A review of the potential of medicinal plants in the management and treatment of male sexual dysfunction

Sexual dysfunction in dichlorvos-exposed male Wistar rat is ameliorated by curcumin and associated with the upregulation of testosterone

Dichlorvos is an organophosphate pesticide that is commonly used for agricultural and domestic control of pests and insects. Despite its usefulness, it exerts reproductive toxicity and induces male sexual dysfunction. On the other hand, curcumin has been reported to improve sexual dysfunction. However, till date, no study has reported the impact of curcumin on dichlorvos-induced sexual dysfunction. This study investigated the effect and associated mechanism of curcumin on dichlorvos-induced sexual dysfunction. Thirty-two male Wistar rats were randomized into four groups; the control (1 mL of olive oil), curcumin-treated (100 mg/kg), DDVP-treated (98.54 g/m3 of dichlorvos by inhalation), and DDVP + Curcumin-treated. Dichlorvos induced sexual dysfunction as depicted by reduced motivation to mate (8.38 ± 0.18 vs. 4.00 ± 0.33, P < 0.0001), prolonged latencies (46.63 ± 1.30 vs. 98.75 ± 1.32, P < 0.0001) and reduced frequencies of mount (14.88 ± 0.52 vs. 8.63 ± 0.38), intromission (9.38 ± 0.50 vs. 3.75 ± 0.31, P < 0.0001), and ejaculation (7.63 ± 0.38 vs. 1.50 ± 0.19, P < 0.0001). These findings were accompanied by suppression of hypothalamic-pituitary-testicular axis, evidenced by marked reductions in circulating FSH (60.00 ± 1.04 vs. 21.13 ± 0.52, P < 0.0001), LH (46.38 ± 1.38 vs. 19.00 ± 0.46, P < 0.0001), and testosterone (6.01 ± 0.50 vs. 0.74 ± 0.05, P < 0.0001). Nonetheless, the administration of curcumin in dichlorvos-exposed rats significantly attenuated dichlorvos-induced sexual dysfunction by improving the assessed indices of male sexual act. Also, curcumin significantly increased serum levels of FSH (21.13 ± 0.52 vs. 47.25 ± 0.10, P < 0.0001), LH (19.00 ± 0.46 vs. 43.00 ± 1.49), and testosterone (0.74 ± 0.05 vs. 3.98 ± 0.08, P < 0.0001). This study revealed that curcumin attenuated dichlorvos-induced sexual dysfunction by activating the hypothalamic-pituitary-testicular axis and upregulating circulating testosterone.

Modulating effects of crocin on lipids and lipoproteins: Mechanisms and potential benefits

Dyslipidemia poses a significant risk to cardiovascular health in both diabetic and non-diabetic individuals. Therefore, it is crucial to normalize lipid homeostasis in order to prevent or minimize complications associated with dyslipidemia. However, pharmacological interventions for controlling lipid metabolism often come with adverse effects. As an alternative, utilizing herbal-based agents, which typically have fewer side effects, holds promise. Crocin, a naturally occurring nutraceutical, has been shown to impact various intracellular pathways, reduce oxidative stress, and alleviate inflammatory processes. Recent evidence suggests that crocin may also confer lipid-related benefits and potentially contribute to the normalization of lipid homeostasis. However, the specific advantages and the cellular pathways involved are not yet well understood. In this review, we present the latest findings regarding the lipid benefits of crocin, which could be instrumental in preventing or reducing disorders associated with dyslipidemia. Additionally, we explore the potential cellular mechanisms and pathways that mediate these lipid benefits.

Antihyperglycemic and aphrodisiac effect of West African Albizia (Albizia zygia) leaves-inclusive diet in diabetes-induced erectile dysfunctional rats

ETHNOPHARMACOLOGICAL RELEVANCE

West African Albizia (Albizia zygia DC J. F. Macbr) leaves are a tropical plant that are frequently used in folkloric medicine to treat a number of illnesses, including type 2 diabetes (TY2D) and erectile dysfunction (ED), without having a complete scientific foundation.

AIM OF THE STUDY

This investigation examined the effect of action of dietary augmentation of Albizia zygia leaves (AZL) on rat sexual functioning and important enzymes related to TY2D and ED.

MATERIALS AND METHODS

Thirty matured adult Wistar rats of the weight 180-200 g were acclimatized in a lab environmental condition for two weeks prior to experiment given food and water to acclimate. Twenty-four of the rats got high fat diet (HFD) for periods of two weeks before receiving streptozotocin (STZ) intraperitoneally (i.p.), 35 mg/kg body weight single dose. Six rats got basal diets. Type 2 diabetes was identified in rats 72 h after STZ treatment. Rats were then used to evaluate the mounting number, mount delay, intromission number, and intromission latency.

RESULTS

Following that, meals supplemented with AZL (5% or 10% inclusion) were given to diabetic-ED rats for 14 days. AZL was added. Therefore, in diabetic-ED rats, AZL supplementation could significantly (p0.05) lower blood glucose levels and the activities of alpha amylase, alpha glucosidase, phosphodiesterase-5, and arginase. In the case of diabetic-ED treated rats in consideration with diabetic-ED control group, nitric oxide levels were increased along with sexual function.

CONCLUSION

Thus, experimental results of this study demonstrated rats that consumed AZL in their diets had less erectile dysfunction. In order to address ED caused by diabetes, AZL could be suggested as functional meals.

Omega 3 fatty acid improves sexual and erectile function in BPF-treated rats by upregulating NO/cGMP signaling and steroidogenic enzymes activities

Bisphenol F (BPF) is an environmental pollutant that has been implicated in sexual dysfunction. Omega 3 fatty acid (O3FA), on the other hand, is an antioxidant with the ability to improve fertility indices. However, no study has explored the possible ameliorative effect of O3FA on BPF-induced sexual dysfunction. Thus, the effect of BPF and/or O3FA on male sexual performance was investigated. Male Wistar rats were randomized into 6 groups, corn oil-treated, O3FA low and high dose (100 and 300 mg/kg), BPF-treated, BPF + O3FA low and BPF + O3FA high dose. BPF significantly impaired male sexual competence, evidenced by a reduction in motivation to mate, prolonged mount, intromission and ejaculation latency, and post-ejaculatory index. Furthermore, a reduction in mount, intromission, and ejaculation frequency were observed. Also, BPF caused a decrease in gonadotropin releasing hormone, follicle stimulating hormone, luteinizing hormone, testosterone, nitric oxide (NO) cyclic guanosine monophosphate (cGMP), 3beta-hydroxysteroid dehydrogenase (3β-HSD), 17beta-hydroxysteroid dehydrogenase (17β-HSD), dopamine, and acetylcholine esterase. Furthermore, it was accompanied by a significant increase in prolactin and estrogen and poor pregnancy outcomes. These observed BPF-led alterations were abolished by O3FA administration. This study showed that O3FA ameliorates BPF-induced sexual dysfunction by upregulating NO/cGMP signaling and steroidogenic enzymes activities.

Efficacy and safety assessment of traditional Chinese medicine for erectile dysfunction: A meta-analysis and trial sequential analysis

BACKGROUND

Several patients with erectile dysfunction do not accept or benefit from conventional therapy with phosphodiesterase type 5 inhibitors; thus, alternative and complementary therapies are in need. Traditional Chinese medicine has been treating erectile dysfunction in China, but its clinical value is inconclusive.

OBJECTIVE

To systematically evaluate the efficacy and safety of traditional Chinese medicine in treating erectile dysfunction.

METHODS

Randomized controlled trials were retrieved from a comprehensive search in the literature published in the past decade from the Web of Science, PubMed, Embase, Cochrane Library, SinoMed, China National Knowledge Internet, WanFang, and VIP. We performed a meta-analysis of the International Index of Erectile Function 5 questionnaire scores, clinical recovery rates, and testosterone levels using Review Manager 5.4 software. The trial sequential analysis was conducted to check the results.

RESULTS

A total of 45 trials with 5016 patients were included. Meta-analysis results showed that traditional Chinese medicine effectively improved the International Index of Erectile Function 5 questionnaire scores (weighted mean difference = 3.78, 95% confidence interval: 3.12, 4.44; p < 0.001), clinical recovery rates (risk ratio = 1.57, 95% confidence interval: 1.38, 1.79; p < 0.001), testosterone levels (weighted mean difference = 2.42, 95% confidence interval: 1.59, 3.25; p < 0.001) compared with the controls. The single and add-on applications of traditional Chinese medicine could improve the International Index of Erectile Function 5 questionnaire score (p < 0.001). The trial sequential analysis confirmed the robustness of the analysis of the International Index of Erectile Function 5 questionnaire scores. A significant difference in the incidence of adverse effects between the treatment and control groups was not observed (risk ratio = 0.82, 95% confidence interval: 0.65, 1.05; p = 0.12).

CONCLUSION

Traditional Chinese medicine can gain better responses in improving the International Index of Erectile Function 5 questionnaire scores, clinical recovery rates, and testosterone levels as an alternative and complementary treatment, with no increase in side effects. However, more standardized, long-term, traditional Chinese medicine and integrative therapy clinical trials are needed to support the clinical application of traditional Chinese medicine.

Substance abuse and male sexual dysfunction: what lies beneath?

INTRODUCTION

Substance abuse has become a worldwide health problem, leading to numerous consequences such as social problems among family members, abnormal behavior, adverse health effects, and psychological problems as well as economic consequences.

OBJECTIVES

We sought to assess the relationship between substance abuse and male sexual health.

METHODS

A search was carried out in the following databases: PubMed, MeSH (Medical Subject Headings), Science Direct, Scopus, Cochrane Library, EMBASE, CINAHL, Academic Search Complete, and the Egyptian Knowledge Bank. The following keywords were used to assess the outcomes for relevant associations: illicit drugs, addiction, substance abuse, sexual health, erectile dysfunction, ejaculatory disorders, impotence, orgasm disorders, and sexual performance.

RESULTS

The initial literature search identified a total of 148 articles in all searched databases. After removal of duplicate studies and application of inclusion/exclusion criteria, 75 reported studies were retained for review, including 38 case-control studies and 37 cross-sectional studies. These articles were classified into the following categories according to the type of abused substance addressed: cannabis/marihuana, 16 articles; opioids, 13 articles; heroin, 11 articles; cocaine, 5 articles; tramadol, 6 articles; ketamine, 2 articles; ecstasy, 4 articles; amphetamine, 2 articles; khat, 7 articles; androgen anabolic steroids, 2 articles; and polydrugs, 7 articles. Most of these recruited articles demonstrated a negative impact of the addressed substance on male sexual health, with variable levels.

CONCLUSION

Substance abuse has negative impacts on male sexual health that should be addressed. More studies conducted with proper methodological and statistical approaches, including logistic regression analysis, are needed to predict the effects of specific substances, considering the rapidly growing effects of non-substance-use disorders on male sexual health.

Managing antipsychotic-related sexual dysfunction in patients with schizophrenia

INTRODUCTION

Schizophrenia is a psychotic disorder and one of the most severe and impactful mental illnesses. Sexual dysfunction is highly prevalent in patients with schizophrenia but remains underdiagnosed and undertreated. Sexual dysfunction is frequently attributed to antipsychotics which may reduce medication adherence, but negative symptoms can also reduce sexual drive.

AREAS COVERED

This review provides an overview of the current knowledge about sexual dysfunction in patients with schizophrenia. The authors first review the literature concerning the mechanisms of sexual dysfunction and explore the impact of antipsychotics on sexual function. Finally, they present the available non-pharmacological and pharmacological treatment strategies for sexual dysfunction in patients with schizophrenia.

EXPERT OPINION

Sexual dysfunction in patients with schizophrenia is still underrated by clinicians despite having a negative impact on the quality of life and therapeutic adherence. Antipsychotic treatment is still perceived as a major cause of sexual impairment. Psychiatrists must be aware of this condition and actively question the patients. A comprehensive approach, addressing pharmacological and non-pharmacological aspects, is fundamental for managing sexual dysfunction in schizophrenia. Pharmacological strategies include (1) Serum-level adjustment of the antipsychotic dose, if possible (2) switching to a well-tolerable antipsychotic (aripiprazole, brexpiprazole) and (3) adding a coadjuvant drug (phosphodiesterase-5 inhibitors).

Low Exercise Tolerance as a Marker of Erectile Dysfunction and Depression among Post-Myocardial Infarction Men

Evidence has grown recently on the correlation between lifestyle and physical activity, and their impact on the functioning of the entire organism. In addition, a decrease in physical efficiency may be an indicator of the early diagnosis of systemic diseases. The aim of this study was to determine whether there is a relationship between exercise tolerance and possible erectile dysfunction or mental disorders. A cross-sectional study was conducted among 254 men in 4 cardiac rehabilitation centers in Poland using the standardized International Index of Erectile Function 5 (IIEF-5) and Beck Depression Inventory (BDI) questionnaires. Erectile dysfunction was directly proportional to the metabolic equivalent of the task (MET) variable. An increase in exercise tolerance by 1 point was associated with an increase in the IIEF-5 score by 1.62 points, indicating a reduction in the severity of erectile dysfunction. The 1-point increase in MET was associated with a 1.8-point decrease in BDI, indicating that an increase in exercise tolerance is associated with a decrease in the severity of depressive disorders. Increasing the tolerance of physical effort has a beneficial effect not only on the general well-being, but also on the sexual and mental health of men. An increase in exercise tolerance is associated with a reduction in the incidence of erectile dysfunction. On the other hand, in patients with depressive disorders, the improvement of exercise tolerance reduces the intensity of depression symptoms. Exercise tolerance can be an early and simple marker at the onset of erectile dysfunction or mood disorders.

Alibertia patinoi (Cuatrec.) Delprete & C.H.Perss. (Borojó): food safety, phytochemicals, and aphrodisiac potential

Although the western discovery of borojó [Alibertia patinoi Cuatrec. (Delprete & C.H.Perss.)] is as recent as 1948, its several traditional uses in gastronomy and medicine, and its fame as an aphrodisiac are long standing and strong: the “love juice” extracted from it is very appreciated in Colombia, Ecuador, and Panama. Its medicinal potential, though, is far wider. This literature review aims to summarize the knowledge about the fruit, its ethnomedical uses, its biological activity and phytochemical composition, to validate ethnomedical claims and to help envision future lines of research. Borojó extracts have confirmed antimicrobial and antioxidant, and potential anticancer activities, which can be at least partially explained by its phytochemical composition -compounds isolated and identified through Gas Chromatography, High Performance Liquid Chromatography and spectroscopic and spectrometric techniques- rich in phenolic compounds, some of which, for example oleuropein, chlorogenic acid and rutin, possess proven biological activity. There is potential for borojó products as a source of bioactive natural products, which have not been exhaustively identified despite phytochemical screenings that show the presence of unstudied compound families: terpenoids, alkaloids, steroids; and functional alimentary products. Although its aphrodisiac properties have not been confirmed, several compounds with confirmed aphrodisiac activity in other species, mainly flavonoids, are also found in borojó. These, coupled with its nutritional profile and perhaps compounds yet unidentified, could validate the claim.

Graphical abstract

Sexual Dysfunction After Traumatic Injury Can Be Corrected by Transcranial Magnetic Stimulation: A Case Report

Neurogenic sexual dysfunction (NSD) is a common problem in patients after spinal and pelvic trauma. New treatment is needed beyond medicine or psychological therapies. A 24-year-old man who fell from a six-floor building suffered from subsequent NSD. Repetitive transcranial magnetic stimulation (rTMS) was the only method used to treat his NSD caused by multiple spinal and pelvic injuries. The therapy lasted for 3 courses. Motor and sensory conduction, as well as sexual function, were evaluated before and after the rTMS intervention. Improvements on patient's nerve conduction and sexual activity were confirmed at a 1-year follow-up. Our findings indicate that rTMS delivered a novel, positive and low-cost modality treatment to the patient with NSD. Clinical efficacy and potential mechanisms by which rTMS regulate NSD need to be investigated by further clinical trials.

Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: A randomized controlled trial

Background and Aim

In Ayurveda, ashwagandha is a popular plant for promoting youthful energy, longevity, and overall well-being. It is also an excellent aphrodisiac herb that aids in the improvement and maintenance of normal sexual health. The present study aims to evaluate the effect of ashwagandha root extract on improving sexual health in adult males.

Methods

In this 8-week randomized, double-blind, placebo-controlled study, we investigated the aphrodisiac property of an ashwagandha root extract in adult males. Fifty participants with lower sexual desire were randomly allocated to take 300 mg of ashwagandha root extract or placebo capsules twice daily. Outcomes were measured using the derogatis interview for sexual functioning-male (DISF-M) questionnaire, serum testosterone, serum prolactin, and short-form survey-36 quality of life questionnaire before and after the intervention.

Results

Compared to placebo, ashwagandha root extract supplementation was associated with a statistically significant increase in the total DISF-M scores (mean difference -9.8; 95% confidence interval, -10.73 to -8.87; p < 0.0001; t-test). It was also associated with a statistically significant increase in serum testosterone levels (-66.52; -80.70 to -52.34; p < 0.0001; t-test). However, the prolactin level did not change after intervention in both the ashwagandha and placebo groups (-1.06; -2.78 to 0.66; p > 0.05).

Conclusion

These findings suggest that ashwagandha demonstrated a significant subjective perception of sexual well-being and assisted in increasing serum testosterone levels in the participants.

Ameliorative Sexual Behavior and Phosphodiesterase-5 Inhibitory Effects of Spondias mangifera Fruit Extract in Rodents: In Silico, In Vitro, and In Vivo Study

The ethanolic extracts of Spondias mangifera fruit (SMFE) were evaluated for aphrodisiac activity. The in-vitro phosphodiesterase-5 (PDE-5) inhibition was assessed based on in-silico molecular docking and simulation studies. In addition, the in-vivo sexual behavior was analyzed in the form of mount (MF, ML), intromission (IF, IL), and ejaculation (EF, EL) frequencies and latencies to validate the in-vitro results. Some biochemical parameters, including PDE-5, nitric oxide, and testosterone, were also observed. The above extract constituted β-amyrin, β-sitosterol, and oleanolic acid and showed tremendous binding with phosphodiesterase-5 and sildenafil. Both the sildenafil and ethanolic extracts (200 and 400 mg/kg/d bodyweight) significantly (p < 0.1, p < 0.05) increased MF, IF, and EF, respectively. In contrast, ML and IL significantly (p < 0.1) decreased, and EL significantly (p < 0.1) increased compared with a normal group of animals. The ethanolic extracts (200 and 400 mg/kg/d bodyweight) and sildenafil further significantly (p < 0.05, p < 0.1) diminished PDE-5 activity significantly (p < 0.05, p < 0.1) and enhanced nitric oxide and testosterone levels, as compared with normal rodents. Therefore, the S. mangifera ethanolic extract might be a valuable alternate aphrodisiac for erectile dysfunction.

Efficacy of Date Palm Pollen in the Male Sexual Dysfunction after Coronary Artery Bypass Graft: A Randomized, Double-Blind, Clinical Trial

Background

Bypass graft surgery of the coronary artery has a significant effect on the creation and development of sexual dysfunction among male patients. The previous studies have demonstrated that date palm pollen (DPP) increases the count and quality of sperm. Additionally, it has been shown that DPP has a protective effect against myocardial infarction and cardiac remodeling. Therefore, this is the first study investigating the impact of DPP (Phoenix dactylifera L.) on managing male sexual dysfunction after coronary artery bypass graft.

Methods

This randomized, double-blind, placebo-controlled clinical trial was conducted on 60 patients (DPP group n = 30, control group n = 30) of Iranian men after coronary artery bypass graft. Two parallel groups were randomly generated from the study participants. The intervention group was prescribed 3 grams of the powder of DPP twice a day (9 AM and 9 PM) for two months, while the control group received the same prescription of the placebo powder.

Results

The DPP consumption significantly increased the International Index of Erectile Function (IIEF) (from 23.21 to 46.57) and the Hurlbert Index of Sexual Desire (HISD) (from 59.39 to 64.45) scores over time in the intervention group. However, there were no significant changes in the control group.

Conclusion

Daily intake of 6 g DPP for two months exhibited beneficial effects on the symptoms of male sexual dysfunction in patients who have undergone coronary artery bypass graft (CABG).

Use of Tribulus terrestris and Lepidium meyenii extract in rats: reproductive, biochemical and body parameters

The oral administration of Tribulus terrestris and Lepidium meyenii extracts on reproductive, biochemical and body parameters was evaluated in rats. Thirty-six male Wistar rats weighting 210 ± 18 g were divided into six experimental groups (n = 6). Each group received, daily for 28 days, different solutions: T. terrestris (100 mg/kg), L. meyenii (1 g/kg) and T. terrestris at doses of 75, 50 and 25 mg/kg combined with L. meyenii at doses of 0.25, 0.5 and 0.75 g/kg, respectively, and distilled water (control). T. terrestris increased (p < 0.05) the serum testosterone, regardless of dose. Combined use of the extracts increased (p < 0.05) the diameter of the epididymal duct and epididymis lumen. The combinations of T. terrestris (75 and 50 mg/kg) with L. meyenii increased (p < 0.05) the sperm concentration. There were no differences (p > 0.05) in the other semen characteristics; relative weight of organs; and serum levels of urea, creatinine, alanine and aspartate transaminase, gamma glutamyl transferase, cholesterol, triglycerides, glucose, follicle-stimulating hormone and luteinizing hormone. No histopathological changes were observed (p > 0.05). It is concluded that the association of T. terrestris and L. meyenii has positive effects on serum testosterone, sperm concentration and epididymal morphology, with no evidence of effects in the testis, liver, spleen and kidneys.

A new original nutraceutical formulation ameliorates the effect of Tadalafil on clinical score and cGMP accumulation

OBJECTIVE

To assess the efficacy of the combination of Tadalafil 5 mg and nutritional supplements composed by Panax ginseng, Moringa Oleifera and Rutin on erectile function in men with mild and moderate vasculogenic ED.

METHODS

we prospectively enrolled 86 patients divided into two groups A (45), B (33) in this multicenter randomized, doubleblind, placebo-controlled trial . Drop out was 8 patients (3 patients in group A and 5 in Group B). At screening visit patients underwent clinical examination, blood test (hormonal and metabolic profile) and filled out the IIEF-5 questionnaire and the SEP-2, SEP-3. Patients were randomized by a computergenerated list to receive either Tadalafil 5 mg once daily plus nutritional supplement once daily (group A) or Tadalafil 5 mg plus placebo with the same administration schedule (group B) for 3 months. Blood samples, IIEF-5, SEP-2 and SEP-3 have been collected again after 3 months. cGMP was measured in platelets of 38 patients at baseline and after one months.

RESULTS

Mean age was 59.98 ± 6.90 (range 38-69), mean IIEF-5 score at baseline was 13.59 ± 3.90. After three months of treatment, IIEF-5 score significantly improved in both groups compared to baseline (13.18 ± 3.75 vs 20.48 ± 2.24, p < 0.0001; 14.15 ± 4.09 vs 19.06 ± 4.36, p < 0.0001, in group A and group B respectively). Patients treated with Tadalafil plus nutritional supplement showed a significantly higher increase in IIEF-5 score compared to those who received placebo (7.27 ± 2.20 and 4.9 ± 2.79, respectively; p < 0.0001;). No hormonal differences and metabolic effects were found. According cGMP result, nutritional supplements ameliorates and extends the activity of the chronic treatment.

CONCLUSIONS

IIEF-5 significant increase in group B, can be ascribed to the nutritional supplement properties and antioxidant effects of moringa oleifera, ginseng and rutin and this can enhance the endothelial NO and cGMP production.

Premature ejaculation and stress

Recent findings indicate that men with premature ejaculation report more frequent sexual problems associated with increased anxiety and interpersonal difficulties. Bearing this in mind, the neuroendocrine changes were examined in men with premature ejaculation and compared to other indicators of stressful experiences to see whether there can be any correlation which could indicate how these factors may contribute to the aetiology of premature ejaculation. Our study comprised 60 male outpatients diagnosed as having secondary premature ejaculation. Clinical examinations were focused on biochemical analysis of cortisol and psychometric scoring using a diagnostic tool for premature ejaculation, traumatic stress and somatoform dissociation. The control group consisted of a 60 healthy men. The results showed significant Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma Symptom Checklist score (R = .86), cortisol level (R = .47) and Somatoform Dissociation Questionnaire score (R = .61). In the control group, the results did not reach statistical significance. Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma symptoms checklist score was (R = .21), cortisol (R = .27) and with Somatoform dissociation questionnaire score (R = .25). These results represent the first reported findings documenting the relationship of traumatic stress indicators with the experience of secondary premature ejaculation and cortisol levels.

Effect of Herbal Medicine on Fertility Potential in Experimental Animals - an Update Review

Introduction:

Sexual function greatly affects the quality of life. Any problem which affects satisfaction is considered sexual dysfunction.

Aim:

The aim of this study was to investigate how recently used of complementary and alternative medicines has increased in treating infertility.

Methods:

Study has descriptive character based on searched and analyzed facts from the published articles in scientific journals.

Results:

The majority of the studies done for the detection of the efficacy of medicinal plants in treating male infertility were done on experimental animals with few clinical studies. However, there is still a need for more studies to have certain results, as conflicting results were noted in different studies done on the effect of the same medicinal plant on spermatogenesis. It might be referred it to the absence of standardization among research models, the difference in extracts, administration route, doses and how long did the experiment last added to differences in the part of the plant used and plant collection. This review summarized the finding of many studies that studied the effect of different medicinal herbs on the testes, epididymis, sperm and prostate parameters, testosterone level and steroidogenesis, erection/ejaculation function and libido.

Conclusion:

The protective effect might be due to OLE competence to antagonize the oxidative stress and LPO. Londium suffruticosum I. suffruticosum leaf extract was administered to sub-fertile male rats, subfertility was induced by carbendazim, it resulted in increased spermatogenesis, increased sperm counts, lessened sperm agglutination by preserving normal pH in testicular microenvironment, increasing the testicular oxidative biomarkers, SOD, and CAT. It was found that the main active components of the extract are alkaloids, steroidal lactones and flavonoids.

Promising role of medicinal plants in the regulation and management of male erectile dysfunction

Male erectile dysfunction (ED) refers to incompetency to reaching and retaining adequate penile tumescence for sexual intercourse. Over 152 million men globally suffer from ED and by 2025, the number of affected individuals is anticipated to be around 322 million. Pharmacological and nonpharmacological therapies such as phosphodiesterase (PDE) inhibitors, alprostadil, penile prosthesis surgery, and hormonal replacement are available for management and recuperation of ED. Nevertheless, such therapies are reported to have adverse effects as well as life-threatening. Accordingly, diversity of medicinal plant species and bioactive active compounds are preferred as therapeutic options because they are natural, abundant, available, low-cost and cause fewer or no side effects. This current review will emphasise the aetiology, risk factors, mechanisms underlying the pathophysiology of ED, treatments of ED as well as their side effects. It also provides medicinal plants that are proven effective in vivo and in vitro for the mitigation and treatment of male ED. This knowledge could be used in the future in drug discovery for the development of more natural drugs with no side effects.

Efficacy of Herbal Based Syrup on male sexual experiences: A double-blind randomized clinical trial

Background and aim

An Aphrodisiac includes any drug and food that arouses sexual instinct, induces venereal desire, and increases pleasure and performance. The present study was designed to clinically evaluate efficacy and safety of Herbal Based Syrup (HBS) composed of Tribulus terrestris L., Panax ginseng C.A. Meyer., Zingiber officinale Rosc, Ceratonia siliqua L., Papaver rhoeas L., and Palm tree pollen on sexual experience of men.

Experimental procedure

The study was designed as a double-blind randomized clinical trial. The main outcome measures were the responses obtained from using the Arizona Sexual Experience Scale (ASEX). The ASEX was completed by 100 married and seemingly healthy men before and after taking one dose of HBS or placebo and at least one sexual intercourse. In addition, possible side effects were observed. A split-plot ANOVA (SPANOVA) design was used for statistical analysis.

Results

Results of analysis of data for each variable of the ASEX showed significantly lower scores in HBS-treated group compared to the placebo (control) group in items of desire, arousal, erection, orgasm and satisfaction (p < 0.05). No drug-related serious adverse events were observed.

Conclusion

Results of this study indicated a significant improvement in sexual experience of men following consumption of HBS. Due to various complications reported about the use of chemical sexual drive enhancers, HBS can be introduced as an alternative with fewer side effects.

•

The syrup enhances sexual desire, arousal, erection, orgasm and satisfaction.

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The syrup may be a useful supplement to improve sexual experience of healthy men.

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The syrup was stable more than 1 year in room temperature.

Acridocarpus Smeathmannii (DC.) Guill. & Perr. Root enhanced reproductive behavior and sexual function in male wistar rats: Biochemical and pharmacological mechanisms

ETHNOPHARMACOLOGICAL RELEVANCE

Novel therapeutic opportunities from medicinal agents continue to arouse scientific interest in recent times. Still, there is a dearth of information as regards experimental evidence generated from medicinal plants that would yield pharmacological agents for the treatment of erectile dysfunction. Acridocarpus Smeathmannii (DC.) Guill. & Perr. Root (ASR) has a long history as an aphrodisiac in African traditional medicine. Thus, this study investigated the reproductive potentials and associated biochemical mechanisms of its hydroethanolic extract (HEASR) in male Wistar rats. Also, the bioactive compounds were identified.

MATERIALS AND METHODS

Fifty-four male albino rats (180 ± 20 g) were divided into nine groups of six rats/group. Control, group 1 received normal saline (10 mL/kg). Groups 2-6 rats were administered sildenafil (1.43 mg/kg/day), mesterolone (0.36 mg/kg/day), doxazocin (0.03 mg/kg/day), HEASR1 (50 mg/kg/day) and HEASR2 (200 mg/kg/day) respectively. Others received co-administration of HEASR2 with standard drugs. Treatment lasted for 28 days via oral gavage.

RESULTS

An acute oral toxicity of HEASR up to 2 g/kg produced no mortality in mice p.o. while the median lethal dose was estimated to be 810 mg/kg i.p. HEASR2 administration or in combination with sildenafil, mesterolone and doxazocin increased mounting frequencies on day 28 by 77.44%, 122.65%, 148.5% and 93.88% and sperm counts by 38.29%, 55.21%, 42.48%, and 48.98% respectively in treated rats. HEASR2 + sildenafil elevated testosterone and follicle stimulating hormone levels by 36.33% and 24.55% while HEASR2 + doxazocin elevated luteinizing hormone levels by 97.44% in rats. HEASR modulated prostate-specific antigen and malondialdehyde levels respectively. Reduced glutathione, superoxide dismutase, and catalase activities were raised in five selected organs. Serum nitric oxide but not cyclooxygenase-2 or tumor necrosis factor-α levels was moderately improved in rats.

CONCLUSION

Overall, the results obtained demonstrated the potential of HEASR as a male reproductive enhancer, thus justify its folklore applications. Further, octadecanoic acid ethyl ester was the most abundant bioactive component present.

Antidiabetic potential of saffron and its active constituents

The prevalence of diabetes mellitus is growing rapidly worldwide. This metabolic disorder affects many physiological pathways and is a key underlying cause of a multitude of debilitating complications. There is, therefore, a critical need for effective diabetes management. Although many synthetic therapeutic glucose-lowering agents have been developed to control glucose homeostasis, they may have unfavorable side effects or limited efficacy. Herbal-based hypoglycemic agents present an adjunct treatment option to mitigate insulin resistance, improve glycemic control and reduce the required dose of standard antidiabetic medications. Saffron (Crocus sativus L.), whilst widely used as a food additive, is a natural product with insulin-sensitizing and hypoglycemic effects. Saffron contains several bioactive β carotenes, which exert their pharmacological effects in various tissues without any obvious side effects. In this study, we discuss how saffron and its major components exert their hypoglycemic effects by induction of insulin sensitivity, improving insulin signaling and preventing β-cell failure, all mechanisms combining to achieve better glycemic control.

The association between subclinical hypothyroidism and erectile dysfunction

Objectives

Erectile dysfunction (ED) is highly prevalent among males, and hypothyroidism is previously reported to be related with ED. However there have been rare studies to investigate the association between subclinical hypothyroidism (SCH) and ED, hence our objective was to fill this gap.

Methods

ED patients who visited the Urology Outpatients Clinic owere recruited consecutively, and males from the Health Manage Center were included as the controls. Serum thyroid and sexual hormones were estimated, and the International Index of Erectile Function (IIEF-5) questionnaires were evaluated as well. Subjects with normal sexual hormones were included for statistical analysis.

Results

One hundred nine ED patients and 32 healthy controls were included in this study. The ratio of SCH and euthyroidism in ED males was 29.36% and 66.06% respectively. The IIEF-5 scores in ED patients with SCH were significantly lower than the controls with euthyroidism (P<0.05). The serum concentrations of TSH and prolactin were significantly higher and free thyroxine lower in ED patients with SCH when compared with the controls with euthyroidism (all p<0.05), and no significant differences of estradiol and total testosterone were found between those two groups. However the IIEF-5 scores were not significantly different between males with SCH and euthyroidism among ED patients (P>0.05).

Conclusions

SCH is common in ED patients and may be associated with ED, whereas the severity of ED is not related to SCH. Screening for thyroid dysfunction in men presenting with ED is recommended.

Summer savory (Satureja hortensis L.) extract: Phytochemical profile and modulation of cisplatin-induced liver, renal and testicular toxicity

The aim of our study was to examine the potential ameliorating effect of the methanolic extract of Satureja hortensis L. (summer savory) aerial parts against cisplatin-induced oxidative damage in renal, hepatic, and testicular tissues. S. hortensis methanol extract at the doses of 50, 100 and 200 mg/kg of body weight were orally administered to Wistar rats once daily for 10 days. Toxicity was induced by intraperitoneal injection of a single dose of cisplatin (7.5 mg/kg of body weight) on the 5th day of the experiment. Applied treatment with S. hortensis extract restored tissue morphology, ameliorated levels of serum parameters for liver, renal and testes function, tissue oxidative stress parameters, and increased Bcl-2/Bax ratio as an indicator of apoptosis in experimental animals caused by application of cisplatin. UHPLC/DAD/HESI-MS/MS analysis revealed that S. hortensis extract was rich in phenolic compounds with rosmarinic acid (24.9 mg/g) as the main compound, followed by caffeic acid (1.28 mg/g) and naringenin (1.06 mg/g). Our findings suggest that S. hortensis may be a valuable source of dietary and pharmacologically important phenolic compounds, especially rosmarinic acid, in pharmaceutical and functional food formulations in order to maintain normal health conditions or as a remedy in various diseases caused by oxidative damage.

Microbiota potential for the treatment of sexual dysfunction

Inability to have a satisfactory sexual intercourse is a serious problem affecting many people. Despite enormous efforts for developing effective treatments for pathologic conditions associated with sexual malfunction, still a lot of patients do not respond well to such treatments. Microbiota has been shown to affect obesity, diabetes, hypertension, stress/anxiety and sex hormonal disturbances. Nevertheless, no research has concentrated on the link between microbiota and human sexuality or sexual dysfunction. We propose another line of enquiry into sexual dysfunction by hypothesizing a relationship between microbiota and factors affecting human sexuality. Hence, it can be assumed that microbiota manipulation may improve sexual behavior and reduce sexual dysfunction. We also discuss the evidence to back up this hypothesis, and present some predictions.

Brysocarpus coccineus (Schum & Thonn) root reinstates sexual competence and testicular function in paroxetine-induced sexual dysfunction in male Wistar rats

The effects of aqueous extract of Brysocarpus coccineus roots (AEBCR) were studied on sexual behaviour and testicular function of paroxetine-induced sexual dysfunction (SD) in male rats. Ninety, sexually matured male rats (150.88 ± 5.53 g) were assigned into two groups: A and B. Fifteen SD animals from group B were each allotted to B1, B2, B3, B4 and B5 and received distilled water (DW), Powmax M (7.14 mg/kg body weight, b.w.) 50, 100 and 150 mg/kg b.w of AEBCR, respectively, for 7 days while the non-SD animals (group A) received DW. Eleven secondary metabolites were present in AEBCR. The lowered (p < .05) ejaculation frequency, penile erection index and penile grooming, higher mount and intromission frequencies, prolonged (p < .05) latencies of mount, intromission, ejaculation, and post-ejaculatory interval, reduced (p < .05) serum luteinising hormone, follicle stimulating hormone, testosterone, nitric oxide and testicular function indices, degenerated seminiferous tubules and low luminal spermatozoa contents by paroxetine were significantly (p < .05) attenuated and/or reinstated by AEBCR and Powmax M. The restoration of androgen-dependent sexual and testicular functions in SD male rats by AEBCR validates its folkloric use as aphrodisiac. Clinical studies are desirable to ascertain the efficacy of AEBCR in SD.

Polysaccharide from Ostrea rivularis attenuates reproductive oxidative stress damage via activating Keap1-Nrf2/ARE pathway

The purpose of this study was to investigate the effects of Ostrea rivularis polysaccharide (ORP) against testicular oxidative stress injury via kelch-like ECH-associated protein 1-nuclear erythroid 2-related factor 2/antioxidant response element (Keap1-Nrf2/ARE) pathway. In pharmacological experiments in vivo, ORP administration could dose-dependently inhibit body and testicular weight loss, ameliorate epididymal sperm quality and protect reproductive impairment in cyclophosphamide-induced male Balb/c mice. Moreover, the mechanism in vivo might be elucidated that ORP could increase expression level of Nrf2 and its downstream ARE gene battery in the testis, promote production of corresponding antioxidative enzymes and protein, and enhance Keap1-Nrf2/ARE signaling pathway to avoid male reproductive dysfunction. In addition, ORP treatment could improve survival capacity of H₂O₂-induced TM4 cells and its antioxidant mechanism in vitro also had been verified to activate Keap1-Nrf2/ARE signaling pathway. Overall, these results showed that ORP as a potent antioxidant could reduce reproductive oxidative stress damage related to Keap1-Nrf2/ARE pathway.

Standardized extract of Bacopa monnieri (CDRI-08): Effect on germ cell dynamics and possible mechanisms of its beneficial action on spermatogenesis and sperm quality in male mice

Bacopa monnieri (BM) is used in traditional medicine as nerve tonic. We have recently shown that CDRI-08, a standardized extract of BM, improves testicular functions and epididymal sperm quality in Parkes (P) mice. The aim of the present study was to investigate the effect of CDRI-08 on germ cell dynamics and mechanisms of its action on spermatogenesis and sperm quality in P mice, and to determine the chemical profile of the extract. CDRI-08 (40 and 80 mg/kg body weight) was orally administered to male mice for 28 days. Germ cell dynamics, oxidative stress parameters in testis and sperm, and expressions of nuclear factor-erythroid-2-related factor-2 (Nrf2), phosphorylated protein kinase B (p-Akt) and upstream kinases in mitogen-activated protein kinase (MAPK) pathway namely MAP2K1, MAP2K2 and MKK4 in the testis were evaluated. The treatment potentiated germ cell dynamics and improved sperm quality by enhancing antioxidant enzymes activities. The beneficial effects of CDRI-08 in the testis involve p-Akt-mediated activation of Nrf2, thereby enhancing antioxidant enzymes activities; upregulation of MAP2K1 and MAP2K2 and suppression of MKK4 are also implicated in this action. A total of 26 phytocomponents were identified in CDRI-08 by GC-MS. The results suggest that CDRI-08 also may prove useful in improving reproductive health in males.