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The reported mean increase in penile length was 4.9 cm in one study and 2.1 cm in another, while the increase in girth ranged between 39.9 and 56.7% [37,39,65]. Austoni et al. reported an augmentation phalloplasty with bilateral saphena grafts in a case series of 39 patients with either hypoplasia of the penis or functional penile dysmorphophobia. Correction of curvature was observed in all patients, no erectile dysfunction was reported, and satisfaction of patients ranged between 90 and 100% [30,31,32,33,34,54,55]. Some supplements may support mood, but emotional balance is key to achieving better sexual performance and overall enhancement results. Penis Enlargement Workouts The 180-day satisfaction guarantee is frequently mentioned in reviews as a significant advantage, providing peace of mind for new users. This guarantee reflects the company’s confidence in their product and their commitment to customer satisfaction. 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More interestingly, several cases of manic-like effects, such as confusion, agitation, irritation, nervousness, anxiety, and bizarre behavior, without history of psychiatric disorder, were reported following ginseng use [77,78,81,85,87,88,90,228]. In fact, most clinical studies with ginseng or ginsenosides reported no psychiatric or neurological side effects or statistically insignificant effects compared to placebo, and were not included in Table 1 [223,224,225,226,227]. Psychiatric and neurological side effects are rare, and causality is difficult to ascertain [77,79,80,82,83,84,85,86,87,89,90,91,92,93,94]. In addition, P. ginseng was proved to increase testosterone, LH, and FSH in healthy volunteers through Rg1 and Rb1, enhancing libido. American ginseng medical use is more recent and has gained popularity in Western countries over recent decades. 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