been used in Chinese and Korean medicine for around 2,000 years. It was prized for tiredness, weakness and ageing, the kind of thing you gave someone who looked worn out. Wild roots were so valuable they were traded like treasure, and rulers kept the best for themselves.

Its reputation as a sex tonic grew from that bigger idea of restoring energy. If a man felt flat, tired and not in the mood, ginseng was meant to bring his spark back. In Korea today, red ginseng is an everyday product, sold as teas, gummies, extracts and drinkable sachets, and plenty of people take it simply to feel more awake.

When Western researchers started testing herbal aphrodisiacs properly, ginseng was one of the first to turn up results worth taking seriously. That's rare. Most famous love herbs have little more than old stories and glossy packaging behind them, so the fact that Korean red ginseng benefits have been measured at all puts it ahead of the crowd.

Several small randomised trials, mostly from Korea, compared red ginseng with a dummy pill in men with erectile dysfunction. In many of them, men taking ginseng reported firmer erections and more satisfying sex after about eight weeks. A 2008 review that pooled several of these trials called the evidence suggestive, while saying bigger and better studies were needed.

A later Cochrane review, one of the most careful kinds of evidence summary, was more cautious. It concluded that ginseng may make only a small difference to erections themselves, though it might slightly improve how satisfied men feel with intercourse. The certainty was rated low, mainly because the trials were small and short.

So the straight answer is this. Ginseng for erectile dysfunction seems to help some men a little, it's unlikely to fix severe problems, and it's nowhere near as strong as prescription tablets. Many of the trials also came from countries where ginseng is a big industry. Promising, yes. Settled, no. That's still more than most herbal aphrodisiacs can say.

The men who seemed to do best in the trials had mild to moderate problems rather than severe ones. If you can usually get hard but it's less firm or less reliable than you'd like, you're the kind of man the research on ginseng for erectile dysfunction is most relevant to.

Getting hard is mostly plumbing. When you're turned on, the blood vessels in the penis relax, blood rushes in and gets trapped there, and you stay firm. A molecule called nitric oxide drives that relaxation. Lab research suggests ginsenosides may support nitric oxide release from the lining of blood vessels, which would help the whole process along.

Ginseng is also called an adaptogen, a loose label for herbs thought to help the body cope with stress and fatigue. That's harder to measure, but it makes sense. Being exhausted is one of the biggest libido killers there is, and a man who feels less drained is more likely to feel horny, stay present and enjoy himself.

Some research has looked at whether ginseng raises testosterone. A few animal studies hint that it might, but the human evidence is weak. If you feel tired, low and uninterested in sex, a simple blood test from your GP will tell you far more than guessing with supplements.

Most studies used somewhere between 1 and 3 grams of red ginseng a day, often split into two or three doses. Many supplements are concentrated extracts, so follow the label rather than trying to work out grams of raw root yourself. More is not better here. It mainly means more chance of side effects.

• pick a Korean red ginseng product that states its ginsenoside content
• take it daily, ideally in the morning or around lunchtime
• skip evening doses, as it can keep some people awake
• keep a quick note of your energy, desire and erections each week
• take a short break after a few months, as many traditional users do

Quality varies wildly. Some cheap products contain very little real ginseng, and a few 'male enhancement' blends have been caught hiding prescription drugs. A reputable brand that's been tested by an independent lab is worth the extra few pounds, especially if you're hoping ginseng for erectile dysfunction will pay off.

This is where most people give up too early. Prescription ED tablets kick in within about an hour. Ginseng doesn't work like that at all. The trials that showed benefits usually ran for eight weeks or more before measuring anything, and the effect builds slowly with daily use.

So taking a capsule on Friday afternoon and expecting a rock-hard Friday night is a recipe for disappointment. Some men say they feel more energetic within a couple of weeks. Changes in erections, if they come, tend to show up later, somewhere between four and eight weeks.

Give a decent product a fair eight to twelve weeks. Then be honest with yourself. If you've noticed nothing in bed by then, it probably isn't going to start, and your money is better spent on a chat with a doctor about options that are proven to work.

Most of the research is in men, but there's a little in women. A small Korean trial in women going through the menopause found that those taking red ginseng reported better arousal than those on a placebo. That's an encouraging hint, not a firm answer, so treat it as something to try rather than a promise.

For many women, low desire is tangled up with stress, tiredness, hormones, pain during sex or relationship strain. Ginseng won't touch most of those directly. If you're healthy and curious about ginseng libido effects, a trial may be worth it, but talk to your GP first, especially around the menopause or if you take hormonal medicines.

Ginseng isn't recommended in pregnancy or while breastfeeding, because there isn't enough safety information. And whatever your body, the things that reliably get you wet or hard still matter most: feeling relaxed, feeling wanted and having enough time to warm up properly.

Ginseng is usually well tolerated, but it isn't for everyone. The most common side effects are trouble sleeping, headaches, an upset stomach and feeling a bit jittery. Some people notice changes in their blood pressure. Taking it earlier in the day sorts out the sleep issue for most.

• people taking warfarin or other blood thinners
• anyone on diabetes medicines, as it can lower blood sugar
• people taking antidepressants, especially MAOIs
• anyone with uncontrolled high blood pressure
• anyone with a hormone-sensitive condition

If you're on any regular medicine, a two-minute chat with a pharmacist is the easiest way to check for interactions. And never combine ginseng with prescription ED tablets without asking your doctor first, since both act on blood vessels and blood pressure.

Used well, ginseng for men is a gentle background support. It may help with energy and confidence, and for some guys that's exactly what was missing. Confidence matters more than you'd think, because worrying about losing your erection is one of the surest ways to lose it.

Try this tonight, ginseng or not. Slow right down. Spend longer on kissing, touch and going down on each other before anyone even thinks about penetration. Sex isn't a hardness test, and taking the pressure off often brings the erection back on its own.

Look after the plumbing too. Erection changes can be an early warning sign of heart disease, diabetes or high blood pressure, because the blood vessels in the penis are small and show trouble first. Regular exercise, decent sleep, less booze and not smoking feed the same vessels ginseng is supposed to help. Use ginseng for erectile dysfunction as one small part of the plan, and see a doctor if things have changed for you.

If your erections are only a bit less reliable than they used to be, and you're otherwise healthy, trying ginseng for erectile dysfunction for a couple of months is a reasonable, low-risk experiment. It suits men who don't want to plan sex around a pill, or who'd like a general energy lift as well as a firmer erection.

If the problem is bigger, though, don't spend a year hoping a root will sort it. Tablets such as sildenafil and tadalafil are well studied, work for most men and are now easy to get through a GP or, for sildenafil, a pharmacist in the UK. They act within an hour, while ginseng takes weeks to show anything at all.

There's no prize for suffering in silence. Plenty of men use a prescription treatment for a while to rebuild their confidence, then find they need it less once the anxiety fades. Whatever you choose, talk it through with your partner. Saying out loud that you'd like more time, more touch or a different pace is sexy in itself, and it takes the spotlight off your penis.