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Epimedium is a genus of flowering plants commonly known as "horny goat weed" and used in traditional Chinese medicine. The primary bioactive compound is icariin. It has been traditionally used for conditions such as erectile dysfunction (ED), sexual dysfunction, osteoporosis (especially postmenopausal), fatigue, and menopausal symptoms[1][2][3][4][5][6]. Icariin is thought to act as a mild phosphodiesterase-5 inhibitor (similar to sildenafil/Viagra) and may promote estrogen biosynthesis by enhancing aromatase expression[3][6]. Other purported mechanisms include anti-inflammatory effects and modulation of various signaling pathways involved in cell cycle regulation and apoptosis[3]. Despite widespread use in supplements marketed for sexual health and bone health support[7], robust clinical evidence supporting these uses in humans remains limited.
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