Evidence Level
Moderate
Maca has a moderate evidence base, primarily from research by Gonzales and colleagues at Universidad Peruana Cayetano Heredia. The most robust finding is for libido enhancement — Shin et al. (2010) conducted a systematic review of 4 RCTs and found sufficient evidence for sexual desire improvement. For fertility, the evidence is promising but limited to small studies. A 2016 BMC Complementary and Alternative Medicine review concluded maca has potential for menopausal symptoms but called for larger, more rigorous trials. Notably, maca does not appear to alter testosterone, estrogen, or other hormone levels directly, suggesting its effects may be mediated through other mechanisms (possibly macamides acting on the endocannabinoid system).