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Monday, September 22, 2014

CAUSES OF IMPOTENCE



CAUSES OF IMPOTENCE by SEXUAL DYSFUNCTION
Sexual dysfunction is a serious medical and social symptom that occurs in 10-52% of men and 25-63% of women. Erectile Dysfunction, the main reason of male impotence, is considered as one of the most important public health problems, since it affects a great percentage of men. Erectile Dysfunction is defined as the consistent inability to obtain or maintain an erection for satisfactory sexual relations. An estimated 20-30 million men suffer from some degree of sexual dysfunction.

1.       Sexual dysfunction occurs commonly in middle-aged and older men.
2.       Impotence occurs in 50% of men with diabetes mellitus.
3.       Atherosclerosis is the cause of approximately 40% of Erectile Dysfunction in men older than 50 years.
4.       Among the most commonly recognized conditions associated are high blood pressure, lipid problems (cholesterol, triglycerides), diabetes, and cigarette smoking.
5.       Endocrine disorders like low testosterone and thyroid problems also contributes to Erectile Dysfunction.
6.       Pelvic trauma, pelvic surgery (major prostate, bladder, and bowel operations) and pelvic radiation therapies are also connected with Erectile Dysfunction.
7.       Direct trauma to the perineum can cause vascular problems in the penis and lead to Erectile Dysfunction that may be treatable by penile artery bypass surgery.
8.       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.
9.       Other organic causes include chronic renal failure, hepatic failure, multiple sclerosis, Alzheimer's disease, sleep apnea and chronic obstructive pulmonary disease.
10.  Chronic alcohol abuse and cigarette smoking also adversely affect sexual potency.
11.  Decrease in hormone level with age, systemic diseases like cancer also influences sexual ability.
12.  Erectile Dysfunction is also associated with some therapeutic agents like antihypertensives, antipsychotics, antidepressants, and drugs for diabetes mellitus.
 

APHRODISIAC


WHAT IS APHRODISIAC?
An aphrodisiac is an agent (food or drug) that arouses sexual desire. The hunt for natural supplement from medicinal plants is being intensified mainly because of its fewer side effects. In this review, we have mentioned the pharmacologically tested (either in man or animal or in both) aphrodisiac plants, which have claimed for its uses.

An aphrodisiac is defined as any food or drug that arouses the sexual instinct, induces veneral desire and increases pleasure and performance. A lot of natural substances have historically been known as aphrodisiacs in Africa and Europe, like yohimbine and the mandrake plant, as well as ground rhinoceros horn in the Chinese culture and “Spanish fly” which is actually toxic. Even in today's culture, there are certain foods that are used as aphrodisiacs, including strawberries and raw oysters. Chocolate, coffee, and honey are also believed to have aphrodisiac potential. Although these natural items are claimed as aphrodisiacs, there is no or little scientific confirmation supporting those assertions.
Aphrodisiacs can be classified by their mode of action into three types: Those that increase libido, potency, or sexual pleasure. Various substances of animal and plant origin have been used in folk medicines of different cultures to energize, vitalize and improve sexual function, and physical performance in men, out of these very few have been identified pharmacologically.
·        For increasing libido, ambrein, a major constituent of Ambra grisea, is used in Arab countries. It contains a tricyclic triterpene alcohol which increases the concentration of several anterior pituitary hormones and serum testosterone.
·        Bufo toad skin and glands contain bufotenine (and other bufadienolides), a hallucinogenic congener of serotonin. It is the active ingredient in West Indian “love stone” and the Chinese medication chan su.
·        In traditional Chinese medicine, Panax ginseng is used as a sex stimulant. It works as an antioxidant by enhancing nitric oxide (NO) synthesis in the endothelium of corpora cavernosa (CC); ginsenosides also cause transmural nerve stimulation-activated relaxation associated with increased tissue cyclic guanosine monophosphate.
·        For increasing sexual pleasure, cantharidin (“Spanish fly”) from blister beetles, which have been used for millennia as a sexual stimulant.
According to Ayurveda, some herbs have been traditionally used as Vajikaran Rasayana herbs because of their putative positive influence on sexual performance in humans.




HERBAL APHRODISIACS

BEST STUDIED HERBAL APHRODISIACS

>Chlorophytum borivilianum (Safed Musli)
The tuberous roots of this plant possess immunomodulatory and adaptogenic properties and are used to cure impotency, sterility, and enhance male potency. Variation in the sexual behavior is observed after uses of this herb root as reflected by reduction of mount latency (ML), ejaculation latency (EL), post-ejaculatory latency, intromission latency (IL), and an increase of mounting frequency (MF) and also reflected enhanced penile erection and reduced hesitation time. The observed effects appear to be attributable to the testosterone like effects.
A study to evaluate the aphrodisiac and spermatogenic potential of the aqueous extract of dried roots of Chlorophytum Borivilianum, and it observed a marked aphrodisiac action, increased libido, sexual vigor and sexual arousal. Similarly it is observed significantly increased sperm count. The roots of this herb can be useful for the treatment of sexual inadequacies, such as premature ejaculation and oligospermia.

>Mondia whitei (Periplocaceae)

Mondia whitei has been used by many traditional medicine practitioners for the management of ED. It is used to increase libido and also for the management of low sperm count. Investigations showed significantly enhanced total motility as well as progressive motility in human spermatozoa. These support the use of Mondia whitei especially in men affected with asthenozoospermia. Researches showed sexual enhancement in sexually inexperienced male rats. This is due to the reduction of the hesitation time of the sexually inexperienced males towards receptive females as indicated by the significant decrease in the ML (mount latency). Herb enhances the sexual power by increasing androgen levels.

>Tribulus terrestris (गोखुरू)
Plant has many common names, including bindii, bullhead, burra gokharu, caltrop, cat's head, devil's eyelashes, devil's thorn, devil's weed, goathead, Puncture Vine, Puncturevine, and tackweed.
Tribulus terrestris is used in traditional medicine to improves libido and spermatogenesis. Steroid saponins is found in herb in significant quantities. It is also found to increase the levels of testosterone, leutinizing hormone, dehydroepiandrosterone, dihydrotestosterone, and dehydroepiandrosterone sulphate.
A study showed the androgen releasing property of the Tribulus terrestris extract and its relation to sexual behavior and intracavernous pressure.

>Saffron, Crocus sativus (केशर)
Crocus sativus L., commonly known as saffron is recommended as an aphrodisiac agent in traditional medicine. But the researches findings do not support a beneficial effect of saffron administration in men with ED.

>Myristica fragrans (जायफल)
The dried kernel of broadly ovoid seeds of Myristica fragrans Houtt. (Nutmeg) has been mentioned in Unani medicine to be of value in the management of male sexual disorders. In a study it was found that administration of 50% ethanolic extract of a single dose of Nutmeg and Clove, and Penegra resulted in the increase in the mating performance.

>Phoenix dactylifera (खजूर)
The date palm pollen (DPP) of Phoenix dactylifera (date palm) is used in the traditional medicine for male infertility. A study showed that the consumption of date palm pollen (DPP) suspensions improved the sperm count, motility, morphology, and DNA quality with a concomitant increase in the weights of testis and Exploring scientifically proven herbal aphrodisiacs epididymis. The date palm contains estradiol and flavonoid components that have positive effects on the sperm quality. It did not significantly affect the weight of the prostate and the seminal vesicle or the histology of the reproductive tissues. From the study, it was concluded that DPP seems to cure male infertility by improving the quality of sperm parameters.

>Lepidium Meyenii (Maca)
Lepidium meyenii (Maca) is traditionally employed for its supposed aphrodisiac and fertilityenhancing properties. Studies proved the aphrodisiac activity of Lepidium meyenii. Experiments shows that treatment with Maca does not affect serum reproductive hormone levels. But oral administration of Maca significantly improve sexual performance parameters.

>Kaempferia Parviflora (Thai Ginseng)
Kaempferia parviflora commonly called Thai black ginger, Thai ginseng or Krachai Dum, is traditionally used to enhance male sexual function. Studies shows that administration of the alcohol extract significantly decreased mount and ejaculatory latencies. It has no effect on fertility or sperm motility. On the other hand, alcohol extract produced a significant increase in blood flow to the testis without affecting the heart rate and mean arterial blood pressure. The studies indicates that alcohol extract had an aphrodisiac activity probably via a marked increase in blood flow to the testis.

>Eurycoma Longifolia (Tongkat Ali)
Eurycoma longifolia (commonly called tongkat ali or pasak bumi) has gained notoriety as a symbol of man's ego and strength by the Malaysian men because it increases male virility and sexual prowess during sexual activities. Eurycoma longifolia produced a dose-dependent, recurrent and significant increase in the episodes of penile reflexes as evidenced by increases in quick flips, long flips and erections. Studies support to the use of the plant by indigenous populations as a traditional medicine for its aphrodisiac property. The proandrogenic effects are shown by studies.

>Satureja Khuzestanica (Satureja)
Satureja khuzestanica essential oil (SKEO) from Satureja khuzestanica Jamzad significantly improved all the parameters evaluated such as potency, fecundity, fertility index, and litter size. SKEO significantly improved cyclo phosphamide (CP)-induced changes in plasma testosterone, sperm quality, spermatogenesis and fertility, toxic stress, and DNA damage. CP-induced toxic effects on androgenesis and spermatogenesis is mediated by free radicals. SKEO protects reproductive system from toxicity of CP through its antioxidant potential and androgenic activity. Moreover, concentrations of FSH and testosterone were significantly increased in SKEO-treated groups. Also the weights of testes, seminal vesicles, and ventral prostate weights were increased by SKEO. Histopathological analysis showed that in male rats treated with SKEO the number of spermatogonium, spermatid cords, Leydig cells, and spermatozoids was increased. Furthermore, in these groups, the Sertoli cells were hypertrophic.

>Panax Ginseng
Panax ginseng is considered as one of the finest aphrodisiacs in the world. As the neurotransmitter inducing penile erection, NO release was shown to be enhanced by Panax ginseng. Ginsenosides enhanced both acetylcholine-induced and transmural nerve stimulation-activated relaxation associated with increased tissue cGMP. The latter effect was eliminated by tetrodotoxin and was associated with decreased tissue cGMP. Ginsenoside-enhanced CC relaxation was attenuated by nitro-l-arginine and oxyhemoglobin, and enhanced by superoxide dismutase. Panax ginseng is used in traditional Chinese medicine as strong aphrodisiac.

>Pausinystalia Johimbe (Yohimbe)
Pausinystalia johimbe a psychoactive plant that contains the MAOI alkaloid (Monoamine oxidase inhibitors are chemicals and have a long history of use in the treatment of depression, Parkinson's Disease and several other disorders). It is widely considered as an herbal aphrodisiac and purported to be helpful for men with erectile dysfunction (ED). It is the only herb listed in the Physician's index reference for sexual function. The US FDA approved yohimbe as the first plant derived drug for treating impotency and was dubbed the “herbal viagra”. It stimulate blood flow by dilating blood vessels and increases the body's production of norepinephrone; which is essential in the formation of erections. This herb can restore potency even to diabetic and heart patients that were suffering from impotency due mainly to their diseases. This herb also acts as a stimulant for the pelvic nerve ganglia and also to boost adrenaline supply to nerve endings, which leads to an increase in sexual sensation and stamina. In men without ED, Yohimbe helps to increase sexual vigor and prolong erections. Yohimbine is a useful treatment option in orgasmic dysfunction.

>Fadogia Agrestis
Fadogia agrestis is potential aphrodisiac and can be helpful to enhance all sexual behaviour parameters (i.e significant increase in MF, IF and significantly prolonged the ejaculatory latency and reduced mount and IL) and evaluated serum testosterone concentration. It can be used to modify impaired sexual functions, especially those arising from hypotestosteronemia.

>Montanoa tomentosa (Zoapatle)
Montanoa tomentosa is used as a traditional remedy for sexual impairment. Studies showed that the herb is useful in enhancing sexual activity and particularly on sexual arousal by increasing sexual potency acting as an oxytocic agent.

>Terminalia catappa (देसी बादाम)
Terminalia catappa is known by the common names country almond, Indian almond, Malabar almond, sea almond, tropical almond, miich, Singapore almond, Louze, بيدان, ketapang, ebelebo, Malabar almond, Indian almond, tropical almond, sea almond, beach almond, Talisay, Kottamba, abrofo nkatie, tavola, castanhola, zanmande, തല്ലി തേങ്ങ, Badam, kotōl, khungu, talis and midhili. Terminalia catappa has a significant aphrodisiac potential. It is observed that T. catappa seeds at small dose had a marked improvement of aphrodisiac action, sexual vigor while in contrast, the higher dose reversibly inhibited all the parameters of sexual behaviour other than mounting.

>Cochitzapotl, Casimiroa Edulis (White Sapote)
The seed extract of Casimiroa edulis, also known as cochitzapotl or White sapote is consumed as an aphrodisiac. Consumption of seed extract shows significant increase in MF, IF, and first sand second ejaculatory latencies. similar mode of action of C. edulis and sildenafil citrate. The aqueous seed extract of Casimiroa edulis possesses alphrodisiac activity and may be used as an alternative drug therapy to restore sexual functions probably via a neurogenic mode of action.

>Turnera diffusa (Damiana)
Turnera diffusa or Damiana is considered as an aphrodisiac and have a stimulating effect on libido. Turnera Diffusa helps to recovers sexual behavior in sexually exhausted male and significantly reduces the post-ejaculatory interval. The studies supports the use of Turnera diffusa as an aphrodisiac and suggest possible therapeutic properties on sexual dysfunction.