Good News for Men’s Sexual Health

By Dr. Jonathan Beatty

Low testosterone levels affect many men (and women), and this problem gets worse as we age. As men age, their bodies produce less testosterone which results in a variety of problems. Erectile dysfunction, breast growth, beer bellies, fatigue and poor concentration are all linked to decreases in testosterone levels. For men this process is termed andropause, and although not an official disease it does have a major impact on overall health and quality of life. Men spend a lot of money on quick fix solutions that do little to manage the actual problem. Coffee to manage our energy, surgery to reduce breast size, the little blue pill – sildenafil, to manage the erection quality. All of these therapies are short lived, so now men are starting to look more at managing testosterone levels.

One of the most common interventions most people seek for andropause is testosterone replacement therapy. There are many ways to administer testosterone; pills, injections, patches and even lozenges. The trouble with this approach to therapy is that it focuses on the effect, not the cause. Long term use of testosterone therapy leads to a decrease of production of testosterone by the body leading to a worsening of the original problem. In fact there is a whole protocol that is needed just to help men discontinue testosterone when needed. Overlooked are the many ways that low testosterone can be addressed without using supplemental testosterone.

One of the newest interventions in this area is the use of an herb called Tongkat Ali (Eurycomia longifolia jack). This herb has shown a lot of promise in early clinical trials and I have to admit, I have seen a very profound effect using this herb with some of my own patients. In the past I have been able to use this herb to help wean men off of testosterone supplementation programs without the need for expensive hormone interventions.

Tongkat ali is also known as Malaysian ginseng and has been used in traditional medicine for years to improve energy and stamina and also as an aphrodisiac. Many herbs that have classically been used as aphrodisiacs don’t usually have clinical research to back them up. Tongkat ali is different. In one trial, men suffering from late onset hypogonadism (the new term for andropause) were studied using tongkat ali. Measured were serum testosterone levels and erectile dysfunction. Pre treatment 10.5% of the patients had no problems with ED and 35.5% had normal testosterone levels. After the treatment 70.1% of the men had no problems with ED and 90.8% of them had normal testosterone levels. This study used 200mg/day of Tongkat ali for 1 month time. 1

The effect of tongkat ali may be multifaceted which may explain why it is so useful an effective clinically. In working with testosterone levels in men, it is important to measure not just overall testosterone levels but to also evaluate men for estrogen levels. The body responds not just to the individual hormones but relies on a proper balance. Tongkat ali has been shown to have anti-estrogenic effects that may help to promote a healthy testosterone: estrogen balance.2

Hormone effects aside the one measure that most men tend to be concerned with is sexual performance. Often we get bogged down in an analysis of numbers but that does not always translate into real world effects. The ability to obtain and maintain erection is very important to men. Dysfunction in this area is often difficult to discuss because men can feel embarrassed when things aren’t working as they should. There are many causes for this including smoking, medication side effects, stress and many more. Tongkat ali will not address all of these topics, if smoking is the cause – quit, if medications are the cause – speak with your doctor about alternatives. If there is another cause it may be worth investigating Tongkat ali. Studies have shown that it can boost erection quality and duration3. These are the very measures by which we evaluate erectile function and dysfunction. It is one thing to be able to achieve erection but also important to be able to maintain it for the required duration.

If you are experiencing symptoms of andropause or erectile dysfunction, don’t be shy, speak to your doctor. The only way a problem will be fixed is to address it. Check to see if Tongkat ali will work for you, or if there are any reasons you shouldn’t take it. This is a relatively safe herb but everyone has individual needs that are best evaluated by a doctor who knows your specific needs.

  1. Andrologia. 2012 May;44 Suppl 1:226-30. doi: 10.1111/j.1439-0272.2011.01168.x. Epub 2011 Jun 15
  2. Reprod Biol. 2012 Jul;12(2):247-55.
  3. J Sex Med. 2012 Apr;9(4):1027-36. doi: 10.1111/j.1743-6109.2011.02296.x. Epub 2011 May 13.


Jonathan Beatty is a Doctor of Naturopathic Medicine in Ontario, having graduated from the Canadian College of Naturopathic Medicine in 2007. Dr Beatty also holds an Honours Bachelor of Science Degree in Nutrition and Nutraceutical Science from the University of Guelph.

Dr. Beatty is a member of the Canadian Association of Physicians for the Environment, the Ontario Association of Naturopathic Doctors and the Canadian Association of Naturpathic Doctors.