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Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis

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Abstract

Purpose

Erectile dysfunction (ED) is a common condition that significantly affects quality of life and interpersonal relationships.

Objective

Our objective was to perform a systematic review and meta-analysis to evaluate the efficacy of herbal dietary supplements in the treatment of ED.

Materials and Methods

We searched five databases to identify randomized controlled trials (RCTs) that evaluated the clinical efficacy of herbal medicines in ED. Quality was assessed and risk of bias was estimated using the Jadad score and the Cochrane risk-of-bias tool.

Results

In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15–0.70; P < 0.01; I2 = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies.

Conclusions

Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.

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References

  1. McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, et al. Incidence and prevalence of sexual dysfunction in women and men: a Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13:144–52.

    Article  PubMed  Google Scholar 

  2. Baumann F, Hehli D, Makaloski V, Schumacher M, Schönhofen H, Diehm N. Erectile dysfunction—overview from a cardiovascular perspective. Vasa. 2017;10:1–7.

    Google Scholar 

  3. Eisenberg ML, Meldrum D. Effects of age on fertility and sexual function. Fertil Steril. 2017;107:301–4.

    Article  PubMed  Google Scholar 

  4. Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile dysfunction in young men-a review of the prevalence and risk factors. Sex Med Rev. 2017;5:508–20.

    Article  PubMed  Google Scholar 

  5. Hsu B, Hirani V, Naganathan V, Blyth FM, Le Couteur DG, Seibel MJ, et al. Sexual function and mortality in older men: the concord health and ageing in men project. J Gerontol A Biol Sci Med Sci. 2017;72:520–7.

    PubMed  Google Scholar 

  6. Hatzimouratidis K, Salonia A, Adaikan G, Buvat J, Carrier S, El-Meliegy A, et al. Pharmacotherapy for Erectile dysfunction: recommendations from the fourth international Consultation for Sexual Medicine (ICSM 2015). J Sex Med. 2016;13:465–88.

    Article  PubMed  Google Scholar 

  7. Doumas M, Lazaridis A, Katsiki N, Athyros V. PDE-5 inhibitors: clinical points. Curr Drug Targets. 2015;16:420–6.

    Article  PubMed  CAS  Google Scholar 

  8. Evans JD, Pace K, Evans EW. Natural therapies used by adult men for the treatment of erectile dysfunction, benign prostatic hyperplasia, and for augmenting exercise performance. J Pharm Pract. 2011;24:323–31.

    Article  PubMed  Google Scholar 

  9. Chauhan NS, Sharma V, Dixit VK, Thakur M. A review on plants used for improvement of sexual performance and virility. Biomed Res Int. 2014;2014:868062.

    PubMed  PubMed Central  Google Scholar 

  10. Cui T, Kovell RC, Brooks DC, Terlecki RP. A urologist’s guide to ingredients found in top-selling nutraceuticals for men’s sexual health. J Sex Med. 2015;12:2105–17.

    Article  PubMed  CAS  Google Scholar 

  11. Marcus DM. Dietary supplements: what’s in a name? What’s in the bottle? Drug Test Anal. 2016;8:410–2.

    Article  PubMed  CAS  Google Scholar 

  12. Izzo AA, Hoon-Kim S, Radhakrishnan R, et al. A critical approach to evaluating clinical efficacy, adverse events and drug interactions of herbal remedies. Phytother Res. 2016;30:691–700.

    Article  PubMed  Google Scholar 

  13. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.

    Article  PubMed  CAS  Google Scholar 

  15. Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. http://handbook.cochrane.org.

  16. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.

    Article  PubMed  Google Scholar 

  17. Follmann D, Elliot P, Suh I, Cutler J. Variance imputation for overviews of clinical trials with continuous response. J Clin Epidemiol. 1992;45:769–73.

    Article  PubMed  CAS  Google Scholar 

  18. Cherdshewasart W, Nimsakul N. Clinical trial of Butea superba, an alternative herbal treatment for erectile dysfunction. Asian J Androl. 2003;5:243–6.

    PubMed  CAS  Google Scholar 

  19. Dording CM, Fisher L, Papakostas G, Farabaugh A, Sonawalla S, Fava M, et al. A double-blind, randomized, pilot dose-finding study of maca root(L. meyenii) for the management of SSRI-induced sexual dysfunction. CNS Neurosci Ther. 2008;14:182–91.

    Article  PubMed  Google Scholar 

  20. Shamsa A, Hosseinzadeh H, Molaei M, Shakeri MT, Rajabi O. Evaluation of Crocus sativus L. (saffron) on male erectile dysfunction: a pilot study. Phytomedicine. 2009;16:690–3.

    Article  PubMed  Google Scholar 

  21. Aldemir M, Okulu E, Neşelioğlu S, Erel O, Kayıgil O. Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction. Int J Impot Res. 2011;23:32–8.

    Article  PubMed  CAS  Google Scholar 

  22. Kobori Y, Suzuki K, Iwahata T, Shin T, Sadaoka Y, Sato R, et al. Improvement of seminal quality and sexual function of men with oligoasthenoteratozoospermia syndrome following supplementation with l-arginine and Pycnogenol®. Arch Ital Urol Androl. 2015;87:190–3.

    Article  PubMed  CAS  Google Scholar 

  23. Ito T, Kawahara K, Das A, Strudwick W. The effects of ArginMax, a natural dietary supplement for enhancement of male sexual function. Hawaii Med J. 1998;57:741–4.

    PubMed  CAS  Google Scholar 

  24. Adimoelja A, Ganeshan P. Protodioscin from herbal plant Tribulus terrestris L improves the male sexual functions, probably via DHEA. Int. J. Impot Res. 1997;9(Supp 1):S1–70.

    Google Scholar 

  25. Ashton AK, Ahrens K, Gupta S, Masand PS. Antidepressant-induced sexual dysfunction and Ginkgo Biloba. Am J Psychiatry. 2000;157:836–7.

    Article  PubMed  CAS  Google Scholar 

  26. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther. 1998;24:139–43.

    Article  PubMed  CAS  Google Scholar 

  27. Cortés-González JR, Arratia-Maqueo JA, Gómez-Guerra LS, Holmberg AR. The use of Butea superba (Roxb.) compared to sildenafil for treating erectile dysfunction. BJU Int. 2010;105:225–8.

    Article  PubMed  CAS  Google Scholar 

  28. Aoki H, Nagao J, Ueda T, Strong JM, Schonlau F, Yu-Jing S, et al. Clinical assessment of a supplement of Pycnogenol® and l-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother Res. 2012;26:204–7.

    Article  PubMed  CAS  Google Scholar 

  29. Asare GA, Afriyie D, Ngala RA, Appiah AA, Anang Y, Musah I, et al. Shrinkage of prostate and improved quality of life: management of BPH patients with croton membranaceus ethanolic root extract. Evid Based Complement Alternat Med. 2015;2015:365205.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Roaiah MF, El Khayat YI, GamalEl Din SF, Abd El Salam MA. Pilot study on the effect of botanical medicine (Tribulus terrestris) on Serum Testosterone Level and Erectile Function in Aging Males With Partial Androgen Deficiency (PADAM). J Sex Marital Ther. 2016;42:297–301.

    Article  PubMed  Google Scholar 

  31. Kang BJ, Lee SJ, Kim MD, Cho MJ. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol. 2002;17:279–84.

    Article  PubMed  Google Scholar 

  32. Wheatley D. Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugs. Hum Psychopharmacol. 2004;19:545–8.

    Article  PubMed  Google Scholar 

  33. Iacono F, Prezioso D, Illiano E, Romeo G, Ruffo A, Amato B. Sexual asthenia: tradamixina versus Tadalafil 5 mg daily. BMC Surg. 2012;12:S23.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ismail SB, Wan Mohammad WM, George A, Nik Hussain NH, Musthapa Kamal ZM, Liske E. Randomized clinical trial on the use of PHYSTA freeze-dried water extract of Eurycoma longifolia for the improvement of quality of life and sexual well-being in Men. Evid Based Complement Alternat Med. 2012;2012:429268.

    PubMed  PubMed Central  Google Scholar 

  35. Choi HK, Seong DH, Rha KH. Clinical efficacy of Korean red ginseng for erectile dysfunction. Int J Impot Res. 1995;7:181–6.

    PubMed  CAS  Google Scholar 

  36. Hong B, Ji YH, Hong JH, Nam KY, Ahn TY. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol. 2002;168:2070–3.

    Article  PubMed  CAS  Google Scholar 

  37. de Andrade E, de Mesquita AA, Claro Jde A, de Andrade PM, Ortiz V, Paranhos M, et al. Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian J Androl. 2007;9:241–4.

    Article  PubMed  Google Scholar 

  38. Kim TH, Jeon SH, Hahn EJ, Paek KY, Park JK, Youn NY, et al. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction. Asian J Androl. 2009;11:356–61.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Choi YD, Park CW, Jang J, Kim SH, Jeon HY, Kim WG, et al. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study. Int J Impot Res. 2013;25:45–50.

    Article  PubMed  CAS  Google Scholar 

  40. Safarinejad MR, Shafiei N, Safarinejad S. An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatment. Int J Impot Res. 2010;22:240–50.

    Article  PubMed  CAS  Google Scholar 

  41. Modabbernia A, Sohrabi H, Nasehi AA, Raisi F, Saroukhani S, Jamshidi A, et al. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology. 2012;223:381–8.

    Article  PubMed  CAS  Google Scholar 

  42. Mohammadzadeh-Moghadam H, Nazari SM, Shamsa A, Kamalinejad M, Esmaeeli H, Asadpour AA, et al. Effects of a topical saffron (Crocus sativus L) gel on erectile dysfunction in diabetics: a randomized, parallel-group, double-blind, placebo-controlled trial. J Evid Based Complementary Altern Med. 2015;20:283–6.

    Article  PubMed  CAS  Google Scholar 

  43. Santos CA Jr, Reis LO, Destro-Saade R, Luiza-Reis A, Fregonesi A. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: a prospective, randomized, double blind study. Actas Urol Esp. 2014;38:244–8.

    Article  PubMed  Google Scholar 

  44. Kamenov Z, Fileva S, Kalinov K, Jannini EA. Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction—a prospective, randomized, double-blind, placebo-controlled clinical trial. Maturitas. 2017;99:20–6.

    Article  PubMed  Google Scholar 

  45. Duračková Z, Trebatický B, Novotný V, Žitňanová I, Breza J. Lipid metabolism and erectile function improvement by pycnogenol®, extract from the bark of pinus pinaster in patients suffering from erectile dysfunction-a pilot study. Nutr Res 2003;23:1189–98.

    Article  CAS  Google Scholar 

  46. Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich E. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial. Andrologia. 2009;41:95–9.

    Article  PubMed  CAS  Google Scholar 

  47. Kulkarni MP, Shinde BS, Chaudhari MK, Avhad GM, Pensalwar SV, Prasad BS, et al. Efficacy and safety of two polyherbal combinations: E-MA-H and E-MA-HP in male sexual dysfunction. Am J Ther. 2011;18:162–9.

    Article  PubMed  Google Scholar 

  48. Shah GR, Chaudhari MV, Patankar SB, Pensalwar SV, Sabale VP, Sonawane NA. Evaluation of a multi-herb supplement for erectile dysfunction: a randomized double-blind, placebo-controlled study. BMC Complement Altern Med. 2012;12:155.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Punyawudho B, Puttilerpong C, Wirotsaengthong S, Aramwit P. A randomized, double-blind, placebo-controlled crossover study of Cappra® for the treatment of mild or mild to moderate erectile dysfunction in Thai male. Afr J Tradit Complement Altern Med. 2012;10:310–5.

    PubMed  PubMed Central  Google Scholar 

  50. Cai T, Morgia G, Carrieri G, Terrone C, Imbimbo C, Verze P, et al. IDIProst® Gold Study Group. An improvement in sexual function is related to better quality of life, regardless of urinary function improvement: results from the IDIProst® Gold Study. Arch Ital Urol Androl. 2013;85:184–9.

    Article  PubMed  Google Scholar 

  51. Nishimatsu H, Kitamura T, Yamada D, Nomiya A, Niimi A, Suzuki M, et al. Improvement of symptoms of aging in males by a preparation LEOPIN ROYAL containing aged garlic extract and other five of natural medicines - comparison with traditional herbal medicines (Kampo). Aging Male. 2014;17:112–6.

    Article  PubMed  Google Scholar 

  52. Udani JK, George AA, Musthapa M, Pakdaman MN, Abas A. Effects of a proprietary freeze-dried water extract of Eurycoma longifolia (Physta) and polygonum minus on sexual performance and well-being in men: a randomized, double-blind, placebo-controlled study. Evid Based Complement Alternat Med. 2014;2014:179529.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Hsieh CH, Tsai HC, Hsu GL, Chen CC, Hsu CY. Herb formula enhances treatment of impotent patients after penile venous stripping: a randomised clinical trials. Andrologia. 2016;48:754–60.

    Article  PubMed  Google Scholar 

  54. Stanislavov R, Nikolova V, Rohdewald P. Improvement of erectile function with Prelox: a randomized, double-blind, placebo-controlled, crossover trial. Int J Impot Res. 2008;20:173–80.

    Article  PubMed  CAS  Google Scholar 

  55. Ledda A, Belcaro G, Cesarone MR, Dugall M, Schönlau F. Investigation of a complex plant extract for mild to moderate erectile dysfunction in a randomized, double-blind, placebo-controlled, parallel-arm study. BJU Int. 2010;106:1030–3.

    Article  PubMed  Google Scholar 

  56. Paulis G, Cavallini G, Brancato T, Alvaro R. Peironimev-Plus® in the treatment of chronic inflammation of tunica albuginea (Peyronie’s disease). results of a controlled study. Inflamm Allergy Drug Targets. 2013;12:61–7.

    Article  PubMed  CAS  Google Scholar 

  57. Sansalone S, Leonardi R, Antonini G, Vitarelli A, Vespasiani G, Basic D, et al. Alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide improve erectile function, sexual quality of life, and ejaculation function in patients with moderate mild-moderate erectile dysfunction: a prospective, randomized, placebo-controlled, single-blinded study. Biomed Res Int. 2014;2014:121396.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Stanislavov R, Rohdewald P. Improvement of erectile function by a combination of French maritime pine bark and roburins with aminoacids. Minerva Urol Nefrol. 2015;67:27–32.

    PubMed  CAS  Google Scholar 

  59. Andrew R, Izzo AA. Principles of pharmacological research of nutraceuticals. Br J Pharmacol. 2017;174:1177–94.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  60. Patel S, Rauf A. Adaptogenic herb ginseng (Panax) as medical food: status quo and future prospects. Biomed Pharmacother. 2017;85:120–7.

    Article  PubMed  CAS  Google Scholar 

  61. Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol. 2008;66:444–50.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  62. Shergis JL, Zhang AL, Zhou W, Xue CC. Panax ginseng in randomised controlled trials: a systematic review. Phytother Res. 2013;27:949–65.

    Article  PubMed  Google Scholar 

  63. Fink HA, MacDonald R, Rutks IR, Wilt TJ. Trazodone for erectile dysfunction: a systematic review and meta-analysis. BJU Int. 2003;92:441–6.

    Article  PubMed  CAS  Google Scholar 

  64. Lee HS, Lee YJ, Chung YH, Lee MY, Kim ST, Ko SK, et al. In vitro and in vivo evaluation of tissue-cultured mountain ginseng on penile erection. J Ginseng Res. 2016;40:334–43.

    Article  PubMed  Google Scholar 

  65. Kim SD, Kim YJ, Huh JS, Kim SW, Sohn DW. Improvement of erectile function by Korean red ginseng (Panax ginseng) in a male rat model of metabolic syndrome. Asian J Androl. 2013;15:395–9.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Achike FI, Kwan CY. Nitric oxide, human diseases and the herbal products that affect the nitric oxide signalling pathway. Clin Exp Pharmacol Physiol. 2003;30:605–15.

    Article  PubMed  CAS  Google Scholar 

  67. Neychev V, Mitev V. Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: fact or Fiction. J Ethnopharmacol. 2016;179:345–55.

    Article  PubMed  CAS  Google Scholar 

  68. Schoonees A, Visser J, Musekiwa A, Volmink J. Pycnogenol® (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane Database Syst Rev. 2012;4:CD008294.

    Google Scholar 

  69. Beharry S, Heinrich M. Is the hype around the reproductive health claims of maca (Lepidium meyenii Walp.) justified? J Ethnopharmacol. 2018;211:126–70.

    Article  PubMed  Google Scholar 

  70. Lee MS, Lee HW, You S, Ha KT. The use of maca (Lepidium meyenii) to improve semen quality: a systematic review. Maturitas. 2016;92:64–9.

    Article  PubMed  Google Scholar 

  71. Lee MS, Shin BC, Yang EJ, Lim HJ, Ernst E. Maca (Lepidium meyenii) for treatment of menopausal symptoms: a systematic review. Maturitas. 2011;70:227–33.

    Article  PubMed  Google Scholar 

  72. Xiong G, Li B, Wang K, Li H. Chinese herb formulae for treatment of erectile dysfunction: a systematic review of randomised controlled clinical trials. Andrologia. 2014;46:201–23.

    Article  PubMed  CAS  Google Scholar 

  73. Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Saf. 2002;25:323–44.

    Article  PubMed  CAS  Google Scholar 

  74. Pavan V. The old made new: natural compounds against erectile dysfunction. Arch Pharm (Weinheim). 2015;348:607–14.

    Article  CAS  Google Scholar 

  75. Tam SW, Worcel M, Wyllie M. Yohimbine: a clinical review. Pharmacol Ther. 2001;91:215–43.

    Article  PubMed  CAS  Google Scholar 

  76. Ernst E, Pittler MH. Alternative therapy bias. Nature. 1997;385:480.

    Article  PubMed  CAS  Google Scholar 

  77. Choi J, Kim TH, Choi TY, Lee MS. Ginseng for health care: a systematic review of randomized controlled trials in Korean literature. PLoS One. 2013;8:e59978.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacy, School of Medicine and Surgery, University of Napes Federico II, Via D. Montesano 49, 80131, Naples, Italy

    Francesca Borrelli & Angelo A. Izzo

  2. Farmacia San Paolo dr Colalto, Piazza Dè l’Osto 37, 37035, San Giovanni Ilarione, Verona, Italy

    Cristiano Colalto

  3. Section of Pharmacology, Department of Medicine, University of Perugia, Piazzale Severi, 06132, S. Andrea delle Fratte, Perugia, Italy

    Domenico V. Delfino

  4. Department of Agricultural and Environmental Sciences, Milan State University, Via Celoria 2, 20133, Milan, Italy

    Marcello Iriti

  5. Working Group “Pharmacognosy and Phytotherapy” of the Italian Pharmacological Society, Viale Abruzzi 32, 20131, Milan, Italy

    Francesca Borrelli, Cristiano Colalto, Domenico V. Delfino, Marcello Iriti & Angelo A. Izzo

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  1. Francesca Borrelli
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Contributions

All authors collectively planned the study. FB and AAI drafted the systematic review manuscript. FB and AAI assessed the eligibility of included articles and extracted data. DD, MI, and CC assessed the quality of the studies. All authors served as adjudicators for disagreements. CC performed the meta-analysis. All authors reviewed the manuscript for intellectual content and approved the final version.

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Correspondence to Francesca Borrelli or Angelo A. Izzo.

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Conflict of interest

Francesca Borrelli, Cristiano Colalto, Domenico V. Delfino, Marcello Iriti, and Angelo A. Izzo have no conflicts of interest that are directly relevant to the content of this manuscript.

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No funding was received in the preparation of this systematic review.

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Borrelli, F., Colalto, C., Delfino, D.V. et al. Herbal Dietary Supplements for Erectile Dysfunction: A Systematic Review and Meta-Analysis. Drugs 78, 643–673 (2018). https://doi.org/10.1007/s40265-018-0897-3

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