what if I told you that there's an herb
that reduces stress and boosts
testosterone by 15 is it for real or all
just a fad I'm Dr Rena Malik urologist
and pelvic surgeon and if you're new
here I make Urologic content on Sexual
Health bladder health and so much more
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share this Channel with your friends so
today we're going to talk about
ashwagandha what it is how it works the
side effects and the data on sexual
function in women and men for
testosterone libido fertility and
erectile function and if you decide
after this video that you do want to
take it stick around to the end to find
out how you're going to take it and what
time it's optimal what dose and what to
look for so ashwagandha is known as
withania thumbnifera it's an herb that
grows in India the Middle East and parts
of Africa it's often used in ayurvedic
medicine as a natural stress relief
immune support anxiety and depression so
how does it work well it contains active
compounds called with thanolides which
are believed to have a variety of health
benefits specifically they're thought to
be anti-inflammatory and maybe have some
antioxidant properties it's also
classified as an adaptogen meaning that
it essentially helps the body to cope
with stress more effectively and
specifically in both short-term and
long-term physical or mental stress and
the way it works specifically is it
actually reduces cortisol which is a
marker that our body releases when we
are adapting to stress so side effects
can include dizziness sleepiness
Headache nausea or other GI symptoms
like vomiting diarrhea there have been
rare cases of liver injury and generally
some emotional blunting and lack of
finding pleasure in everyday activities
and this is because it works on a number
of different Pathways including
serotonin Pathways which often have are
part of our pleasure Pathways it can
also interact with blood pressure meds
or anti-anxiolytics like benzodiazepines
and you definitely don't want to take it
if you're pregnant trying to get
pregnant breastfeeding or on any sort of
immunosuppressive medications if you
have type 1 diabetes or any sort of
thyroid disease you want to avoid this
supplement also it can have a blood
thinning effect it's actually considered
a Nightshade plant and so if you are
allergic to Nightshade plants which can
be plants like tomatoes eggplants
potatoes and peppers you want to stay
away from this so let's start with how
this affects sexual function in women in
2015 50 women were randomized to receive
KSM 66 ashwagandha which is a
water-based extract or a placebo which
was made of starch so they took these at
300 milligrams twice a day daily for
eight weeks and what they found that
there was significant improvements in
female sexual function specifically in
arousal lubrication orgasm and
satisfaction and overall their sexual
distress score was lower they had a
greater number of successful sexual
income accounts so moving on to
fertility in men there have been two
studies that I've looked at five grams
of ashwagandha root powder given to
infertile men again these are really
small studies and this is only looking
at specific semen parameters not
specifically leading to live births
which is actually what matters when
you're looking at infertility so in the
first study they had 68 infertile men
between the ages of 22 and 40 years of
age they all had a sperm count that was
somewhere between 5 to 20 million per
milliliters and also had other abnormal
semen parameters and had been trying to
conceive for at least the last year and
then they looked at these men before the
study started and then at 90 days later
and they found that with the ashwagandha
root powder they were able to see a
significant increase in sperm
concentration which was actually almost
167 from 9 million to about 26 million
they also saw significant increases in
semen volume as well as sperm utility
after day 90. and interestingly they
also saw a serum testosterone increase
by about 17 percent and the reason they
think this works is because as I
mentioned earlier ashwagandha is an
antioxidant and when thinking about
infertility the reason a lot of men
often have issues with infertility is
because the environment of the testicles
which produce testosterone may have a
lot of antioxidants and so the
antioxidant properties of ashwagandha
may be helpful in this respect another
study looked at infertile men who were
also heavy smokers and noted to be
psychologically stressed and they again
gave them the same five grams of the
root powder for three months and they
found again they had an increase in
sperm count as well as motility in a
second study they did the similar
process with a number of men who either
had abnormal semen parameters with
infertility or also had psychological
stress and infertility to see if this
improved and in fact again they saw in
this very small study that there was
some improvements in sperm concentration
as well as motility I think the take
home from this about infertility is that
it may be helpful but we really don't
have enough data to recommend it widely
and again the issue with any of these
supplements is that we don't know that
what they put on the bottle is actually
what's in the supplements because
there's very little regulation of
supplements and again these studies only
looked at people for up to about 90 days
so what happens if you take it longer
than that do you still see benefits and
the other issue is that when you look at
sperm parameters in general there's a
variation even from person to person
between day to day as well as if you've
had a cold or a flu or something that
can affect your temperature that can
also significantly reduce your sperm
concentration so what about
erections so in men who had erectile
dysfunction there's really only been one
human study that looked at psychogenic
erectile dysfunction if you want to
learn more about that make sure you
check out my video about psychogenic
erectile dysfunction these men took two
grams of ashwagandha root extract with
meals for 60 days and ultimately they
found that they really didn't see any
difference in erectile function so let's
talk about testosterone so I already
mentioned in the infertility study that
they saw an increase in testosterone in
another randomized study where they
looked at men getting 240 milligrams of
ashwagandha extract with 35 of
withinolide glycosides they were looking
at actually how it affected cortisol and
DHEA but as a secondary outcome they
looked at testosterone and they measured
this at starting of the study and then
60 days later and what they found was
that after those 60 days there was a 10
increase in testosterone levels in the
ashwagandha group however when comparing
the changes between the placebo group
and the ashwagandha group they were
actually not statistically significant
meaning while the numbers increased it
wasn't any clinically different than the
placebo group and likely the change was
just due to chance and other Studies
have looked at specifically stressed men
as well as men who were also undergoing
a resistance training program and saw
some improvements with testosterone but
as we know stress and testosterone are
very much correlated if you have higher
levels of cortisol that inhibits
testosterone production so if you reduce
cortisol in a stressed individual you
should see improvements in testosterone
if you're not stressed maybe that
benefit won't be so obvious as I
mentioned previously in my video about
testosterone exercise resistance
training particularly of large muscle
groups does result in increases in
testosterone so in that other study that
looked at men who had a resistance
training program who knows if it was
from the ashwagandha or the resistance
training lastly what about libido well
we know again ashwagandha reduces stress
and when you have chronic stress it
obviously causes sexual dysfunction and
reduces your libido there's actually
been no human studies specifically on
libido however in animal studies using
moderate doses in mice they saw
reductions in stress as well as more
sexual activity in those who were
chronically stressed taking ashwagandha
however in an alternative study they
actually saw lowering of libido because
they gave a large dose of ashwagandha 3
grams per kilogram which may have been
actually sedative and maybe made the
mice more sleepy again the data for
these sort of supplements is really all
over the place and not very very strong
however if you have none of the
contraindications I discussed earlier in
the video and you are interested in
trying it and you have the income to try
it then by all means it's okay to do so
just make sure you talk to your doctor
about it to make sure there's no
contraindications between any of the
medications that you're on so when do
you want to take it well you don't want
to blend all your cortisol first thing
in the morning so you want to take it
ideally in the afternoon and the evening
and all the majority of the studies
looked at a 300 milligram dose and you
want to get the highest percentage of
withinolide glycosides within that
ashwagandha extract as you can also the
majority of these studies were 8 to 12
weeks so if you're going to take it take
it during times of real stress like your
having a stressful time take it for a
short period of time 8 to 12 weeks no
more because we don't really know what
preventing cortisol production over long
periods of time will do to your body and
lastly because it's a supplement you
want to assess the supplement make sure
it undergoes third-party testing so that
what you're getting in the supplement is
actually what you're taking and try to
investigate if that particular
supplement has undergone some studies of
its own rather than just pulling studies
generally about ashwagandha so bottom
line ashwagandha may have some health
benefits for stress reduction and
potentially improvements in female
sexual function testosterone and maybe
infertility but we need a lot more
studies to really confirm that this is
actually true however we do have
wonderful treatment options for low
libido low testosterone infertility and
erectile dysfunction so if you are
experiencing any of those things make
sure to see your local urologist
infertility Specialist or sexual health
expert to help guide you with
evidence-based medicine that can really
help as always I'm going to take care of
yourself because you're worth it
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