Alternative medicine and herbal remedies in the treatment of erectile dysfunction: A systematic review

Abstract

Objectives: To systematically review and discuss the current evidence from placebo-controlled clinical trials that investigated the use of alternative medicines and herbal remedies in the management of erectile dysfunction (ED). Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)based systematic review using specific keyword combinations was conducted on the PubMed and Scopus databases. Randomised controlled trials investigating herbal medicine in at least one group and using the International Index of Erectile Function (IIEF) as an outcome in patients primarily diagnosed with ED were included for review. Results: Following the literature search, screening and eligibility analysis, a total of 42 articles were included. The 42 articles were categorised as single herb extractions (n = 14), combination herbal formula (n = 5), combination of herbal formula and non-herbal nutraceuticals (n = 7), non-herbal nutraceuticals (n = 5), acupuncture and moxibustion (n = 2), diet and nutrition (n = 3), exercise (n = 5), and topical treatments (n = 1). Based on the results, Korean ginseng, Pygnogenol and Prelox, Tribulus terrestris, Lepidium meyenii, L-arginine, acupuncture and lifestyle interventions were the more predominantly investigated treatments interventions for ED. Conclusions: Panax ginseng, Pygnogenol, Prelox and Tribulus terrestris have promising evidence as herbal products, alongside L-arginine as a nutritional supplement, for ED based on IIEF outcomes, and warrant further clinical investigation. The mechanisms of action remain unclear, but each of these appears to in part increase nitric oxide synthesis. Importantly, improved diet and exercise should be considered, particularly in patients with obesity or diabetes mellitus.

A Case Report of Male infertility and Gynecomastia in High Altitude Area: Clinical Evaluation and Management

“…He gave a history of "alternative medicine treatment" for his impotency. A systematic review of placebo-controlled clinical trials that investigated the use of alternative medicines and herbal remedies in the management of erectile dysfunction showed improvement in impotency 10 . Third case: He was a 27 years old man from an affluent family of Baluchistan and was extremely obese with a weight more than 200kg and height of 6 feet 2 inches.…”

The Efficacy of Acupuncture on Patients with Erectile Dysfunction: A Review

“…The penis is composed of arterioles and capillaries, blood filled sinuses, and smooth muscles. Normal erection is initiated through external stimuli via somatic and autonomic pathways [ 62 ]. The autonomic nerve originates from an important branch of the pelvic plexus, i.e., the cavernous nerve.…”

The Mechanisms and Management of Age-Related Oxidative Stress in Male Hypogonadism Associated with Non-communicable Chronic Disease

“…Numerous plants with antioxidant properties have been associated with increased testosterone in males, including improvements in male sexual behaviour, libido, and sexual function. The more common plants investigated include: Anacyclus pyrethrum , Arctium lappa , Cinnamomum zeylanicum , Coleus forskohlii , Corchorus depressus , Cynanchum wilfordii , Cyperus esculentus , Eurycoma longifolia , Garcinia cambogia , Lepidium meyenii , Moringa oleifera , Mucuna pruriens , Nigella sativa , Panax ginseng , Pedalium murex , Rhodiola rosea and Tribulus terrestris , Trigonella foenum-graecum Urtica doica , and Withania somnifera [ 197 , 198 , 199 , 200 ]. Trigonella foenum-graecum and Withania somnifera showed promising positive effects in clinical studies, whereas Lepidium meyenii , Rhodiola rosea , Tribulus terrestris , and Panax ginseng appeared to have less clinical evidence for increasing male testosterone, but may improve erectile dysfunction [ 199 , 200 ].…”