Does ashwagandha give you erectile dysfunction? This is a common concern among men considering this popular herbal supplement. Ashwagandha (Withania somnifera) is an adaptogenic herb from Ayurvedic medicine, widely available in the UK as a food supplement. Whilst it is generally well-tolerated, understanding its potential effects on sexual health is important. Current evidence does not suggest that ashwagandha causes erectile dysfunction; limited research actually indicates possible benefits for male sexual function, though this evidence remains preliminary. If you experience erectile difficulties whilst taking any supplement, consult your GP for a proper assessment, as erectile dysfunction can signal underlying health conditions requiring medical attention.

What Is Ashwagandha and How Does It Work?

Ashwagandha (Withania somnifera) is a traditional herbal remedy originating from Ayurvedic medicine, commonly used as an adaptogen—a substance believed to help the body manage stress. The root and berry extracts contain bioactive compounds called withanolides, which are thought to modulate various physiological processes including the hypothalamic-pituitary-adrenal (HPA) axis, the body's central stress response system.

The proposed mechanisms of action are largely based on preclinical studies and include reducing cortisol levels, enhancing antioxidant activity, and potentially influencing neurotransmitter systems. Some preliminary research has explored ashwagandha's potential effects on testosterone levels and male reproductive health, though the evidence base remains limited and further well-designed trials are needed.

Regulation and availability in the UK:

• Most ashwagandha products are classified as food supplements by the Medicines and Healthcare products Regulatory Agency (MHRA) and are not licensed medicines

• Some herbal products may carry MHRA Traditional Herbal Registration (THR); look for the THR logo, which indicates the product meets specific safety and quality standards

• Food supplements do not undergo the same rigorous testing and approval process as pharmaceutical medications, and UK law prohibits medical claims for these products

• Ashwagandha is widely available over the counter in health food shops, pharmacies, and online retailers

• Quality, purity, and withanolide concentration can vary significantly between manufacturers; purchase from reputable sources

It is important to recognise that whilst ashwagandha has a long history of traditional use, the clinical evidence supporting many of its purported benefits remains preliminary. Most studies have been small-scale, and larger, well-designed randomised controlled trials are needed to establish efficacy and safety profiles comprehensively. Anyone considering ashwagandha should discuss this with their GP or pharmacist, particularly if they have existing health conditions or take other medications.

Potential Side Effects of Ashwagandha

Whilst ashwagandha is generally considered well-tolerated when taken at recommended doses, it is not without potential adverse effects. Understanding these side effects is essential for informed decision-making, particularly as the supplement is not subject to the same regulatory oversight as licensed medicines.

Common side effects reported in clinical studies and post-marketing surveillance include:

• Gastrointestinal disturbances such as nausea, diarrhoea, abdominal discomfort, and indigestion

• Drowsiness or sedation, particularly at higher doses or when combined with other sedating substances; do not drive or operate machinery if you feel drowsy, and avoid alcohol

• Headache and dizziness in some individuals

• Skin rash or allergic reactions in those sensitive to plants in the Solanaceae family

More serious but less common concerns include potential effects on thyroid function. Ashwagandha may increase thyroid hormone levels, which could be problematic for individuals with hyperthyroidism or those taking thyroid medications. There have also been case reports of hepatotoxicity (liver injury) associated with ashwagandha supplements, though causality has not always been definitively established.

Stop taking ashwagandha and seek medical attention immediately if you develop:

• Signs of liver injury: jaundice (yellowing of skin or eyes), dark urine, pale stools, severe itching, right upper abdominal pain, persistent nausea or vomiting

• Signs of thyrotoxicosis: palpitations, tremor, unexplained weight loss, heat intolerance, anxiety, or restlessness

Important contraindications and interactions:

• Pregnancy and breastfeeding: avoid use due to insufficient safety data and potential uterine stimulant effects

• Autoimmune conditions: theoretical concerns exist about immune system stimulation; caution advised if taking immunosuppressants

• Diabetes: may lower blood glucose levels; monitor blood sugar closely if taking antidiabetic medications

• Blood pressure medications: possible additive effects on lowering blood pressure; monitoring may be required

• Thyroid medications: may interact with levothyroxine or antithyroid drugs; thyroid function should be monitored

• Sedatives and anxiolytics: may enhance sedative effects; avoid concurrent use

The variability in supplement quality means that contaminants or adulterants could contribute to adverse effects. Always purchase from reputable sources and inform your healthcare provider about all supplements you are taking. If you suspect an adverse reaction to ashwagandha, you can report it via the MHRA Yellow Card scheme at https://yellowcard.mhra.gov.uk/.

When to Seek Medical Advice About Erectile Dysfunction

Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is a common condition affecting men of all ages, though prevalence increases with age. ED can have significant psychological and relationship impacts, and importantly, it may be an early indicator of underlying cardiovascular disease or other health conditions.

You should consult your GP if:

• Erectile difficulties persist for more than a few weeks or are worsening

• ED is causing significant distress or affecting your relationship

• You experience other symptoms alongside ED, such as reduced libido, testicular pain, or difficulty with ejaculation

• You have cardiovascular risk factors (hypertension, diabetes, high cholesterol, smoking) as ED may indicate vascular problems

• ED developed after starting a new medication or supplement

Your GP will typically conduct a thorough assessment including medical history, medication review, lifestyle factors, and psychological wellbeing. According to NICE Clinical Knowledge Summaries (CKS) on Erectile Dysfunction, initial investigations may include:

• Blood pressure measurement and cardiovascular risk assessment (e.g., QRISK)

• Body mass index (BMI) and waist circumference

• Fasting glucose and HbA1c to screen for diabetes

• Lipid profile to assess cardiovascular risk

• Urinalysis

• Renal and liver function tests as indicated

• Morning testosterone levels if symptoms suggest hypogonadism (low testosterone), such as reduced libido, fatigue, or loss of morning erections

• Serum prolactin if low libido is accompanied by galactorrhoea or other features

• Thyroid function tests if clinically indicated

ED is often multifactorial, with both physical and psychological components. Common physical causes include vascular disease, diabetes, neurological conditions, hormonal imbalances, and medication side effects. Psychological factors such as anxiety, depression, stress, and relationship difficulties can also contribute significantly.

Your GP may refer you to a specialist (urology, endocrinology, or sexual health services) if there are suspected endocrine disorders, Peyronie's disease, failure of first-line therapy, or complex comorbidities.

When to seek urgent medical attention:

• Priapism (painful erection lasting more than four hours)—this is a medical emergency requiring immediate treatment to prevent permanent damage

• Suspected penile fracture: acute severe penile pain, swelling, and bruising after trauma during sexual activity

• Sudden onset ED accompanied by chest pain, breathlessness, or other cardiac symptoms

Early consultation allows for identification of treatable underlying causes and access to evidence-based treatments, which may include lifestyle modifications, psychological support, or oral medications such as phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil). PDE5 inhibitors are contraindicated in men taking nitrates or riociguat due to the risk of severe hypotension. Your GP will assess your cardiovascular fitness and suitability for sexual activity before prescribing these medications.

Does Ashwagandha Cause Erectile Dysfunction?

There is no established clinical evidence linking ashwagandha to causing erectile dysfunction. In fact, the limited research available suggests the opposite—that ashwagandha may have potential benefits for male sexual health, though this evidence base remains preliminary and of low certainty.

Several small studies have explored ashwagandha's effects on male reproductive parameters. Some research has indicated that ashwagandha supplementation may be associated with modest increases in testosterone levels, improved sperm quality, and enhanced sexual function in men experiencing stress-related sexual difficulties. The proposed mechanisms include stress reduction through cortisol modulation, antioxidant effects on reproductive tissues, and potential direct effects on the hypothalamic-pituitary-gonadal axis.

However, it is crucial to interpret these findings with appropriate caution. Most studies have been small, of short duration, and conducted in specific populations (such as infertile men or those with diagnosed stress). The quality of evidence does not yet meet the standards required for clinical recommendations, and ashwagandha is not recognised in UK clinical guidelines (NICE CKS or NHS) as a treatment for erectile dysfunction.

Important considerations:

• Individual responses to supplements vary considerably

• If ED develops after starting ashwagandha, this may be coincidental rather than causal; other factors such as stress, underlying health conditions, or concurrent medications may be responsible

• Changes in libido, energy, or mood may sometimes be perceived as erectile difficulties

• The psychological impact of health anxiety about supplements can itself contribute to sexual difficulties

If you have concerns that ashwagandha or any other supplement may be affecting your sexual function, the appropriate course of action is to:

1. Stop taking the supplement if you suspect it is causing adverse effects

2. Consult your GP or pharmacist for a comprehensive assessment of potential causes

3. Ensure your healthcare provider is aware of all supplements and over-the-counter products you are taking

4. Consider whether other lifestyle factors, medications, or health conditions might be contributing

ED is a common and treatable condition with multiple potential causes. Evidence-based treatments are available through the NHS, and your GP can guide you towards appropriate investigations and management tailored to your individual circumstances. Self-treatment with supplements should not replace professional medical assessment, particularly as ED may indicate underlying cardiovascular or metabolic conditions requiring attention. Ashwagandha is not a recommended treatment for ED in UK clinical practice, and relying on it may delay access to effective, evidence-based care.

Frequently Asked Questions