Horny Goat Weed/Epimedium species (aka horny goat weed) have been utilized for the treatment of erectile dysfunction in Traditional Chinese Medicine for many years. Icariin (ICA) is the active moiety of Epimedium species.

Icariin is a member of the class of flavonols that is kaempferol which is substituted at position 8 by a 3-methyl but-2-en-1-yl group and in which the hydroxy groups at positions 3, 4′, and 7 have been converted to the corresponding 6-deoxy-alpha-L-mannopyranoside, methyl ether, and beta-D-glucopyranoside, respectively. A phosphodiesterase-5 inhibitor, it is obtained from several species of plants in the genus Epimedium and is thought to be the main active ingredient of the Chinese herbal medicine Herba Epimedii (yinyanghuo). It has a role as a bone density conservation agent, a phytoestrogen, an EC 3.1.4.35 (3′,5′-cyclic-GMP phosphodiesterase) inhibitor, and an antioxidant. It is a glycosyloxyflavone and a member of flavonols.

Another Name of Horny Goat Weed

OTHER NAME(S): Barrenwort, Épimède, Épimède à Grandes Fleurs, Épimède du Japon, Epimedium, Epimedium acuminatum, Epimedium brevicornum, Epimedium grandiflorum, Epimedium Grandiflorum Radix, Epimedium koreanum, Epimedium macranthum, Epimedium pubescens, Epimedium sagittatum, Epimedium violaceum, Epimedium wushanese, Herba Epimedii, Herbe Cornée de Chèvre, Hierba de Cabra en Celo, Japanese Epimedium, Xian Ling Pi, Yin Yang Huo.

Mechanism of Action

Horny Goat Weed has a high affinity to human alpha-2 adrenoceptors, moderate affinity to alpha-1 adrenoceptors, and low affinity to some of the serotonin and dopamine receptors in the central and peripheral nervous systems []. Alpha-2 adrenoceptors mediate erection-inhibiting impulses in the central nervous system. Yohimbine is generally believed to enhance central sexual impulse by blocking the alpha-2 adrenoceptors in the locus coeruleus in the brain []. In the periphery, yohimbine has been suggested to inhibit alpha-1 and alpha-2 adrenoceptors as well as enhancing the release of nitric oxide (NO) from cavernosal endothelial cells [, ]. In conclusion, the mechanism of action of yohimbine in enhancing sexual function is currently unclear.

Although you can have ED at any age, it becomes more common as men age. In the United States, approximately 12 percent of men younger than 60, 22 percent of men aged 60 to 69, and 30 percent of men 70 or older have ED, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Indications ofHorny Goat Weed

Horny Goat Weed is an herbal supplement that can be used for erectile dysfunction, sexual dysfunction (male or female) and menopausal symptoms. Although more research is need with regard to its efficacy, horny goat weed can also be used for weak back and knees, joint pain, osteoarthritis, mental and physical fatigue, memory loss, high blood pressure, heart disease, bronchitis, liver disease, HIV/AIDS, polio, chronic leucopenia, viral infections of the heart, bone loss after menopause, weak bones (osteoporosis), and as a tonic.

  • Weak and brittle bones (osteoporosis) – Taking a specific extract of horny goat weed for 24 months in combination with calcium supplements decreases bone loss of the spine and hip in women who have passed menopause better than taking calcium alone. Chemicals in the extract act somewhat like the hormone estrogen.
  • Health problems after menopause – Taking horny goat weed water extract for 6 months can decrease cholesterol and increase estrogen levels in postmenopausal women.
  • Bronchitis.
  • Ejaculation problems.
  • Erectile dysfunction (ED).
  • Fatigue.
  • Heart disease.
  • High blood pressure.
  • HIV/AIDS.
  • Joint pain.
  • Liver disease.
  • Memory loss.
  • Sexual problems.
  • Other conditions.
  • Natural Supplement for men and women – Horny Goat Weed is a plant that contains high levels of Icariin. This natural herb is a type of flavonoid that may help boost energy, performance, and stamina.
  • Infused with pure and potent enhancers – Our formula is the perfect synergy of Horny Goat Weed extracts and other herbal energy boosters like Maca, Tongkat Ali, Panax Ginseng, L-Arginine, and Saw Palmetto.
  • Promotes healthy circulation – Our supplement may support holistic health. A healthy flow and relaxed muscles contribute to intensified sensations and mental alertness.
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A study published in the Journal of Sexual MedicineTrusted Source investigated its effects on rats. Researchers found that rats treated with purified extract of horny goat weed showed improved erectile function. Another study found that icariin is effective in inhibiting human PDE5, the substance that blocks erections, in test tubes. It also determined that sildenafil (Viagra) is 80 times more potent than icariin.


Dosages of Horny Goat Weed

  • 2 caps (1,000 mg, may vary with manufacturer) orally per day
  • 3-4 caps orally 90 minutes before sexual activity
  • May also be taken as a tea
  • Preventing osteoporosis: a specific phytoestrogen extract of epimedium containing 60 mg icariin, 15 mg daidzein, and 3 mg genistein, along with 300 mg of elemental calcium orally per day

Dosage Considerations – Should be Given as Follows

  • Adults receiving dialysis or other immunocompromising conditions
  • Recombivax HB (40 mcg/mL): 40 mcg intramuscularly at 0, 1, and 6 months, OR
  • Engerix-B (20 mcg/mL): 40 mcg intramuscularly at 0, 1, and 6 months

Side Effects of Horny Goat Weed

Side effects of Horny Goat Weed include

  • dizziness
  • vomiting
  • dry mouth
  • thirst
  • nose bleed
  • spasms
  • severe breathing problems
  • irregular heartbeats (arrhythmia)
  • slows blood clothing
  • increased risk of bleeding
  • low blood pressure (hypotension)
  • fainting

Drug Interactions of Horny Goat Weed

Moderate – Be cautious with this combination.
  • Estrogens – Horny goat weed might have some of the same effects as estrogen and might increase blood levels of estrogen in some women. Taking horny goat weed with estrogen might increase the effects and side effects of estrogen. Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.
  • Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) – Some medications are changed and broken down by the liver. Horny goat weed might decrease how quickly the liver breaks down some medications. Taking horny goat weed along with some medications that are changed by the liver might increase the effects and side effects of some medications. Before taking horny goat weed, talk to your healthcare provider if you take any medications that are changed by the liver. Some of these medications that are changed by the liver include caffeine, clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline (Slo-bid, Theo-Dur, others), zileuton (Zyflo), Zolmitriptan (Zomig), and others.
  • Medications changed by the liver (Cytochrome P450 2B6 (CYP2B6) substrates) – Some medications are changed and broken down by the liver. Horny goat weed might decrease how quickly the liver breaks down some medications. Taking horny goat weed along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking horny goat weed, talk to your healthcare provider if you take any medications that are changed by the liver. Some medications that are changed by the liver include bupropion (Wellbutrin), cyclophosphamide (Cytoxan), dexamethasone (Decadron), efavirenz (Sustiva), ketamine (Ketalar), methadone (Dolophine), nevirapine (Viramune), orphenadrine (Norflex), phenobarbital, sertraline (Zoloft), tamoxifen (Nolvadex), valproic acid (Depakote), and numerous others.
  • Medications for high blood pressure (Antihypertensive drugs) – Horny goat weed might lower blood pressure. Taking horny goat weed along with medications for high blood pressure might cause your blood pressure to go too low.  Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.
  • Medications that can cause an irregular heartbeat (QT interval-prolonging drugs) – Horny goat weed might increase your heart rate. Taking horny goat weed along with medications that can cause an irregular heartbeat might cause serious side effects including an irregular heartbeat. Some medications that can cause an irregular heartbeat include amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), ibutilide (Covert), procainamide (Pronestyl), quinidine, sotalol (Betapace), thioridazine (Mellaril), and many others.
  • Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) – Horny goat weed might slow blood clotting. Taking horny goat weed along with medications that also slow clotting might increase the chances of bruising and bleeding. Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
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Are there interactions with herbs and supplements?

  • Herbs and supplements that might lower blood pressure – Horny goat weed might lower blood pressure. Taking it along with other herbs and supplements that could decrease blood pressure might increase the risk of blood pressure dropping too low. Some of these herbs and supplements include Andrographis, casein peptides, cat’s claw, coenzyme Q-10, fish oil, L-arginine, lycium, stinging nettle, theanine, and others.
  • Herbs and supplements that might slow blood clotting – Horny goat weed might slow blood clotting. Taking horny goat weed along with other herbs and supplements that also slow clotting might increase the chances of bruising and bleeding. These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, quassia, red clover, turmeric, willow, and others.

Pregnancy Category of Horny Goat Weed

  • Pregnancy and breast-feeding – Horny goat weed is POSSIBLY UNSAFE when taken by mouth during pregnancy. There is a concern that it might harm the developing fetus. Avoid using it. Not enough it knew about the safety of using horny goat weed during breast-feeding. Stay on the safe side and avoid using.
  • Bleeding disorders – Horny goat weed might slow blood clotting. This might increase the risk of bleeding. In theory, taking horny goat weed might make bleeding disorders worse.
  • Hormone-sensitive cancers and conditions – Horny goat weed acts like estrogen and can increase estrogen levels in some women. Horny goat weed might make estrogen-sensitive conditions, such as breast and uterine cancer, worse.
  • Low blood pressure – Horny goat weed might lower blood pressure. In people who already have low blood pressure, using horny goat weed might drop blood pressure too low and increase the risk of fainting.
  • Surgery – Horny goat weed might slow blood clotting. This might increase the risk of bleeding during surgery. Stop taking horny goat weed at least 2 weeks before surgery.
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References