Condition

Sexual Health

Sexual health relies on hormones, blood flow, nerves, and mood working together, so stress, aging, or conditions like diabetes can dampen desire and erections. The evidence is moderate for Tongkat Ali, where research found erections went up. That finding came from one small study of 128 people, and tribulus showed no clear difference in a hormone measure among just 21 people.

Sources: PMID 26365449

Supplements studied: 11
Graded outcomes: 10
Trials: 12
People studied: 2,046

Evidence by supplement

Strong
Moderate
Limited
Very limited

11 supplements

Tongkat Ali

Tongkat Ali: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Erections Small Increase	Improves (the measure goes up)	Small effect	1 study	128 people
Studies that measured erections Efficacy of Tongkat Ali (Eurycoma longifolia) on erectile function improvement: systematic review and meta-analysis of randomized controlled trials.Complement Ther Med · PMID 26365449
	Testosterone	Improves (the measure goes up)		4 studies	109 people
Studies that measured testosterone Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism?Andrologia · PMID 21671978 The effect of Eurycoma Longifolia on the regulation of reproductive hormones in young males.Andrologia · PMID 33559971 Effect of Eurycoma longifolia standardised aqueous root extract-Physta ® on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicentre studyFood Nutr Res · PMID 34262417 and 1 more on the Tongkat Ali page
	Sperm Quality	Improves (the measure goes up)		1 study	109 people
Studies that measured sperm quality Randomized Clinical Trial on the Use of PHYSTA Freeze-Dried Water Extract of Eurycoma longifolia for the Improvement of Quality of Life and Sexual Well-Being in MenEvid Based Complement Alternat Med · PMID 23243445
	IGF-1	Improves (the measure goes up)			109 people
	Libido	Improves (the measure goes up)			109 people
	Seminal Motility	Improves (the measure goes up)			109 people
	Serum DHEA	Improves (the measure goes up)			109 people
	Sex Hormone Binding Globulin	Improves (the measure goes up)			109 people
	Subjective Well-Being	Improves (the measure goes up)			109 people
	Weight	Changes; see studies			109 people

Vitamin C

Vitamin C: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Depression Symptoms Small Improvement	Improves (the measure goes down)	Small effect	1 study	81 people
Studies that measured depression symptoms High-dose ascorbic acid increases intercourse frequency and improves mood: a randomized controlled clinical trialBiol Psychiatry · PMID 12208645
	Plasma Vitamin C	Improves (the measure goes up)		1 study	81 people
Studies that measured plasma vitamin c Molecular detection of exercise-induced free radicals following ascorbate prophylaxis in type 1 diabetes mellitus: a randomised controlled trialDiabetologia · PMID 18769906
	Frequency of Intercourse	Improves (the measure goes up)			81 people

Cistanche (Cistanche tubulosa/deserticola)

Sexual Function: improves

Cistanche (Cistanche tubulosa/deserticola): outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Sexual Function Traditional use for sexual vitality. Animal studies show improved erectile response and testosterone synthesis pathway restoration. Limited human RCT data for this specific outcome.	Improves (the measure goes up)	Moderate effect

Licorice

Luteinizing Hormone
Testosterone: improves

Licorice: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Luteinizing Hormone No effect		NoneNo effect	1 study	25 people
Studies that measured luteinizing hormone Licorice reduces serum testosterone in healthy womenSteroids · PMID 15579328
	Testosterone	Improves (the measure goes up)		4 studies	25 people
Studies that measured testosterone Licorice consumption and serum testosterone in healthy manExp Clin Endocrinol Diabetes · PMID 14520600 Liquorice consumption and salivary testosterone concentrationsLancet · PMID 11716893 Reduction of serum testosterone in men by licoriceN Engl J Med · PMID 10515764 and 1 more on the Licorice page

Alcohol

Cortisol
Estrogen
Testosterone: improves

Alcohol: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Cortisol No effect on cortisol		NoneNo effect	1 study	8 people
Studies that measured cortisol Sex hormones and adrenocortical steroids in men acutely intoxicated with ethanolAlcohol · PMID 6443186
	Estrogen No effect		NoneNo effect		8 people
	Testosterone	Improves (the measure goes up)		5 studies	24 people
Studies that measured testosterone Effects of acute alcohol intake on pituitary-gonadal hormones in normal human malesJ Pharmacol Exp Ther · PMID 894528 Effect of moderate alcohol consumption on plasma dehydroepiandrosterone sulfate, testosterone, and estradiol levels in middle-aged men and postmenopausal women: a diet-controlled intervention studyAlcohol Clin Exp Res · PMID 15166654 Acute effect of alcohol on androgens in premenopausal womenAlcohol Alcohol · PMID 10684783 and 2 more on the Alcohol page
	Follicle-Stimulating Hormone	Improves (the measure goes up)			8 people
	Luteinizing Hormone	Improves (the measure goes up)			24 people
	Prolactin	Improves (the measure goes up)			8 people

Tribulus Terrestris

Luteinizing Hormone
Testosterone: improves

Tribulus Terrestris: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Luteinizing Hormone No effect		NoneNo effect		21 people
	Testosterone	Improves (the measure goes up)		3 studies	21 people
Studies that measured testosterone Prospective Analysis on the Effect of Botanical Medicine (Tribulus terrestris) on Serum Testosterone Level and Semen Parameters in Males with Unexplained InfertilityJ Diet Suppl · PMID 27337519 Short term impact of Tribulus terrestris intake on doping control analysis of endogenous steroidsForensic Sci Int · PMID 18282674 The aphrodisiac herb Tribulus terrestris does not influence the androgen production in young menJ Ethnopharmacol · PMID 15994038

Red Clover Extract

Breast Density
Total cholesterol: improves
Follicle-Stimulating Hormone: improves

Red Clover Extract: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Breast Density No effect		NoneNo effect		401 people
	Total cholesterol	Improves (the measure goes down)		2 studies	401 people
Studies that measured total cholesterol Red clover isoflavones are safe and well tolerated in women with a family history of breast cancerMenopause Int · PMID 18380954 Effect of isoflavones on lipids and bone turnover markers in menopausal womenMaturitas · PMID 15207886
	Follicle-Stimulating Hormone	Improves (the measure goes up)			401 people

Maca

Blood glucose
Estrogen: changes; see studies
Libido: improves

Maca: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Blood glucose No effect		NoneNo effect		197 people
	Estrogen	Changes; see studies		1 study	57 people
Studies that measured estrogen Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen contentMenopause · PMID 18784609
	Libido	Improves (the measure goes up)		1 study	254 people
Studies that measured libido A pilot investigation into the effect of maca supplementation on physical activity and sexual desire in sportsmenJ Ethnopharmacol · PMID 19781622
	Testosterone	Improves (the measure goes up)		1 study	57 people
Studies that measured testosterone Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy menAndrologia · PMID 12472620
	Fatigue Symptoms	Improves (the measure goes down)			197 people
	Hemoglobin	Improves (the measure goes up)			197 people
	Quality of Life	Improves (the measure goes up)			197 people
	Subjective Well-Being	Improves (the measure goes up)			197 people

Vitamin E

Lymphocyte Count
Total cholesterol: improves
Triglycerides: improves

Vitamin E: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People
	Lymphocyte Count No effect		NoneNo effect		184 people
	Total cholesterol	Improves (the measure goes down)		2 studies	184 people
Studies that measured total cholesterol Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitisN Engl J Med · PMID 20427778 Plasma transforming growth factor-beta1 level and efficacy of alpha-tocopherol in patients with non-alcoholic steatohepatitis: a pilot studyAliment Pharmacol Ther · PMID 11564008
	Triglycerides	Improves (the measure goes down)		2 studies	184 people
Studies that measured triglycerides Study on the effect of megavitamin E supplementation in manAm J Clin Nutr · PMID 347918 Megavitamin E supplementation in manAm J Clin Nutr · PMID 803000
	Serum T4	Improves (the measure goes up)		1 study	184 people
Studies that measured serum t4 Effects of elevated d-alpha(RRR)-tocopherol dosage in manJ Nutr Sci Vitaminol · PMID 2732807
	Serum T3	Improves (the measure goes up)			184 people
	Sexual Function	Improves (the measure goes up)			184 people
	Subjective Well-Being	Improves (the measure goes up)			184 people

Ashwagandha

Sexual Function: improves

Ashwagandha: outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Sexual Function	Improves (the measure goes up)		1 study	50 people
Studies that measured sexual function Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot StudyBiomed Res Int · PMID 26504795

Panax Ginseng (Korean Ginseng)

Libido: improves

Panax Ginseng (Korean Ginseng): outcomes studied for Sexual Health
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Libido	Improves (the measure goes up)		1 study	28 people
Studies that measured libido Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical studyJ Sex Med · PMID 20141583

Key findings

ErectionsTongkat AliImproves (the measure goes up)
Depression SymptomsVitamin CImproves (the measure goes down)
Sexual FunctionCistanche (Cistanche tubulosa/deserticola)Improves (the measure goes up)

The Sexual Health & Vitality Support protocol

2 primary supplements · 8 supporting supplements

Tongkat Ali (Eurycoma longifolia)200–400 mg standardized extract daily
L-Arginine3–5 g daily

See the full protocol

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Studies cited

1 study from PubMed

Does yoga improve sexual function? A systematic review and meta-analysis of randomized clinical trials.Complement Ther Clin Pract · PMID 38830273

Evidence by supplement

Key findings

The Sexual Health & Vitality Support protocol

Shop the evidence-backed picks

Studies cited

Related conditions

Supplement stack for Sexual Health