The following herbs are used to improve sexual function:
• Anise imitates the female hormone estrogen, increasing sexual intensity and satisfaction
• Epimedium, a Chinese herb, has a testosterone-like substance and enhances a woman’s sexual desire
• Fenugreek augments breast size and is used to elevate sex drive
• Fennel prolongs orgasm, allowing men to enjoy sex for a longer period of time
• Guarana seed tea has aphrodisiac effect
• Quebracho (in South America) and Sheng Jing (in China) are used in male infertility and erectile dysfunction (impotence)
Erectile dysfunction (ED) is a condition defined by the inability to attain or maintain penile erection sufficient for satisfactory sexual intercourse. In 1995, it was estimated that approximately 152 million men worldwide suffered from erectile dysfunction, with projections for 2025 growing to a prevalence of 322 million affected men. In the past, erectile dysfunction was believed to be caused by nonspecific psychological causes; however, in the past two decades, the majority of cases have been attributed to an organic etiology. Although erectile dysfunction patients can have a number of medical conditions, organic erectile dysfunction is usually associated with vascular risk factors such as arteriosclerosis, hypertension, diabetes mellitus, Peyronie’s disease, and renal disease. In addition, pelvic trauma and pelvic surgery (radical prostatectomy or radical cystectomy) can cause erectile dysfunction by either vascular or nerve damage.
Since the early 1980s, understanding about the pharmacology of the erectile mechanism has advanced significantly. Basic research in corporal cavernosal smooth muscle (CCSM) physiology and identification of the central mediators involved in the erectile process has contributed to the development of pharmacological agents that can effectively treat erectile dysfunction patients. At present, the diagnosis and treatment of erectile dysfunction has evolved to the point where virtually every patient suffering from erectile dysfunction can be successfully treated. Vacuum erection devices, intracavernosal injection therapy, intraurethral suppositories, oral medications, penile vascular procedures, and surgical implantation of prosthetic devices offer most men a viable option to correct their erectile dysfunction. However, despite the overall success and efficacy of the aforementioned therapies, there are implicit side effects, complications, and contraindications. Therefore, the development of future therapeutic options for the treatment of erectile dysfunction should focus on those strategies with fewer adverse effects and an absence of contraindications. Gene therapy for the treatment of erectile dysfunction may become a viable and relatively noninvasive therapeutic option.
A variety of endocrine, vascular, neurological, and psychiatric diseases disrupt normal sexual and reproductive function in men. Furthermore, sexual dysfunction may be the presenting symptom of systemic disease.
Failure Of Erection
The organic causes of erectile impotence can be grouped into endocrine, drug, local, neurological, and vascular causes (TABLE Some Organic Causes of Erectile Impotence in Men).
TABLE Some Organic Causes of Erectile Impotence in Men
|Histamine (H2) blockers (e.g., cimetidine)|
|Central-acting sympatholytics (e.g., clonidine and methyldopa)|
|Peripheral-acting sympatholytics (e.g., guanadrel)|
|Monoamine oxidase inhibitors|
|Central nervous system depressants|
|Sedatives (e.g., barbiturates)|
|Antianxiety drugs (e.g., diazepam)|
|Drugs of habituation or addiction|
|Anterior temporal lobe lesions|
|Diseases of the spinal cord|
|Loss of sensory input|
|Disease of dorsal root ganglia|
|Disease of nervi erigentes|
|Radical prostatectomy and cystectomy|
|Diabetic autonomic neuropathy and various polyneuropathies|
|Aortic occlusion (Leriche syndrome)|
|Atherosclerotic occlusion or stenosis of the pudendal or cavemosa arteries|
|Arterial damage from pelvic radiation|
|Disease of the sinusoidal spaces|
Note: Sexuality is an integral part of one’s identity; it is a reflection of how one feels about oneself and how one interacts with others. Sexual function refers to the physiological ability to perform in a sexually satisfying manner, with or without a partner. Drugs can influence both sexuality and sexual function.
Sheng Jing (TABLE Ingredients of the Chinese Herbal Formula Sheng Jing) has been tested in 202 patients, given twice a day for 60 d. The results showed “a significant improvement in sperm density, motility and grade, levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) and reduction in serum anti-sperm antibody titers. Sperm density increased from 16.2 x 106/ml to 56.1 x 106/ml. Sperm density in men with severe oligospermia (2.1 x 106/ml) also experienced significant improvements (17.9 x 106/ml). Sperm motility increased from 34% to 46%. They reported a 78% pregnancy rate in the 148 couples available for follow-up”.
TABLE Ingredients of the Chinese Herbal Formula Sheng Jing
|Western Name||Chinese Name|
|Antler gelatin||Lu jiao jiao|
|Epimedium||Yin yang huo|
|Cherokee rosa||Jin ying zi|
|Schizandra||Wu wei zi|
|Loranthus||Sang Ji Sheng|
|Rehmannia||Shu di huang|
|Lycium||Gou qi zi|
|Cuscuta||Tu si zi|
|Morinda||Ba Ji Tian|
|Rubus||Fu Pen Zi|
|Achyranthes||Huai niu xi|
In addition, the efficacy of acupuncture on penile erection has been tested. Organic disease was excluded by a combination of nocturnal penile tumescence monitoring and pharmacologically enhanced duplex ultrasonography. Twenty-nine patients with a mean age of 40 years received a series of ten treatments over a 4-week period. If no improvement was observed, they received a second course of ten treatments. Mean follow-up was 8 months. Of the patients, 69% demonstrated successful results, defined as having two or more erections per week that were satisfactory for intercourse.