Tongkat Ali: Testosterone, Stress and Sexual Health (2026 Evidence Review)

Key Takeaways

Tongkat ali is one of only a few herbal supplements with meta-analysis evidence for increasing testosterone, specifically in hypogonadal men. It also improved erectile function scores in men with mild ED, lowered cortisol in stressed adults, and increased sperm motility in one trial. Trials used 100 to 300 mg a day of standardized hot-water extract, mostly Physta, for periods from one month to six months (Tambi et al., 2012; Chinnappan et al., 2021; Leitão et al., 2021). The main limitation: many studies included authors from the extract's manufacturer, and independent replication is thin. It does not replace testosterone replacement therapy for clinical hypogonadism.

What is tongkat ali?

Tongkat ali is a Southeast Asian shrub whose root has been used in traditional Malaysian and Indonesian medicine for centuries. The scientific name is Eurycoma longifolia. Its main bioactive compounds are quassinoids, particularly eurycomanone, which is used to standardize most commercial extracts (Farag et al., 2023).

Most clinical trials tested a patented hot-water root extract called Physta, standardized to eurycomanone content, at doses of 100 to 300 mg per day. Results from Physta trials may not apply to products made with different extraction methods or standardization.

Does tongkat ali increase testosterone?

In men with low testosterone, probably yes. The 2022 meta-analysis pooled five RCTs and found a significant increase in total testosterone (SMD 1.35, p = 0.001), with the effect confirmed in the hypogonadism subgroup (Leisegang et al., 2022). In the Tambi trial, 76 men with late-onset hypogonadism took 200 mg of standardized extract for one month. Before treatment, 35.5% had normal testosterone; afterward, 90.8% did (Tambi et al., 2012).

A separate 12-week RCT tested 100 mg and 200 mg doses in men with low testosterone. The 200 mg dose significantly raised total testosterone from week 4 onward compared with placebo (Chinnappan et al., 2021). DHEA also rose, and cortisol fell.

The picture is different in men who already have normal levels. The 2024 systematic review of testosterone boosters classified tongkat ali as "possibly effective" for men with late-onset hypogonadism and for healthy men, but not for athletes (Morgado et al., 2024). Shilajit and ashwagandha received the same "possibly effective" rating in other subgroups.

The Chinnappan trial also tracked how men felt. Scores on the Aging Males' Symptoms scale and the Fatigue Severity Scale fell more with both doses of Physta than with placebo at every time point, and handgrip strength rose within both supplement groups by week 12 (Chinnappan et al., 2021). Free testosterone rose within each supplement group but did not differ significantly from placebo, a reminder that the hormone story is clearer for total testosterone than for the free fraction.

How does tongkat ali work?

The mechanism is not settled. In the Chinnappan trial, 200 mg a day raised total testosterone above placebo, DHEA rose within the treated groups, and cortisol fell (Chinnappan et al., 2021). That pattern points to effects on both the reproductive and the stress-hormone systems. The Tambi trial measured testosterone and symptom scores but not upstream hormones, so it cannot show where in the hormonal chain the extract acts (Tambi et al., 2012).

Cortisol may be part of the picture. In the Talbott stress trial, cortisol exposure fell 16% while testosterone status rose 37% (Talbott et al., 2013). No trial has tested whether the cortisol drop causes the testosterone rise, and the participants were selected for being stressed, which may be why the effect was so clear.

A 2023 review groups the root's bioactives into quassinoids, canthin-6-one alkaloids, tirucallane triterpenes, squalene derivatives and steroids, with quassinoids, chiefly eurycomanone, making up a large share (Farag et al., 2023). The concentration of these compounds varies significantly with extraction method, plant age and geographic origin, which is why standardized extracts produce more consistent results than raw root powder.

What are the proven benefits of tongkat ali?

Beyond testosterone, the best-supported effects are cortisol reduction under stress, modest improvement in erectile function in men with mild ED, and improved sperm motility. Each comes from a small number of trials.

Stress and cortisol

Talbott and colleagues gave 200 mg of tongkat ali or placebo to 63 moderately stressed adults for four weeks. The supplement group saw cortisol drop 16% and testosterone rise 37%. Mood scores for tension, anger and confusion also improved (Talbott et al., 2013). This is a single trial, and the participants were selected for being stressed, so the results may not generalize to people with normal stress levels.

Erectile function

A meta-analysis of two RCTs found no significant overall difference in erectile function scores, but a subgroup of men with lower baseline scores did improve (Kotirum et al., 2015). A six-month trial combining tongkat ali with exercise found that the combination improved erectile function and testosterone in men with androgen deficiency of the aging male (Leitão et al., 2021). The study was small, with 45 men split across four groups.

Sperm quality

A 12-week RCT in 109 men found that 300 mg of Physta improved erectile function scores, and at the end of treatment sperm motility was up 44.4% and semen volume 18.2% (Ismail et al., 2012). Erectile function and libido scores also improved. The study included an author from the extract's manufacturer.

Mood and quality of life

A trial of tongkat ali plus a multivitamin in adults aged 25 to 65 found within-group improvements in quality of life, vitality and social functioning, but no significant between-group differences for most measures (George et al., 2018). The supplement seems to improve how people feel, but isolating the tongkat ali effect from the multivitamin and from placebo response is hard with this design.

Who benefits most from tongkat ali?

Men with late-onset hypogonadism (clinically low testosterone associated with aging symptoms) have the strongest evidence. The Tambi trial moved 90.8% of LOH patients into the normal testosterone range (Tambi et al., 2012). Men under chronic stress are the next best-supported group (Talbott et al., 2013).

Healthy young men with normal testosterone levels are the least likely to see a noticeable difference. The 2024 systematic review classified tongkat ali as "possibly effective" for healthy men and for hypogonadal men, but not for athletes (Morgado et al., 2024).

The fertility data adds another group: men trying to conceive. The Ismail trial found improved sperm motility and volume (Ismail et al., 2012), though the study was manufacturer-funded and has not been independently replicated.

Does tongkat ali help athletic performance?

The direct performance data is weak. The 2024 systematic review rated tongkat ali "possibly effective" for men with late-onset hypogonadism and for healthy men, but did not list it among the options with evidence in male athletes (Morgado et al., 2024). A 6-month, four-arm trial in 45 men with age-related androgen deficiency found the largest gains in erectile function and testosterone when 200 mg of tongkat ali was combined with exercise training (Leitão et al., 2021).

Tongkat ali is marketed heavily to gym-goers and bodybuilders, but the evidence does not support its use as a sports performance supplement. Testosterone levels in healthy young athletes are already near their physiological ceiling. A modest natural increase, even if it occurs, does not translate into the kind of anabolic drive that changes body composition or strength. For evidence-based sports supplements, creatine monohydrate has a vastly deeper data set.

Where tongkat ali might indirectly help athletes is stress management. Hard training elevates cortisol, and the Talbott trial found a 16% cortisol reduction (Talbott et al., 2013). Lower cortisol could improve recovery and sleep quality, both of which support training adaptation. But that is two inferential leaps away from the data, not a direct performance finding.

Does tongkat ali help strength or muscle recovery?

The results are mixed. In a small pilot study of physically active older adults, 400 mg a day for five weeks raised total and free testosterone and grip strength in both men and women (Henkel et al., 2014). In trained young rugby players, a week of supplementation before hard eccentric exercise did nothing for hormones, performance or muscle damage (Zakaria et al., 2023).

The pilot study also found that the rise in free testosterone in women went along with a fall in sex hormone-binding globulin, the protein that carries testosterone in the blood (Henkel et al., 2014). It was a small study, which limits how far the results can be pushed.

An 8-week trial combined 200 mg a day with resistance training. Training improved lower-limb isokinetic power with or without tongkat ali. Peak power output rose in the group that took tongkat ali alongside training, while relative anaerobic power rose with training alone, and the urinary testosterone-to-epitestosterone ratio did not change (Chen et al., 2019).

Taken together, tongkat ali may help older adults or people with lower baseline testosterone more than it helps young athletes who already train hard. That fits the hormone data, but it has not been tested head to head.

Can tongkat ali help with male infertility?

The evidence is weak but suggestive. In an uncontrolled study, 350 men from couples with unexplained infertility took 200 mg a day; among the 75 who completed a full 3-month cycle, all semen parameters improved, and 11 couples (14.7%) conceived naturally (Tambi et al., 2010).

Without a placebo group, there is no way to know how many of those pregnancies would have happened anyway, and most participants did not complete the first cycle. The randomized Ismail trial adds some support, with better sperm motility and semen volume at the end of 12 weeks (Ismail et al., 2012). Couples dealing with infertility should treat tongkat ali as a possible add-on to medical evaluation, not a replacement for it.

Does tongkat ali affect immune function?

One trial suggests a modest effect. In middle-aged Japanese adults with lower immune scores, 200 mg a day of Physta for four weeks raised an overall immune-vigor score and the counts of total, naive and CD4+ T cells compared with placebo, with no serious adverse events (George et al., 2016).

This is a single four-week study of blood markers. It did not measure infections or illness, so it says nothing yet about whether tongkat ali helps people stay well.

Does tongkat ali work for women?

Evidence is limited to one trial. In perimenopausal and postmenopausal women, Physta 100 mg reduced total menopause quality-of-life (MENQOL) scores by 33.9% over 12 weeks, with improvements in the physical and sexual domains and no significant changes in reproductive hormones (Muniandy et al., 2025). The protocol was published in 2023, and two of its authors are employees of Biotropics, the extract's manufacturer (Muniandy et al., 2023).

Tongkat ali vs shilajit vs ashwagandha

All three are classified as "possibly effective" for testosterone in the Morgado 2024 systematic review, but in different populations: tongkat ali in hypogonadal and healthy men, ashwagandha in healthy men, and purified shilajit (PrimaVie) in men with late-onset hypogonadism (Morgado et al., 2024). None is a proven alternative to testosterone replacement therapy.

Our tongkat ali vs shilajit comparison and tongkat ali vs fadogia vs ashwagandha comparison go deeper into the head-to-head evidence. In brief, tongkat ali has the most testosterone-specific trial data of the three.

What to stack tongkat ali with (and what not to)

Ashwagandha is the most common pairing. The 2024 systematic review classified both as "possibly effective" for testosterone in different populations (Morgado et al., 2024). No trial has tested the combination.

Shilajit is another traditional pairing. Purified shilajit (PrimaVie) was rated "possibly effective" for testosterone in men with late-onset hypogonadism in the same review. Our tongkat ali vs shilajit comparison covers the evidence for each and when the combination adds value.

Fadogia agrestis is often stacked with tongkat ali in social media protocols. Our three-way comparison covers why the fadogia evidence is much thinner than tongkat ali's.

If you are already on TRT, do not add tongkat ali without talking to the doctor managing your treatment. No trial has tested the combination.

D-aspartic acid and tribulus terrestris are other common "test booster" ingredients. The Morgado review found that most proposed boosters, these two included, did not raise total testosterone (Morgado et al., 2024). Stacking tongkat ali with ingredients that lack evidence adds cost without adding benefit.

How much tongkat ali should you take?

Most positive trials used 200 mg of standardized hot-water extract (Physta, standardized to eurycomanone) per day. The Chinnappan trial tested 100 mg and 200 mg and found the higher dose more effective (Chinnappan et al., 2021). One fertility trial used 300 mg (Ismail et al., 2012). There is no evidence that doses above 400 mg provide additional benefit.

Timing has not been formally studied. Total testosterone rose above placebo from week 4 in the Chinnappan trial, while the stress and mood changes in the Talbott trial were measured at four weeks. Give it at least 4 to 8 weeks before evaluating.

How do you know if tongkat ali is working?

Begin with 200 mg per day of a standardized hot-water extract with a stated eurycomanone content. In the Chinnappan trial, this dose raised total testosterone above placebo from week 4 onward (Chinnappan et al., 2021). Taking it with breakfast is a simple routine, though timing has not been studied.

Some users cycle tongkat ali on and off. No study has tested whether cycling is beneficial or necessary. The clinical trials used continuous daily dosing for 4 to 24 weeks. If you choose to cycle for cautionary reasons, there is no evidence against it, but also no evidence for it.

Monitor your response. If you are taking tongkat ali for low testosterone symptoms, get a baseline total testosterone test before starting and retest at 8 to 12 weeks. If the numbers have not moved meaningfully, the supplement is probably not working for you. Subjective improvements in mood, energy or libido without a testosterone change could still reflect the cortisol-lowering effect.

Stacking with ashwagandha is common. The proposed mechanisms differ: tongkat ali's best-documented effects are on testosterone, while ashwagandha is studied mainly for the stress response. Our three-way comparison covers when the combination makes sense and when it is redundant.

How to tell a good tongkat ali product from a bad one

Standardization and testing are the two things that matter. The clinical trials used Physta, a patented hot-water extract standardized to eurycomanone content. A product that does not state its eurycomanone content on the label cannot be compared with trial results.

Product quality is the practical problem. Results from Physta trials cannot be assumed for extracts made differently, and a product that does not state its eurycomanone content cannot be compared with the trial material at all. The Natural Standard review compiled the safety and efficacy data available up to 2013 using a graded approach (Ulbricht et al., 2013), and the evidence has grown since, mainly through Physta trials.

Practical checks: look for a standardized hot-water extract, a stated eurycomanone content and a third-party certificate of analysis. Avoid products that combine tongkat ali with a dozen other ingredients at undisclosed doses. The trials tested tongkat ali alone or with a multivitamin, not in proprietary blends.

Is tongkat ali safe?

In the 12-week Chinnappan trial, no clinically relevant safety changes were observed (Chinnappan et al., 2021), and in the Ismail trial all safety parameters were comparable to placebo (Ismail et al., 2012). A menopausal trial in women also reported no adverse effects (Muniandy et al., 2025).

The main caution is product quality. Trial results come almost entirely from standardized hot-water extracts, mostly Physta (Chinnappan et al., 2021; Ismail et al., 2012), and cannot be assumed for other products. Stick with brands that publish third-party test results and state the eurycomanone content of the extract.

Women considering tongkat ali should know that most trials enrolled only men. One completed trial in perimenopausal and postmenopausal women reported benefits without hormonal changes (Muniandy et al., 2025). Pregnant and breastfeeding women should avoid it.

What happens when you stop taking tongkat ali?

No study has measured what happens to testosterone levels after discontinuation. The Tambi trial ran for one month and did not include a washout period (Tambi et al., 2012). The Chinnappan trial ran for 12 weeks with no follow-up (Chinnappan et al., 2021). That gap matters.

Whether levels hold, fall back to baseline or dip below it after stopping is simply unknown. Anyone stopping after a long course should recheck testosterone rather than assume.

If you are weighing tongkat ali against testosterone replacement therapy (TRT) for late-onset hypogonadism, that gap matters. TRT is usually a long-term treatment with its own monitoring. Whether a supplement course offers a meaningful alternative is a question for an endocrinologist, not something the current trials can answer.

When tongkat ali is not enough

Tongkat ali is not a substitute for testosterone replacement therapy (TRT). The trials enrolled men with mildly to moderately low levels; the Chinnappan trial, for example, took men aged 50 to 70 with total testosterone below 300 ng/dL (Chinnappan et al., 2021). Men with very low levels on repeat testing, severe symptoms, or suspected pituitary or testicular problems need an endocrinologist, not a supplement.

If your levels are borderline and your symptoms mild, a supplement trial alongside medical follow-up is reasonable. If your levels are clearly low or your symptoms include depression, erectile failure or significant muscle loss, medical evaluation comes first. Tongkat ali can sit inside a plan a doctor oversees, but it should not delay diagnosis of a treatable condition.

Symptoms often blamed on low testosterone, such as fatigue and low libido, have many other possible causes, which is why testing comes first. Attributing them to testosterone and self-treating with tongkat ali when the real cause is something else wastes time and can delay effective treatment.

How independent is the tongkat ali evidence?

Most tongkat ali clinical trials were funded by Biotropics Malaysia Berhad, the company that manufactures and sells the Physta extract. This does not automatically invalidate the results, but it does mean the evidence base lacks the independent replication that would make it definitive.

The Talbott cortisol trial, the Chinnappan dose-response trial, the Ismail fertility trial, and the George quality-of-life trial all declared Biotropics funding or author affiliations (Talbott et al., 2013; Chinnappan et al., 2021; Ismail et al., 2012; George et al., 2018). The Leisegang meta-analysis pooled these trials and acknowledged the limitation (Leisegang et al., 2022). Until an independent group runs a well-powered trial with the same extract, treat the positive results as promising, not settled.

A disclosure: YourHealthier sells Shilajit Adaptogen Complex, which contains 100 mg of a 300:1 tongkat ali extract alongside shilajit, ashwagandha and sea moss. The trials in this article used different extracts and doses, most often 200 mg of Physta, so their results cannot be read as results for our product, and nothing here is a claim about it.

Frequently Asked Questions

References

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