PMID- 33871063 OWN - NLM STAT- MEDLINE DCOM- 20210531 LR - 20231006 IS - 1469-493X (Electronic) IS - 1361-6137 (Linking) VI - 4 IP - 4 DP - 2021 Apr 19 TI - Ginseng for erectile dysfunction. PG - CD012654 LID - 10.1002/14651858.CD012654.pub2 [doi] LID - CD012654 AB - BACKGROUND: Dietary supplements with ginseng, or ginseng alone, are widely used for a broad range of conditions, including erectile dysfunction. Ginseng is particularly popular in Asian countries. Individual studies assessing its effects are mostly small, of uneven methodological quality and have unclear results. OBJECTIVES: To assess the effects of ginseng on erectile dysfunction. SEARCH METHODS: We conducted systematic searches on multiple electronic databases, including CENTRAL, MEDLINE, Embase, CINAHL, AMED, and loco-regional databases of east Asia, from their inceptions to 30 January 2021 without restrictions on language and publication status. Handsearches included conference proceedings. SELECTION CRITERIA: We included randomized or quasi-randomized controlled trials that evaluated the use of any type of ginseng as a treatment for erectile dysfunction compared to placebo or conventional treatment. DATA COLLECTION AND ANALYSIS: Two authors independently classified studies and three authors independently extracted data and assessed risk of bias in the included studies. We rated the certainty of evidence according to the GRADE approach. MAIN RESULTS: We included nine studies with 587 men with mild to moderate erectile dysfunction, aged from 20 to 70 years old. The studies all compared ginseng to placebo. We found only short-term follow-up data (up to 12 weeks). Primary outcomes Ginseng appears to have a trivial effect on erectile dysfunction when compared to placebo based on the Erectile Function Domain of the International Index of Erectile Function (IIEF)-15 instrument (scale: 1 to 30, higher scores imply better function; mean difference [MD] 3.52, 95% confidence interval [CI] 1.79 to 5.25; I(2) = 0%; 3 studies; low certainty evidence) assuming a minimal clinically important difference (MCID) of 4. Ginseng probably also has a trivial effect on erectile function when compared to placebo based on the IIEF-5 instrument (scale: 1 to 25, higher scores imply better function; MD 2.39, 95% CI 0.89 to 3.88; I(2) = 0%; 3 studies; moderate certainty evidence) assuming a MCID of 5. Ginseng may have little to no effect on adverse events compared to placebo (risk ratio [RR] 1.45, 95% CI 0.69 to 3.03; I(2) = 0%; 7 studies; low certainty evidence). Based on 86 adverse events per 1000 men in the placebo group, this would correspond to 39 more adverse events per 1000 (95% CI 27 fewer to 174 more). Secondary outcomes Ginseng may improve men's self-reported ability to have intercourse (RR 2.55, 95% CI 1.76 to 3.69; I(2) = 23%; 6 studies; low certainty evidence). Based on 207 per 1000 men self-reporting the ability to have intercourse in the placebo group, this would correspond to 321 more men (95% CI 158 more to 558 more) per 1000 self-reporting the ability to have intercourse. Ginseng may have a trivial effect on men's satisfaction with intercourse based on the Intercourse Satisfaction Domain of the IIEF-15 (scale: 0 to 15, higher scores imply greater satisfaction; MD 1.19, 95% CI 0.41 to 1.97; I(2)=0%; 3 studies; low certainty evidence) based on a MCID of 25% improvement from baseline. It may also have a trivial effect on men's satisfaction with intercourse based on item 5 of the IIEF-5 (scale: 0 to 5, higher scores imply more satisfaction; MD 0.60, 95% CI 0.02 to 1.18; 1 study; low certainty evidence) based on a MCID of 25% improvement from baseline. No study reported quality of life as an outcome. We found no trial evidence to inform comparisons to other treatments for erectile dysfunction, such as phosphodiesterase-5 inhibitors. We were unable to conduct any predefined subgroup analyses. AUTHORS' CONCLUSIONS: Based on mostly low certainty evidence, ginseng may only have trivial effects on erectile function or satisfaction with intercourse compared to placebo when assessed using validated instruments. Ginseng may improve men's self-reported ability to have intercourse. It may have little to no effect on adverse events. We found no trial evidence comparing ginseng to other agents with a more established role in treating erectile dysfunction, such as phosphodiesterase-5 inhibitors. CI - Copyright (c) 2021 The Authors. Cochrane Database of Systematic Reviews published by John Wiley & Sons, Ltd. on behalf of The Cochrane Collaboration. FAU - Lee, Hye Won AU - Lee HW AD - Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South. FAU - Lee, Myeong Soo AU - Lee MS AD - Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea, South. AD - Korean Convergence Medicine, University of Science and Technology, Daejeon, Korea, South. FAU - Kim, Tae-Hun AU - Kim TH AD - Korean Medicine Clinical Trial Center, College of Korean Medicine, Kyung Hee University, Seoul, Korea, South. FAU - Alraek, Terje AU - Alraek T AD - Institute of Health Sciences, Kristiania University College, Oslo, Norway. AD - NAFKAM, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway. FAU - Zaslawski, Chris AU - Zaslawski C AD - College of Traditional Chinese Medicine, University of Technology, Sydney, Australia. FAU - Kim, Jong Wook AU - Kim JW AD - Department of Urology, Korea University Guro Hospital, Seoul, Korea, South. FAU - Moon, Du Geon AU - Moon DG AD - Department of Urology, Korea University Guro Hospital, Seoul, Korea, South. LA - eng SI - ClinicalTrials.gov/NCT01479426 PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20210419 PL - England TA - Cochrane Database Syst Rev JT - The Cochrane database of systematic reviews JID - 100909747 RN - 0 (Placebos) SB - IM CIN - J Urol. 2022 Oct;208(4):917-919. PMID: 35881852 MH - Adult MH - Aged MH - Coitus MH - Confidence Intervals MH - Erectile Dysfunction/*drug therapy MH - Humans MH - Male MH - Middle Aged MH - *Panax MH - Patient Satisfaction MH - Phytotherapy/*methods MH - Placebos/therapeutic use MH - Randomized Controlled Trials as Topic MH - Young Adult PMC - PMC8094213 COIS- HWL: none known. MSL: editorial board of Journal of Ginseng Research. THK: none known. TA: none known. CZ: serves as President of the Chinese Medicine Council of New South Wales (Australia) and receives payment from the organization for his role; serves as Member of the Accreditation Committee of the Chinese Medicine Board of Australia and receives payment from the organization for his role; received consultancy support paid to his institution by the Korea Institute of Oriental Medicine to fund a research assistant to work on a research project relating to post sequelae of stroke; his institution (University of Technology Sydney, Australia) received payment from the Korea Institute of Oriental Medicine for consultancy research not related to this review; and received support from the Korea Institute of Oriental Medicine for conference attendance at the Korea Institute of Oriental Medicine. JWK: none known. DGM: none known. EDAT- 2021/04/20 06:00 MHDA- 2021/06/01 06:00 PMCR- 2021/04/19 CRDT- 2021/04/19 08:53 PHST- 2021/04/19 08:53 [entrez] PHST- 2021/04/20 06:00 [pubmed] PHST- 2021/06/01 06:00 [medline] PHST- 2021/04/19 00:00 [pmc-release] AID - CD012654.pub2 [pii] AID - 10.1002/14651858.CD012654.pub2 [doi] PST - epublish SO - Cochrane Database Syst Rev. 2021 Apr 19;4(4):CD012654. doi: 10.1002/14651858.CD012654.pub2.