Short- and Long-term Effects of Ginkgo Biloba Extract on Sexual Dysfunction in Women


Ginkgo biloba extract (GBE) facilitates blood flow, influences nitric oxide systems, and has a relaxant effect on smooth muscle tissue. These processes are important to the sexual response in women and, hence, it is feasible that GBE may have a therapeutic effect. The present study was the first to provide an empirical examination of the effects of both short- and long-term GBE administration on subjective and physiological (vaginal photoplethysmography) measures of sexual function in women with Sexual Arousal Disorder. A single dose of 300 mg GBE had a small but significant facilitatory effect on physiological, but not subjective, sexual arousal compared to placebo in 99 sexually dysfunctional women. The long-term effects of GBE on sexual function were assessed in 68 sexually dysfunctional women who were randomly assigned to 8 weeks treatment of either (1) GBE (300 mg/daily), (2) placebo, (3) sex therapy which focused on training women to attend to genital sensations, or (4) sex therapy plus GBE. When combined with sex therapy, but not alone, long-term GBE treatment significantly increased sexual desire and contentment beyond placebo. Sex therapy alone significantly enhanced orgasm function compared with placebo. Long-term GBE administration did not significantly enhance arousal responses beyond placebo. It was concluded that (1) neither short- or long-term administration of GBE alone substantially impacts sexual function in women, (2) a substantial placebo effect on sexual function exists in women with sexual concerns, and (3) teaching women to focus on genital sensations during sex enhances certain aspects of women’s sexual functioning.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5


  1. 1.

    The therapist manual is available from the corresponding author upon request.


  1. Auguet, M., & Clostre, F. (1983). Effects of an extract of ginkgo biloba and diverse substances on the phasic and tonic components of the contraction of an isolated rabbit aorta. General Pharmacology, 14, 277–280.

  2. Auguet, M., DeFeudis, F. V., & Clostre, F. (1982). Effects of ginkgo biloba on arterial smooth muscle responses to vasoactive stimuli. General Pharmacology, 13, 169–171.

  3. Azadzoi, K. M., Kim, N., Brown, M. L., Goldstein, I., Cohen, R. A., & Saenz de Tejada, I. (1992). Endothelium-derived nitric oxide and cyclooxygenase products modulate corpus cavernosum smooth muscle tone. Journal of Urology, 147, 220–225.

  4. Basson, R., & Brotto, L. A. (2003). Sexual psychophysiology and effects of sildenafil citrate in oestrogenised women with acquired genital arousal disorder and impaired orgasm: A randomized controlled trial. British Journal of Obstetrics and Gynecology, 100, 1014–1024.

  5. Basson, R., McInnes, R., Smith, M. D., Hodgson, G., & Kippiker, N. (2002). Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with Female Sexual Arousal Disorder. Journal of Women’s Health & Gender-Based Medicine, 11, 367–377.

  6. Boolell, M., Allen, M. J., Ballard, S. A., Gepi-Attee, S., Muirhead, G. J., Naylor, A. M., et al. (1996). Sildenafil: An orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. International Journal of Impotence Research, 8, 47–52.

  7. Bryk, A. S., Raudenbush, S. W., & Congdon, R. T. (1996). Hierarchical linear and nonlinear modeling with the HLM/2L and HLM/3L programs (2nd ed.). Chicago: Scientific Software International Inc.

  8. Burnett, A. L. (1997). Nitric oxide in the penis: Physiology and pathology. Journal of Urology, 157, 320–324.

  9. Caruso, S., Intelisano, G., Lupo, L., & Agnello, C. (2001). Premenopausal women affected by sexual arousal disorder treated with sildenafil: A double-blind, cross-over, placebo-controlled study. British Journal of Obstetrics and Gynaecology, 108, 623–628.

  10. Chivers, M. L., Seto, M. C., Lalumiere, M. L., Laan, E., & Grimbos, T. (2005, July). The agreement of genital and subjective measures of sexual arousal: A meta-analysis. Poster presentation to the annual meeting of the International Academy of Sex Research, Ottawa, Canada.

  11. Christen, Y., Courtois, Y., & Droy-Lefaix, M. T. (1995). Effects of ginkgo biloba extract (EGB 761) on aging and age-related disorders. Paris, France: Elsevier.

  12. Cohen, A. J., & Bartlik, B. (1998). Ginkgo biloba for antidepressant-induced sexual dysfunction. Journal of Sex and Marital Therapy, 24, 139–143.

  13. DeFeudis, F. V. (1991). Ginkgo biloba extract (GBE 761): Pharmacological activities and clinical applications. Paris, France: Elsevier.

  14. Dinsmore, W. W., Hodges, M., Hargreaves, C., Osterloh, I. H., Smith, M. D., & Rosen, R. C. (1999). Sildenafil citrate (Viagra) in erectile dysfunction: Near normalization in men with broad-spectrum erectile dysfunction compared with age-matched healthy control subjects. Urology, 53, 800–805. [Erratum in: Urology, 1999, 53, 1072].

  15. Dunlop, W. P., Cortina, J. M., Vaslow, J. B., & Burke, M. J. (1996). Meta-analysis of experiments with matched groups or repeated measures designs. Psychological Methods, 1, 170–177.

  16. Ellison, J. M., & DeLuca, P. (1998). Fluoxetine-induced genital anesthesia relieved by ginkgo biloba extract. Journal of Clinical Psychiatry, 59, 199–200.

  17. FDA Guidance document. (2000). Guidance for industry: Female sexual dysfunction: Clinical development of drug products for treatment.

  18. Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A. M., Riggs, D. S., Feeny, N. C., et al. (2005). Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73, 953–964.

  19. Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998) Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338, 1397–1404.

  20. Janssen, E. (2001). Psychophysiological measurement of sexual arousal. In M. W. Wiederman & B. E. Whitley (Eds.), Handbook for conducting research on human sexuality (pp. 139–171). Mahwah, NJ: Erlbaum.

  21. Jung, F., Morowietz, C., Kiesewetter, H., & Wenzel, E. (1990). Effect of ginkgo-biloba on fluidity of blood an peripheral microcirculation in volunteers. Drug Research, 40, 589–593.

  22. Kang, B., Lee, S., Kim, M., & Cho, M. (2002). A placebo-controlled, double-blind trial of ginkgo biloba for antidepressant-induced sexual dysfunction. Human Psychopharmacology, 17, 279–284.

  23. Kirsch, I. (1997). Specifying nonspecifics: Psychological mechanisms of placebo effects. In A. Harrington (Ed.), The placebo effect: An interdisciplinary exploration (pp. 166–186). Cambridge, MA: Harvard University Press.

  24. Kleijnen, J., & Knipschild, P. (1992). Ginkgo biloba. Lancet, 340, 1136–1139.

  25. Koltringer, P., Eber, O., Lind, P., Langsteger, W., & Wakonig, P. (1989). Mikrozirkulation und Viskoelastizitat des Vollblutes unter Ginkgo-biloba-extrakt. Eine plazebokontrollierte, randomisierte Doppelblind-Studie. Perfusion, 1, 28–30.

  26. Maitra, I., Marcocci, L., Droy-Lefaix, M. T., & Packer, L. (1995). Peroxyl radical scavenging activity of ginkgo biloba extract EGB 761. Biochemical Pharmacology, 49, 1649–1655.

  27. Marcocci, L., Maguire, J. J., Droy-Lefaix, M. T., & Paker, L. (1994). The nitric oxide-scavenging properties of ginkgo biloba extract Egb 761. Biochemical and Biophysical Research Communications, 201, 748–755.

  28. Marks, L. S., Duda, C., Dorey, F. J., Macairan, M. L., & Santos, P. B. (1999). Treatment of erectile dysfunction with Sildenafil. Urology, 53, 19–24.

  29. Meston, C. M. (2003). Validation of the Female Sexual Function Index (FSFI) in women with female orgasmic disorder and in women with hypoactive sexual desire disorder. Journal of Sex & Marital Therapy, 29, 39–46.

  30. Meston, C. M., & Gorzalka, B. B. (1992). Psychoactive drugs and human sexual behavior: The role of serotonergic activity. Journal of Psychoactive Drugs, 24, 1–40.

  31. Meston, C. M., & Heiman, J. R. (1998). Ephedrine-activated physiological sexual arousal in women. Archives of General Psychiatry, 55, 652–656.

  32. Meston, C. M., Rellini, A. H., & McCall, K. M. (2005, October). The sensitivity of continuous laboratory measures of physiological and subjective sexual arousal for diagnosing women’s sexual dysfunction. Poster presentation to the annual meeting of the International Society for the Study of Women’s Sexual Health, Las Vegas, NV.

  33. Meston, C. M., & Trapnell, P. D. (2005). Development and validation of a five factor` sexual satisfaction and distress scale: The Sexual Satisfaction Scale for Women (SSS-W). Journal of Sexual Medicine, 2, 66–81.

  34. Montorsi, F., McDermott, T. E., Morgan, R., Olsson, A., Schultz, A., Kirkeby, H. J., et al. (1999). Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies. Urology, 53, 1011–1018.

  35. Paick, J. S., & Lee, J. H. (1996). An experimental study of the effect of ginkgo biloba extract on the human and rabbit corpus cavernosum tissue. Journal of Urology, 156, 1876–1880.

  36. Park, K., Goldstein, I., Andry, C., Siroky, M., Krane, R. J., & Azadzoi, K. (1997). Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency. International Journal of Impotence Research, 9, 27–37.

  37. Park, K., Moreland, R. B., Goldstein, I., Atala, A., & Traish, A. (1998). Sildenafil inhibits phosphodiesterase type 5 in human clitoral corpus cavernosum smooth muscle. Biochemical and Biophysical Research Communications, 249, 612–617.

  38. Porsolt, R. D., Martin, P., Lenegere, A., Fromage, S., & Drieu, K. (1990). Effects of an extract of ginkgo biloba (GBE 761) on “learned helplessness” and other models of stress in rodents. Pharmacology, Biochemistry and Behavior, 36, 963–971.

  39. Prause, N., & Janssen, E. (2005). Blood flow: Vaginal photoplethysmography. In I. Goldstein, C. M. Meston, S. R. Davis, & A. M. Traish (Eds.), Women’s sexual function and dysfunction: Study, diagnosis, and treatment (pp. 368–382). London: Taylor & Francis.

  40. Rapin, J. R., Lamproglou, I., Drieu, K., & DeFeudis, F. V. (1994). Demonstration of the “anti-stress” activity of an extract of ginkgo biloba (GBE 761) using a discrimination learning task. General Pharmacology, 25, 1009–1016.

  41. Rellini, A. H., McCall, K. M., Randall, P. K., & Meston, C. M. (2005). The relationship between self-reported and physiological measures of female sexual arousal. Psychophysiology, 42, 116–124.

  42. Rellini, A. H., & Meston, C. M. (2006). The sensitivity of events logs, self-administered questionnaires and photoplethysmography to detect treatment-induced changes in female sexual arousal disorder (FSAD) diagnosis. Journal of Sexual Medicine, 3, 283–291.

  43. Rosen, R., D’Agostino, R., Brown, C., Heiman, J., Leiblum, S., Meston, C. M., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26, 191–208.

  44. Rosen, R., Lane, R., & Menza, M. (1999). Effects of SSRIs on sexual function: A critical review. Journal of Clinical Pharmacology, 19, 67–85.

  45. Sintchak, G., & Geer, J. H. (1975). A vaginal plethysmograph system. Psychophysiology, 12, 113–115.

  46. Smith, P. F., Maclennan, K., & Darlington, C. L. (1996). The neuroprotective properties of the ginkgo biloba leaf: A review of the possible relationship to platelet-activating factor (PAF). Journal of Ethnopharmacology, 50, 131–139.

  47. Stimmel, G. L., Dopheide, J. A., & Stahl, S. M. (1997). Mirtazapine: An antidepressant with noradrenergic and specific serotonergic effects. Pharmacotherapy, 17, 10–21.

  48. Straus, J., & von Ammon, C. (1996). Placebo effects: Issues for clinical practice in psychiatry and medicine. Psychosomatics, 37, 315–326.

  49. Toesca, A., Stolfi, V. M., & Cocchia, D. (1996). Immunohistochemical study of the corpora cavernosa of the human clitoris. Journal of Anatomy, 188, 513–520.

  50. Tyler, V. E. (1993). Ginkgo. In V. E. Tyler (Ed.), The honest herbal (pp. 149–151). New York: Pharmaceutical Products Press.

  51. van Beek, T. A., van Scheeren, H. A., Rantio, T., Melger, W. Ch., & Lelyveld, G. P. (1991). Determination of ginkgolides and bilobalide in ginkgo biloba leaves and phytopharmaceuticals. Journal of Chromatography, 543, 375–387.

  52. Wiegel, M., Meston, C. M., & Rosen, R. C. (2005). The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex and Marital Therapy, 31, 1–20.

  53. Wiegel, M., Scepkowski, L. A., & Barlow, D. H. (2006). Cognitive and affective processes in female sexual dysfunction. In I. Goldstein, C. M. Meston, S. R. Davis, & A. M. Traish (Eds.), Women’s sexual function and dysfunction: Study, diagnosis, and treatment (pp. 85–92). London: Taylor & Francis.

Download references


This publication was made possible by Grant Number 5 RO1 AT00224-02 from the National Center for Complementary and Alternative Medicine to Cindy Meston. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Complementary and Alternative Medicine. The authors wish to thank Jessica Davis for her assistance in all phases of this investigation.

Author information

Correspondence to Cindy M. Meston.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Meston, C.M., Rellini, A.H. & Telch, M.J. Short- and Long-term Effects of Ginkgo Biloba Extract on Sexual Dysfunction in Women. Arch Sex Behav 37, 530–547 (2008) doi:10.1007/s10508-008-9316-2

Download citation


  • Ginkgo biloba
  • Female sexual dysfunction
  • Sex therapy
  • Vaginal photoplethysmography