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Nutritional and Herbal Medicine for Men's Health

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  • Korean Ginseng

Healthy hormone balance and general fitness and wellbeing are essential to male health, and underpin a healthy reproductive function as well as fertility, stamina, vitality, optimal libido and a healthy sexual function. 

Erectile dysfunction, lowered libido and male infertility are on the rise: One in five men over 40 have difficulty getting or keeping an erection;[1] and male infertility accounts for up to half of all infertility cases.[2]  

Erectile dysfunction (ED) 

A multifactorial condition, ED is primarily a physical condition and is strongly linked to cardiovascular disease, lack of exercise, obesity, smoking and hypercholesterolemia. 

Dr Carolyn Allan, the medical advisor to Andrology Australia, believes 75% of erectile dysfunction has a physical cause and in most cases it’s likely to be artery damage.[3

Physical causes such as nerve damage after prostate surgery or introduction of a medication that affects sexual function may be implicated. But for most men with erection problems there is an underlying cause that interferes with how the penis functions by decreasing blood flow or affecting nerves, such as diabetes, obesity, hypertension or high cholesterol.[11]

Men with ED may experience an inability to attain an erection; an inability to maintain an erection adequately for intercourse; delayed or absent ejaculation despite adequate stimulation; and an inability to control timing of ejaculation.[14]

The effects of ED on men may include depression, loss of self-confidence, loss of intimacy in a relationship and reduced quality of life.5 Despite these far-reaching effects however, statistics have shown men are reluctant to address the condition with only 6% men with ED ever seeking treatment.[6]


In men, libido is governed by both gonadal hormones and brain neurotransmitters and is known to gradually decline in men after the age of 50. A reduction in male libido is associated with low testosterone.[7,8]

Researchers suggest changes to male testosterone synthesis and metabolism during ageing may be responsible for this shift, changes may include an increase in sex hormone binding globulin (SHBG) and a decline in testosterone receptor sensitivity.[7]

Other factors may include obesity, hyperinsulinaemia, chronic stress and oxidative stress. Medications such as selective serotonin re-uptake inhibitors (SSRIs) are also associated with sexual dysfunction, with 25% of users affected.[5]

Common signs and symptoms of low libido include lack or loss of sexual desire, difficulty achieving orgasm, and anxiety and/or depression.

Male infertility 

Male infertility is often asymptomatic with the most common, presenting symptom being that the patient’s partner is unable to get pregnant after 12 months of unprotected intercourse. Male infertility accounts for up to half of all infertility cases and affects approximately 1 in 20 men.[1]

It most commonly occurs when the male is unable to produce or deliver fully functioning sperm to the female ova. If the sperm is underdeveloped or abnormally shaped, is unable to move properly, or the numbers of sperm in the ejaculate are abnormally low, infertility is not uncommon. 

Mounting evidence suggests that oxidative stress is a major contributing factor in 30-80% of male infertility cases.[11] Oxidative stress occurs when the production of reactive oxygen species (ROS) exceeds the body’s antioxidant defense mechanism leading to cellular damage. ROS damage sperm cell membranes resulting in reduced sperm motility and altered sperm DNA, compromising the quality of semen parameters and reducing the ability of the sperm cell to fertilize the oocyte.[11]

Other major causative and risk factors that can contribute to the incidence of male infertility include: sperm production problems (from genetic causes, infections, medicines and chemicals), blockage of sperm transport, sperm antibodies, ejaculation issues, hormonal problems,9 stress, structural reproductive disturbances due to trauma, varicoceles, mumps, hormonal imbalances such as testosterone deficiency, oestrogen excess, sperm antibody production, an increased toxic load from smoking, excess alcohol, recreational drugs and nutritional deficiencies. 

Nutrition for men’s health 


Zinc plays an important role in human cells and body processes and is perhaps the most critical trace mineral for male sexual function.

Involved in virtually every aspect of male reproduction, including hormone metabolism, sperm count, motility and morphology, and normal testicular development, zinc can be found in high concentrations in the both the prostate and the testes. Zinc also plays an important role in the polymeric organisation of macromolecules such as RNA and DNA, in protein synthesis and cell division and assists the stability of the cell membranes.[110,11]

An important component of the body’s antioxidant system that retards the oxidative process, zinc is also a specific and essential cofactor for the adequate formation and function of the antioxidant enzyme copper-zinc superoxide dismutase and various metalloenzymes.[11]

Chronic zinc deprivation generally results in not only an increased sensitivity to the effects of oxidative stress due to inadequate activity of these enzymes,[12] but to oligospermia, hypogonadism and idiopathic male infertility.[13-15] In fact, even marginal zinc deficiency may lead to decreased levels of testosterone levels and spermatogenesis, with lower levels of zinc typically found in infertile men.[16]

Many studies have shown an improvement not only sperm count but in motility and morphology too when zinc supplementation is used.[16-21]

Zinc/drug interactions:[11]
  • Zinc absorption maybe reduced by coffee, folate, iron and calcium. Separate doses by at least two hours.
  • Zinc may decrease the absorption and efficacy of tetracycline or quinolone antibiotics. Separate doses by at least two hours.
  • Zinc interacts with NSAIDs. Separate by two hours.​


Selenium is essential in the synthesis of testosterone, the production and maturation of healthy spermatozoa, and sperm motility.[22-24]
Found in high concentrations in the tail of the sperm, selenium profoundly influences the structure of sperm, with the tail of the sperm reliant on adequate selenium status to maintain its “whip-like” action. Without sufficient selenium, sperm are unable to swim in the right direction or display marked immobility thus preventing fertilization of the oocyte.

Involved in several major metabolic pathways including antioxidant defense systems, immune function and thyroid hormone metabolism,25 sperm capsular selenoprotein is also involved in the stability and motility of the mature sperm and forms part of the glutathione peroxidase antioxidant system.[6,2726,27] This is paramount for spermatogenesis and protects the sperm against the effects of reactive oxygen species.[28]


Along with its protective antioxidant effects, L-carnitine can be found in high concentrations in the epididymis and is required by spermatozoa for maturation and semen quality.[11]

The motility of the sperm correlates directly with the L-carnitine content;[29,30] the higher the L-carnitine content, the more motile the sperm. Conversely, when L-carnitine levels are low, sperm development, function and motility are drastically reduced. 

Herbal medicines for men’s health

Turnera diffusa (damiana)

Traditionally used in Mexican medicine for sexual inadequacy, impotence, and as an aphrodisiac and an invigorator, damiana has also been prescribed in western herbal medicine for depression and anxiety with a predominant sexual factor.[31]

Observed to suppress aromatase activity,[32] damiana may increase testosterone in the body.[11]

Tribulus terrestris (tribulus)

A popular herb in both Ayurvedic and Chinese medicine, tribulus is prescribed as a tonic that increases virility, fertility and sperm production,31 and used in Eastern European folk medicine for increasing muscle strength and sexual potency.[33]

Modern application and research has shown tribulus to be valuable in increasing sperm motility, viability and velocity, and has effects on libido and sexual functioning.[11,33]

These modern uses, however, stem from Bulgarian research using a standardised tribulus leaf preparation, which is rich in the steroidal saponin protodioscin. Protodioscin has been clinically proven to improve sexual desire and enhance erection via the conversion of protodioscine to DHEA (De-Hydro-Epi-Androsterone).[34]

Tribulus grown on different soils does not consistently produce the active component protodioscin. The geographical region in which this herb is grown can greatly impact its phytochemical profile, with Bulgarian tribulus showing a totally different chemical profile and a much higher concentration of protodioscin when compared to the commonly used Indian tribulus.[34,35]

Tribulus/drug interactions:[33]
  • Hypoglycemic drugs: Tribulus may lower blood glucose levels.
  • Steroids: Tribulus may increase levels of steroid hormones.
  • Hypertensive drugs: Tribulus has been found to have a hypotensive action and may affect hypertension drugs.
  • Calcium channel blockers: Tribulus may add to calcium channel blocker effects due to its negative chronotropic activity in cardiac muscle. 
  • Beta-blockers: Tribulus may add to beta-blocker effects due to its negative chronotropic activity in cardiac muscle.

Panax ginseng (Korean ginseng)

With a strong reputation as a male tonic, Panax ginseng has been used to promote energy in men where there is lowered vitality and where physical performance and sexual function require enhancement. 

Shown to increase production of gonadotropins in vitro, with wide-spread benefits to male fertility and reproductive function, Panax ginseng not only increases testosterone levels, and improves both sperm count and motility,[36] but clinical trials have also shown ginseng to improve erectile dysfunction and lowered libido.[37]

Major constituents of ginseng, the ginsenosides, have been shown to have corticosteroid-like effects, binding to the glucocorticoid receptor.[38] These steroidal saponins may partly explain the attenuating effects of Panax ginseng on elevated corticosterone in both acute and chronic stress models.

It is believed the ginsenosides, may also help the body adapt to stress through regulation of the endocrine and immune systems via the hypothalamic-pituitary axis. Panax ginseng may also raise plasma adrenocorticotropic hormone (ACTH) in the relaxed state, thereby increasing the ability to withstand stress.[39]

Ginseng/drug interactions:[11]
  • Hypoglycemic drugs: Panax ginseng may lower blood glucose. 
  • Impotency drugs: Theoretically, Panax ginseng may have additive effects when taken concomitantly with agents used for impotence.

 Withania somnifera (withania)

Known as Indian ginseng, withania root has been used in Ayurvedic medicine as a strengthening and rejuvenating tonic for debility and convalescing, an aphrodisiac and for insomnia.[39] Withania is also regarded in Ayurveda as a rasayana herb and so promotes physical and mental health, increases resistance of the body to stressors, revitalises the body in debilitated conditions and increases longevity.[40]

Often prescribed as an adaptogen, withania can also improve semen quality by regulating reproductive hormone levels, reducing oxidative stress, and reversing lowered levels of testosterone, LH, FSH and prolactin.[41]

Withania root contains steroidal compounds including withanolides that are regarded as quality markers.[42]

Pinus pinaster (pine bark)

The production of abnormal quantities of ROS is thought to be involved in many facets of human male infertility. Sperm exposed to superoxide anions are rendered dysfunctional by lipid peroxidation and altered membrane function, as well as impaired metabolism, morphology and motility.[43]

Through its antioxidant action, maritime pine bark improves sperm function and quality, and erectile dysfunction by enhancing superoxide dismutase activity and increasing nitric oxide levels, which is the chief chemical mediator of penile erection.[43-45]

Men’s healthy lifestyle tips:

  • Moderate alcohol intake
  • Maintain a healthy weight
  • Stop smoking
  • Exercise regularly
  • A balance diet 
  • Good quality sleep 
  • Herbal and nutrition supplementation 
  • Regular health checkups with your GP


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