Q&A

Korean red ginseng effective for treatment of erectile dysfunction

J Fam Pract. 2003 January;52(1):12-31
By
Amy Price, MD
John Gazewood, MD, MSPH
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  • BACKGROUND: Is Korean red ginseng effective in the treatment of erectile dysfuntion? Although many treatments for erectile dysfunction are available, patients seem to prefer oral medications, such as sildenafil. Patients also may prefer herbal medicines for many reasons, including relatively low cost, ready availability, and safety. Ginseng is a traditional Asian remedy for sexual dysfunction that is widely used in the United States and has a reassuring safety profile.
  • POPULATION STUDIED: Study subjects were 45 men with erectile dysfunction without previous treatment recruited from a urology clinic in Korea. Erectile dysfunction was defined as the persistent inability to achieve and maintain erection sufficient for normal sexual satisfaction. Mean age was 54 years. About 70% of patients had moderate or severe erectile dysfunction as measured by a Korean version of the International Index of Erectile Function (IIEF), and more than 50% had at least 1 other chronic medical problem such as diabetes or hypertension. Patients excluded from the study were those with a history of radical prostatectomy, spinal cord injury, serious neurologic illnesses such as Parkinson disease and multiple sclerosis, alcohol abuse, or other herbal abuse, drug ingestion that enhances or interferes with sexual function, drug ingestion with known interaction with ginseng, hormonal therapy, and cancer chemotherapy.
  • STUDY DESIGN AND VALIDITY: This was a double-blind, placebo-controlled, crossover study. All patients underwent baseline evaluations including IIEF self-assessment, measurement of rigidity and tumescence experienced during audiovisual sexual stimulation, penile duplex ultrasonography, and response to an intrapenile injection of papaverine, phentolamine, and prostaglandin E1. Subjects were then randomized to receive korean red ginseng, 900 mg three times daily, or a placebo three times daily, for 8 weeks. After a 2-week washout period, subjects received another 8 weeks of crossover treatment. Patients were assessed every 4 weeks during the two 8-week treatment periods. At the end of the study, data for all 45 subjects obtained during active treatment were compared against data obtained during placebo treatment.
  • OUTCOMES MEASURED: Improvement in erectile function was measured by self-report on the IIEF and its subscales and by objective assessments of penile blood flow, size, and rigidity.
  • RESULTS: After 8 weeks of treatment, patients showed significant improvement in mean IIEF scores compared with placebo (baseline, 28.0 ± 16.7; Korean red ginseng, 38.1 ± 16.6; placebo, 30.9 ± 15.7). When taken individually, scores for erectile function, sexual desire, and intercourse satisfaction were significantly improved in the treated group. Scores for orgasmic function and overall satisfaction were not statistically improved. Sixty percent of treated patients experienced an improvement in erection as opposed to 20% of the placebo group (number needed to treat, 2.5). In particular, scores on questions relating to penetration and maintenance were significantly higher for the Korean red ginseng group. No data were reported for partner satisfaction.
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PRACTICE RECOMMENDATIONS

Korean red ginseng (Panax ginseng*) is a safe, widely available alternative remedy that improves patients’ ability to achieve and maintain an erection sufficient for intercourse, even in a population with severe erectile dysfunction. It is a reasonable, nonprescription treatment, especially for men with reservations about taking sildenafil (Viagra). A 500-mg capsule of Korean red ginseng costs about 6 cents, compared with $10 for a tablet of sildenafil.

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