When considering treatment options for male performance support, as practitioners, we automatically think of traditional male tonics such as Tribulus terrestris (tribulus) and others. However, there are other herbs we should also be considering when looking to support male physiology, including Panax ginseng (Korean ginseng) and Withania somnifera (withania).
Tribulus
Traditionally, extracts of the aerial part and fruit of tribulus were used as a diuretic, male tonic and as an aphrodisiac.[1] Today, tribulus is widely promoted in the sporting industry as a natural way to enhance circulating androgen concentrations in athletes and bodybuilders.[1] A recent systematic review was undertaken to determine modern indications for the use of tribulus as a male performance supportive adjunct. Tribulus provided promising mediation of testosterone, dihydrotestosterone (DHT) and dehydroepiandrosterone (DHEA) levels in animal studies.[2] Further research is required elucidate the mechanism of action of tribulus in humans.
Erectile dysfunction
Organic, physiological, endocrine and psychological factors are involved in the ability to attain and maintain an erection.[3] Herbal medicines such as Panax ginseng (Korean ginseng) and Withania somnifera (withania) provide potential in supporting male physiology because of the unique multiple actions that adaptogens provide.
Korean ginseng
A literal translation of the word ginseng is ‘man essence’, because of its associated affinity with the male body.[4] In traditional Chinese medicine (TCM), ginseng is highly regarded as the most potent qi tonic used to benefit those with low vitality, poor immunity, metabolic dysfunction but also to enhance physical performance and sexual function.[5]
Korean ginseng has been clinically demonstrated to alleviate erectile dysfunction by improving the ability to achieve and maintain erections in male patients.[6] A collection of constituents found in ginseng known as ginsenosides are able to facilitate penile erection by directly inducing vasodilation of the penile corpus cavernosum, via mediation of NO release from endothelial cells and perivascular nerves.[7]
In a double-blind, placebo-controlled study of men diagnosed with erectile dysfunction, 900mg of Korean ginseng was administered three times daily for eight weeks. The positive results of this study included: higher rates of penile tip rigidity, improved penetration rates and overall improvement in erection maintenance versus placebo group.[8]
Additional ginseng may provide benefit men with poor sperm parameters. Animals treated with ginseng (1g/kg/day orally for 56 days) exhibited significant increase in sperm count and motility due to activation of cAMP-responsive modulation in the testes.[9]
Withania
Withania is often referred to as Indian ginseng because it is used in much the same way as Korean ginseng. However, it is considered less stimulating.[7] In Ayurvedic medicine, withania is referred to as a ‘rasyana’ and used to promote physical and mental health, improve vitality and promote longevity.[4] Traditional and modern uses of withania include as an adaptogen, diuretic, sedative, antioxidant, anti-inflammatory and an aphrodisiac.[10]
Recent research has proposed that withania has the ability to inhibit lipid peroxidation from occurring as well as indirectly mimicking gamma amino-butyric acid (GABA) endocrine stress-induced risk factors associated with male infertility.[10]
A double-blind placebo-controlled study was undertaken in oligospermic males. The withania group received 225mg of the proprietary KSM-66® extract three times daily. Those receiving withania had a number of statistically significant outcomes after 12 weeks including increase in sperm concentration, seminal volume, motility and raised free testosterone versus baseline measurements.[11] This evidence promotes the use of KSM-66® for the treatment of oligospermic males for preconceptional and male performance support.
References
- Pokrywka A, Obmiński Z, Malczewska-Lenczowska J, et al. Insights into supplements with Tribulus terrestris used by athletes. J Hum Kinet 2014;41:99-105. [Abstract]
- Qureshi A, Naughton DP, Petroczi A. A systematic review on the herbal extract Tribulus terrestris and the roots of its putative aphrodisiac and performance enhancing effect. J Diet Suppl 2014;11(1):64-79 [Abstract]
- Heaton J, Adams M. Causes of erectile dysfunction. Endocrine 2004;23(2-3):119-124 [Abstract]
- Braun L, Cohen M. Herbs and natural supplements: an evidence-based guide, 4th Edition. Sydney: Churchill Livingstone Elsevier, 2014. [Abstract]
- Nagappan A, Karunanithi N, Sentrayaperumal S, et al. Comparative root protein profiles of Korean ginseng (Panax ginseng) and Indian ginseng (Withania somnifera). Am J Chin Med. 2012;40(1):203-218. [Abstract]
- Price A, Gazewood J. Korean red ginseng effective for treatment of erectile dysfunction. J Fam Pract 2003;52(1):20-21. [Abstract]
- Murphy LL, Lee TJ. Ginseng, sex behavior, and nitric oxide. Ann N Y Acad Sci 2002;962:372-377. [Abstract]
- Hong B, Ji YH, Hong JH, et al. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol 2002;168(5):2070-2073. [Abstract]
- 9. Park WS, Shin DY, Kim DR, et al. Korean ginseng induces spermatogenesis in rats through the activation of cAMP-responsive element modulator (CREM). Fertil Steril 2007;88(4):1000-1002. [Abstract]
- Sengupta P, Agarwal A, Pogrebetskaya M, et al. Role of Withania somnifera (Ashwagandha) in the management of male infertility. Reprod Biomed Online 2018;36(3):311-326 [Abstract]
- Ambiye VR, Langade D, Dongre S, et al. Clinical evaluation of the spermatogenic activity of the root extract of ashwagandha (Withania somnifera) in oligospermic males: a pilot study. Evid Based Complement Alternat Med 2013;2013:571420. [Abstract]
DISCLAIMER:
The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.
