Ashwagandha, a traditional Ayurvedic herb, is increasingly marketed for erectile dysfunction, but how much should you take—and does it actually work? Whilst some studies suggest ashwagandha may support stress reduction and testosterone levels, there is no clinically validated dosage for erectile dysfunction, and evidence remains limited. Most research has used 300–600 mg of standardised root extract daily, though these doses were not specifically tested for ED. This article examines the evidence, safety considerations, and when to seek medical advice for erectile problems.
Summary: There is no clinically validated dosage of ashwagandha specifically for erectile dysfunction, though studies on stress and male reproductive health have used 300–600 mg of standardised root extract daily.
- Ashwagandha is an Ayurvedic herb not licensed by the MHRA for treating erectile dysfunction in the UK.
- Proposed mechanisms include stress reduction, potential testosterone support, and nitric oxide pathway modulation, but human evidence is limited.
- Most studies used 300–600 mg daily of standardised root extract for 8–12 weeks, though not specifically for ED.
- Common side effects include gastrointestinal upset and drowsiness; rare cases of liver injury have been reported.
- Ashwagandha may interact with thyroid medications, immunosuppressants, sedatives, diabetes drugs, and antihypertensives.
- Persistent erectile dysfunction warrants GP assessment to identify underlying causes and access evidence-based treatments such as PDE5 inhibitors.
Table of Contents
- What Is Ashwagandha and How Does It Work for Erectile Dysfunction?
- Recommended Ashwagandha Dosage for Erectile Dysfunction
- Clinical Evidence: Does Ashwagandha Help with Erectile Function?
- Safety Considerations and Potential Side Effects
- When to Seek Medical Advice for Erectile Dysfunction
- Frequently Asked Questions
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What Is Ashwagandha and How Does It Work for Erectile Dysfunction?
Ashwagandha (Withania somnifera) is a medicinal herb traditionally used in Ayurvedic medicine, native to India and parts of the Middle East. Also known as Indian ginseng or winter cherry, it is sometimes described as an 'adaptogen'—a traditional herbal term (not a formal medical classification) for substances believed to help the body manage stress. The root and berry extracts contain bioactive compounds, including withanolides, which are thought to be responsible for many of its purported health effects. It is important to note that ashwagandha is botanically distinct from Panax ginseng, and their effects are not interchangeable.
In relation to erectile dysfunction (ED), ashwagandha is proposed to work through several potential mechanisms, though evidence in humans remains limited and of low certainty. Firstly, chronic stress and elevated cortisol levels are recognised contributors to sexual dysfunction in men. Ashwagandha may help modulate the hypothalamic-pituitary-adrenal (HPA) axis, potentially reducing stress-related hormonal imbalances that can impair erectile function, though this mechanism is largely theoretical. Secondly, some animal and preliminary human studies suggest ashwagandha may support testosterone production in men with low baseline levels or infertility, but the clinical significance of this effect for erectile function in men with normal testosterone remains uncertain.
Additionally, ashwagandha has been investigated for its potential effects on nitric oxide pathways. Nitric oxide is essential for penile erection, as it promotes smooth muscle relaxation and increased blood flow to the corpus cavernosum. Some preclinical research indicates that ashwagandha may enhance nitric oxide synthesis, but robust human evidence is lacking, and these mechanisms remain theoretical.
In the UK, ashwagandha is widely available as a food supplement and is not licensed by the Medicines and Healthcare products Regulatory Agency (MHRA) as a medicine for the treatment of erectile dysfunction. Some products may carry a Traditional Herbal Registration (THR) mark, but this does not indicate a licensed indication for ED. Its efficacy and safety profile for erectile dysfunction have not been formally evaluated to the same standard as prescription medications, and neither NICE nor the BNF recommend ashwagandha for this condition.
Recommended Ashwagandha Dosage for Erectile Dysfunction
There is currently no officially established, UK-endorsed, or clinically validated dosage of ashwagandha specifically for erectile dysfunction. The doses discussed below are derived from studies investigating ashwagandha for other indications—such as stress reduction and male reproductive health—and do not represent evidence-based recommendations for ED.
Most studies have used doses ranging from 300 mg to 600 mg of standardised root extract per day, often divided into two doses. Some trials have employed higher doses, up to 1,250 mg daily, though these are less common and the extract type and safety monitoring in those studies are not always clearly reported. It is important to understand that milligram amounts are not directly comparable across different products, as extracts vary widely. Root extracts are the most extensively studied, whilst leaf or whole-plant extracts may differ in composition and effect. Most commercially available ashwagandha supplements in the UK are standardised to contain a specific percentage of withanolides, usually between 1.5% and 5%, but standardisation methods and assays can vary between manufacturers.
When selecting a product, choose a reputable UK or EU brand that clearly states the withanolide content, follows Good Manufacturing Practice (GMP) standards, and ideally provides evidence of third-party testing. Products with a Traditional Herbal Registration (THR) logo have met certain quality standards, though they are not licensed for erectile dysfunction. Avoid unverified sources or products with unclear labelling.
Key considerations for dosing include:
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Start low and go slow: If you are new to ashwagandha, consider beginning with a lower dose (e.g., 300 mg daily) to assess tolerance.
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Consistency: Most studies administered ashwagandha daily for a minimum of 8 to 12 weeks before assessing outcomes, suggesting that any potential benefits may require sustained use. Long-term safety beyond 12 weeks is uncertain.
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Timing: Ashwagandha can be taken with or without food, though some individuals find it better tolerated with meals.
It is essential to follow the manufacturer's instructions on the product label and not exceed recommended doses without professional guidance. Review your use after 8 to 12 weeks and discuss continuation with your GP or pharmacist. Because ashwagandha is classified as a food supplement rather than a medicine, it is not subject to the same rigorous regulatory oversight, and product quality and potency can vary significantly between brands.
Clinical Evidence: Does Ashwagandha Help with Erectile Function?
The clinical evidence supporting ashwagandha for erectile dysfunction is limited, of low certainty, and largely indirect. Most research has focused on its effects on stress, anxiety, testosterone levels, and general sexual function rather than erectile dysfunction specifically. Small, short-term randomised controlled trials (RCTs) that have assessed erectile function using validated tools such as the International Index of Erectile Function (IIEF) have shown modest or mixed effects, with high risk of bias and small sample sizes. There are currently no large-scale, high-quality RCTs demonstrating that ashwagandha effectively treats erectile dysfunction as a primary outcome.
One randomised controlled trial published in 2015 investigated ashwagandha supplementation (675 mg daily for 90 days) in men with stress-related infertility. Participants experienced significant improvements in sperm quality and increases in serum testosterone compared to placebo. Whilst improved testosterone may theoretically benefit erectile function in men with low baseline levels, this study did not directly measure erectile performance or use validated erectile function tools, and its findings cannot be extrapolated to men with ED.
Another study examining ashwagandha's effects on stress and quality of life in adults found reductions in cortisol levels and improvements in self-reported sexual well-being. However, these findings were based on subjective measures rather than objective assessments of erectile function.
It is also important to recognise that erectile dysfunction is a multifactorial condition with diverse underlying causes, including vascular disease, diabetes, neurological disorders, hormonal imbalances, and psychological factors. The National Institute for Health and Care Excellence (NICE) and the BNF do not recommend ashwagandha for the treatment of erectile dysfunction. NICE guidance emphasises a thorough clinical assessment to identify and address the root cause of ED. Whilst ashwagandha may offer some benefit for stress-related sexual difficulties, it is unlikely to be effective for ED caused by significant organic pathology, such as atherosclerosis or severe diabetes. Men considering ashwagandha should view it as a complementary approach rather than a substitute for evidence-based medical treatment.
Safety Considerations and Potential Side Effects
Ashwagandha is generally well tolerated by most individuals when used at recommended doses for short to moderate durations (up to 12 weeks in most studies). However, as with any supplement, there are potential side effects and safety considerations to be aware of. Commonly reported adverse effects are typically mild and may include gastrointestinal symptoms such as nausea, diarrhoea, abdominal discomfort, or indigestion. These effects are often dose-dependent and may resolve with dose reduction or discontinuation.
Less commonly, ashwagandha has been associated with drowsiness or sedation, particularly at higher doses, due to its purported calming properties. Individuals should exercise caution if driving or operating machinery until they understand how the supplement affects them. There have also been rare case reports of liver injury (hepatotoxicity) associated with ashwagandha use. If you experience symptoms such as jaundice (yellowing of the skin or eyes), dark urine, pale stools, persistent itching (pruritus), right upper abdominal pain, or marked fatigue, stop taking ashwagandha immediately and seek medical advice.
Product quality and standardisation can vary significantly between brands, and contamination or adulteration is a potential concern with unregulated supplements. Choose reputable products with clear labelling and evidence of quality control.
Important contraindications and interactions include:
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Thyroid disorders: Ashwagandha may increase thyroid hormone levels and should be used cautiously in individuals with hyperthyroidism or those taking thyroid medication. Monitoring may be required.
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Immunosuppression: As an immunomodulator, ashwagandha may theoretically interfere with immunosuppressive therapy in transplant recipients or those with autoimmune conditions.
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Sedatives and CNS depressants: Ashwagandha may potentiate the effects of benzodiazepines, barbiturates, or alcohol, increasing the risk of excessive sedation.
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Diabetes medications: There is some evidence that ashwagandha may lower blood glucose, potentially increasing the risk of hypoglycaemia when combined with antidiabetic drugs. Blood glucose monitoring may be advisable.
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Antihypertensive medications: Ashwagandha may have additive blood-pressure-lowering effects, increasing the risk of hypotension or dizziness.
Pregnant and breastfeeding women should avoid ashwagandha, as safety data in these populations are insufficient. Men taking any prescribed medications—including those for erectile dysfunction, high blood pressure, diabetes, or thyroid conditions—should discuss potential interactions with their GP or pharmacist before starting ashwagandha.
If you experience any suspected side effects from ashwagandha, you can report them via the MHRA Yellow Card Scheme at www.mhra.gov.uk/yellowcard or by downloading the Yellow Card app. Reporting helps improve the safety monitoring of herbal products and medicines.
When to Seek Medical Advice for Erectile Dysfunction
Erectile dysfunction is a common condition affecting men of all ages, though prevalence increases with age. Whilst occasional difficulty achieving or maintaining an erection is not unusual, persistent or recurrent ED warrants medical evaluation. It is important to consult your GP if erectile difficulties occur regularly, cause distress, or affect your relationship or quality of life. Early assessment can help identify underlying health conditions and ensure appropriate management.
You should seek medical advice if:
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Erectile dysfunction persists for more than a few weeks or is worsening over time.
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You experience other symptoms such as reduced libido, fatigue, mood changes, or difficulty with ejaculation, which may suggest hormonal imbalances.
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You have cardiovascular risk factors (e.g., hypertension, high cholesterol, diabetes, smoking) or a history of heart disease, as ED can be an early marker of vascular disease.
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You are taking medications that may contribute to ED, such as antihypertensives, antidepressants, or antipsychotics.
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You experience sudden onset of ED, particularly if accompanied by penile pain, curvature, or trauma, which may indicate Peyronie's disease or other structural abnormalities.
Seek urgent medical assessment if you experience cardiovascular red flags such as exertional chest pain, unexplained breathlessness, or dizziness, as these may indicate serious underlying heart disease.
Your GP will typically conduct a thorough history and physical examination, including assessment of cardiovascular risk factors, psychological well-being, and medication review. Blood tests may be arranged to check fasting lipids, HbA1c (for diabetes screening), and morning total testosterone (repeated if low). If hypogonadism is suspected, further tests such as prolactin, luteinising hormone (LH), and follicle-stimulating hormone (FSH) may be considered.
According to NICE guidance, first-line treatment for ED often involves lifestyle modification (weight loss, smoking cessation, increased physical activity) and, where appropriate, phosphodiesterase-5 (PDE5) inhibitors such as sildenafil, tadalafil, or vardenafil, which have robust evidence of efficacy and safety. PDE5 inhibitors are contraindicated in men taking nitrates (e.g., glyceryl trinitrate for angina) or riociguat, due to the risk of severe hypotension. Men with complex cardiovascular disease should have their suitability for PDE5 inhibitors reviewed by a clinician.
Referral to specialist services may be appropriate in certain circumstances, including:
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Urology: for anatomical causes (e.g., Peyronie's disease), failure of first-line oral therapy, or consideration of other treatments (e.g., intracavernosal injections, vacuum devices, penile prosthesis).
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Endocrinology: for confirmed hypogonadism or other hormonal disorders.
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Psychosexual therapy: for predominantly psychogenic ED or relationship difficulties.
Whilst supplements like ashwagandha may appeal as a 'natural' option, they should not delay or replace evidence-based medical assessment and treatment. Erectile dysfunction can be a sentinel symptom of serious underlying conditions, including cardiovascular disease and diabetes. Addressing the root cause, rather than relying solely on unregulated supplements, is essential for both sexual health and overall well-being. For further information, visit the NHS page on erectile dysfunction or discuss your concerns with your GP.
Frequently Asked Questions
Can ashwagandha actually improve erectile dysfunction?
The evidence that ashwagandha improves erectile dysfunction is limited and of low certainty. Most studies have focused on stress reduction and testosterone levels rather than erectile function directly, and there are no large-scale trials demonstrating efficacy for ED as a primary outcome.
What dose of ashwagandha should I take for erectile problems?
There is no officially validated dose of ashwagandha for erectile dysfunction. Studies on stress and male reproductive health have typically used 300–600 mg of standardised root extract daily, divided into two doses, for 8–12 weeks, though these were not specifically designed to treat ED.
Is ashwagandha safe to take with Viagra or other ED medications?
Ashwagandha may interact with PDE5 inhibitors like sildenafil (Viagra) or tadalafil, particularly if it affects blood pressure or blood glucose. You should discuss any supplement use with your GP or pharmacist before combining it with prescription ED medications to avoid potential interactions.
How long does it take for ashwagandha to work for sexual function?
Most studies administered ashwagandha daily for at least 8–12 weeks before assessing outcomes, suggesting any potential benefits may require sustained use. Effects on sexual function, if any, are unlikely to be immediate and long-term safety beyond 12 weeks is uncertain.
What are the side effects of taking ashwagandha for ED?
Common side effects include gastrointestinal upset, nausea, and drowsiness. Rare but serious effects include liver injury, so stop taking ashwagandha and seek medical advice if you develop jaundice, dark urine, pale stools, or persistent abdominal pain.
When should I see my GP instead of trying ashwagandha for erectile dysfunction?
You should consult your GP if erectile dysfunction persists for more than a few weeks, causes distress, or is accompanied by cardiovascular risk factors such as diabetes or high blood pressure. ED can be an early sign of serious underlying conditions, and evidence-based treatments like PDE5 inhibitors are more effective than unregulated supplements.
The health-related content published on this site is based on credible scientific sources and is periodically reviewed to ensure accuracy and relevance. Although we aim to reflect the most current medical knowledge, the material is meant for general education and awareness only.
The information on this site is not a substitute for professional medical advice. For any health concerns, please speak with a qualified medical professional. By using this information, you acknowledge responsibility for any decisions made and understand we are not liable for any consequences that may result.
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