In Asia, E. longifolia is a well-known aphrodisiac and malaria remedy. People tend to use the roots, bark, and fruits of the flowering plant to make remedies.

According to a 2016 reviewTrusted Source, in traditional medicine, people use E. longifolia to relieve the following conditions:

• sexual dysfunction
• malaria
• high blood pressure
• anxiety
• intestinal worms
• diarrhea
• aging
• itching
• dysentery
• constipation
• exercise recovery
• fever
• diabetes
• cancer
• jaundice
• lumbago
• indigestion
• leukemia
• aches and pains
• syphilis
• osteoporosis

The same review concluded that E. longifolia is a promising herbal remedy for some conditions. However, there is insufficient evidence regarding its safety and efficacy.

People also use the plant roots to stimulate appetite and increase strength and energy. Others use them as an antibiotic.

Traditionally, people drank a water decoction of the plant. Nowadays, though, there are many E. longifolia products available, including powders and capsules.

The plant contains many bioactive compounds, including alkaloids and steroids. Quassinoids are the major active compound in the roots.

Herbalists regard the plant as an adaptogen. An adaptogen is an herb that helps the body adapt to different kinds of stress, including physical, chemical, and biological stress.

Benefits

Tongkat ali may have health benefits for certain conditions. The following sections will look at some of these conditions in more detail.

Male fertility and sexual performance

Some research indicates that E. longifolia may enhance male fertility and sexual performance.

According to a 2016 reviewTrusted Source, animal and human studies suggest that the beneficial effects may include:

• increased semen volumes, sperm count, sperm viability, and sperm motility
• increased production of testosterone
• enhanced erectile function and sexual performance

A 2019 studyTrusted Source in rats suggested that the aphrodisiac effects of E. longifolia may be due to the elevation of testosterone levels and enhancement of dopamine in the brain.

Ergogenic aid

Athletes sometimes use ergogenic aids to enhance their performance. E. longifolia may act as an ergogenic aid because it decreases stress and increases testosterone levels, according to one 2016 reviewTrusted Source.

The researchers concluded that with high dosages and long-term supplementation, E. longifolia might have some benefit in relation to endurance performance.

A 2014 pilot studyTrusted Source in physically active people aged 57–72 years reported enhanced muscle strength and increases in testosterone following supplementation with E. longifolia extract for 5 weeks.

Bone health

A 2018 reviewTrusted Source examined the evidence for E. longifolia on osteoporosis in rats. It concluded that E. longifolia seemed less effective than other traditional Malaysian herbs.

However, there could still be potential for its use in preventing bone loss, according to the review.

Stress

A study in the Journal of the International Society of Sports NutritionTrusted Source assessed stress hormones in 63 people taking tongkat ali extract or a placebo for 4 weeks.

The researchers saw significant improvements in anger, tension, and confusion in people taking the extract. Testosterone levels increased, and levels of the stress hormone cortisol decreased.

They concluded that tongkat ali might be an effective remedy for modern-day chronic stress, sleep deprivation, and exercise training.

Another study from 2018Trusted Source looked at the combined effects of E. longifolia and multivitamins in moderately stressed but otherwise healthy participants. The participants reported enhanced vigor and emotional well-being. Glucose concentrations also decreased, which may also have contributed to the participants’ well-being.

Cancer

ScientistsTrusted Source are discovering and identifying new quassinoids in E. longifolia that may help fight cancer. Laboratory studiesTrusted Source in test tubes indicate that the compounds are toxic to lung and cervical cancer cells.

A review from 2018Trusted Source identified 16 compounds in E. longifolia, isolated from various parts of the plant, that showed promising anticancer properties.

Another laboratory studyTrusted Source indicated that quassinoids from E. longifolia were effective against human prostate cancer cells. However, the Endocrine SocietyTrusted Source contraindicate testosterone treatment in prostate cancer, so using the plant for this condition is not advisable.

Anti-inflammatory and antimicrobial effects

Some researchTrusted Source indicates that E. longifolia is effective against bacteria, including Escherichia coli and Salmonella typhi.

In test tube studies, extracts of the plant showed anti-inflammatory and antioxidant properties.

Risks and side effects

A 2016 reviewTrusted Source on the safety and toxicity of E. longifolia reported that it does not seem to have detrimental effects on sperm in test tubes when the scientists used it in therapeutic doses. However, animal studies show that in higher concentrations, it may be toxic.

The same review concluded that scientists consider E. longifolia safe as long as people do not take it in high doses. The authors recommend taking 200–400 milligramsTrusted Source daily with caution, especially if the person is an older adult.

People who have hormonal cancers should be cautious of taking E. longifolia, as it may increase testosterone levels. Although laboratory studies have indicated beneficial effects, these effects may not be the same in the human body.

People taking medications to lower their blood glucose should speak to their doctor before taking E. longifolia, as it may increase the effects of these medications.

According to the review, some sources advise people with certain conditions to avoid E. longifolia. These conditions include cancer, heart disease, and kidney disease. People with weakened immune systems should also be cautious.