International Journal of Impotence Research (2012) 25, 45–50& 2012 Macmillan Publishers Limited All rights reserved 0955-9930/12
www.nature.com/ijir

ORIGINAL ARTICLE

Effects of Korean ginseng berry extract on sexual function in men
with erectile dysfunction: a multicenter, placebo-controlled,
double-blind clinical study
YD Choi1, CW Park2, J Jang2, SH Kim2, HY Jeon2, WG Kim2, SJ Lee2 and WS Chung
Ginseng is beneﬁcial for many aspects of human physiology, including sexual function. In this study, we have evaluated the efﬁcacy
and safety of an extract of ginseng berry, which has a ginsenoside proﬁle distinct from other parts of the plant, on sexual function inmen with erectile dysfunction. In all, 119 men with mild-to-moderate ED participated in a multicenter, randomized, double-blind,parallel, placebo-controlled clinical study. They were administered 4 tablets of either standardized Korean ginseng berry (SKGB,
350 mg ginseng berry extract per tablet), or placebo, daily, for 8 weeks. Efﬁcacy was assessed with the International Index of Erectile
Function (IIEF)-15 and premature ejaculation diagnostic tool (PEDT) at the end of the 4th and 8th week. We observed that the total
and each of the individual domain scores of IIEF-15 increased from 40.95±7.05 to 46.19±12.69 signiﬁcantly in the SKGB by the 8th
week (Po0.05). The erectile function domain of IIEF changed slightly from 17.17±2.57 to 18.59±5.99 in the SKGB group by the 8th
week (Po0.05). In addition, PEDT scores signiﬁcantly improved from 9.14±4.57 to 7.97±4.4 and 7.53±4.26 in the SKGB group
after 4 and 8 weeks of treatment (Po0.05). Safety markers including hormone and lipid in the blood were assessed at the end of
the 4th and 8th week and they remained unchanged. Oral administration of the SKGB extract improved all domains of sexualfunction. It can be used as an alternative medicine to improve sexual life in men with sexual dysfunction.
International Journal of Impotence Research (2012) 25, 45–50; doi:10.1038/ijir.2012.45; published online 20 December 2012
Keywords: ejaculation; erection; ginseng berry; sexual function

INTRODUCTION
Sexual dysfunction has a severe impact on the quality of life ofaffected individuals. Two main symptoms of sexual dysfunction
are ED and premature ejaculation (PE). Some studies report thatapproximately more than half of the male population has somedegree of ED1 and one-third of the global male population, acrossall age groups, has some degree of PE.2 To treat these symptoms,
drugs such as PDE5 inhibitors and selective serotonin reuptake
inhibitors are commonly used. However, these substances
can produce negative side effects, including headache,gastrointestinal disorder, muscle pain and blurred vision, andmay have dangerous interactions with other medications.3,4
To avoid the risks of potential side effects associated with drugs,
people often turn to dietary supplements or phytotherapy. Panax
ginseng is particularly common and widely used in oriental
countries, because of its property of boosting the immune system,
as well as providing vigor and enhancing sexual activity.5 It
contains medicinal ingredients, including saponin, polysaccharide,polyacetylene, phenols, gomisin, acidic peptide and carbohyderate.6 The major active components are ginsenosides, aclass of steroid glycosides and triterpene saponins naturally
occurring in the root, leaf and berry.7,8 Each part of the plant has adistinct ginsenoside proﬁle; thus, different parts probably havedifferent pharmacological activities.7,9Ginsenosides have been shown to enhance nitric oxide (NO)production in cultured porcine endothelial cells,10 rat ventricular
myocytes,11 rat thoracic aorta12 and guinea-pig cardiomyocytes,13

by inducing NO synthase (NOS) activity. More recently,
ginsenoside Rg1, which is abundantly present in ginseng berry,
was also reported to improve male copulation behavior via the
NO/cGMP pathway.14 Based on the above ﬁndings, wehypothesized that ginseng berry ameliorates sexual function via
the NO/endothelial NOS pathway and enhances male sexual
health.
This study was carried out to evaluate the effects ofstandardized ginseng berry extract on erectile function, ejaculation and other aspects of sexual function, in men with ED.

MATERIALS AND METHODS
Preparation of SKGB
Freshly harvested 4-year-old Korean ginseng berry (P. ginseng CA Meyer)
cultivated in Chungbuk province of South Korea were used. The seeds
were separated, and the pulp and juice were dried. The dried ginseng
berries were reﬂuxed with 70% ethanol for 10 h. The extract was ﬁlteredand evaporated under vacuum at 45 1C to obtain standardized Korean
ginseng berry extract (SKGB). The concentration of seven major ginsenosides in SKGB was analyzed by high-performance liquid chromatography
and the analysis results are shown in Figure 1.
Each 700 mg SKGB tablet consisted of 350 mg of standardized ginseng
berry extract. The content of ginsenoside-Re in standardized ginseng berry
extract was maintained at 10%. SKGB tablets also contain excipients andcoating materials, such as hydroxypropyl methylcellulose and microcrystalline cellulose. Placebo tablets are made of microcrystalline cellulose, andthey also contain excipients and coating materials. SKGB and placebo

1
Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea and 2R&D Center, Amorepaciﬁc Corporation, Gyeonggi-do,
South Korea. Correspondence: Dr WS Chung, Department of Urology, Ewha Womans University School of Medicine, Urology Department EU Mok-dong Hospital,
911-1 Mok-dong, Yangcheon-ku, Seoul 158-710, South Korea.
E-mail: woochung@ewha.ac.kr
Received 13 April 2012; revised 8 October 2012; accepted 26 November 2012; published online 20 December 2012

Effect of ginseng berry on sexual function
YD Choi et al

46

Figure 2. Design of the study. The schematic depicts the course of
the randomized, placebo-controlled trial. V1–V4 denotes the
hospital visit of the participants; V1, initial screening and recruitment of subjects; V2, assignment of subjects to either the SKGB or
Placebo group; V3 and V4, evaluation of efficacy parameters andsafety markers at 4 and 8 weeks.
Figure 1. Percentage weight of the seven ginsenosides in the SKGB
group obtained by high-performance liquid chromatography
analysis. Rb1, ginsenoside-Rb1; Rb2, ginsenoside-Rb2; Rc, ginsenoside-Rc; Rd, ginsenoside-Rd; Re, ginsenoside-Re; Rg1, ginsenosideRg1; Rg2, ginsenoside-Rg2.

tablets were identical in appearance. All process was controlled undergood manufacturing practice condition, which is managed by Korea Foodand Drug Administration. After the tablet production, we checked thecontent of ginsenoside-Re, especially in the ﬁnal SKGB tablets. During thetrials, four tablets (two tablets at a single time after breakfast and dinner) of
SKGB or placebo were given daily for 8 weeks.

Subjects
In this study, 119 men with mild-to-moderate ED were recruited between
May 2010 and January 2011. Selected participants were screened using theInternational Index of Erectile Function (IIEF)-5 scores, and were found to
fall within a range of 13–21; they were thereby assessed as having mild-tomoderate ED. They had suffered from ED for a period of 3 or more months,
and their ages were between 20 and 70 years. All the participants were
married and agreed to make at least four attempts a month at sexualintercourse with their spouse.
Exclusion criteria were as follows: (i) ED caused by endocrine systemdiseases; ED patients suffering from hypogonadism, which can be treatedby testosterone; (ii) prostate disease or cancer; (iii) severe penile pathology:
patients with peyronie’s disease who cannot have sexual intercourse; (iv)stroke, myocardial infarction, unstable angina within the previous 6months; (v) liver, kidney and nerve system diseases; (vi) intake of 5-areductase inhibitor within the previous 2 weeks; (vii) intake of PDE-5
inhibitors or self-injection with vasodilators for ED treatment within theprevious 2 weeks; (viii) intake of ginseng or red ginseng within theprevious 2 weeks; (ix) uncontrolled hypertension (over 170/100 mm Hg); (x)uncontrolled hyperglycemia (over 180 mg dl  1 on an empty stomach); (xi)alcohol or drug abuse; and (xii) participation in other clinical tests within
the previous 3 months.
This study was carried out in accordance with the Declaration of Helsinki
and was approved by the Institutional Review Board of Severance Hospitalof Yonsei University College of Medicine and Mokdong Hospital of Ewha
Womans University College of Medicine. Written consent was obtained
from all subjects after they were provided a detailed description of theexperimental procedures and informed that they could withdraw from thestudy at any time.

Study design
This was a multicenter, randomized, double-blind, parallel, placebocontrolled study that lasted for 8 weeks. The ﬁrst visit was for the purposeof screening, following which, the participants were randomly assigned to
one of the two 8-week long treatment arms by using a computerized
method of random list generation (Figure 2): (1) SKGB group, which
received four tablets of SKGB daily, and (2) Placebo group, which received
placebo tablets. All participants, investigators, pharmacists and study
personnel were blinded to treatment allocation. Baseline parameters,cholesterol levels and hormonal status, including total testosterone andprolactin, were measured at the beginning and the end of the study (8International Journal of Impotence Research (2012), 45 – 50

weeks). Clinical information and trial data were collected during individualinterviews (0, 4 and 8 weeks), conducted by a well-trained interviewer.
All participants underwent a thorough medical history review and aphysical examination. The primary efﬁcacy measure was the score of theerectile function domain of IIEF-15 at 4 and 8 weeks of treatment. The
secondary outcomes were other remaining domains of IIEF-15 (intercourse
satisfaction, orgasmic function, sexual desire and overall satisfaction) and
the PE diagnostic tool (PEDT). The outcome measurements used the
Korean version of IIEF and PEDT in this study that were veriﬁed for its
reliability and validity.15,16
All men underwent a physical and clinical laboratory examination (blood
chemistry and microscopic urine analysis); their vital signs (pulse and bloodpressure) were measured and an electrocardiogram was also obtained forsafety evaluation. All populations were asked to report potential side
effects related to the treatment. Every 4 weeks, all parameters werecompared within groups, as well as between the SKGB and the Placebogroup.

Statistical analysis
Statistical analyses were performed using the SPSS software (version
12.0.1.; SPSS Inc., Chicago, IL, USA). A value of Po0.05 was considered toindicate a signiﬁcant difference in demographic characteristics, effectiveness and safety measurements. The primary and secondary efﬁcacy
outcomes were evaluated using Wilcoxon’s signed-rank test, which wasused for within-group comparisons and analysis of covariance with thebaseline as covariate between groups. The hematological parameters,
blood chemistry, hormone levels and lipid levels in the blood as well asvital sign measurements followed a normal distribution and were
evaluated by the t-test between groups and paired t-test within groups.
The comorbid conditions were evaluated by the w2 test between groups.
All the data were represented as mean±s.d.

RESULTS
Study population
Of the total 119 subjects, one subject from the SKGB group was
excluded because he wished to discontinue the study. Thus, 118
subjects comprising the intent-to-treat group (SKGB: N ¼ 59;
Placebo: N ¼ 59) completed the entire evaluation, including the
IIEF-15 and PEDT questionnaires in the 8-week study. The SKGB
and Placebo groups were similar with respect to age, demographic characteristics and medical history (Table 1).
Erectile function
The erectile function domain of IIEF-15 scores at 0, 4 and 8 weeks,
using intent-to-treat set analysis, is depicted in Table 2. The SKGB
group showed slight improvement with statistical signiﬁcanceafter 8 weeks of treatment, as shown by within-group analysis(P ¼ 0.046 vs 0.487 in the Placebo group).
& 2012 Macmillan Publishers Limited

Effect of ginseng berry on sexual function
YD Choi et al

47
Table 1.

Baseline characteristics
Double-blind treatment
SKGB (N ¼ 59)

Placebo (N ¼ 59)

P-valueAge (years), mean±s.d.
Min, max
IIEF-5, mean±s.d.
Min, max
ED duration (in years), mean±s.d.
Min, max

57.49±7.94
31, 6914.36±1.86
13, 214.67±5.19
0.25, 25

57.32±8.41
32, 6914.59±1.79
13, 204.31±5.12
0.25, 300.911*

Comorbid conditions,a n (%)
Cardiovascular disorders
Gastrointestinal disorders
Genitourinary disorders

17 (34.00)
2 (4.00)
14 (28.00)

23 (40.35)
3 (5.26)
12 (21.05)

0.497*
0.708*

1.000**
1.000**
1.000**

Abbreviations: ED, erectile dysfunction; IIEF, International Index of Erectile Function; SKGB, standardized Korean ginseng berry. *P-value by t-test. **P-value by
w2 test. aConditions other than those of the exclusion criteria.

Table 2.

Changes in the IIEF-15 score at 4 and 8 weeks of treatment
Baseline

4 Weeks

P-valuea

8 Weeks

P valuea

Erectile function domain
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valueb17.17±2.57
17.56±2.89

17.73±4.72
16.29±5.33
0.065

0.450
0.074

18.59±5.99
18.00±5.12
0.501

0.046
0.487

Intercourse satisfaction domain
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valueb7.10±1.88
7.68±1.70

7.90±2.52
7.22±2.56
0.026

0.013
0.217

8.02±2.74
8.08±2.25
0.902

0.005
0.216

Orgasmic function domain
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valueb5.58±1.71
6.27±2.07

6.24±2.10
6.07±2.24
0.167

0.020
0.644

6.46±2.34
6.61±2.17
0.719

0.002
0.284

Sexual desire domain
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valueb5.86±1.61
6.47±1.49

6.54±1.59
6.32±1.57
0.050

0.001
0.360

6.73±1.54
6.71±1.64
0.266

0.001
0.265

Overall satisfaction domain
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valueb

5.24±1.38
5.42±1.68

5.85±1.57
5.76±1.85
0.603

0.006
0.268

6.39±1.59
6.15±1.71
0.342

0.001
0.012

Total IIEF-15 score
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valueb40.95±7.05
43.39±7.20

44.25±10.74
41.63±11.55
0.04

0.011
0.205

46.19±12.69
45.61±10.81
0.55

0.002
0.134

Mean±s.d.

Abbreviations: ANCOVA, analysis of covariance; IIEF, International Index of Erectile function; SKGB, standardized Korean ginseng berry.
The values represent mean±s.d. aWithin-group comparison: P-value by Wilcoxon’s signed-rank test. bBetween-group comparison: P-value by ANCOVA test.

Other sexual functions(a) IIEF-15 score: The IIEF-15 scores during the 8-week treatment
period are also shown in Table 2. Both within- and intergroup
analysis indicate a signiﬁcant increase in the total IIEF-15 scores
after 4 and 8 weeks of treatment (Po0.05). The four remaining
domains other than erectile function were also analyzed:
intercourse satisfaction, orgasmic function, sexual desire andoverall satisfaction. All of these domains showed signiﬁcant
improvement during the treatment period in the SKGB group(Po0.05) but not in the Placebo group (P40.05), except overallsatisfaction domain (P ¼ 0.012). Intergroup analysis revealed asigniﬁcant increase in total and intercourse satisfaction domain& 2012 Macmillan Publishers Limited

scores only, at 4 weeks of treatment (P ¼ 0.040 and 0.026,
respectively).
(b) Ejaculatory function: The comparisons of PEDT values of thegroups at 4 and 8 weeks of treatment are shown in Table 3. The
PEDT score improved in the SKBG group from 9.14 to 7.97 and7.53 at 4 and 8 weeks, respectively. Both inter- and within-group
analysis revealed statistically signiﬁcant differences (Po0.05).
Hormonal and safety evaluation
The beneﬁcial effect of SKGB on sexual function is not related tohormonal or cholesterol levels in the blood, as no changes wereInternational Journal of Impotence Research (2012), 45 – 50

Effect of ginseng berry on sexual function
YD Choi et al

48
Table 3.

Comparisons of PEDT scores of the SKGB and placebo groups before and after treatment
Baseline

4 Weeks

P-valuea

8 Weeks

P-valuea

9.14±4.57
10.46±4.79

7.97±4.45
10.31±4.88
0.019

0.004
0.753

7.53±4.26
9.66±4.57
0.017

0.001
0.177

Mean±s.d.
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valueb

Abbreviations: ANCOVA, analysis of covariance; PEDT, premature ejaculation diagnostic tool; SKGB, standardized Korean ginseng berry.
The values represent mean±s.d. aWithin-group comparison: P-value by Wilcoxon’s signed-rank test. bBetween-group comparison: P-value by ANCOVA test.

Table 4. Analysis of cholesterol and hormone levels in the blood of
SKGB and placebo group patients before and after treatment
Mean±s.d.

8 Weeks

Pvaluea

Total cholesterol (mg dl  1)
SKGB (N ¼ 59)
192.66±37.09
Placebo (N ¼ 59)
187.34±33.11b
P-value

191.58±31.32
184.02±40.62
0.682

0.763
0.419

HDL-cholesterol (mg dl  1)
SKGB (N ¼ 59)
45.81±10.07
Placebo (N ¼ 59)
48.75±12.70
P-valueb46.95±9.32
49.42±12.85
0.735

0.264
0.454

LDL-cholesterol (mg dl  1)
SKGB (N ¼ 59)
113.76±31.72
Placebo (N ¼ 59)
113.39±29.93
P-valueb117.12±28.70
113.03±28.21
0.327

0.305
0.854

Testosterone (ng ml  1)
SKGB (N ¼ 59)
500.53±189.58
Placebo (N ¼ 59)
482.05±171.83
P-valueb499.32±168.00
469.57±154.02
0.649

0.937
0.523

9.25±11.35
6.69±5.11
0.252

0.142
0.642

Prolactin (ng ml  1)
SKGB (N ¼ 59)
Placebo (N ¼ 59)
P-valuebBaseline

7.12±4.26
6.39±4.84

Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein;
SKGB, standardized Korean ginseng berry.
The values represent mean±s.d. aWithin-group comparison: P-value by
paired t-test. bBetween-group comparison: P-value by t-test.

observed in these factors in the serum of treated patients(Table 4). Furthermore, assessment of safety markers, including
blood chemistry, urinalysis and vital signs of participants, showedno signiﬁcant difference after the treatment period.
Although one case of mild gastrointestinal symptom wasreported during 0–4 weeks in the Placebo group, no patient
experienced any critical side effects that would have prevented
them from completing the clinical trial.

DISCUSSION
Human sexuality is very complex, and with multiple factors
affecting sexual desire, function, orgasm and overall satisfaction.
Sexual dysfunction can result from aging or physical disorders
affecting the NO pathway.17–19 Various treatment options areavailable, including the use of medication, phytotherapy,
behavioral therapy, psychiatric consultation and surgery. Despite
the successful advent of PDE5 inhibitors for ED and selective
serotonin reuptake inhibitors for PE, a large number of patientswith mild ED are reluctant to use medication or surgery and prefer
phytotherapy.20
International Journal of Impotence Research (2012), 45 – 50

Among the complementary medicines or dietary supplementsthat can improve sexual function, ginseng appears to be one of
the most attractive options. Ginseng has been used in Asian
countries to promote several health aspects, including sexualfunction, rarely having any adverse effects.21 Several studies havedescribed the clinical efﬁcacy of ginseng and its extract fortreatment of ED.20,22 However, Jang et al.23 reported that out of 28
published articles on the effect of ginseng on the treatment of ED,
only 7 articles satisﬁed their strict criteria of being double-blind,placebo-controlled trials.23 The meta-analysis showed thatginseng improved sexual performance. More recently,
Shamloul24 reported that these seven studies did not consider
the nature of the placebo used. Moreover, some of these studies
did not describe baseline comparison of ED symptoms or obtainappropriate ethical approval.20–24 The clinical trial describedherein was designed as a multicenter, randomized, double-blind,placebo-controlled study, addressing both the efﬁcacy and safetyof SKGB extract in men with mild-to-moderate ED.
In our study, we have used ginseng berry, which is mostabundant in ginsenoside, to treat male individuals with ED. A
number of other clinical studies show that ginseng improvessexual function; however, neither did they mention the method of
extract preparation nor did they quantify the components of theexperimental product.24–26 Standardization of herb or plant
extracts is important for comparing herbal therapy withconventional medicine and to ensure the delivery of the correct
dose in a consistent manner. Our study is the ﬁrst clinical trial thatinvestigates the effect of a standardized and characterized
ginseng berry extract on sexual function. Standardization ofginseng berry extract makes our study more reliable andreproducible.
We report that the SKGB-treated group showed improvement inall domains of sexual function. Clinical observation of patients
after the 8-week treatment indicates that SKGB has a positiveeffect on their sexual life.
Ginseng has been used to treat ED and its efﬁcacy has beenshown in several studies.20,22,25–27 Because ginseng is not a drugthat can treat severe ED, we enrolled mild-to-moderate ED
patients only. We found that SKGB group showed improvement
after 8 weeks of treatment by within-group analysis. A 1.5-pointchange could be considered clinically dubious for recommending
SKGB as a drug; however, it could be useful if used as asupplement. According to a recent review article, the PDE5-I (thatis, Tadalaﬁl) could improve erectile function by four points. And
the minimal clinically important differences in the EF domain were2, 5 and 7 for patients with mild, moderate and severe baseline
ED, respectively.28 We checked the number of patients who
experienced more than four-point change in IIEF-EF domain andfound that 22 (37%) men from the SKGB group and 17 men (28%)
from the Placebo group showed this improvement. As our clinicaltest included the patients with mild-to-moderate ED, 1.5-pointchange in the SKGB group could mean that SKGB can be usefulas a supplement rather than as a drug. SKGB exhibited an
improvement that was comparable with well-known supplements,
such as Lepidium Meyenii (Maca) and Pyconogenol, that have
similar or high IIEF-5 score (1.6 and 1.1, respectively).29,30 Further,& 2012 Macmillan Publishers Limited

Effect of ginseng berry on sexual function
YD Choi et al49
we did not observe any adverse effects during clinical test
contrary to other supplements such as yohimbine.31
A run-in phase (period) is very useful to screen potential
subjects for adherence and placebo response. Although we tried
to screen out the subjects with inclusion/exclusion criteria as well
as detailed interviews, we did not have a run-in phase in thisclinical trial. In the future study, the inclusion of a run-in phaseneeds to be considered so that we could achieve more signiﬁcantresults on a highly selected group of patients.
Ginseng has several potential healing properties and pharmacological activities.26 Ginsenosides, the principle molecularingredients of ginseng, can induce activation of largeconductance K (Ca) channels in smooth muscles.32 Ginseng
enhances the NO synthesis in the endothelium and acts as anantioxidant, having a protective effect.33,34 Ginsenosides activate
endothelial NOS to release NO and inhibit calcium accumulation,
thereby preventing NO-induced calcium channel blockade.35 In aprevious report, the ginseng saponin ginsenoside was shown toeffectively improve libido and sexual potency via the NO/cGMP
pathway.14 Thus, the beneﬁcial effects of SKGB may be mediatedby endothelium-derived NO.
Ginseng has also been described to have a role in rat brain
synaptosomes, inhibiting the uptake of dopamine, serotonin,
glutamate, noradrenalin and r-aminobutyric acid, in a concentration-dependent manner.36 Other clinical studies, indicating
favorable effects of ginseng on the psychomotor performanceof healthy volunteers receiving ginseng, support this mechanismof action.37 The central effects of ginseng are probably responsible for improving sexual desire and the intercourse satisfaction
scores presented in this study. However, in overall satisfaction, Placebo group also showed signiﬁcant improvement(P ¼ 0.012), even though it was not as signiﬁcant as in the SKGB
group (P ¼ 0.001). Therefore, we would like to acknowledge
that placebo effect might also be displayed in this kind of
measurement.
To our knowledge, this is the ﬁrst clinical study to evaluate theeffects of ginseng extract throughout the ejaculation process inmen with ED. PE is the most common male sexual complaint aswell as the most prevalent ejaculatory disorder. According to a
published report, PE has a prevalence of 16–38% in the malepopulation.38 The PEDT was developed to systematically apply the
DSM-IV-TR criteria in the diagnosis of PE.15,39 PEDT assesses
important factors, including control over ejaculation, frequency ofPE, minimum sexual stimulation, stress or bother to the patientand partner. This tool has been proven to be highly effective in
detecting and following up the patients with PE in several
geographical areas, such as Korea, Turkey, the United States andGermany.15 In our study, the PEDT scores signiﬁcantly improved
within the SKGB group during the treatment and in comparison to
the Placebo group. Although the underlying pathophysiology of
PE is not well understood, possible mechanisms of the SKGBinduced improvement of ejaculatory function could involve
increased NO synthesis and reduced sympathetic tone andsmooth muscle dilation in the vas deferens and seminal vesicles,
which could in turn oppose sympathetic vasoconstriction anddelay ejaculation. In addition, reduced performance anxiety,because of better erection, and downregulation of the erectile
threshold to a lower level of arousal could also account for theobserved positive effects of SKGB.40 Our results strongly support
that the SKGB might be effective in men with PE and can help
improve the quality of their sexual life. However, we would like tospecify that this study did not aim at curing patients with PE
because our patients were enrolled based on their erectile
function only.
Reports of side effects of ginseng are scarce and those that exist
report mild effects. Reported adverse effects are headache,insomnia, gastric problem and constipation.20,25,26 No single
adverse event pertaining to SKGB was noted in this study. Also,& 2012 Macmillan Publishers Limited

we did not ﬁnd any change in blood chemistry, hormone and lipid
proﬁle throughout the study. However, a long-term study
spanning more than a year might be required for conﬁrming
the safety proﬁle.
In conclusion, Korean ginseng berry treatment was both
efﬁcacious and well tolerated in men with mild-to-moderate ED,
who were dissatisﬁed with their sexual health. We therefore
believe that SKGB is a safe method for improving overall sexualfunction and satisfaction in patients suffering from mild-tomoderate ED.

CONFLICT OF INTEREST
The authors declare no conﬂict of interest.

ACKNOWLEDGEMENTS
This study was supported by a grant from the Korea Healthcare Technology R&D
Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A084120)
and Amorepaciﬁc.

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