Herbal dietary supplements for erectile dysfunction: A systematic review and meta-analysis of randomized-controlled trials

Fourteen RCTs with a total of 1227 males with ED were included. Mean age of study participants ranged from 35 to 65 years; and follow-up ranged from 1 month to 6 months. Herbal dietary supplements had a significant, positive effect on erectile function (standard mean difference (SMD) = 1.20, 95 % confidence interval (CI): 0.64-1.76), orgasmic function (SMD = 1.09, 95 % CI: 0.34-1.83), sexual desire (SMD = 1.02, 95 % CI: 0.45-1.60), intercourse satisfaction (SMD = 1.48, 95 % CI: 0.83-2.13), overall satisfaction (SMD = 0.93, 95 % CI: 0.45-1.40), and serum testosterone level (SMD = 0.54, 95 % CI: 0.04-1.05) compared to effects in the control groups. Saffron was effective in improving erectile function, orgasmic function, and intercourse satisfaction, while ginseng benefited erectile function, orgasmic function, sexual desire, overall satisfaction, and serum testosterone levels. In contrast, evidence for other agents such as <i>Tribulus terrestris</i> and Maca remains insufficient, underscoring the need for larger, high-quality trials with longer follow-up.