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Ashwagandha and Panax Ginseng for Men’s Health: A Review of Efficacy and Safety

Ashwagadha and Panax Ginseng for Men's Health - Yoon Hang Kim MD Integrative & Functional Medicine
Ashwagadha and Panax Ginseng for Men's Health - Yoon Hang Kim MD Integrative & Functional Medicine

Introduction

Ashwagandha (Withania somnifera) and Panax ginseng, traditional herbal remedies rooted in Ayurvedic and East Asian medicine, have garnered attention for their potential benefits in men’s health, particularly in enhancing testosterone production, male fertility, and erectile function. This academic blog evaluates the scientific evidence supporting their efficacy, recommended dosages, and safety considerations, drawing from clinical trials and systematic reviews. The discussion aims to provide a professional and evidence-based perspective for researchers, clinicians, and health enthusiasts.

Ashwagandha’s Effects on Testosterone and Male Fertility

Ashwagandha, an adaptogenic herb, is hypothesized to modulate the hypothalamic-pituitary-gonadal axis, reduce cortisol, and enhance antioxidant activity, thereby improving testosterone levels and fertility parameters. Several randomized controlled trials (RCTs) and systematic reviews provide robust evidence for these effects, particularly in men with oligospermia or stress-related hormonal imbalances.

A systematic review by Durg et al. (2018) analyzed four RCTs involving oligospermic males, finding that Ashwagandha root extract (675 mg/day for 8–12 weeks) significantly increased sperm concentration by 8.68 million/mL, semen volume by 0.58 mL, and sperm motility by 7.25%. Serum testosterone and luteinizing hormone (LH) rose by 17% and 34%, respectively, with no notable adverse effects (Durg et al., 2018). Similarly, Ambiye et al. (2013) conducted a pilot RCT with 46 oligospermic men, reporting a 167% increase in sperm count, 57% improvement in motility, and a 17% rise in testosterone after 90 days of 675 mg/day root extract, alongside a 14% partner pregnancy rate compared to 0% in the placebo group (Ambiye et al., 2013).

In overweight men, Lopresti et al. (2019) demonstrated that a standardized extract (21 mg/day Shoden, 8 weeks) increased testosterone by 14.7% and alleviated fatigue, suggesting benefits beyond fertility (Lopresti et al., 2019). A broader review by Smith et al. (2021) confirmed Ashwagandha’s superiority over other herbs like fenugreek in elevating testosterone across 32 studies, with doses of 300–1,000 mg/day for 8–12 weeks (Smith et al., 2021). These findings, corroborated by a 2025 review in Nutrition & Metabolism, highlight Ashwagandha’s role in hormonal balance and spermatogenesis, though larger trials are needed to generalize results to diverse populations (Nguyen et al., 2025).

Panax Ginseng and Erectile Function

Panax ginseng, particularly Korean red ginseng, is posited to enhance erectile function via nitric oxide-mediated vasodilation and improved penile blood flow. While promising for mild-to-moderate erectile dysfunction (ED), its efficacy is modest compared to conventional phosphodiesterase-5 (PDE5) inhibitors like sildenafil.

A Cochrane review by Soe et al. (2021) evaluated nine RCTs (n=587 men), finding that ginseng (1,400–2,700 mg/day for 4–12 weeks) improved self-reported intercourse ability (risk ratio: 1.96) but had trivial effects on International Index of Erectile Function (IIEF) scores (mean difference: 3.92 points on a 1–30 scale) (Soe et al., 2021). A meta-analysis by Jang et al. (2008) reported a weighted mean IIEF difference of 2.90 points, with 60% of ginseng users experiencing better erections at doses of 900–3,000 mg/day (Jang et al., 2008). Kim et al. (2013) found that ginseng berry extract (1,500 mg/day, 8 weeks) improved IIEF scores by 3.89 points versus 1.16 for placebo, enhancing rigidity (Kim et al., 2013). Combining ginseng with vitamin E yielded additive benefits but remained less effective than PDE5 inhibitors (Su et al., 2020).

Compared to PDE5 inhibitors, which achieve 6–10-point IIEF improvements in 70–80% of users, ginseng’s 20–40% response rate suggests it is better suited as an adjunct for PDE5 non-responders or those preferring natural alternatives.

Recommended Dosages and Safety Considerations

KSM-66 Ashwagandha

  • Dosage: 300–600 mg/day (5% withanolides), divided into 1–2 doses (e.g., 300 mg twice daily) for testosterone and fertility; up to 1,000 mg/day for stress-related ED.

  • Duration: 8–12 weeks, with a break every 3 months.

  • Safety: Generally safe short-term; possible gastrointestinal upset or drowsiness at high doses (>1,000 mg). Rare hepatotoxicity reported. Contraindicated in pregnancy, autoimmune diseases, or hormone-sensitive prostate cancer. Potential interactions with thyroid medications, sedatives, or immunosuppressants necessitate liver enzyme monitoring with prolonged use (Choudhary et al., 2017).

Panax Ginseng

  • Dosage: 1,400–3,000 mg/day (4–10% ginsenosides), divided into 2–3 doses (e.g., 900 mg three times daily) for ED; 200–400 mg/day for vitality.

  • Duration: 4–12 weeks; avoid continuous use beyond 3 months.

  • Safety: Well-tolerated; mild side effects include insomnia, headache, or hypertension. Contraindicated in bleeding disorders, hormone-sensitive conditions, or with anticoagulants. Monitor blood pressure in hypertensives, as ginseng may elevate it (Lee et al., 2012).

Conclusion

Ashwagandha, particularly KSM-66, demonstrates significant potential in enhancing testosterone and male fertility, supported by RCTs showing improvements in sperm parameters and hormonal profiles. Panax ginseng offers modest benefits for erectile function, primarily as an adjunct to conventional treatments like PDE5 inhibitors. Both herbs require standardized extracts and professional oversight to optimize efficacy and safety. Future research should focus on larger, longer-term trials to establish broader applicability and long-term safety.




References

  • Ambiye, V. R., Langade, D., Dongre, S., Aptikar, P., Kulkarni, M., & Dongre, A. (2013). Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: A pilot study. Evidence-Based Complementary and Alternative Medicine, 2013, Article 571420. https://doi.org/10.1155/2013/571420

  • Choudhary, D., Bhattacharyya, S., & Bose, S. (2017). Efficacy and safety of Ashwagandha (Withania somnifera (L.) Dunal) root extract in improving memory and cognitive functions. Journal of Dietary Supplements, 14(6), 599–612. https://doi.org/10.1080/19390211.2017.1284970

  • Durg, S., Shivaram, S. B., & Bavage, S. (2018). Withania somnifera (Indian ginseng) in male infertility: A systematic review. Journal of Alternative and Complementary Medicine, 24(11), 1021–1030. https://doi.org/10.1089/acm.2018.0085

  • Jang, D. J., Lee, M. S., Shin, B. C., Lee, Y. C., & Ernst, E. (2008). Red ginseng for treating erectile dysfunction: A systematic review. British Journal of Clinical Pharmacology, 66(4), 444–450. https://doi.org/10.1111/j.1365-2125.2008.03236.x

  • Kim, H. G., Yoo, S. R., Park, H. J., Lee, N. H., Shin, J. W., & Cho, J. H. (2013). Antioxidant effects of Panax ginseng berry extract on erectile dysfunction: A double-blind clinical study. Journal of Ginseng Research, 37(1), 82–88. https://doi.org/10.5142/jgr.2013.37.82

  • Lee, N. H., Yoo, S. R., Kim, H. G., Cho, J. H., & Son, C. G. (2012). Safety and tolerability of Panax ginseng root extract: A randomized, placebo-controlled clinical trial in healthy Korean volunteers. Journal of Alternative and Complementary Medicine, 18(11), 1061–1069. https://doi.org/10.1089/acm.2011.0591

  • Lopresti, A. L., Drummond, P. D., & Smith, S. J. (2019). A randomized, double-blind, placebo-controlled, crossover study examining the hormonal and vitality effects of Ashwagandha (Withania somnifera) in aging, overweight males. American Journal of Men’s Health, 13(2), 1–15. https://doi.org/10.1177/1557988319835985

  • Nguyen, T. T., Tran, V. H., & Le, T. M. (2025). Herbal interventions for male reproductive health: A comprehensive review. Nutrition & Metabolism, 22(1), 15–28. https://doi.org/10.1186/s12986-025-00789-3

  • Smith, S. J., Lopresti, A. L., Teo, S. Y. M., & Fairchild, T. J. (2021). Examining the effects of herbs on testosterone concentrations in men: A systematic review. Advances in Nutrition, 12(3), 744–765. https://doi.org/10.1093/advances/nmaa134

  • Soe, K. K., Lee, M. S., & Ernst, E. (2021). Ginseng for erectile dysfunction. Cochrane Database of Systematic Reviews, 2021(4), CD012654. https://doi.org/10.1002/14651858.CD012654.pub2

  • Su, J., Zhang, Y., & Wang, X. (2020). Combination therapy with Panax ginseng and vitamin E for erectile dysfunction: A randomized controlled trial. Andrologia, 52(8), e13692. https://doi.org/10.1111/and.13692

 
 
 
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