Of the 25 subjects in Group A, 15 scored the response to the therapy as “Excellent,” 9 as “Good,” and 1 as a “Moderate.” The compliance was excellent for all the patients in both the groups. Mean number of successful sexual encounters in ashwagandha root extract treated and placebo-treated groups. Mean number of total sexual encounters in ashwagandha root extract treated and placebo-treated groups. However, significant improvement was observed in the number of successful sexual encounters. No significant improvement was observed for the ashwagandha-treated group or the placebo group in terms of the total number of sexual encounters after 4 weeks and 8 weeks. Although SD is a common side effect of SSRIs, its pathophysiology remains largely unknown, as well as therapeutic treatment .For example, someone might use natural supplements while also addressing underlying health issues like high blood pressure or diabetes.Vitamin D is essential for overall health and can be synthesized by your body when exposed to sunlight.Many options exist, from medication, counseling, lifestyle changes, surgeries, and vacuum devices to improve erectile function.SD and depression are both syndromes that may be caused by the same dysfunctional brain systems.More recently, people have become interested in how this common spice might affect sexual wellness and reproductive health.This article explores when it’s safe to use cloves for sexual health purposes and when it’s time to talk to a doctor.Transforming the understanding and treatment of mental illnesses. Population and data collection If any reaction continues or worsens, notifying your healthcare professional is essential. While oral ED drugs can lead to headaches and flushing, PRP therapy has an alternative side effect profile that may be more favorable for some patients. This innovative treatment option contrasts with traditional ED treatments like oral medications, which often come with their own risks and limitations. Again, physiologically diminished LH and testosterone levels were observed in hypogonadal men suffering from ED, which were completely restored after treatment with W. Physiological data highlight the ability of ginsenosides to increase the penis blood flow by improving the activity of eNOS. Panax ginseng, also known as Korean ginseng, was present in about 52% of the supplements. A total of 23 studies (only RCTs) were finally included in this study. The literature review on ingredients identified 194 records published from 1987 onward, yielding 110 potentially eligible studies. When the study is terminated, the sponsor shall immediately notify all principal investigators of clinical research units, ethics committees, and relevant regulatory authorities and submit relevant written explanations. Before conducting statistical analysis, the statistician, sponsor, and primary investigator of the clinical research team will comprehensively determine whether to exclude the subject based on factors such as the completion of the study by the subject and reasons for withdrawal and make relevant explanations in the statistical report. (2) The subject is unable to comply with the requirements of the study protocol for medication use, testing, and provision of relevant research data. The diagnosis of qi deficiency and blood stasis in traditional Chinese medicine includes the diagnosis of qi deficiency and blood stasis as described above. The study plan to conducted in five medical institutions in China. Along with the above symptoms, there may be a decrease in sexual desire. Genitals relax during sexual intercourse. Phosphoric acid is indicated in cases of ED where the erection is weak or cannot be maintained during sexual intercourse. Staphysagria is administered in case of impotency when due to self-abuse or overindulgence sexual exhaustion sets in. There is sexual nervousness with feeble erections. These effects of niacin may help with erections in men with high cholesterol. Fenugreek has been studied more for libido and perceived sexual well-being than purely for fenugreek's effect on erections. Zinc can help with ED by supporting testosterone production and reproductive health, but this helps when zinc deficiency is present. Many people tolerate L-citrulline for ED well, and it may be a more “steady” way to support nitric oxide levels. Better blood flow is very important for stronger erections. Despite deep-rooted attention to alternative therapy of erectile dysfunction, the mechanism of action and advantages of every treatment option must be completely investigated before its usage (Burnett, 2012 ▶).Accordingly, fifty-four published articles and thesis papers were finally included in this study.Demographic characteristics (sex, age, relationship status, country of origin, occupation and daily activities) and a detailed medical history of all participants were also collected.Oral administration enhanced the sexual function of the mice and rats, as evidenced by an increase in the number of complete intromissions and the number of sperm-positive females in normal mice, and a decrease in the LPE in male rats with ED.These formulas improve erectile function when the root is Liver qi stagnation.Erectile dysfunction (ED) is defined as the persistent inability to obtain or maintain sufficient penile erection to allow satisfactory sexual intercourse (Khera and Goldstein 2011).This surge in cellular activity enhances erectile function and can make sexual performance more predictable.Sexual dysfunction is also caused by various factors such as psychological disorders like anxiety, depression, stress, fear of sex, neurological disorders, stroke, cerebral trauma and Parkinson's disease, penile diseases like phinosis, peyroniesetc. Therefore, the dose may need to be lowered for these patients 102,103. To treat patients with mild to moderate occlusive peripheral arterial disease, it is recommended that naftidrofuryl be administered orally at a dose of 300 to 600 mg/day in three divided sub-doses, swallowed whole. Naftidrofuryl is used in the treatment of cardiovascular diseases , senile dementia , and Alzheimer’s disease . The induced reduction in the lactate/pyruvate ratio in healthy human volunteers during exercise suggests that naftidrofuryl increases the efficiency of aerobic metabolism in oxygen-deprived tissues . In a double-blind study in human volunteers, naftidrofuryl increased erythrocyte deformability and flow . Mean score for “desire” domain of Female Sexual Function Index (FSFI) in ashwagandha root-treated group and placebo-treated group. The mean total FSFI score at week 4 of the study period was found to be 20.25 ± 1.66 in Group A and 17.69 ± 1.62 in Group B. At week 8 of the study period, the mean total FSFI score was 23.86 ± 2.02 in Group A and 20.06 ± 2.38 in Group B (Figure 3). The FSFI domain scores were suggestive of sexual problems linked to desire, orgasm, lubrication, satisfaction, arousal, and pain. All the women enrolled in the present study had total FSFI scores suggestive of FSD. Per cent improvement in the Mean Female Sexual Function Index (FSFI) Score for “pain” domain in ashwagandha root-treated group and placebo-treated group. Talk to a health care provider before starting or stopping any medication. The light box, which is about 20 times brighter than ordinary indoor light, filters out the potentially damaging UV light, making this a safe treatment for most. For this treatment, the person sits in front of a very bright light box (10,000 lux) every day for about 30−45 minutes, usually first thing in the morning, from fall to spring. Find tips for talking with a health care provider to improve your care and get the most out of your visit. However, the total number of RCTs included in the analysis, the total sample size and the methodological quality of the primary studies were too low to draw definitive conclusions. Six of the included RCTs compared the therapeutic efficacy of red ginseng with placebo. Systematic searches were conducted on 20 electronic databases without language restrictions. Korean red ginseng (unskinned Panax ginseng before it is steamed or otherwise heated and subsequently dried) is one of the most widely used herbal remedies. This strategy may allow for the development of new therapeutic strategies based on concepts of TCM and integrated medicine. Explore key milestones, discoveries, and the impact of NIMH-funded studies on mental health. Over 40 research groups conduct basic neuroscience research and clinical investigations of mental illnesses, brain function, and behavior at the NIH campus in Bethesda, Maryland. Learn more about NIMH newsletters, public participation in grant reviews, research funding, clinical trials, the NIMH Gift Fund, and connecting with NIMH on social media. Erectile dysfunction, or ED, is a common condition, affecting up to one-third of adult men. Key Takeaways Routine labs keep you ahead of aging by helping flag problems early and track key functions like your cardiovascular, metabolic, and hormonal health. Low sex drive in women Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone23. Nevertheless, psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. Thus, ED causes reported include, damage to nerves, arteries, smooth muscles, and fibrous tissues. According to Uganda's health policy priorities8,25, men's reproductive health is not given any mention. Reproductive health care did not appear on the health agenda until recent after the Cairo conference on population and the Peking conference on women that it indeed became a live issue4. Subgroup analyses of the effects of saffron based on dimensions of Erectile Function questionnaire. Since the studies were heterogeneous, random effect model was performed and to additionally clarify this heterogeneity, we performed sub-group and sensitive analyses. The horizontal lines denote the 95% CI, ■ point estimate (size of the square corresponds to its weight); ♦, combined overall effect of treatment Of these four studies, trial by Shamsa et al. was not included in our quantitative analysis because of the absence of a placebo group. Vitamin D and endocrine system The medicinal plants used in male-related conditions will be very significant in the present and future generations. Furthermore, research in natural products is on the increase in both developed and developing nations to show that there is renewed interest in medicines of natural origin. In the event of increased biotechnology and the use of modified living organisms in agriculture, health and environment, most people will go for natural products18,26. The plant parts harvested especially those of wild medicines such as roots and stem, pose threat to the future survival of natural reservoirs if domestication strategies are not adopted in the near future. Yet, there is increasing trend in usage of traditional medicine in developed countries30. No complementary health approaches have been shown to be safe and effective for sexual enhancement or treating ED. Further, saffron anti-inflammatory, radical-scavenging and neuro-protective properties have been reported in some studies (Hosseinzadeh and Younesi, 2002 ▶, Hosseinzadeh et al., 2012 ▶) . The mechanism of action of saffron on sexual function is unknown. Numerous other ingredients are found in popular dietary supplements and nutraceuticals marketed for improvement in sexual function.Deciding to talk with your health care provider is an important step.Physicians must be aware of the ingredients in these supplements to better counsel patients about the efficacy of these supplements.Your healthcare professional asks questions about your symptoms and checks your hormone levels.We will provide information, including trial identifier, about potentially relevant ongoing studies in the table 'Characteristics of ongoing studies'.Stress is one of the most common causes for erectile dysfunction and sexual weakness.Black maca appeared to have more beneficial effects on sperm counts and epididymal sperm motility after 42 days of treatment .Penile erection is predominantly a vascular event and according to the studies there is a strong association between ED and atherosclerotic cardiovascular (ASCV) diseases.In primary category erectile dysfunction, men may have never got an erection and ED is there from the beginning. Botanical Medicine and Natural Products Used for Erectile Dysfunction Recommendations may include sex education, counseling, and sometimes medicine and hormone therapy. Most women benefit from a treatment approach aimed at the many causes behind this condition. Your healthcare professional can look for reasons that your sex drive isn't as high as you'd like. For some women, low sex drive is part of an ongoing condition called sexual interest-arousal disorder. If low sex desire concerns you, talk with your gynecologist or another member of your healthcare team. A variety of plants have been used as sex stimulants or sexual performance enhancer in traditional systems of medicine of various countries 4–6. Although many synthetic drugs are available and/or used to treat these problems, some of the drawbacks for these drugs include them being expensive and also their ability to provoke serious adverse effects, effective natural treatments are therefore still in demand. The present review provides an overview of the herbs and their active molecule with claims for improvement of sexual behaviour. Before taking any medicine for erectile dysfunction, get your healthcare professional's OK. Diagnosing erectile dysfunction involves having a physical exam and answering questions about your medical and sexual history. Thus, the interpretation of results of the current study is restricted because of methodological flaws and huge heterogeneity among the included studies, and infertility and erectile dysfunction status. 1. Data Analysis Like for other side effects SSRIs, another method to cope with sexual dysfunction is to switch to another class antidepressant agent. Some studies reported up to 80% of SSRI-induced sexual side effects.43 The experience of sexual side effects varies between males and females beyond adolescents. In fact, it has been implicated the fact of a variety of organs like female genital organs have oxytocin receptors may lead us to consider that it has a possible preparatory role on the later and final periods of the sexual process, like ejaculation and orgasm, preparing all required muscular contraction and lubrication effects.29 On the other hand, it has been reported that the infusion of oxytocin antagonists into cranial vertebrae has resulted in an inhibitory effect on the female sexual behavior of rats.30 In a recent investigation, the influence of the intranasal administration of oxytocin was examined in twenty-nine healthy heterosexual couples. On the other hand, in clinical trials, it is not used structured sexual dysfunction inventories, instead of this, it is utilized unstructured questions on sexual dysfunction. An aphrodisiac is an agent (food or drug) that arouses sexual desire. Procreation was an important moral and religious issue and aphrodisiacs were sought to ensure both male and female potency. & Serefoglu, E.C. Current and emerging treatment options for premature ejaculation. Olivier and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. In fact, studies have revealed that the incidence of sexual dysfunction related to a variety of antidepressant drugs may be more in clinical daily practice compared to that reported in the prescribing information.23–25 Probably, in phase studies, report of sexual dysfunction is lower than in real situations. Only 20% of prescribers discuss with their patients the management strategies for adverse sexual effects related to antidepressants.23 Yet, there are a number of effective pharmacological and nonpharmacological treatment options for antidepressant-induced sexual dysfunction. The best clinical evidence supports starting treatment with an antidepressant that has a better adverse sexual effect profile, such as bupropion or mirtazapine, particularly in patients concerned about their sexual functioning and in those with sexual dysfunction at baseline.17 However, this option may not be feasible in some circumstances (eg, bupropion is contraindicated in women with eating disorders 22). This study was carried out mainly to document medicinal plants used in the treatment of sexual impotence and erectile dysfunction disorders in western Uganda. As such, healthcare practitioners should counsel patients seeking to use ginseng products about this lack of consistency among studies examining its influence on erectile function. Because 1 in 6 women in the United States takes antidepressants and a substantial proportion of patients report some disturbance of sexual function while taking these medications, it is a near certainty that the practicing clinician will need to know how to assess and manage antidepressant-related female sexual dysfunction. Additionally, further investigations into the safety and efficacy of these traditional herbal remedies used in the treatment of erectile dysfunction and other male-related conditions are recommended in Uganda. For instance, medicinal plants documented in this study like Warburgia ugandensis and Cirtopsis articulata used in erectile dysfunction and sexual impotence and ED need to be conserved based on their demand and medicinal value to the people. The men with sexual impotence and erectile dysfunction deserve proper diagnosis of the conditions and treatment. Erectile Dysfunction (ED) is the inability to attain or sustain an erection for sexual intercourse. Subsequently, clinicians should monitor possible changes in sexual function, and should select an individualized strategy for the management of TESD if it appears and is badly tolerated by the patient or their partner. However, given the data, it is essential to gather a full psychosexual history before the start of AD medication. There is unanimous agreement that the incidence of TESD is currently underestimated by clinicians and that clinicians rarely ask patients about their sexual activity (be it due to a lack of time, preparation, or interest). In these cases, it is desirable to build collaborations with licensed sex therapists who can work with patients on issues such as low desire and who may be able to help patients learn to broaden their concept of sexual pleasure and sexual intimacy with a partner. In this review, our aim is to interpret the mechanisms by which vitamin-D might regulate anatomy and physiology of penis. Literature support that vitamin-D is important for different systems of the human body including, but not limited to endocrine and immune systems, vasculature and endothelial function of the body. All personal and order information is handled securely using HIPAA-compliant systems, ensuring your data is protected and your orders remain discreet. The traditional dosage of ashwagandha raw root powder is 3000 mg twice a day, as reported in the literature, across a variety of applications. The HCARE treatment was considered as an adjunctive therapy to the counselling sessions. All of these factors contributed to the study sample being relatively homogeneous. Qualitative interviews indicated that career women and full-time homemakers were reluctant to participate in this study for an inability to comply with the needs and schedule of the study. Those who were finally enrolled into the study were mostly married women, not working in jobs, and coming from affluent households with domestic help. However, the unselective action of radiation therapy can also damage normal cells, leading to side effects. Radiation therapy is sometimes given to patients as part of the cancer therapy. Since CP targets rapidly dividing cells, it is extensively used to suppress tumor malignancy, and as an immunosuppressant for organ transplantation patients. Cyclophosphamide (CP) is an alkylating agent that shows cytostatic effects by forming covalent DNA adducts. It has been shown that the sperm count of ejaculated sperms that were incubated with ginseng extract was significantly higher than those treated with vehicle.41 Treatment with ginsenoside Rg1 (50 μg/ml) significantly increases sperm motility and membrane integrity of post-thawed sperms as compared with fresh and untreated thawed sperms.42 These findings suggest that the addition of ginseng extract to the cryogen for sperm storage could enhance fertility. By strengthening the walls of blood vessels throughout your body, including those within the penis, vitamin C promotes efficient blood flow. Vitamins play a crucial role in supporting overall health and well-being.Such as vitamin C and folic acid, their influence extends beyond general wellness. Supplements provide a concentrated dose of niacin that can support optimal levels within the body. This increased circulation can be particularly beneficial for individuals with ED since adequate blood flow is essential for achieving and maintaining an erection. Niacin acts as a vasodilator, meaning it widens blood vessels and enhances blood flow throughout the body. There are important treatment alternatives for SSRI-induced sexual dysfunction including drug choices from switching to treatment to adjunctive agents, herbal remedy methods, and psychotherapeutic approaches particularly CBT. SSRI-induced sexual dysfunction should be well screened and managed because it is often ignored, not questioned and might affect treatment prognosis badly, causing problems of medication adherence. Another herbal compound, saffron, a spice obtained by the flower of Crocus sativus plant comparatively placebo was also tried in patients who were taking the fluoxetine of 15 mg twice daily and developed sexual dysfunction for four weeks66 and was found that compared to placebo augmentation the saffron group showed a better improvement in a variety of dimensions of sexuality such as arousal, lubrication, and pain, without any difference between side effect and safety profiles of saffron plant and placebo. Herbal treatments have been also used to reduce antidepressant including SSRIs related to sexual dysfunction. It was found that switching from sertraline to nefazodone considerably reduced drug-related sexual dysfunction, without any worsening of clinical presentation.50 If you have a low platelet concentration or blood clotting issues, your body may not react favorably to the treatment. This practice contributes to better safety tracking and informs future treatment advice, ensuring that patients receive the best care possible. Swelling, bruising, and mild pain at the injection site are the most commonly reported side effects of PRP injections. Although PRP uses your own blood, minimizing the risk of immunologic reactions, it is still not without potential side effects. If you’ve tried traditional ED treatments and didn’t notice much difference or faced side effects, PRP could be a useful treatment option worth considering. In particular, all these studies were supported by manufacturers and are vulnerable to a degree of possible bias. Therefore, it is questionable whether the benefits of these herbal supplements outweigh its risk. Lack of adequate evidence, no evaluation, and absence of any regulatory obligations undertake rigorous testing for safety and efficacy of herbal supplements before they sold over-the-counter (OTC). ED in both diabetic and non-diabetic men is characterized by marked endothelial dysfunction. Although there are many triggering risk factors, vascular ED is a result of endothelial dysfunction and/or atherosclerosis; and low VD is correlated with endothelial dysfunction. However, in an observational retrospective study involving more than 10,000 patients, Vacek et al. showed that use of VD supplement improved survival in VD deficient subjects, supporting the potential benefit of this intervention. Because of its vascularity, ED is accepted as a marker of coronary endothelial dysfunction and atherosclerosis. Although there are many links between ED, ASCV disease and VD, to date, there are no prospective studies evaluating VD supplementation in patients with ED. Studies indicate that excessive consumption affects sex hormone levels and may lead to sperm abnormalities.Avoid any blood thinners like aspirin or some herbs, as they can contribute to bruising or delay healing.Rates of spontaneous remission of treatment emergent sexual dysfunction (TESD) 2,16,71,72,73.& Serefoglu, E.C. Current and emerging treatment options for premature ejaculation.Procreation was an important moral and religious issue and aphrodisiacs were sought to ensure both male and female potency.Erectile dysfunction (ED) is defined as the inability to obtain and keep a penile erection firm enough for satisfactory sexual performance.To further measure the severity of SD, potentially valid options for males include the International Index of Erectile Function (IIEF) and the Sexual Encounter Profile (SEP) , while potentially valid options for females include the Sexual Interest and Desire Inventory-Female (SIDI-F) . It can cause ED by damaging the blood vessels and causing a decrease in testosterone levels. It is followed by the release of blood into the general blood circulation that causes relaxation of penis and brings it to its original state of not being sexually aroused. Erectile dysfunction symptoms include problems in getting an erection, weak erection or difficulty in sustaining an erection hard enough for sex. This medicine suits cases of ED if genitals are relaxed during sexual intercourse and the patient feels extremely exhausted after emissions. Old men, wishing to enjoy sexual pleasure or to secure the affections of women, as well as those suffering from senile decay or sexual incapacity, and persons weakened with sexual excesses may also use Vajikaran remedies. An excerpt of the definition derived from these texts suggests that a youth in sound health taking regularly some sort of Vajikarana remedy may enjoy the pleasure of youth every night during all the seasons of the year . Vajikarana herbs are also the basis for therapies recommended in Kamasutra, a treatise defining methods for appropriate sexual satisfaction amongst couples. Of the 30 patients referred to our neurobehavioral outpatient clinic from January 2020 to December 2021, 13 Caucasian male patients, with a mean age of 29.53 (±4.57) years, were included in the study. Given that no recognized treatment for the syndrome exists, patients were treated based on their features, needs, expectancies and according to the few data coming from case reports and series. In both sexes, decreased sexual desire in depression is the most prominent symptom, and dysfunctions of sexual arousal and orgasm may also occur . Of the 30 patients referred to our neurobehavioral outpatient clinic from January 2020 to December 2021, 13 Caucasian male patients (mean age 29.53 ± 4.57 years), previously treated with SSRIs, were included in the study. The traditional healers treat sexual impotence and ED by prescribing some of these herbs in tea or using local beers, fermented milk and porridge. These plants in the tables we are discussing have been in use for centuries in treating or managing conditions in male reproductive organs. The common methods of plant medicine preparation included boiling, chewing, pounding, cooking, roasting and smoking. Thirty-three medicinal plants both cultivated (Table 1) and wild harvested (Table 2) were documented and identified in the area of study. To document male related ailments men are particularly more knowledgeable and most men share their problems with men. If resolution of a disagreement is not possible, we will designate the study as 'awaiting classification' and we will contact study authors for clarification. We will resolve any discrepancies through consensus or recourse to a third review author (Lee MS). We will also contact the main manufacturers of ginseng products to identify unpublished and relevant trials. We will contact the authors of the included studies and researchers in the field with regard to any potential ongoing and unpublished studies, if necessary. We will update the literature if it is more than six months from the publication date, and incorporate any new studies if identified. All types of ginseng, regardless of species (e.g. Panax ginseng, Panax quinquefolius and Panax japonicus), processed status (e.g. white ginseng or red ginseng), or dose will be included. We will include trials in which only a subset of participants are eligible as long as data are available separately for the relevant subsets. Second, ginseng has the potential benefit of improving cardiovascular risk factors including hypertension, hyperglycemia and hyperlipidemia, which are regarded to be important risk factors of ED (Buettner 2006). First, ginseng and ginsenosides promote endothelial nitric oxide (NO) release, which exerts a direct effect on ED through triggering erection mediated by relaxation of the smooth muscles of the corpus cavernosum (Choi 1998; Choi 1999; De Andrade 2007). If any reaction continues or worsens, notifying your healthcare professional is essential.Endothelial cells form the inner lining of the blood vessels and release Nitric Oxide.The dangers of loosing valuable indigenous knowledge (IK) on sexual impotence and ED are likely to occur because westernization in the present generation.Nearly a century ago in 1922, McCollum et al. reported that the factor that cures rickets was a new vitamin, which they called vitamin D (VD).In vivo microdialysis in conscious male rats revealed that dopamine transmission increases sharply in the striatum, nucleus accumbens, and medial preoptic area during copulation 15–17.This essential nutrient plays a vital role in maintaining the health of your blood vessels.He was the fellowship director at the Center for East-West Medicine and led courses for physician fellows, residents, and medical students.This plant has been named in this manner as its roots resemble the lower limbs of a human, Traditionally, ginseng has been used to restore and enhance the normal well-being of the body.The first unblinding time is after the blind check is completed and the database is locked, and the second unblinding time is after the statistical analysis report is completed. Your doctor will evaluate factors such as existing medical conditions and current medications to ensure safety. Before using Viagra®, it is crucial to consult a healthcare provider to determine if it is suitable for your specific health condition. This improved circulation facilitates a stronger and longer-lasting erection during sexual activity. Viagra® inhibits phosphodiesterase type 5 (PDE5), an enzyme responsible for this restriction, allowing blood vessels in the penis to relax and expand. The key to Viagra’s effectiveness lies in increasing blood flow to the penis. The observed effects appear to be attributable to the testosterone like effects of the extracts.In 2019, only PSSD gained an official recognition after the European Medical Agency concluded that PSSD is a medical condition that persists after discontinuation of SSRIs and SNRIs .It is important to make some cautionary notes on our study's results so that the reader is conservative and guarded about the conclusion that HCARE supplementation can offset FSD.Age, ED severity, coexisting health issues, and compliance with lifestyle recommendations can affect how fast and vigorously you respond.The strongest predictors of postdiscontinuation adverse sexual effects are female sex, depressive symptoms (suggesting incomplete remission), and decreased genital sensitivity.42 Because it may take several months for symptoms related to sexual dysfunction to improve with watchful waiting, this may not be a practical solution for some, and medication nonadherence is a potential concern.Many women experience sexual dysfunction where there are orgasm disorders and sexual difficulties.Thus, it could be used in the future as a therapeutic agent for patients with memory impairment . Ginseng appears to have some efficacy in treating ED over placebo, but despite its benign side effect profile, the quality of studies examining its effects is low and additional research is needed to evaluate the efficacy of ginseng for the treatment of ED. Randomized controlled trials (RCTs) employing ginseng have assessed the herb’s efficacy in improving erectile function. While medical treatments are available, patients are reluctant to discuss ED with physicians and often utilize dietary supplements to attempt to treat their ED. NO is an essential molecule and serves multiple functions including vasodilatation and many anti-atherogenic properties. Because of the presence of VD and VDR in the endothelial cells and the pivotal role of NO and eNOS in the endothelial activity, it is conceivable that an interaction between VD and NO is capable of influencing vascular function. When researchers restricted their analysis to 562 men (among 3390 men) with serum levels of sex hormones and adjusted for sex hormone levels, the association of VD with ED became even stronger. The latter study indicated that VD played a protective role for testes and against testicular damage induced by diabetes, and the possible mechanism might be effective through regulating attenuation of inflammation and inactivating caspase cascade. This article does not contain any studies with human or animal subjects performed by any of the authors. More methodologically rigorous, large-scale clinical trials are still needed to determine the extent to which encouraging findings in rodent, cell culture, and ex vivo models are generalizable to human populations. To assess an extensive array of toxicological evidence of herbal supplements pharmacovigilance safety programs should be adopted. In the Russian medical system, this extract is recommended for oral use at a daily dose of 20–40 drops for an adult. Tests on healthy volunteers have also concluded that the active compounds of eleuthero affect cell defense, physical fitness, and lipid metabolism . In an in vivo study, an aqueous extract of eleuthero reduced acute stress in mice . Overall, the extract has improved learning ability by enhancing cognitive function and memory retention. It has been suggested that glial cells may produce NO by an enzyme-independent mechanism when stimulated by superoxide radicals, and the study results verified the antioxidant activity of Brahmi plant extract . Increased levels of ROS have been shown to be related with diminished motility of the spermatozoa and increased DNA damage, and may even induce germ cell apoptosis (Irani et al.,2017 ▶,Agarwal and Said, 2005 ▶, Wang et al., 2003 ▶). Recent studies have explored the effect of reactive oxygen species (ROS) on sperm. However, none of them has resulted in a complete treatment (Isidori et al., 2006 ▶, Kumar et al., 2006 ▶). Approximately 15% of couples are infertile, and in half of these cases, a male factor is involved (Hamada et al., 2012 ▶, Mosher, 1988). One of male infertility problems is infertility that is defined as the failure to get pregnant after one year of regular, unprotected intercourse. Erectile Dysfunction - Randomized Controlled Trials (PubMed®) A service of the National Library of Medicine, PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. People with diabetes, high blood pressure, high cholesterol, or heart disease often take drugs containing nitrates, and men with these conditions frequently have ED. For example, some of them may interact with drugs that contain nitrates, leading to a dangerous decrease in blood pressure. To treat diabetic ED, this is essential, and the patient must reduce or eliminate carbohydrate consumption if he wants to recuperate his normal erectile function. As a man ages, he loses the Kidney essence, "The Fire of the Gate of Life." This essence is limited, and if we lose it or waste it, and if there is no more, erectile function can not be performed. Many options exist, from medication, counseling, lifestyle changes, surgeries, and vacuum devices to improve erectile function. The mechanisms underlying the effect of ginseng in treating ED are thought to be related to multiple pathways (Moyad 2012). Consequently, pharmacological ingredients that are related to the effect of ginseng on ED should be identified to elucidate the underlying mechanism of action (Ernst 2010). Ginseng has also been used to improve general conditions relevant to quality of life and athletic performance in the healthy population (Bahrke 2009; Coleman 2003). Reproductive Health care is the second most prevalent health care problem on African continent4. Pamplona-Roger27 defines impotence as the inability to finish sexual intercourse due to lack of penile erection. The word “impotence” may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm23. The concept of reproductive health care has been focusing mainly on women disregarding men and yet men are part. We will document reasons for exclusion of studies that may have reasonably been expected to be included in the review in a 'Characteristics of excluded studies' table. Two review authors (Lee HW, Kim T‐H) will independently scan the abstract, title, or both, of remaining records retrieved, to determine which studies should be assessed further. The bibliographic references of all included trials will be reviewed to identify other potentially relevant studies. We will search for ongoing studies by accessing the following databases. Health Topics Terrestris to male lambs and rams improves plasma testosterone and spermatogenesis . Treatment also restored the levels of SOD, catalase, GSH, and ascorbic acid in seminal plasma of infertile men. Pruriens significantly ameliorated psychological stress and seminal plasma lipid peroxide levels along with improved sperm count and motility. Pruriens treatment to infertile men regulates steroidogenesis and improves semen quality 91, 92. Cognitive-behavioral therapy is useful for dealing with the negative thoughts that develop in many patients, such as sexual inadequacy and low self-esteem 54,55. The presence of few not validated approaches highlights the difficulty in choosing the treatment that must be targeted at the individual level in patients with PSSD. In particular, muscle vibrations (MVs) have already been used to manage different pelvic floor dysfunctions due to diverse pathologies . In our sample, a patient with no response to previous pharmacological treatment received an intensive alternative treatment using Vibra -Plus, with a beneficial role in his sexual symptoms, including sexual hypoesthesia and anorgasmia. Although many nutraceuticals claiming to improve erectile function contain zinc, the lack of literature supporting its use highlights how ingredients included in these products are often done so without adequate scientific support. Althoughzinc can improve sexual desire in rats in a dose-dependent fashion, no studies have evaluated its efficacy in the treatment of ED. Thus far, limited evidence exists that zinc supplementation increases testosterone levels or overall sexual function in men with adequate zinc intake. Zinc, however, is commonly included in dietary supplements targeted at improving overall sexual function. 12. Patient's Global Assessment of Response to Therapy (PGART) Rates of spontaneous remission of treatment emergent sexual dysfunction (TESD) 2,16,71,72,73. In patients (with or without partners) who consider preserving sexual function as relevant, the ethical obligation of discussing possible sexual side effects of AD medication should always be kept in mind before prescribing it so that the patient can make an adequately informed decision about their treatment. Ashwagandha has traditionally been used to treat weakness, erectile dysfunction, performance anxiety in men, and diminished sexual desire in both men and women 6–8. A number of literatures have reported the cooccurrence of depression, anxiety, and sexual dysfunction 8–12. Too much physical activity without proper rest, like excessive running, may deplete Spleen and Kidney Yang and will produce erectile dysfunction. Also, constant fear and anxiety feelings will deplete the kidney energy producing erectile dysfunction. Excessive worry will affect the Heart and Spleen, and it may affect the blood flow disturbing erectile function. Of course, if someone is stronger than average, he won't be affected if he overdoes it, but guys with health problems should reduce their ejaculation ratio to fasten their recovery of erectile function. Insufficiency of Jing or essence will lead to infertility and erectile dysfunction. The therapeutic effects of ginseng are very diverse, and the evidence for its efficacy in treating several conditions such as cardiovascular disease (Buettner 2006), Alzheimer's disease (Lee 2009), common cold (Seida 2011), and hypertension (Hur 2010), has been evaluated. Ginseng has been one of the most popular trade goods for health care and treatment of diseases in Asia, and is currently consumed in 35 countries around the world (Baeg 2013). Your healthcare professional asks questions about your symptoms and checks your hormone levels. In Eastern medicine, deer velvet is sought after for its Chinese medicinal properties which include boosting one’s endurance and improving one’s immunity. A significant proportion of these potency-inducing supplements in Asia have been found to contain PDE5-inhibitors substrates such as tadalafil and sildenafil (30). While there is no scientific evidence supporting this practice, the cultural beliefs remain strong and supplements containing extracts from animal penises are readily available in the form of capsules, often mixed with herbal compounds pitching similar erectogenic properties. An aphrodisiac is defined as any food or drug that arouses the sexual instinct, induces venereal desire and increases pleasure and performance (29). Warm yang can energize kidneys to benefit the body, remove toxins, invigorate qi and promote blood circulation. This plant has been named in this manner as its roots resemble the lower limbs of a human, Traditionally, ginseng has been used to restore and enhance the normal well-being of the body. Contraindications include patients on tricyclic antidepressants, anti-hypertensives and central nervous system stimulants. Common side effects include headache, sweating, agitation, hypertension and insomnia. Some patients may not wish to change their treatment or may not respond to suggested TESD alleviation strategies.As this study is the first double-blind, placebo-controlled, multicentre randomized controlled trial of traditional Chinese medicine for the treatment of ED, we chose only two internationally recognized scales to evaluate the subjective sexual experience of ED patients.The only herbal medications that have been studied for erectile dysfunction are Panax ginseng, Butea superba, Epimedium herbs (icariin), Tribulus terrestris, Securidaca longipedunculata, Piper guineense, and yohimbine.The dispensing of herbal medicines used in sexual impotence and ED using local beers, fermented milk and porridge possibly the alcoholic content improves on the kind of active chemicals extracted than water alone12.Key Takeaways Your lifestyle, including nutrition, fitness, sleep habits, and stress, is far more important than you think to your testosterone and sexual health after 40.Often, patients’ ongoing SSRI treatment use over the optimum dosage of medication.In fact, the enrolled patients were almost diagnosed and treated for different psychiatric disorders in other outpatient clinics, and came to our attention due to the onset of the symptom after SSRI intake and/or its persistence after withdrawal.Assessment of sexual functioning is important, not only at the initial visit but also at subsequent visits and can be accomplished with direct inquiry. Erectile dysfunction has remained as one of the major global health issues. We summarize and critically review recent evidence—both human and non-human—supporting the role of six commonly cited herbs on men’s and women’s sexual health, identifying possible mechanisms of action, as well as gaps in the literature. It should be kept in mind that a number of men are at risk of yielding to the temptation of using these supplements for improving their sexual functions. The current laws regulating sexual enhancing supplements assume that all supplements are safe until the dozens of deaths are reported due to adverse events. Studies on some of the natural supplements such as Yohimbine, Ginseng and Maca to regain the sexual vigour are burdened with serious adverse effects. When it comes to scientific development, in Western medicine, an analytic approach is often used to identify and resolve medical challenges. The following article reviews our current understanding regarding the philosophical approach, and evaluates the evidence surrounding various ED therapies between mainstream Western medicine and TCM (see Table 1). Western medicine involves a step-wise approach by targeting the relevant organ systems to treat various clinical symptoms; but TCM focuses on restoring the balance between various organs to achieve harmony and holistic approach to inner sense (4). “Don’t be afraid to bring up a sexual health concern,” says Dr. Simone. For others, sexual side effects continue to be a problem. How severe sexual side effects are depends on the person and the specific type and dose of antidepressant. Further studies with larger cohorts of participants should be focused on the potential mechanisms and therapeutic effects of B12 on ED. This study was conducted in order to discover the functions of HCY, B12 and FA in ED. If ED has a medical cause, supplements alone are unlikely to fix it. Individuals with specific medical conditions, allergies, or taking medications should exercise particular caution when considering alternative medicine practices. Some practices may carry potential risks or interact with existing medical treatments. The people of Ethiopia depend heavily on medicinal plants to ease their ailments, including erectile dysfunction. In this review, we revisit and evaluate empirical research on six herbal supplements purported to affect sexual and/or reproductive function in men and women. People using Phosphodiesterase type 5 (PDE-5) inhibitors mainly suffer from erectile dysfunction (ED). From the conservation point of view, medicinal plants usage will continue to grow in popularity as people seek ways to support health naturally and gently31. This indigenous knowledge in medicine ought to be documented for future use and sustainable utilisation19. The dangers of loosing valuable indigenous knowledge (IK) on sexual impotence and ED are likely to occur because westernization in the present generation. However, most of the herbal remedies used in male ailments are not well documented and researched. This rare and/or under-reported clinical entity is still not recognized by many specialists in the field. Tricyclics, serotonin and norepinephrine reuptake inhibitors (SNRIs) as well as antipsychotics have been reported to cause enduring SD, beside the well-known (although rare) long-term effects on the extrapyramidal system, including tardive dyskinesia . Large-sample prospective cohort studies and randomized clinical trials are needed to investigate the real prevalence of this clinical entity and confirm such a promising approach to a potentially debilitating illness. Although our data come from a retrospective open-label study with a small sample size, drugs positively modulating the central nervous system serotonin/dopamine ratio, such as vortioxetine, could be used to potentially improve PSSD. In the absence of more definitive human data, patients should be cautioned before considering ED-S use, particularly in light of the availability of highly effective FDA-approved drugs and increasingly affordable therapeutic options. This demonstrates how tissue repair can transcend mere wound healing and aid various forms of sexual dysfunction. These studies show that improved blood flow is a major way PRP helps sexual function. This surge in cellular activity enhances erectile function and can make sexual performance more predictable. Ginseng has been demonstrated to have a cytoprotective effects against these toxins, in which administration of Panax ginseng extract is reported to significantly reduce the 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced pathological and genotoxical damages in rat testes.54 In addition, treatment of Panax ginseng is found to protect Sertoli cells from the cytotoxic effects of bisphenol A.55 Daily treatment of Asian ginseng (25–100 mg/kg) or ginsenoside Rg1 (2.5–10 mg/kg) demonstrates a dose-dependent increase in mounting, intromission, and penis licking in mice which are exposed to estrous females.18 Such effects are not observed in mice treated with ginsenoside Rb1, Rb2, and Ro. In this review, we will summarize the effects of ginseng on male sex performance and spermatogenesis. In the United States, 17% constantly visited herbal therapist in the past 18 mo out of the 29% of infertile couples who use complementary and alternative medicine.3 In a clinic-based survey conducted in Jordan, 44% of infertile patients use herbal medicine as part of their infertility treatment.4 Among them, 8% went for Chinese medication.4 In South Australia, 29% of interviewed infertile subjects use herbal remedies, in which 4.2% uses ginseng.5 In addition, ginseng is found to improve the sperm quality and count of healthy individuals as well as patients with treatment-related infertility. PRP’s effect on blood flow has been backed by clinical studies, which report better penile hemodynamics and higher IIEF scores in treated men. Collectively, these processes are designed to repair damage, promote nerve and vessel health, and assist in reclaiming sexual function. There have not been sufficient experimental studies and results to support prophylactic use, even though the use of herbal supplements with nootropic effects has shown little risk of side effects and contraindications have been minimal. It is recommended that the constriction band be removed within 30 mins to return the penis to its flaccid state, as prolonged application of the constriction band can compromise both arterial and venous blood flow (7). If a pre-loaded constriction band is applied over the base of the penis to prevent outflow of blood and maintain tumescence for intercourse, it is considered a vacuum constriction device (VCD). Vacuum draws mixed arterial and venous blood into the corporal bodies and distends the corporal sinusoids to create an erected penis. The vacuum device is approved by USA Food and Drug Administration (FDA) for treatment of ED since 1982. The practice of isolating compounds and understanding its pharmacological attributes before using it as a drug therapy has been a strength of Western medicine. Demographic characteristics (sex, age, relationship status, country of origin, occupation and daily activities) and a detailed medical history of all participants were also collected. In fact, the enrolled patients were almost diagnosed and treated for different psychiatric disorders in other outpatient clinics, and came to our attention due to the onset of the symptom after SSRI intake and/or its persistence after withdrawal. The patients enrolled were referred by general practitioners or other neurologists/psychiatrists to RSC (a recognized specialist of such syndromes), or they reached the clinic through information coming from Google or other media/social sites.