Efficacy and Safety of Common Ingredients in Aphrodisiacs Used for Erectile Dysfunction: A Review

Srivatsav, Ashwin; Balasubramanian, Adithya; Pathak, Ujval Ishu; Rivera-Mirabal, Jorge; Thirumavalavan, Nannan; Hotaling, James M.; Lipshultz, Larry I.; Pastuszak, Alexander W.

doi:10.1016/j.sxmr.2020.01.001

Cited by 20 publications

(13 citation statements)

References 57 publications

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“…A variety of natural products, including isolated compounds from plants, have been tested for treatment of male sexual dysfunction (21). Although guidelines do not give any specific recommendation for their use, natural extracts are potentially useful in the management and treatment of male sexual dysfunction (16). Ginseng has been tested for its therapeutic properties, which include improving sexual function (22), physical performance ( 23), treating cancer (24), diabetes (25) and hypertension (26).…”

Section: Discussionmentioning

confidence: 99%

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

Mirone

Napolitano

Bianca

et al. 2021

Arch Ital Urol Androl

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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.

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Section: Discussionmentioning

confidence: 99%

“…Emerging shreds of evidence propose an increasing role of herbal-based dietary supplements and nutraceuticals in the management of ED, for their anti-oxidant, anti-inflammatory and anti-proliferative properties. (16).…”

Section: Original Papermentioning

confidence: 99%

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

Mirone

Napolitano

Bianca

et al. 2021

Arch Ital Urol Androl

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“…Other herbal aphrodisiacs that were not included in this literature review are commonly used, but data on their safety profile are also limited [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…In 2014, Corazza et al reviewed the psychoactive effects of four popular sexual enhancers [ 6 ]. In March 2020, Srivatsav et al reviewed the efficacy and the safety profile of several common aphrodisiacs used in the treatment of erectile dysfunction, but the study was not exhaustive and psychiatric and neurological adverse effects were not addressed [ 14 ]. In this review, we aimed to summarize and interpret the findings of cases and preclinical and clinical studies reporting psychiatric and neurological adverse effects associated with the use of aphrodisiacs of plant origin.…”

Section: Introductionmentioning

confidence: 99%

Pharmacology of Herbal Sexual Enhancers: A Review of Psychiatric and Neurological Adverse Effects

et al. 2020

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Sexual enhancers increase sexual potency, sexual pleasure, or libido. Substances increasing libido alter the concentrations of specific neurotransmitters or sex hormones in the central nervous system. Interestingly, the same pathways are involved in the mechanisms underlying many psychiatric and neurological disorders, and adverse reactions associated with the use of aphrodisiacs are strongly expected. However, sexual enhancers of plant origin have gained popularity over recent years, as natural substances are often regarded as a safer alternative to modern medications and are easily acquired without prescription. We reviewed the psychiatric and neurological adverse effects associated with the consumption of herbal aphrodisiacs Areca catechu L., Argemone Mexicana L., Citrus aurantium L., Eurycoma longifolia Jack., Lepidium meyenii Walp., Mitragyna speciosa Korth., Panax ginseng C. A. Mey, Panax quinquefolius L., Pausinystalia johimbe (K. Schum.) Pierre ex Beille, Piper methysticum G. Forst., Ptychopetalum olacoides Benth., Sceletium tortuosum (L.) N. E. Brown, Turnera diffusa Willd. ex. Schult., Voacanga africana Stapf ex Scott-Elliot, and Withania somnifera (L.) Dunal. A literature search was conducted on the PubMed, Scopus, and Web of Science databases with the aim of identifying all the relevant articles published on the issue up to June 2020. Most of the selected sexual enhancers appeared to be safe at therapeutic doses, although mild to severe adverse effects may occur in cases of overdosing or self-medication with unstandardized products. Drug interactions are more concerning, considering that herbal aphrodisiacs are likely used together with other plant extracts and/or pharmaceuticals. However, few data are available on the side effects of several plants included in this review, and more clinical studies with controlled administrations should be conducted to address this issue.

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“…The IIEF is a validated subjective score with high sensitivity and specificity for ED [1], and is used as a global standard in the clinical investigation of conventional and surgical interventions for ED [9,10]. ED can be classified as severe (IIEF score ≤7), moderate (8)(9)(10)(11), mild-to-moderate (12)(13)(14)(15)(16) and mild (17)(18)(19)(20)(21), while a IIEF score of ≥22 indicates no ED [9].…”

Section: Introductionmentioning

confidence: 99%

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

Leisegang

Finelli

2021

Arab Journal of Urology

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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.

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Efficacy and Safety of Common Ingredients in Aphrodisiacs Used for Erectile Dysfunction: A Review

Cited by 20 publications

References 57 publications

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

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

Pharmacology of Herbal Sexual Enhancers: A Review of Psychiatric and Neurological Adverse Effects

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

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