ED supplements, ingredient by ingredient: what the evidence shows

Status: Dietary supplement: not FDA-approved to treat any disease. Source: NCCIH herb fact sheets (yohimbe, ashwagandha, ginkgo), checked 2026-10-17.

In short: the supplement aisle sells a long list of ingredients for erectile dysfunction (ED), and the research behind them is thin. This page goes through the ones men ask about most, one at a time, and labels each with what the published studies actually show. Ginseng has the most trials, and its effect is small. A handful of others have one or two small trials. Several have none in men with ED at all, and one, yohimbe, has a safety record worth knowing before you buy anything. For the bigger picture on lifestyle change versus medicine, see our guide to natural remedies for ED vs medication.

Do ED supplements work?

For most ingredients, the honest answer is that nobody has shown they do. A 2018 review of 24 randomized trials in 2,080 men with ED found that ginseng significantly improved erectile scores, that other herbs gave mixed or very preliminary results, that just 7 of the trials had a mostly low risk of bias, and that more research is needed “before the use of herbal products in ED can be recommended” (Borrelli et al., Drugs 2018). A 2025 meta-analysis of 14 placebo-controlled trials in 1,227 men reached a similar place: saffron and ginseng had the most consistent results, while evidence for other agents, including Tribulus terrestris and maca, “remains insufficient,” and the authors said routine clinical use of the other herbs “cannot yet be endorsed” (Herbal dietary supplements for ED, J Tradit Complement Med 2025).

Supplements also reach the shelf differently from medicines. The National Center for Complementary and Integrative Health (NCCIH) notes that, unlike drugs, dietary supplements are not approved by the FDA before they are sold, and that makers are responsible for their own safety and labeling checks (NCCIH, Ginkgo).

The evidence table: ingredient by ingredient

Each ingredient gets one label, set only from the sources on this page: “consistent benefit in trials”, “mixed or small trials”, “little or none”, or “safety concern”. No ingredient on this list earns the first label.

The sections below give the detail and the source behind each row.

Ginseng: the most-studied ED supplement

Ginseng is the supplement with the most trial data, and that data points to a small effect at best. A Cochrane review of 9 trials, all comparing ginseng with placebo, rated the effect on the erectile function score as “trivial” and the certainty of the evidence as low (Lee et al., Cochrane review 2021). The same review found ginseng may improve men’s self-reported ability to have intercourse, again with low certainty. Most of the trials were run in Korea, which limits how far the results travel. Our natural remedies guide covers ginseng alongside L-arginine.

Yohimbe: why it is the one to be careful with

Yohimbe is labeled a safety concern because its active compound has been linked with serious heart and nervous-system events, and supplement labels do not tell you how much you are getting. NCCIH says yohimbine has been associated with irregular heartbeat, blood pressure problems, heart attacks and seizures, that a 2015 analysis of 49 US yohimbe supplements found the amount varied widely and most labels did not state it, and that yohimbe supplements have been restricted or banned in many countries (NCCIH, Yohimbe). It also can interact with two classes of antidepressants (MAO inhibitors and tricyclics).

There is an older evidence trail for yohimbine, the purified compound sold by prescription. A 1998 meta-analysis of 7 trials found prescription yohimbine did better than placebo for ED (Ernst and Pittler, J Urol 1998). NCCIH is clear that this does not carry over to supplements: yohimbe sold as a dietary supplement “may not work like the prescription medication,” there is very little research on the supplement in people, and it is illegal in the US to market an over-the-counter yohimbine product as an ED treatment without FDA approval.

Horny goat weed: lab studies, not human trials

Horny goat weed (Epimedium, whose main compound is icariin) has been studied in animals and in cells, not in controlled trials of men with ED. A 2026 evidence-graded review of icariin rated its ED evidence as level B, “supported by in vitro and animal data,” with no clinical trials listed, and noted that intact icariin taken by mouth reaches the bloodstream only in negligible amounts (Gu et al., Front Pharmacol 2026). A 2025 case report described a 33-year-old man admitted to hospital with severe muscle spasms and raised muscle and kidney markers after a month of an Epimedium supplement bought online (Cureus case report, 2025). One case does not show how common this is, but it is a reminder that “herbal” does not mean tested.

Ashwagandha, tongkat ali and ginkgo

All three are sold heavily to men, and none has shown a clear benefit for erections in trials.

• Ashwagandha. In a randomized trial of 95 men with psychogenic ED (86 finished), ashwagandha root powder did no better than a placebo powder over 60 days, and neither group improved by the trial’s threshold (Mamidi and Thakar, Ayu 2011). NCCIH says limited evidence suggests it may raise testosterone over 2 to 4 months, that rare cases link it to liver injury, and that men with hormone-sensitive prostate cancer should avoid it (NCCIH, Ashwagandha).
• Tongkat ali. A meta-analysis found only 2 trials (139 men) and no significant overall difference from placebo on erectile scores; a subgroup with lower starting scores did improve, and the authors asked for more trials (Kotirum et al., Complement Ther Med 2015). The 2025 meta-analysis found one further trial, in 23 men (J Tradit Complement Med 2025).
• Ginkgo. Two small placebo-controlled trials tested ginkgo for sexual problems caused by antidepressants, and neither found a significant difference from placebo (Kang et al., 2002; Wheatley, 2004). NCCIH says there is no conclusive evidence that ginkgo helps any health condition, and that it may raise bleeding risk in people taking blood thinners such as warfarin (NCCIH, Ginkgo).

DHEA and maca

DHEA and maca each rest on very few trials in men with ED, too few to draw a conclusion.

• DHEA. The main trial randomized 40 men with ED and low DHEA levels to DHEA or placebo for 6 months. Scores were higher with DHEA, but the authors wrote that their patient group was “too small to do relevant statistical analysis” (Reiter et al., Urology 1999). A 2018 review concluded that large, well-designed studies are still needed to define any role for DHEA in men with ED (El-Sakka, World J Mens Health 2018). DHEA is a hormone, which is one more reason to raise it with a clinician rather than add it on your own.
• Maca. A systematic review found 4 small trials of maca for sexual function, only one of them in men with ED, and called the evidence limited because the number of trials, their size and their quality were all too low for firm conclusions (Shin et al., BMC Complement Altern Med 2010).

Do zinc, vitamin D or magnesium help ED?

None of the three has been shown to improve erections in men who take them as a supplement. These are the “best vitamins for ED and testosterone” that turn up in searches, so the detail matters:

• Zinc. In 720 men with sexual complaints, lower blood zinc went with lower testosterone, but not with worse erection scores once hormones were accounted for (Miyoshi et al., Int J Urol 2023). The NIH Office of Dietary Supplements (ODS) warns that high zinc intakes taken for weeks can interfere with copper absorption, reduce immune function and lower HDL cholesterol (ODS, Zinc).
• Vitamin D. Observational studies link low vitamin D with ED, but a 2025 systematic review found trial results inconsistent (Matukaitiene et al., J Clin Med 2025). The largest trial, which analyzed 8,920 Australian men aged 60 to 84, concluded that vitamin D supplements are “unlikely to prevent or improve erectile dysfunction” (D-Health Trial, Clin Nutr ESPEN 2024). ODS notes that too much supplemental vitamin D can cause toxicity (ODS, Vitamin D).
• Magnesium. A US survey of 3,917 men linked a higher magnesium depletion score with more ED (Chen et al., Front Nutr 2025). That is an association in one snapshot, not proof that low magnesium causes ED or that a supplement fixes it. ODS says high supplemental doses commonly cause diarrhea and that magnesium interacts with some antibiotics and osteoporosis drugs (ODS, Magnesium).

Do testosterone boosters help ED?

There is no good evidence that over-the-counter “testosterone boosters” improve ED, and most do not even raise testosterone. Researchers who examined 50 popular boosters found 90% claimed to “boost T,” yet only 24.8% of their ingredients had published data showing a testosterone increase, 10.1% had data showing a decrease, and some products went over the safe upper limit for zinc, vitamin B3 or magnesium (Clemesha et al., World J Mens Health 2020). A 2024 systematic review of 52 studies covering 27 proposed boosters found that most fail to raise total testosterone, with only a few rated effective or “possibly effective” in specific groups, such as tongkat ali in men with age-related low testosterone (Morgado et al., Int J Impot Res 2024).

So the query “best testosterone booster for erectile dysfunction” has no evidence-backed answer. Whether low testosterone is part of your ED is a question for a blood test and a clinician, not a supplement label; our guide to ED and low testosterone explains how that is checked.

Why does the FDA warning list matter?

It matters because the most common hidden ingredient in “sexual enhancement” supplements is the prescription drug they claim to replace. FDA’s list of sexual enhancement and energy products found to contain hidden ingredients had 441 entries as of October 15, 2026, and FDA warns that if a product is not on the list, “that does not mean it is safe” (FDA, Sexual Enhancement and Energy Product Notifications). A study of FDA warnings from 2007 to 2016 counted 776 adulterated supplements, 353 of them marketed for sexual enhancement, and sildenafil was the hidden ingredient in 166 of those 353 (Tucker et al., JAMA Netw Open 2018).

A hidden dose of sildenafil is not a harmless bonus. The Viagra label says sildenafil can boost the blood-pressure-lowering effect of nitrates, so it must not be taken by men who use nitrate medicines in any form (Viagra prescribing information, DailyMed). A man who takes nitroglycerin for chest pain cannot follow that rule if he does not know the drug is in the capsule. Our page on hidden drugs in “natural” ED pills walks through what FDA has found and how to report a problem.

How to read a supplement claim

A few checks sort most supplement claims quickly. Ask whether the ingredient was tested in men with ED, not in rats or in healthy volunteers; whether the trial had a placebo group; how many men took part; and whether the result was a change in an erection score or only in a blood marker such as testosterone. On those tests, every ingredient on this page falls short of the evidence behind FDA-approved ED medicines. Our guide to how to read ED evidence explains the study types in more detail, and the habits with real support, such as regular exercise, are covered in the lifestyle section.

The bottom line

No supplement on this list has consistent trial evidence for ED. Ginseng has the most studies and a small effect; tongkat ali and maca have a few small trials; horny goat weed has only animal data; ashwagandha, ginkgo, DHEA, zinc, vitamin D and magnesium show little or no benefit for erections; and yohimbe carries real heart and blood pressure risks. Testosterone boosters mostly do not raise testosterone, and FDA keeps finding prescription ED drugs hidden in products sold as natural. A checkup that looks for the cause is a better first step than any bottle.

Sources

Every clinical statement on this page traces to one of these sources:

• NCCIH, Yohimbe (last updated May 2025): little research in people; risks including irregular heartbeat, blood pressure problems, heart attacks and seizures; variable content; illegal to market OTC yohimbine for ED without FDA approval.
• NCCIH, Ashwagandha (last updated March 2023): limited evidence for testosterone; rare liver injury; avoid with hormone-sensitive prostate cancer; supplements not FDA-approved before sale.
• NCCIH, Ginkgo (last updated February 2025): no conclusive evidence for any condition; bleeding risk with anticoagulants.
• Herbal dietary supplements for erectile dysfunction: a systematic review and meta-analysis of randomized-controlled trials (J Tradit Complement Med, 2025): 14 trials, 1,227 men; saffron and ginseng most consistent; evidence for Tribulus terrestris and maca insufficient; one tongkat ali trial of 23 men.
• Borrelli F, et al. Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis (Drugs, 2018): 24 trials, 2,080 men; ginseng significant, other herbs mixed or very preliminary; 7 trials mostly low risk of bias.
• Lee HW, et al. Ginseng for Erectile Dysfunction: A Cochrane Systematic Review (2021): 9 trials, all versus placebo; trivial effect on erectile function score; low certainty; most trials conducted in South Korea.
• Ernst E, Pittler MH. Yohimbine for erectile dysfunction: a systematic review and meta-analysis (J Urol, 1998): 7 trials of yohimbine monotherapy versus placebo.
• Gu C, et al. Icariin: from preclinical promise to clinical reality (Front Pharmacol, 2026): ED evidence from cell and animal studies only; negligible bioavailability of intact icariin.
• Herba Epimedium (Horny Goat Weed) Toxicity: A Case Report (Cureus, 2025): muscle spasms with raised creatine kinase and creatinine after an online Epimedium supplement.
• Mamidi P, Thakar AB. Efficacy of Ashwagandha in the management of psychogenic erectile dysfunction (Ayu, 2011): 95 men randomized, 86 completed; no benefit over placebo.
• Kotirum S, et al. Efficacy of Tongkat Ali on erectile function improvement: systematic review and meta-analysis (Complement Ther Med, 2015): 2 trials, 139 men; no significant overall difference.
• Kang BJ, et al. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction (Hum Psychopharmacol, 2002): no significant difference from placebo.
• Wheatley D. Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugs (Hum Psychopharmacol, 2004): no statistically significant differences.
• Reiter WJ, et al. Dehydroepiandrosterone in the treatment of erectile dysfunction (Urology, 1999): 40 men; authors called the sample too small for relevant statistical analysis.
• El-Sakka AI. Dehydroepiandrosterone and Erectile Function: A Review (World J Mens Health, 2018): large well-designed studies still needed.
• Shin BC, et al. Maca for improving sexual function: a systematic review (BMC Complement Altern Med, 2010): 4 small trials; limited evidence.
• Miyoshi M, et al. Low serum zinc concentration is associated with low serum testosterone but not erectile function (Int J Urol, 2023): 720 men.
• NIH ODS, Zinc Health Professional Fact Sheet (updated January 6, 2026): effects of high zinc intakes, including on copper absorption.
• Duarte Romero B, et al. The effect of three years of vitamin D supplementation on erectile dysfunction: the D-Health Trial (Clin Nutr ESPEN, 2024): 8,920 men; supplementation unlikely to prevent or improve ED.
• Matukaitiene R, et al. The Association Between Vitamin D Levels and Erectile Dysfunction in Men: A Systematic Review (J Clin Med, 2025): association in observational studies; inconsistent trial results.
• NIH ODS, Vitamin D Health Professional Fact Sheet (updated June 27, 2025): toxicity from excess supplemental vitamin D.
• Chen X, et al. Magnesium deficiency score predicts erectile dysfunction risk and mortality: NHANES 2001-2004 (Front Nutr, 2025): cross-sectional association in 3,917 participants.
• NIH ODS, Magnesium Health Professional Fact Sheet (updated January 6, 2026): diarrhea at high supplemental doses; medication interactions.
• Clemesha CG, et al. ‘Testosterone Boosting’ Supplements Composition and Claims Are not Supported by the Academic Literature (World J Mens Health, 2020): 50 products; 24.8% of ingredients with data showing a testosterone increase.
• Morgado A, et al. Do “testosterone boosters” really increase serum total testosterone? A systematic review (Int J Impot Res, 2024): 52 studies, 27 boosters; most fail to raise total testosterone; a few rated effective or possibly effective in specific groups.
• FDA, Sexual Enhancement and Energy Product Notifications (checked 2026-10-17): 441 entries as of October 15, 2026; absence from the list does not mean a product is safe.
• Tucker J, et al. Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With FDA Warnings (JAMA Netw Open, 2018): 776 adulterated supplements, 353 for sexual enhancement, sildenafil in 166.
• VIAGRA (sildenafil citrate) prescribing information, Pfizer, DailyMed: use with nitrates is contraindicated.
• NIDDK, Symptoms and Causes of Erectile Dysfunction (last reviewed October 2024): conditions linked to ED, including heart and blood vessel disease, diabetes, high blood pressure and low testosterone.