Maca

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Maca

Common Names

  • Maca-maca
  • Maino
  • Ayak chichira
  • Ayak willku

For Patients & Caregivers

How It Works

Maca may increase sexual function, but more studies are needed.

Maca is an herbaceous plant related to the cabbage family and is a nutritional staple in Peru. It is used in traditional medicine to improve stamina and sexual functioning. Lab experiments suggest various properties and benefits, but only a few studies have been conducted in humans. Some of these studies suggest possible benefit to improve sexual dysfunction or menopausal symptoms, but more studies are needed to determine safety and effectiveness.

Maca may affect blood hormone levels, so patients should discuss any use of this supplement with their physician.

Purported Uses
  • To treat infertility
    No clinical trials support this use.
  • To improve sexual function
    Evidence is limited and mixed for both men and women. Larger trials are needed to determine safety and efficacy.
  • To improve strength and stamina
    Evidence is limited and more study is needed.
Do Not Take If

You have a hormone-sensitive cancer: Although it is unclear the extent to which maca may affect blood hormone levels, patients should discuss any use of this supplement with their physician.

Side Effects

Unverified possible reactions include: altered menstrual cycles, moodiness, cramps, gastritis and insomnia

Case report

  • Prolonged bleeding and high testosterone levels: In a woman in her thirties who took 1 tsp daily of maca powder to improve energy and libido. Bleeding began within a few weeks of this regimen and improved after she stopped taking maca. High testosterone levels also returned to normal 1 month after she stopped taking maca.
Special Point

Maca may interfere with lab tests that measure testosterone levels.

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For Healthcare Professionals

Scientific Name
Lepidium meyenii, Lepidium peruvianum
Clinical Summary

Maca is a nutritionally valuable plant native to Peru that grows in harsh climates above 4,000 feet. It has been used traditionally to enhance fertility and sexual performance in both men and women and to relieve menopausal symptoms (1). In vitro, maca or its constituents have demonstrated antiviral (17), antioxidant (18), anti-inflammatory, analgesic, or neuroprotective (19) activities. Animal studies suggest maca may increase endurance (6), enhance sexual function (2) (5), and improve memory deficits (14). It also demonstrated antidepressant (20) and postmenopausal hormone-modulating (21) effects.

Only a few small trials have been conducted in humans. Maca consumption was associated with lower serum IL-6 levels and higher health status (22). In men, preliminary findings suggest supplementation may enhance subjective sexual well-being (11), but data are mixed on whether it can affect various parameters of semen quality (3) (4) (35). In women, several studies suggest maca improves both antidepressant- and menopause-induced sexual dysfunction (12) (24) (25) (26), although one small study showed neither hormonal nor immunological effects (27). In addition, systematic reviews have deemed evidence for improving sexual dysfunction (13) (28) (29) or menopausal symptoms (15) to be limited. Another review found maca is not an effective anti-aging agent (16).

A case report showed maca may interfere with testosterone immunoassays (30). Although it is unclear the extent to which maca may affect blood hormone levels, patients should discuss any use of this supplement with their physician.

Purported Uses
  • Infertility
  • Libido
  • Stamina
  • Menopause
Mechanism of Action

Maca contains glucosinolates, mostly benzylglucosinolate, along with hydroxy or methoxylated benzyl derivatives and tryptophan-derived compounds, and depending on the phenotype (red, yellow, purple or black) may be associated with different biological effects (31).

In vitro, both methanolic and aqueous extracts of maca exhibit estrogenic activity (10). A methanol maca extract demonstrated antiviral activity against Flu-A and Flu-B viruses (17). An isolated N‑alkylamide from maca root exerted cannabimimetic actions (32). Maca polysaccharides demonstrated radical scavenging activity (18). Macamides, normally not present in fresh plants but introduced during traditional drying practices (31), are fatty acid amide hydrolase inhibitors that modulate release of neurotransmitters (19). Antidepressant-like effects were associated with activation of both noradrenergic and dopaminergic systems and attenuation of oxidative stress (20).

In animal models, maca powder enhanced serum luteinizing hormone (LH) levels in female rats during the proestrus LH surge in a dose-dependent manner, suggesting it may enhance fertility (33). In postmenopausal models, maca modulates hormone levels particularly by decreasing follicle-stimulating hormone (FSH) levels (21).

In humans, although maca does not affect serum levels of LH, FSH, prolactin, testosterone, or estradiol in men (4) (9), it appears to modulate some hormone levels in women in some studies (24) (26) but not others (25) (27). Increased LH and decreased FSH that corresponded with improved sexual functioning in postmenopausal women are potentially attributed to a negative feedback loop, resulting in increased androgen production (24) (26). It may also exert androgenic effects at the testosterone receptor on target organs without affecting testosterone or gonadotrophin levels (24) (30). At the same time, the benefits of maca for antidepressant-induced sexual dysfunction in women may be more a function of advancing age rather than menopausal status, as there was no correlation with estrogen levels (24).

Adverse Reactions

Subjective reports of altered menstrual cycles, moodiness, cramps, gastritis, and insomnia (34). Flu-like symptoms and vomiting were reported in one study, but it is unclear if these were caused by maca (24).

Case report

Prolonged intermenstrual bleeding, elevated testosterone: In a woman in her thirties who ingested maca powder 1 tsp daily to improve energy levels and libido (30).

Herb Lab Interactions

Maca may interfere with testosterone immunoassays (30).

Dosage (OneMSK Only)
References
  1. Muhammad I, Zhao J, Dunbar DC, Khan IA. Constituents of Lepidium meyenii ’maca’. Phytochemistry 2002;59:105-10.
  2. Zheng BL, He K, Kim CH, Rogers L, Shao Y, Huang ZY et al. Effect of a lipidic extract from lepidium meyenii on sexual behavior in mice and rats. Urology 2000;55:598-602.
  3. Gonzales GF, Cordova A, Vega K, et al. Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia 2002;34:367-72.
  4. Gonzales GF, Cordova A, Gonzales C, Chung A, Vega K, Villena A. Lepidium meyenii (Maca) improved semen parameters in adult men. Asian J Androl 2001;3:301-3.
  5. Cicero AF, Piacente S, Plaza A, Sala E, Arletti R, Pizza C. Hexanic Maca extract improves rat sexual performance more effectively than methanolic and chloroformic Maca extracts. Andrologia 2002;34:177-9.
  6. Balick MJ,.Lee R. Maca: from traditional food crop to energy and libido stimulant. Altern Ther Health Med 2002;8:96-8.
  7. Li G, Ammermann U, Quiros CF. Glucosinolate Contents in Maca (Lepidium peruvianum chacon) Seeds, Sprouts, Mature Plants and Several Derived Commercial Products. Economic Botany 2001;55:255-62.
  8. Piacente S, Carbone V, Plaza A, Zampelli A, Pizza C. Investigation of the tuber constituents of maca (Lepidium meyenii Walp.). J Agric Food Chem. 2002;50:5621-5.
  9. Gonzales GF, Cordova A, Vega K, et al. Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men. J Endocrinol 2003;176(1):163-8.
  10. Valentova K, Buckiova D, Kren V, et al. The in vitro biological activity of Lepidium meyenii extracts. Cell Biol Toxicol 2006;22(2):91-9.
  11. Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich E. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial. Andrologia. 2009 Apr;41(2):95-9.
  12. Dording CM, Fisher L, Papakostas G, et al. A double-blind, randomized, pilot dose-finding study of maca root (L. meyenii) for the management of SSRI-induced sexual dysfunction. CNS Neurosci Ther. 2008 Fall;14(3):182-91.
  13. Shin BC, Lee MS, Yang EJ, Lim HS, Ernst E. Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44.
  14. Rubio J, Dang H, Gong M, et al. Aqueous and hydroalcoholic extracts of Black Maca (Lepidium meyenii) improve scopolamine-induced memory impairment in mice. Food Chem Toxicol. 2007 Oct;45(10):1882-90.
  15. Lee MS, Shin BC, Yang EJ, Lim HJ, Ernst E. Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review. Maturitas. 2011 Nov;70(3):227-33.
  16. Hunt KJ, Hung SK, Ernst E. Botanical extracts as anti-aging preparations for the skin: a systematic review. Drugs Aging. 2010 Dec 1;27(12):973-85.
  17. Del Valle Mendoza J, Pumarola T, Gonzales LA, et al. Antiviral activity of maca (Lepidium meyenii) against human influenza virus. Asian Pac J Trop Med. Sep 2014;7s1:S415-420.
  18. Zha S, Zhao Q, Chen J, et al. Extraction, purification and antioxidant activities of the polysaccharides from maca (Lepidium meyenii). Carbohydr Polym. Oct 13 2014;111:584-587.
  19. Almukadi H, Wu H, Bohlke M, et al. The macamide N-3-methoxybenzyl-linoleamide is a time-dependent fatty acid amide hydrolase (FAAH) inhibitor. Mol Neurobiol. Oct 2013;48(2):333-339.
  20. Ai Z, Cheng AF, Yu YT, et al. Antidepressant-like behavioral, anatomical, and biochemical effects of petroleum ether extract from maca (Lepidium meyenii) in mice exposed to chronic unpredictable mild stress. J Med Food. May 2014;17(5):535-542.
  21. Zhang Y, Yu L, Jin W, et al. Effect of ethanolic extract of Lepidium meyenii Walp on serum hormone levels in ovariectomized rats. Evid Based Complement Alternat Med. Jul-Aug 2014;46(4):416-419.
  22. Gonzales GF, Gasco M, Lozada-Requena I. Role of maca (Lepidium meyenii) consumption on serum interleukin-6 levels and health status in populations living in the Peruvian Central Andes over 4000 m of altitude. Plant Foods Hum Nutr. Dec 2013;68(4):347-351.
  23. Stone M, Ibarra A, Roller M, et al. A pilot investigation into the effect of maca supplementation on physical activity and sexual desire in sportsmen. J Ethnopharmacol. Dec 10 2009;126(3):574-576.
  24. Dording CM, Schettler PJ, Dalton ED, et al. A double-blind placebo-controlled trial of maca root as treatment for antidepressant-induced sexual dysfunction in women. 2015;2015:949036.
  25. Brooks NA, Wilcox G, Walker KZ, et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content. Menopause. Nov-Dec 2008;15(6):1157-1162.
  26. Meissner HO, Kapczynski W, Mscisz A, et al. Use of gelatinized maca (Lepidium peruvianum) in early postmenopausal women. Int J Biomed Sci. Jun 2005;1(1):33-45.
  27. Stojanovska L, Law C, Lai B, et al. Maca reduces blood pressure and depression, in a pilot study in postmenopausal women. Climacteric. Feb 2015;18(1):69-78.
  28. Ernst E, Posadzki P, Lee MS. Complementary and alternative medicine (CAM) for sexual dysfunction and erectile dysfunction in older men and women: an overview of systematic reviews. Maturitas. Sep 2011;70(1):37-41.
  29. Lee MS, Shin BC, Yang EJ, et al. Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review. Maturitas. Nov 2011;70(3):227-233.
  30. Srikugan L, Sankaralingam A, McGowan B. First case report of testosterone assay-interference in a female taking maca (Lepidium meyenii). BMJ Case Rep. 2011 Mar 25;2011:bcr0120113781.
  31. Esparza E, Hadzich A, Kofer W, et al. Bioactive maca (Lepidium meyenii) alkamides are a result of traditional Andean postharvest drying practices. Phytochemistry. Aug 2015;116:138-148.
  32. Hajdu Z, Nicolussi S, Rau M, et al. Identification of endocannabinoid system-modulating N-alkylamides from Heliopsis helianthoides var. scabra and Lepidium meyenii. J Nat Prod. Jul 25 2014;77(7):1663-1669.
  33. Uchiyama F, Jikyo T, Takeda R, et al. Lepidium meyenii (Maca) enhances the serum levels of luteinising hormone in female rats. J Ethnopharmacol. Feb 3 2014;151(2):897-902.
  34. Corazza O, Martinotti G, Santacroce R, et al. Sexual enhancement products for sale online: raising awareness of the psychoactive effects of yohimbine, maca, horny goat weed, and Ginkgo biloba. Biomed Res Int. 2014;2014:841798.
  35. Alcalde AM, Rabasa J. Does Lepidium meyenii (Maca) improve seminal quality? Andrologia. Jul 12 2020:e13755.
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