Ginkgo (Ginkgo biloba)
Evidence-based guide to Ginkgo: benefits, dosage, safety and interactions.
Evidence
Mixed: Well-established for microcirculation generally (EGb 761, hundreds of trials); for SSRI-induced sexual dysfunction specifically, an early positive pilot (Cohen 1998) was not replicated in a stricter 2004 trial (Kang et al.).
Traditional use and mechanism
Microvascular circulation improvement; cognitive support in aging; claudication (leg circulation). Ancient Chinese use of Ginkgo nuts and leaves for respiratory and circulatory conditions. Oldest living tree species (270 million years).
Safety
Well-researched. Most common side effects: GI upset, headache. Serious concern: anticoagulant interaction (clinically documented — 12.94% co-prescription prevalence with antiplatelet drugs in hospital study, Mai et al. 2025 PLOS ONE). Must stop 2 weeks before any planned surgery. Ginkgolic acids (toxic) are removed in standardised EGb 761 preparations — non-standardised products may still contain them.