Can Ginkgo Biloba Help with Erectile Dysfunction?

Can Ginkgo Biloba Help with Erectile Dysfunction?

The Short Answer: Probably not, based on what we know today.

Ginkgo biloba turns up on almost every list of natural options for erectile problems. The reasoning sounds right: ginkgo affects blood flow, and erections depend on blood flow. But when researchers tested it properly in people, the results did not hold up.

The pattern is worth understanding, because it repeats across a lot of supplement research. One early study without a placebo group reported a big effect. That study got quoted everywhere.

Then better-designed trials with placebo groups found no difference between ginkgo and a dummy pill. The early result came from the study design, not the herb.

What Ginkgo Biloba Is

Ginkgo biloba comes from one of the oldest surviving tree species on earth. The leaves are extracted to make supplements, usually standardized to a set percentage of flavone glycosides and terpene lactones, the two compound groups thought to be active. The most-studied standardized extract is EGb 761, which is what appears in most clinical trials.

It has been used in traditional Chinese medicine for centuries and is one of the best-selling herbal supplements worldwide. Most of the serious research on it looks at memory and circulation in older adults, not sexual function.

What the Research Actually Found

The Animal Study

The research most often cited for ginkgo and erections was done in animals.

• Study: A 2003 study published in Urology examined high-dose ginkgo biloba extract in rats following cavernous nerve injury.
• Findings: The researchers reported improved nerve survival, preserved nitric oxide synthase fibers, and increased smooth muscle content.
• Limitation: This is a nerve-injury recovery model in rodents. It is legitimate science, and it says nothing about a man taking a capsule.

The Trials in Men

There is no large, well-designed randomized controlled trial showing that ginkgo biloba improves erectile function.

• A systematic review of herbal therapies for erectile dysfunction published in The Journal of traditional and complementary medicine examined the available evidence for multiple supplements. The authors concluded that while some herbs showed promise, the evidence for ginkgo was insufficient to recommend its use for ED.
• A review of clinical trials published in Avicenna journal of phytomedicine concluded that "G. biloba has limited positive effects on sexual function and more studies are needed to confirm these findings."

Reviews of Herbal Options

Reviews of herbal options for sexual health consistently place ginkgo in the weak-evidence category, well behind Panax ginseng.

"While Ginkgo Biloba shows potential for improving circulation, the current clinical evidence is insufficient to recommend it as a standalone treatment for erectile dysfunction. It may be best considered as a complementary approach alongside established therapies." — Dr. Andrew McCullough, MD, Professor of Urology

The study that started the hype

Cohen and Bartlik (1998, Journal of Sex & Marital Therapy) conducted an open-label study with 63 patients and reported an 84% response rate for ginkgo in treating antidepressant-induced sexual dysfunction.

However, there was no placebo group, and everyone knew they were taking ginkgo—meaning expectation alone likely drove the results.

Who Should Avoid Ginkgo

Do not take ginkgo, or check with your doctor first, if you:

• Take warfarin, a direct oral anticoagulant, clopidogrel, aspirin, or regular NSAIDs
• Have a bleeding disorder
• Have surgery or a dental procedure coming up. Standard guidance is to stop herbal supplements at least two weeks beforehand
• Have a seizure disorder or take seizure medication. Ginkgo seeds contain ginkgotoxin, and there are case reports of seizures
• Take an SSRI or other antidepressant, without asking your prescriber
• Take medication for diabetes or blood pressure
• Are pregnant or breastfeeding
• Are under 18

Never eat raw or roasted ginkgo seeds. They are toxic and are not the same thing as leaf extract.

What Has Better Evidence

If you came here looking for something that actually helps, here is where the evidence sits.

• See a doctor first. Ongoing erectile difficulty is worth investigating. It can be an early sign of heart disease or diabetes, and approved treatments work well. Highest-value step on this list.
• Exercise. Aerobic exercise has some of the strongest evidence of any approach for erectile difficulty tied to circulation. Gerbild H et al., Sexual Medicine, around 2018, a systematic review reporting that 40 minutes of moderate to vigorous aerobic exercise four times a week improved erectile function scores.
• Stop smoking. Smoking damages blood vessels directly.
• Sleep and weight. Both affect testosterone and vascular health.

When to See a Doctor

Book an appointment if erectile difficulty has lasted more than a few weeks, came on suddenly, started after a new medication, or comes alongside chest pain, shortness of breath, unusual fatigue, or a known heart condition or diabetes.

There is nothing embarrassing about this conversation. Doctors have it constantly, and what is underneath it often matters for more than your sex life.

Conclusion

Ginkgo biloba may be worth taking for other reasons, but the evidence for erectile function is thin. A plausible mechanism is not the same as a proven result, and in this case the properly designed studies did not back up the early ones.

If erectile difficulty is affecting you, the steps with real evidence behind them are less exciting than a supplement but far more likely to work: get evaluated, move more, stop smoking, and sleep properly. Start there.