Epimedium Benefits: Evidence, Safety and Cautions

Quick answer

Epimedium benefits, in short: Epimedium, also called horny goat weed, is a herb used in traditional Chinese medicine and sold as an extract, often for sexual health and bone strength. The human evidence is thin. A meta-analysis of 10 small Chinese trials in people with osteoporosis found better bone density scores [1], and a 6-week trial in 58 healthy postmenopausal women found it safe on blood tests [2]. For sexual function, the evidence is mostly lab-based [3]. Liver safety is unclear: one database reports no liver injury from oral horny goat weed [4], but lab and animal studies suggest some extracts can harm the liver [5][6]. We rate the evidence D: small, short human trials only.

What is epimedium?

Epimedium is a genus of plants (several species, including E. sagittatum, E. brevicornum and E. koreanum) whose leaves are used as a “kidney tonic” in traditional Chinese medicine [6]. The main active compounds are flavonoids, including one called icariin. Species differ in their composition and toxicity, and products vary in which one they use [7].

Epimedium benefits: what might it help with?

Possible benefit	Rating	In plain words
Bone density in osteoporosis	Early	10 small trials, used alongside or instead of standard drugs. Long-term effects are uncertain [1]
Bone markers in healthy postmenopausal women	Early	One 6-week trial in 58 women, mainly a safety study [2]
Sexual function	Early	Mostly lab and mechanism research, with no solid human trials we could verify [3]

Ratings describe how good the research is, not a promise that it will work for you.

What the research says

• Osteoporosis (10 trials, 890 people). Epimedium, alone or alongside standard drugs, was linked to higher bone mineral density in the spine, hip and wrist, and to a shorter time to back-pain relief. Adverse reactions were low, mostly mild digestive problems or skin allergies. The authors said more high-quality, long-term studies are needed [1]. PubMed · DOI
• Safety trial in postmenopausal women (58 people). A purified extract (740 mg a day) for 6 weeks caused no significant side effects and no changes in liver, blood or kidney tests. A bone-building marker (bone-specific alkaline phosphatase) was higher, but the study was small and short [2]. PubMed · DOI
• Sexual function. A narrative review says icariin acts on enzymes and pathways involved in erections in cell and animal studies and could be a potential treatment, but it called for more clinical research [3]. PubMed · DOI
• Liver, a database report. LiverTox, a US database on drug-related liver injury, says oral horny goat weed has not been linked to raised liver enzymes or to clinically apparent liver injury [4]. PubMed
• Liver, lab and animal findings. In rats, 28 days of an ethanol extract of E. koreanum raised liver enzymes and damaged liver tissue [5]. A review of this species says crude extracts show potential liver toxicity [6]. A Chinese review noted an increasing number of adverse-reaction reports for the leaf and for patent medicines containing it, and listed liver toxicity among the concerns [7]. PubMed · DOI

The key limits: the human trials are small, short and mostly in people with osteoporosis, so they say little about healthy adults or long-term use. The liver evidence points both ways, and most of the warning signs come from animals.

Amounts and how people take it

These are amounts used in studies, not recommendations.

• Study amount: 740 mg a day of a purified prenylflavonoid extract for 6 weeks in postmenopausal women [2].
• Other forms: the osteoporosis trials mostly used traditional preparations such as capsules, tablets or decoctions, in a variety of doses. We didn’t find one agreed dose [1].
• Type matters: species and extracts differ in composition and toxicity [7], so results from one product may not apply to another.

Side effects, interactions and who should check first

Reported side effects in the osteoporosis trials were mild, mainly digestive problems and skin allergies [1], and the liver is the main open question (see above) [4][5][6][7]. Separately, the US Food and Drug Administration (FDA) warns that many “male enhancement” and sexual-health supplements are likely to be contaminated with hidden drug ingredients that can cause serious health problems and hospital admission, and epimedium is marketed for sexual enhancement, so buy with care [8].

Who should check with a doctor or pharmacist first

Check with a doctor or pharmacist first if you:

• have liver disease, or have ever had abnormal liver tests [4][5][6]
• take any regular medicine, as we found no verified interaction data
• are considering it for erectile problems. Speak to a doctor rather than relying on a supplement [8]
• are pregnant or breastfeeding, as we found no verified safety data
• are under 18

Where can I buy it?

Availability varies by country; not authorized for sale in the UK or EU yet [9][10][11]. We don’t link to any epimedium products.

FAQ

What is epimedium?

Epimedium, also called horny goat weed, is a herb used in traditional Chinese medicine, where the leaves are used as a “kidney tonic” [6]. It is sold as an extract, often for sexual health and bone strength. The main active compounds are flavonoids, including icariin, and species and products differ in composition and toxicity [7].

Does epimedium work?

The human evidence is thin. A meta-analysis of 10 small Chinese trials in people with osteoporosis found better bone density scores [1], and a 6-week trial in 58 healthy postmenopausal women was mainly a safety study [2]. For sexual function the evidence is mostly lab-based [3]. We rate the evidence D.

How much epimedium per day?

There is no agreed dose. A 6-week trial in postmenopausal women used 740 mg a day of a purified prenylflavonoid extract [2], while the osteoporosis trials mostly used traditional preparations in varied doses [1]. Species and extracts differ [7], so one product’s results may not apply to another. These are study amounts, not recommendations.

Is epimedium safe?

It is unclear. LiverTox reports no liver injury from oral horny goat weed [4], but animal and review sources flag possible liver toxicity from crude extracts [5][6]. The FDA also warns that many sexual-health supplements are likely to contain hidden drug ingredients [8]. Ask a doctor or pharmacist first, especially with liver disease or regular medicines.

Does epimedium affect sleep?

We found no human study of epimedium and sleep, so we can’t say. The trials we found measured bone density and bone markers [1][2], and the research on sexual function is mostly lab-based [3]. If you take any regular medicine or have a long-term condition, ask a doctor or pharmacist before trying it.

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Talk to your doctor

This page is for general information and is not medical advice. Speak to a doctor or pharmacist before starting any supplement, especially if you are pregnant or breastfeeding, take any medicine, or have a health condition.

References

We cite only studies and official pages we checked against PubMed, the publisher or the agency’s own site. The A to E evidence grades are explained in our editorial policy. See also our medical disclaimer and affiliate disclosure.

1. Zhang XQ, Hua ZH, Huang CJ, et al. The efficacy and safety of Epimedium in the treatment of primary osteoporosis: a systematic review and meta-analysis. Front Med (Lausanne). 2025. PubMed · DOI
2. Yong EL, Cheong WF, Huang Z, et al. Randomized, double-blind, placebo-controlled trial to examine the safety, pharmacokinetics and effects of Epimedium prenylflavonoids, on bone specific alkaline phosphatase and the osteoclast adaptor protein TRAF6 in post-menopausal women. Phytomedicine. 2021. PubMed · DOI
3. Niu Y, Lin G, Pan J, et al. Deciphering the myth of icariin and synthetic derivatives in improving erectile function from a molecular biology perspective: a narrative review. Transl Androl Urol. 2022. PubMed · DOI
4. National Institute of Diabetes and Digestive and Kidney Diseases. Horny Goat Weed. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury (NCBI Bookshelf). Bethesda (MD): NIDDK. 2012. PubMed record
5. Li P, Zhang L, Guo Z, et al. Epimedium koreanum Nakai-Induced Liver Injury-A Mechanistic Study Using Untargeted Metabolomics. Front Pharmacol. 2022. PubMed · DOI
6. Qian HQ, Wu DC, Li CY, et al. A systematic review of traditional uses, phytochemistry, pharmacology and toxicity of Epimedium koreanum Nakai. J Ethnopharmacol. 2024. PubMed · DOI
7. Wang D, Jia DX, Li ZZ, et al. [Discussion on safety evaluation and risk control measures of Epimedii Folium]. Zhongguo Zhong Yao Za Zhi. 2019. PubMed · DOI
8. U.S. Food and Drug Administration. Sexual Enhancement and Energy Product Notifications. FDA
9. European Commission. Application for consultation to determine the status of a novel food: extract from Epimedium brevicornum Maxim leaves (outcome: a novel food requiring prior authorisation under Regulation (EU) 2015/2283). European Commission
10. European Commission. Decisions terminating the procedure (novel food authorisation procedures for Epimedium sagittatum ended on 20 October 2022 and 27 March 2026, without updating the Union list). European Commission
11. Food Standards Agency. Authorised Regulated Food and Feed Products for Great Britain: novel food authorisations register (no epimedium entry found when checked on 1 November 2026). FSA register