Does rhodiola rosea help erectile dysfunction? This question arises frequently as men seek natural alternatives to conventional treatments. Rhodiola rosea is a herbal adaptogen traditionally used to combat stress and fatigue, and some believe it may support sexual function indirectly by reducing psychological factors that contribute to erectile difficulties. However, rhodiola is not authorised for treating erectile dysfunction by UK regulatory bodies, and robust clinical evidence supporting its use for this indication is lacking. This article examines the available evidence, safety considerations and evidence-based alternatives for managing erectile dysfunction in the UK.

What Is Rhodiola Rosea and How Does It Work?

Rhodiola rosea is a perennial flowering plant native to cold regions of Europe, Asia and the Arctic. Traditionally used in Scandinavian and Russian folk medicine, it is classified as an adaptogen—a substance believed to help the body adapt to physical and psychological stress. The root of the plant contains active compounds including rosavins (rosavin, rosin, rosarin) and salidroside, which are thought to be responsible for its purported effects. Extracts are typically standardised to these compounds, though the content can vary between products.

Rhodiola is marketed primarily for its potential to reduce fatigue, enhance mental performance and improve mood. The proposed mechanism of action involves modulation of the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the body's stress response. It is hypothesised that rhodiola may influence levels of stress hormones such as cortisol, though robust clinical evidence for these effects in humans is limited. Some research suggests it may affect neurotransmitter activity, including serotonin and dopamine pathways, which play roles in mood regulation and sexual function, but these mechanisms remain largely theoretical.

In the context of erectile dysfunction (ED), the rationale for using rhodiola centres on its potential to alleviate stress-related sexual difficulties. Psychological factors—particularly anxiety, depression and chronic stress—are recognised contributors to ED. If rhodiola can reduce stress and improve overall wellbeing, it might indirectly support sexual function. However, there is no robust clinical evidence that rhodiola has a direct pharmacological action on the vascular or neurological mechanisms that underpin erections, unlike established treatments such as phosphodiesterase-5 (PDE5) inhibitors.

Rhodiola rosea is available in the UK as a food supplement and in some products registered under the MHRA Traditional Herbal Registration (THR) scheme for the temporary relief of symptoms associated with stress, such as fatigue and mild anxiety. Rhodiola is not authorised for the treatment of erectile dysfunction by the Medicines and Healthcare products Regulatory Agency (MHRA), the European Medicines Agency (EMA) or NICE. THR registration reflects traditional use and does not constitute proof of efficacy.

Evidence and Research on Rhodiola for Sexual Function

The scientific evidence supporting rhodiola rosea for erectile dysfunction is limited and inconclusive. Most studies have focused on its effects on fatigue, cognitive function and mood, rather than sexual health specifically. A small number of older studies have explored rhodiola's impact on sexual function, but these are generally of low methodological quality, with small sample sizes and lack of robust controls.

One frequently cited study from the 1970s, conducted in Russia, reported improvements in sexual function among men with ED or premature ejaculation after taking rhodiola extract. However, this research has not been replicated in well-designed, peer-reviewed trials, and the findings are difficult to interpret by modern standards. More recent systematic reviews examining adaptogens for sexual dysfunction have concluded that there is insufficient high-quality evidence to recommend rhodiola for this indication.

The potential benefit of rhodiola in ED may be indirect, mediated through improvements in psychological wellbeing. Stress, anxiety and depression are well-established risk factors for erectile dysfunction. Some evidence suggests rhodiola may have mild effects on stress-related symptoms and fatigue, though the quality of included studies is variable. A 2018 systematic review in Phytomedicine found modest evidence for rhodiola's efficacy in reducing symptoms of stress and fatigue. If rhodiola does improve stress-related symptoms, it might theoretically benefit men whose ED has a significant psychological component, though this has not been demonstrated in clinical trials.

It is crucial to recognise that no UK or EU regulatory body has established a link between rhodiola rosea and the treatment of erectile dysfunction. Current NICE Clinical Knowledge Summary (CKS) on Erectile Dysfunction does not mention herbal supplements, and evidence-based treatment remains centred on lifestyle modification, psychological interventions and pharmacotherapy with PDE5 inhibitors. The EMA's Committee on Herbal Medicinal Products (HMPC) has assessed rhodiola for traditional use in temporary relief of stress-related symptoms only, not for sexual dysfunction.

Safety, Side Effects and Interactions to Consider

Rhodiola rosea is generally considered safe when used short-term at recommended doses, though long-term safety data are lacking. Most people tolerate it well, but side effects can occur. Commonly reported adverse effects include:

• Dizziness or light-headedness

• Dry mouth

• Sleep disturbances (particularly if taken late in the day; morning dosing is advisable)

• Gastrointestinal upset, including nausea

• Jitteriness or agitation in sensitive individuals

These effects are typically mild and resolve on discontinuation. If you experience agitation, manic symptoms, palpitations or any severe or unexpected reaction, stop taking rhodiola and seek medical advice. Severe allergic reactions (e.g., rash, swelling, difficulty breathing) require urgent medical attention.

Because rhodiola is available as a food supplement and in THR-registered products, the quality and purity of supplements can vary significantly between manufacturers. Contamination, adulteration or inaccurate labelling are potential concerns with unregulated herbal products. Where possible, choose products with MHRA THR registration or other quality assurance.

Drug interactions are an important consideration. Rhodiola may theoretically interact with medications metabolised by the liver's cytochrome P450 enzyme system, though clinical significance is unclear. Of particular relevance to men with ED:

• Antidepressants: Rhodiola may have additive effects with SSRIs, SNRIs or MAOIs, with a theoretical risk of serotonin syndrome (symptoms include agitation, sweating, tremor, diarrhoea, fever and confusion). If you take antidepressants, discuss rhodiola use with your GP or pharmacist before starting.

• Antihypertensive medications: There is limited evidence that rhodiola might influence blood pressure; caution is advised if taking medications for hypertension.

• Anticoagulants and antiplatelet drugs: Some adaptogens may affect platelet function, though evidence for rhodiola specifically is weak. Discuss with your GP or pharmacist if you take warfarin, DOACs or antiplatelet agents.

Contraindications and precautions: Rhodiola is not recommended in pregnancy or breastfeeding due to insufficient safety data, or in children and young people under 18 years. Men with bipolar disorder should exercise caution, as some reports suggest rhodiola may trigger manic episodes. Do not use if you have a known hypersensitivity to rhodiola.

Reporting side effects: If you suspect you have experienced a side effect from rhodiola or any other supplement or medicine, you can report it via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or by searching for 'MHRA Yellow Card' in the Google Play or Apple App Store.

Patient safety advice: If you are considering rhodiola for erectile dysfunction, discuss this with your GP or pharmacist, particularly if you have existing health conditions or take regular medications. Do not use herbal supplements as a substitute for evidence-based treatments without medical guidance. If you experience persistent erectile dysfunction, contact your GP for proper assessment, as ED can be an early marker of cardiovascular disease or other underlying health conditions requiring investigation.

Alternative Treatments for Erectile Dysfunction in the UK

For men experiencing erectile dysfunction in the UK, evidence-based treatments are available through the NHS and private healthcare. The NICE Clinical Knowledge Summary (CKS) on Erectile Dysfunction recommends a structured approach to assessment and management.

Assessment and investigations: Your GP will take a full medical and sexual history, perform relevant examinations and may arrange blood tests to check for underlying conditions. Baseline investigations typically include:

• Blood pressure and BMI

• Fasting glucose or HbA1c (to screen for diabetes)

• Lipid profile (cholesterol and triglycerides)

• Morning total testosterone (taken between 8 and 11 am); if low, a repeat test is recommended, with further endocrine evaluation if confirmed

ED can be an early warning sign of cardiovascular disease, as the vascular changes that cause ED often precede coronary artery disease. Do not delay seeking help—early assessment and treatment can improve outcomes and may identify important health risks.

Lifestyle modifications are fundamental and should be addressed in all men with ED:

• Smoking cessation

• Reducing alcohol intake

• Regular physical exercise (at least 150 minutes of moderate activity weekly)

• Weight management if overweight or obese

• Optimising management of chronic conditions such as diabetes, hypertension and hyperlipidaemia

Psychological interventions are important when ED has a psychological component or when relationship factors contribute. Psychosexual counselling or cognitive behavioural therapy (CBT) may be offered, either alone or in combination with pharmacological treatment. Relationship counselling can be beneficial when ED affects both partners.

First-line pharmacological treatment consists of PDE5 inhibitors, which include:

• Sildenafil (Viagra and generics)

• Tadalafil (Cialis and generics)

• Vardenafil (Levitra and generics)

• Avanafil (Spedra)

These medications work by enhancing the natural erectile response to sexual stimulation through increased blood flow to the penis. They are effective in approximately 70–80% of men and are generally well-tolerated. Generic sildenafil is commonly prescribed on the NHS when clinically appropriate. Sildenafil 50 mg is also available as an over-the-counter (OTC) pharmacy medicine in the UK, subject to pharmacist assessment.

Important contraindications and cautions for PDE5 inhibitors include:

• Absolute contraindication: Use of nitrates (e.g., GTN spray, isosorbide mononitrate) or nicorandil (risk of severe hypotension)

• Caution: Recent myocardial infarction or stroke, severe hypotension, unstable angina, severe heart failure

• Interaction: Alpha-blockers (e.g., tamsulosin, doxazosin)—risk of postural hypotension; dose adjustment and timing may be needed

A cardiovascular risk assessment should be considered before starting treatment if there are concerns about fitness for sexual activity. Refer to the electronic Medicines Compendium (EMC) Summary of Product Characteristics (SmPC) for each PDE5 inhibitor for full prescribing information.

Testosterone replacement therapy may be considered if symptomatic hypogonadism is confirmed on repeat morning testosterone tests and after appropriate evaluation and, where indicated, specialist referral.

Second-line treatments for men who do not respond to or cannot tolerate PDE5 inhibitors include:

• Vacuum erection devices (VEDs)

• Intracavernosal injections (e.g., alprostadil)—note risk of priapism (erection lasting >4 hours, requiring urgent medical attention)

• Intraurethral alprostadil

• Penile prosthesis surgery (for refractory cases)

When to seek medical advice and red flags:

• Always see your GP if you experience persistent or recurrent erectile dysfunction.

• Seek urgent medical attention if you experience chest pain during sexual activity, sudden loss of vision or hearing, or an erection lasting more than 4 hours (priapism).

• Refer to urology if there is penile deformity, suspected Peyronie's disease, or severe or sudden-onset ED with other neurological or vascular symptoms.

• If you experience sudden loss of erection capability or ED following trauma or surgery, contact your GP promptly.

For further information, see the NICE CKS: Erectile Dysfunction, the NHS website page on erectile dysfunction, and the EMC (MHRA) Summaries of Product Characteristics for individual PDE5 inhibitors.

Frequently Asked Questions