Updated: Mar 31
I believe that supplements and herbs are too weak to address the symptoms except in milder cases of PSSD/PFS. That said, there are a few herbs that are potent enough to have an effect and are worth experimenting with. One of those herbs is Panax Ginseng, and here's why.
Panax Ginseng (aka Red Korean Ginseng):
Panax Ginseng is a very common supplement and is pretty easy to acquire, making it an ideal choice for mild cases who aren't interested in online pharmacies.
I often recommend Panax ginseng to my patients for regimens of trial & error if their testosterone is low. I like this herb because it has unique properties not found elsewhere.
Before I outline its beneficial effects, there is a misconception that I must address:
Is Panax Ginseng an 5α-reductase inhibitor?
The main substance responsible for 5α-reductase inhibition of Panax Ginseng is 'Ginsenoside Ro'. This ginsenoside is heavily concentrated in the rhizome of the plant, not the main root . Most supplements of Panax Ginseng are extracts of the main root, not the rhizome. If you suspect that your supplement contains the rhizome part, you can always email your supplier for info regarding the extraction process and whether the rhizome is included.
So what makes this herb good?
1- Testosterone: In mild PSSD cases, I noticed that testosterone and free testosterone are almost always on the low side of the normal range. Panax ginseng can raise the luteinizing hormone (LH), stimulating the testes into producing more testosterone [2, 3].
2- Glutamate & GABA: Panax Ginseng has a novel mechanism of action where it modulates the energetic state of the central nervous system (CNS) through activating non-NMDA glutamate receptors and GABA-A receptors simultaneously . It also promotes glutamate release in the hippocampal neurons, leading to anti-depressant and pro-cognitive effects . Despite raising glutamate release, it has neuroprotective effect by inhibiting NMDA receptors signaling .
4- Dopamine (DA) & Norepinephrine (NE): It increases DA and NE release in the prefrontal cortex . This has beneficial effects on attention, cognitive processing, sensorimotor function and memory.
5- Acetylcholine (ACh): It has neuroprotective and neurotrophic effects through increasing central ACh neurotransmission and enhancing dendritic outgrowth .
7- HPA Axis: It upregulates glucocorticoid receptors (GR), leading to anti-stress effect . It also acts as an agonist at the GR . As an adaptogen, it modulates the HPA axis in favor of anti-stress effects .
8- Estrogen: It is a phytoestrogen that activates estrogen receptors. Furthermore, it prevents stress-mediated downregulation of ER-β receptors . Estrogen receptor activation is crucial both for male and female libido .
9- Nitric Oxide (NO): Panax Ginseng inhibits inducible nitric oxide synthase (iNOS). iNOS is a pro-inflammatory enzyme that hinders neural signaling via cytokine production and could lead to activation of the microglia . Panax Ginseng prevents this. Activation of GR leads to stimulation of eNOS, leading to better endothelial NO signaling in penile tissues [17, 18].
My favorite herbal treatments for PSSD are Panax Ginseng and Tongkat Ali. These two herbs have proved time and again positive effects in my patients, especially when combined with high-quality Shilajit.
Panax Ginseng has very unique properties not found in other aphrodisiac herbs. Its potency is evident and easily felt by many of my patients. It's, however, suitable for mild cases only. More severe cases require prescription drugs and/or research chemicals to find symptomatic relief.
My next article will be on Tongkat Ali and its unique properties.
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