This 8-week randomized controlled trial included 50 adult men (average age of 35) with no health conditions who took either 600 mg of ashwagandha root extract (KSM-66 Ashwagandha® standardized to more than 5% total withanolides, the primary bioactive compound) or a placebo.

The primary outcomes of interest was the score on the self-reported Derogatis Interview For Sexual Functioning-Male (DISF-M) questionnaire that evaluates sexual cognition/fantasy, arousal, behavior, desire, and orgasm. The secondary outcomes were changes in serum testosterone and prolactin levels and the short-form survey–36 quality of life questionnaire score.

🔍 Digging Deeper: Measuring sexual health

The World Health Organization defines sexual health as a “state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.” Conversely, sexual dysfunction is defined as the various ways in which people may have “difficulty experiencing personally satisfying, non-coercive sexual activities.”^[6] Sexual dysfunction appears to affect about 40% of women and 30% of men.^[7]^[8] Considering that diagnosis of sexual dysfunction generally requires a person to feel distress for several months, and sex can be taboo or associated with a stigma depending on different population characteristics (e.g., sex, religion, culture), it is useful to have a proper tool to measure and discuss sexual function. It has been suggested that access to assessment tools for sexual health can reduce associated stigma and increase help-seeking.^[9]^[10]

According to a meta-review of measurement tools (i.e., questionnaires) used to assess sexual function, 31 of 110 questionnaires are internally consistent and reliable. The most commonly assessed aspects of sex were arousal, desire, satisfaction and pleasure, and frequency. Although there is no consensus on the “best” questionnaire, the most comprehensive one was determined to be the Derogatis Sexual Functioning Inventory (DSFI). It is one of the few instruments that assesses distress, relationship issues, fantasies, and cultural and gender roles.^[11]

The DSFI was developed in the mid-1970s and is often used in clinical research and practice.^[12] It has been reported to reliably assess clinically meaningful changes in sexual health and generally exhibits sufficient sensitivity to discriminate differences between groups.^[13] It has a relatively strong test-retest reliability, content validity (i.e., the extent to which the questionnaire represents all aspects of sexual health), and construct validity (i.e., how well the questionnaire responses represent what is not directly measurable).^[11]^[14]

Ashwaganda, sexual health, and testosterone Original paper