Erectile dysfunction (ED) affects many men and can significantly impact quality of life and relationships. Whilst prescription medications such as sildenafil remain the mainstay of treatment, some men explore complementary approaches including herbal remedies. Red ginseng, a traditional East Asian medicine derived from steamed Panax ginseng root, has attracted attention for its potential effects on erectile function. This article examines the evidence for red ginseng in managing ED, how it may work, appropriate usage, safety considerations, and its place alongside conventional treatments within UK clinical practice.

What Is Red Ginseng and How Does It Work?

Red ginseng, also known as Korean red ginseng or Panax ginseng, is a traditional herbal remedy that has been used in East Asian medicine for centuries. It is produced by steaming and drying the root of the ginseng plant, a process that gives it its characteristic reddish-brown colour. This steaming process alters the ginsenoside profile (creating compounds such as Rg3), which are thought to contribute to its potential therapeutic effects.

The proposed mechanisms by which red ginseng might influence erectile function are multifaceted, though primarily supported by laboratory and animal studies rather than human clinical evidence. Ginsenosides, the primary active constituents, are theorised to promote the release of nitric oxide (NO) from endothelial cells and nerve terminals in the corpus cavernosum of the penis. Nitric oxide is a crucial signalling molecule that relaxes smooth muscle tissue in blood vessels, thereby increasing blood flow to the penis—a fundamental requirement for achieving and maintaining an erection. While phosphodiesterase type 5 (PDE5) inhibitors like sildenafil work by inhibiting PDE5 to enhance cGMP signalling, red ginseng may work through different pathways with generally smaller clinical effects.

Additionally, red ginseng may exert antioxidant and anti-inflammatory effects that could potentially improve vascular health, though human evidence for this specific to erectile function is limited. Chronic inflammation and oxidative stress are known contributors to endothelial dysfunction, which is a common underlying cause of erectile dysfunction (ED), particularly in men with cardiovascular disease or diabetes. Some research suggests that red ginseng may have stress-reducing properties that could help with psychological factors contributing to erectile difficulties. However, whilst these mechanisms are biologically plausible, the clinical evidence supporting red ginseng's efficacy in treating ED remains an area of ongoing investigation.

How to Use Red Ginseng for Erectile Function

Red ginseng is available in various formulations, including capsules, tablets, powders, teas, and liquid extracts. It's important to note that clinical studies have primarily used standardised extracts with specific ginsenoside concentrations, rather than teas or powders. When considering red ginseng for erectile function, select products from reputable sources that clearly state their ginsenoside content.

In the UK, herbal products may be registered under the MHRA's Traditional Herbal Registration (THR) scheme, indicated by a THR mark on the packaging. THR products meet standards for quality, safety information and traditional use. Products without THR registration are typically sold as food supplements under Food Standards Agency oversight, with less stringent quality requirements.

The typical dosage used in research studies ranges from 600 mg to 3,000 mg per day of standardised extract, usually divided into two or three doses. Most clinical trials investigating erectile dysfunction have used doses of approximately 900 mg to 1,500 mg taken daily for a period of 8 to 12 weeks. Red ginseng is not an immediate treatment like prescription ED medications; rather, it may require consistent use over several weeks before any potential benefits become apparent.

Before starting red ginseng, men experiencing erectile dysfunction should consult their GP. This is particularly important because ED can be an early warning sign of underlying cardiovascular disease, diabetes, or hormonal imbalances that require proper medical assessment. Initial evaluation typically includes blood pressure measurement, cardiovascular risk assessment, blood tests for glucose, lipids, and sometimes morning testosterone if symptoms of hypogonadism are present.

Be cautious about purchasing 'herbal' products for erectile dysfunction from unregulated sources. The MHRA has repeatedly identified unlicensed products marketed for ED that contain undeclared prescription medicines or their analogues. Purchase from UK-regulated pharmacies or look for products with the THR mark to reduce this risk.

Side Effects and Safety Considerations

Red ginseng is generally considered well-tolerated when used at recommended doses for short to moderate durations. However, like all herbal supplements, it can cause side effects in some individuals. The most commonly reported adverse effects include headache, digestive upset, sleep disturbances (insomnia), and nervousness or restlessness. These effects are typically mild and may resolve with dose reduction or discontinuation of the supplement.

Some men may experience changes in blood pressure. Red ginseng has been reported to cause both increases and decreases in blood pressure in different individuals, which may be of particular concern for those with pre-existing hypertension or cardiovascular conditions. Rarely, red ginseng may have mild oestrogenic effects, potentially leading to breast tenderness or gynaecomastia (breast tissue enlargement in men).

Drug interactions are an important consideration. Red ginseng may interact with several classes of medications, including:

• Anticoagulants (such as warfarin) – red ginseng may reduce warfarin's anticoagulant effect (lower INR); avoid without specialist advice and monitor INR closely if used together

• Antiplatelet drugs (such as aspirin or clopidogrel) – theoretical interaction; use with caution

• Antidiabetic medications – it may enhance blood glucose-lowering effects, potentially causing hypoglycaemia; monitor blood glucose levels regularly

• Immunosuppressants – theoretical interaction based on limited evidence; consult a specialist before use

• Stimulant medications – combined use may increase the risk of overstimulation and cardiovascular effects

• Monoamine oxidase inhibitors (MAOIs) – avoid combination due to potential for agitation or mania

Men taking prescription ED medications such as sildenafil, tadalafil, or vardenafil should exercise caution, as the combined vasodilatory effects could theoretically lead to excessive blood pressure lowering.

Contraindications include active bleeding disorders, scheduled surgery (discontinue at least two weeks prior), and hormone-sensitive conditions including certain cancers (e.g., breast, prostate). Men with a history of cardiovascular events, bipolar disorder, or severe liver or kidney disease should seek medical advice before use. If you experience chest pain, severe headache, visual disturbances, allergic reactions (rash, swelling, breathing difficulty), or an erection lasting more than four hours (priapism), seek immediate medical attention.

Report any suspected side effects to the MHRA through the Yellow Card scheme (website or app).

Does Red Ginseng Help with Erectile Dysfunction?

The evidence regarding red ginseng's effectiveness for erectile dysfunction is mixed but cautiously promising. Several systematic reviews and meta-analyses have examined the available clinical trials, with results suggesting a potential modest benefit, though the quality of evidence remains moderate at best. A 2018 systematic review published in the British Journal of Clinical Pharmacology analysed multiple randomised controlled trials and concluded that red ginseng may offer some improvement in erectile function compared to placebo, but emphasised that larger, more rigorous studies are needed.

Most clinical trials have used validated assessment tools such as the International Index of Erectile Function (IIEF) to measure outcomes. Studies typically report improvements in IIEF scores among men taking red ginseng compared to placebo, with effect sizes that are statistically significant but generally smaller than those achieved with conventional PDE5 inhibitors. The improvements appear to be most notable in men with mild to moderate ED rather than severe cases, and in those whose erectile difficulties have a psychogenic or mixed aetiology rather than purely organic causes.

It is important to emphasise that red ginseng is not licensed for erectile dysfunction in the UK and is not recommended by NICE. The National Institute for Health and Care Excellence (NICE) guidelines for managing ED primarily recommend PDE5 inhibitors as first-line pharmacological treatment, followed by other options such as vacuum devices, alprostadil or psychosexual therapy as appropriate. The evidence base for red ginseng does not yet meet the threshold for formal clinical recommendation.

Men experiencing erectile difficulties should first undergo proper medical assessment to identify and address any underlying causes, such as cardiovascular disease, diabetes, hormonal imbalances, or psychological factors. Referral to urology or endocrinology may be appropriate for men with Peyronie's disease, anatomical abnormalities, or suspected hypogonadism. Lifestyle modifications—including smoking cessation, weight management, regular exercise, and stress reduction—remain fundamental to managing ED and should not be overlooked in favour of supplements.

For men who wish to try red ginseng as a complementary approach alongside conventional treatment or lifestyle changes, it may be reasonable to do so under medical supervision, particularly if they have mild symptoms and no contraindications. However, it should not replace evidence-based treatments or delay proper medical evaluation. If erectile dysfunction persists or worsens despite trying red ginseng or other interventions, or if it is accompanied by other concerning symptoms, men should contact their GP for further assessment and management options.

Frequently Asked Questions