Herbs for Libido, Sex Drive and Sexual Health: What the Trials Actually Show
The herbs with the best evidence for libido are maca root (raised sexual desire independently of hormones in a 12-week RCT), Panax ginseng (the most-trialled herb for erectile function, with a 2018 Cochrane review finding small benefits) and saffron (improved desire and arousal in several trials, including people with antidepressant-induced sexual problems). Fenugreek, tongkat ali and ashwagandha have moderate data for desire and modest effects on testosterone; tribulus, the best-selling 'testosterone herb', does not raise testosterone in any controlled trial.
This guide is for adults, of any sex, whose interest in sex has dropped or whose arousal and performance are unreliable, and who want to know which supplements have real human data. Low desire usually has more to do with stress, sleep, relationship strain, antidepressants, alcohol and low mood than with any herb-fixable hormone shortfall, so we also cover those levers. Testosterone claims are graded strictly: 'modest' means a statistically significant change of a few percent in one or two trials, not a transformation.
See a doctor rather than a supplement shelf if you are a man with new erectile difficulty, since erectile dysfunction is frequently the first sign of cardiovascular disease and shows up on average three years before a heart attack or stroke; if you have low desire with fatigue, loss of body hair, breast tenderness or small testes (testosterone and prolactin should be measured, not guessed at); if pain is involved; or if the change followed a new medication. Men already taking nitrates or PDE5 inhibitors such as sildenafil must read the interaction notes below before adding anything.
Quick answer
- Maca root — increased sexual desire at 8–12 weeks in RCTs without changing testosterone
- Panax ginseng — small improvement in erectile function across 9 trials in a Cochrane review
- Saffron — improved desire, arousal and erectile scores, including in people on SSRIs
- Fenugreek extract — raised libido scores and free testosterone modestly in 12-week trials
- Tongkat ali — moderate gains in desire and small testosterone rises in men with low levels
- Tribulus — the most popular pick and the one that does not raise testosterone in any RCT
The 10 best herbs and supplements for libido and sexual health
Ranked by the strength of human evidence. Strong = multiple trials or a meta-analysis. Moderate = a few small trials. Preliminary = early or animal data.
A 12-week double-blind trial in 57 men gave 1.5 or 3 g/day of maca and found increased self-reported sexual desire from week 8 compared with placebo, with no change in testosterone, oestradiol or LH. A separate RCT found 3 g/day improved libido in women with SSRI-induced sexual dysfunction. A 2010 systematic review of four RCTs concluded maca improves sexual desire with limited, mixed evidence for erectile function. The effect is on desire, and it is hormone-independent.
- Key evidence
- Gonzales 2002 RCT, 57 men, 12 weeks; Shin 2010 systematic review of 4 RCTs
- Studied dose
- 1.5–3 g/day of dried maca root powder or an equivalent gelatinised extract, for at least 8–12 weeks
- Best for
- Low desire in either sex, including people whose libido dropped on antidepressants
- Cautions
- Well tolerated; mild stomach upset and insomnia at higher doses. A cruciferous relative, so theoretical goitrogen concern in untreated hypothyroidism. Avoid in hormone-sensitive cancers out of caution despite the lack of hormonal effect in trials.
Ginseng is the most-studied herb for erectile function. A 2018 Cochrane review of nine trials (587 men) found it probably has a small effect on erectile function compared with placebo, with low-certainty evidence and no serious harms. In the best single trial, 45 men on 900 mg three times daily for 8 weeks improved IIEF erectile scores from 16.4 to 21.0 versus almost no change on placebo. Separate small trials report increased arousal in women. Expect a modest effect, well short of a PDE5 inhibitor.
- Key evidence
- Lee 2021 Cochrane review, 9 RCTs, 587 men; Hong 2002 crossover RCT, 45 men
- Studied dose
- 1–3 g/day of Korean red ginseng root (or 200–400 mg of an extract standardised to ginsenosides), for 8–12 weeks
- Best for
- Mild to moderate erectile difficulty, especially with fatigue
- Cautions
- May lower blood glucose and add to diabetes medication; can interact with warfarin (reducing its effect) and MAOI antidepressants. Insomnia and raised blood pressure in some users; avoid with stimulants. Stop 1–2 weeks before surgery.
Saffron has an unusually consistent set of small trials. In 36 men with fluoxetine-induced erectile dysfunction, 30 mg/day for 4 weeks improved erectile scores significantly versus placebo; in 38 women on fluoxetine with sexual dysfunction, the same dose improved arousal, lubrication and pain scores. In 20 men with primary erectile dysfunction, 200 mg/day for 10 days increased erection frequency and rigidity measurements. A 2019 systematic review of six RCTs concluded saffron improves sexual function, especially in antidepressant-related cases.
- Key evidence
- Modabbernia 2012 RCT, 36 men on fluoxetine; Kashani 2013 RCT, 38 women on fluoxetine; 2019 systematic review of 6 RCTs
- Studied dose
- 30 mg/day of saffron stigma extract (usually 15 mg twice daily) for 4–6 weeks
- Best for
- Sexual side effects from SSRIs in either sex; also low mood with low desire
- Cautions
- Safe at 30 mg/day; doses above 1.5 g/day are toxic and 5 g can be fatal. Avoid in pregnancy (uterine stimulant). Mild blood-pressure-lowering and antiplatelet effects, so caution with anticoagulants. Some people report dizziness or nausea.
A 2011 RCT in 60 healthy men gave 600 mg/day of a fenugreek extract (Testofen) for six weeks and found a significant increase in self-reported sexual arousal and orgasm scores versus placebo. A 2016 12-week trial in 120 men aged 43–70 found the same dose improved sexual function scores and raised free and total testosterone within the normal range. A 2020 meta-analysis of four trials found a small but significant testosterone increase. In 80 women with low libido, 600 mg/day for 8 weeks improved desire and arousal.
- Key evidence
- Rao 2016 RCT, 120 men, 12 weeks; Mansoori 2020 meta-analysis of 4 RCTs on testosterone
- Studied dose
- 600 mg/day of a standardised fenugreek seed extract (such as Testofen) for 6–12 weeks
- Best for
- Men over 40 with reduced desire and borderline testosterone; women with low libido
- Cautions
- Lowers blood sugar and adds to diabetes drugs. Mild anticoagulant effect; stop before surgery and caution with warfarin. Avoid in pregnancy (uterine stimulant) and with peanut or chickpea allergy (cross-reactivity). Causes a maple-syrup body odour.
A 2022 meta-analysis of nine trials found tongkat ali increased total testosterone by a mean of about 1.7 nmol/L in men, with larger effects in those who started low or were older, and no meaningful change in young men with normal levels. A 12-week RCT in 109 men on 300 mg/day reported improved erectile function scores and sexual libido ratings versus placebo. Effects are real but modest, and the trials are mostly small and partly industry-funded.
- Key evidence
- Leitão 2022 meta-analysis of 9 trials on testosterone; Ismail 2012 RCT, 109 men, 12 weeks
- Studied dose
- 200–400 mg/day of a standardised root water extract (often 1–2% eurycomanone) for 12 weeks
- Best for
- Men over 40 with low-normal testosterone, fatigue and reduced desire
- Cautions
- Can raise testosterone enough to matter in prostate cancer or anyone on hormone therapy; avoid. Insomnia and restlessness reported. Some products have been adulterated with mercury or sildenafil, so choose third-party tested brands. Not studied in pregnancy.
An 8-week RCT in 50 women with low sexual function gave 600 mg/day of a root extract and found greater improvement in arousal, lubrication, orgasm and satisfaction scores (FSFI) than placebo. In men, 600 mg/day for 8 weeks raised testosterone by about 15% in one trial in overweight men aged 40–70, and a 2018 study found a 17% rise in testosterone and 167% rise in sperm count in infertile men. The libido benefit probably comes mainly from its anti-stress and sleep effects; the hormone changes are modest.
- Key evidence
- Dongre 2015 RCT, 50 women, 8 weeks; Lopresti 2019 RCT, overweight men, testosterone
- Studied dose
- 300–600 mg/day of a root extract standardised to withanolides (such as KSM-66), for 8 weeks
- Best for
- Low desire driven by stress, poor sleep and anxiety, in either sex
- Cautions
- Rare cases of liver injury reported; stop with dark urine or jaundice. May increase thyroid hormone levels and interact with thyroid medication. Sedative; adds to benzodiazepines and alcohol. Avoid in pregnancy. Stop two weeks before surgery.
L-citrulline
Preliminary evidenceCitrulline is converted to arginine and raises nitric oxide, the same pathway PDE5 inhibitors act on. In a 2011 single-blind crossover trial, 24 men with mild erectile dysfunction took 1.5 g/day for a month: 50% reported improved erection hardness scores versus 8% on placebo. A later trial found citrulline plus the antioxidant trans-resveratrol improved erectile scores when added to a PDE5 inhibitor. Only small trials exist, but the mechanism is well established.
- Key evidence
- Cormio 2011 crossover trial, 24 men, 1.5 g/day for 1 month
- Studied dose
- 1.5–3 g/day of L-citrulline (or 3–6 g citrulline malate) for at least 4 weeks
- Best for
- Mild erectile difficulty in men who want a non-prescription option, or alongside a PDE5 inhibitor under medical advice
- Cautions
- Lowers blood pressure; combined with nitrates, PDE5 inhibitors or blood-pressure drugs it can cause dizziness or fainting. Tell your doctor before combining. Generally very well tolerated otherwise.
Zinc
Preliminary evidenceZinc is needed for testosterone synthesis, and restricting it in young men for 20 weeks cut testosterone by almost three-quarters in a classic study, while supplementing deficient elderly men for 6 months nearly doubled it. The catch is that zinc only raises testosterone when you were low to begin with; trials in zinc-replete athletes show no change. It belongs on the list as a check-and-correct nutrient rather than a booster.
- Key evidence
- Prasad 1996, zinc restriction and repletion study in men
- Studied dose
- 15–30 mg/day elemental zinc with food for 8–12 weeks if dietary intake or serum zinc is low
- Best for
- Men with low zinc intake, vegetarians, heavy sweaters, and people with low-normal testosterone
- Cautions
- Nausea if taken without food. Above 40 mg/day long term depletes copper. Separate from antibiotics and iron by 2 hours. No benefit if levels are normal.
Shatavari (Asparagus racemosus) is the Ayurvedic female tonic and is the libido herb most often marketed to women. Animal studies show oestrogenic and adaptogenic activity, and a 2018 pilot found a shatavari-containing formula improved menopausal symptoms, but there is no randomised trial testing shatavari alone on sexual desire or arousal in humans. It is included because the question is common and the safety profile is good, not because the evidence is.
- Key evidence
- Animal and mechanistic data; no human RCT for libido
- Studied dose
- 500–1,000 mg/day of root extract, or 3–6 g/day of powdered root, traditionally for 8–12 weeks
- Best for
- Women in perimenopause who want a traditional option alongside better-studied picks like maca
- Cautions
- Possible oestrogenic activity; avoid in hormone-sensitive cancers. Mild diuretic effect; caution with lithium and diuretics. Rare allergy in people sensitive to asparagus. Avoid in pregnancy unless advised by an Ayurvedic practitioner.
Tribulus is on this list to set the record straight. Controlled trials in athletes, young men and older men consistently find no change in testosterone at 450–1,500 mg/day over 4–12 weeks, and a 2016 systematic review concluded it does not raise testosterone in humans. What it may do is modestly increase desire: a 2017 RCT in 45 women with low libido found 750 mg/day for 12 weeks improved desire and arousal scores, and a small trial in men with mild erectile dysfunction reported improved IIEF scores. A libido herb with no hormonal effect, oversold as a hormone booster.
- Key evidence
- Qureshi 2014 and Neychev 2016 reviews: no testosterone effect; Akhtari 2014 RCT in women
- Studied dose
- 750 mg/day of a saponin-standardised extract for 12 weeks, as used in the women's trial
- Best for
- Low desire in women who have tried maca; not for anyone hoping to raise testosterone
- Cautions
- Lowers blood sugar and blood pressure, adding to diabetes and antihypertensive drugs. Case reports of kidney and liver toxicity at high doses. Avoid in pregnancy and in prostate conditions.
How to choose
- If the problem is desire rather than performance: maca (either sex) or fenugreek (men over 40) first, with ashwagandha added if stress and poor sleep are obvious drivers.
- If the problem is erections: Panax ginseng or citrulline have the best herbal data, but a PDE5 inhibitor from a doctor works for 70–80% of men and the appointment doubles as a cardiovascular check.
- If libido dropped after starting an SSRI: saffron 30 mg/day has specific trials for this, and maca has one. Ask your prescriber about dose timing or a switch before adding supplements.
- If you suspect low testosterone: get a morning blood test. Below range, treatment is a medical conversation; low-normal, tongkat ali and fenugreek have modest data; normal, nothing on this list will change it and tribulus certainly will not.
- If you are a woman around menopause: vaginal dryness and pain respond to local oestrogen or moisturisers far better than any oral herb; maca and saffron help desire, shatavari is traditional but unproven.
- If you want the most for one purchase: maca is cheap, safe, hormone-free and has the most consistent desire data across sexes.
What to skip
Tribulus as a testosterone booster
Every controlled trial in humans shows no rise in testosterone. It may nudge desire slightly, but it is sold on a claim it has never met.
Horny goat weed
Its active icariin is a weak PDE5 inhibitor in the lab, but there are no human trials for erectile function or libido, and products are sometimes spiked with real sildenafil, which is dangerous with nitrates.
'Natural' sexual enhancement pills from gas stations and online
The FDA has found hundreds of these contain undeclared sildenafil, tadalafil or analogues. With nitrates they can cause a fatal drop in blood pressure.
DHEA and oral testosterone 'precursors'
DHEA is a hormone, not a herb; it helps only in adrenal insufficiency and some postmenopausal women under supervision, converts to oestrogen in men, and is banned in sport.
Safety and when to see a clinician
- See a clinician if erectile difficulty is new or progressive. It predicts cardiovascular disease, diabetes and depression, and it is often the first sign; a cholesterol, glucose and blood-pressure check is the real first step.
- Nitrates (GTN sprays, isosorbide, and recreational poppers) must never be combined with PDE5 inhibitors or with supplements that have been spiked with them. Citrulline, ginseng and arginine also lower blood pressure and can cause faintness combined with sildenafil or antihypertensives.
- Fenugreek, ginseng and tribulus lower blood sugar; if you take insulin, sulfonylureas or metformin, monitor closely. Ginseng and fenugreek also affect warfarin and antiplatelet drugs.
- Tongkat ali, fenugreek, ashwagandha and DHEA can change hormone levels. Avoid them in prostate or breast cancer, with hormonal therapies, and in pregnancy or breastfeeding. Saffron and fenugreek stimulate the uterus.
- Ashwagandha carries rare liver-injury reports and can alter thyroid tests; stop two weeks before surgery along with ginseng and fenugreek because of bleeding and sedation effects.
- Low desire with fatigue, low mood, weight change, loss of body hair or breast tenderness deserves a hormone and prolactin panel, not a supplement. A testosterone-lowering medication (opioids, some antidepressants, finasteride, spironolactone) is a common and reversible cause.
What matters as much as any herb
- Cardiovascular fitness: erectile function tracks blood-vessel health. A 2023 meta-analysis found aerobic exercise improved erectile scores by about 2.5–5 IIEF points, comparable to some drug effects, with the biggest gains in the men with the worst baseline.
- Alcohol and smoking: more than a couple of drinks blunts arousal and erections acutely, and chronic heavy use lowers testosterone; smoking roughly doubles the risk of erectile dysfunction.
- Sleep: a week of 5-hour nights cut testosterone by 10–15% in healthy young men in a controlled study, and poor sleep is one of the most common hidden causes of low desire in both sexes.
- Medication review: SSRIs, SNRIs, beta-blockers, opioids, antihistamines, finasteride and hormonal contraception all reduce desire or arousal in a meaningful fraction of users. A dose change or switch often beats any supplement.
- Relationship and mental health: desire discrepancy, unresolved conflict, anxiety and depression are the most frequent causes in sex-therapy clinics; a few sessions with a psychosexual therapist have better evidence than most herbs.
Frequently asked questions
What is the best herb for libido?
Maca root has the most consistent trial record for sexual desire in both men and women, at 1.5–3 g/day for 8–12 weeks, and it works without changing hormones. For erectile function specifically, Panax ginseng has the most trials, with small but real benefits.
Which herbs actually raise testosterone?
Only modestly, and mainly in men who start low. Tongkat ali raised testosterone by about 1.7 nmol/L in a 2022 meta-analysis, fenugreek and ashwagandha by roughly 10–17% in single trials, and zinc only if you were deficient. Tribulus does not raise it at all despite the marketing.
Can herbs help erectile dysfunction?
A little. A Cochrane review found Panax ginseng probably has a small effect, and citrulline improved erection hardness in half of men with mild ED in a small trial. PDE5 inhibitors remain far more effective, and new erectile problems should prompt a cardiovascular check before anything else.
Is it safe to take libido herbs with Viagra?
Ginseng, citrulline and arginine all lower blood pressure through the same nitric-oxide pathway, so combining them with sildenafil or tadalafil can cause dizziness or fainting, especially with alcohol. Nothing on this list should be combined with nitrates. Ask your prescriber before stacking.
What helps libido in women?
Maca and saffron have the best RCT data for desire and arousal in women, ashwagandha improved all domains of sexual function in a 50-woman trial, and fenugreek extract helped in one 80-woman study. For dryness or pain around menopause, local oestrogen or a good vaginal moisturiser works better than any oral herb.
How long do libido supplements take to work?
Most positive trials ran 8–12 weeks, and maca's benefit did not appear until week 8. Saffron is the exception, with effects at 4 weeks. If nothing has changed at 12 weeks, it is not going to.
Does low libido mean low testosterone?
Usually not. Most people with low desire have normal testosterone, and stress, sleep debt, antidepressants, alcohol and relationship issues are far more common causes. A morning blood test settles the question; treat the number only if it is actually low and symptoms match.
References
- Gonzales GF, et al.. Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia (2002)View source
- Shin BC, et al.. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complementary and Alternative Medicine (2010)View source
- Lee HW, et al.. Ginseng for erectile dysfunction. Cochrane Database of Systematic Reviews (2021)View source
- Modabbernia A, et al.. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology (2012)View source
- Kashani L, et al.. Saffron for treatment of fluoxetine-induced sexual dysfunction in women: randomized double-blind placebo-controlled study. Human Psychopharmacology (2013)View source
- Rao A, et al.. Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease, increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study. The Aging Male (2016)View source
- Leitão AE, et al.. Eurycoma longifolia (Jack) improves serum total testosterone in men: a systematic review and meta-analysis of clinical trials. Medicina (Kaunas) (2022)View source
- Dongre S, Langade D, Bhattacharyya S. Efficacy and safety of ashwagandha (Withania somnifera) root extract in improving sexual function in women: a pilot study. BioMed Research International (2015)View source
- Cormio L, et al.. Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology (2011)View source
- Neychev V, Mitev V. Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: fact or fiction. Journal of Ethnopharmacology (2016)View source
- Vlachopoulos CV, et al.. Erectile dysfunction as a predictor of cardiovascular events and death: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes (2013)View source
- Tainted sexual enhancement products. U.S. Food and Drug AdministrationView source
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Ask about libido and sexual healthThis guide is educational and is not medical advice. Herbs and supplements can interact with prescription medicines and are not regulated like drugs. Talk with a clinician or pharmacist before starting anything new, especially if you are pregnant, breastfeeding, have a chronic condition, or take medication.