Tongkat ali has been shown to raise testosterone. It is alleged that it does so by stimulating the Leydig cells of the testicles to produce more testosterone. This is different from the action of testosterone products, which act like the body's own testosterone and therefore causes the Leydig cells to shut down their production of the hormone. For this reason, all exogenous testosterone products, including anabolic steroids, cause testicular and penile shrinkage.
I do think that this is not sufficiently emphasized by anti-doping campaigns: athletes who dope with testosterone and anabolic steroids will cause their penises to become as small as their thumbs or little fingers, and unfortunately, if exogenous testosterone or anabolic steroids are taken for some time, the loss in size can be permanent.
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