Document Type : Review Articles

Authors

1 Endourology Ward, Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran

2 Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

5 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

6 Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

7 Research Center for Traditional Medicine and History of Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

8 Persian Medicine Network (PMN), Universal Scientific Education and Research Network (USERN), Tehran, Iran

9 Vice Chancellor of Academic Affairs, Smart University of Medical Sciences, Tehran, Iran

10.30476/jhsss.2022.96706.1667

Abstract

Background: Sexual dysfunction is one of the most prevalent complaints in men over 50 years old, which can negatively affect marital life and self-esteem. Consumption of oral drugs has various limitations, and they have serious interactions with other oral agents.
Methods: In this review article, the main traditional Persian medicine (TPM) sources were reviewed for topical suggestions for the treatment of men with sexual dysfunction. In addition, the herbal medicines and their constituents were reviewed in electronic databases including PubMed, Scopus, and Web of Sciences.
Results: In TPM sources, various agents in oil, decoction, dry powder, suppository, and enema preparations are suggested to treat decreased libido, premature ejaculation, and erectile dysfunction. These preparations often include volatile agents that enhance percutaneous absorption. Accordingly, the literature review suggested that the mechanisms of these remedies could be related to enhancing the regional blood flow to the genitalia, inducing venous smooth muscle relaxation and increasing the tonicity of pelvic floor muscles.
Conclusion: TPM suggestions in treating sexual dysfunction in men can ignite new ideas for further research based on the proposed mechanisms of action.

Highlights

Abdolreza Haghpanah (Google Scholar)

 

Mohammad Mahdi Parvizi (Google Scholar)

 

Keywords

  1. Rao TS, Tandon A, Manohar S, Mathur S. Clinical practice guidelines for management of sexual disorders in elderly. Indian J Psychiatry. 2018;60:S397. doi: 10.4103/0019-5545.224478. PMCID: PMC5840913.
  2. Busato W, Galindo C. Topical anaesthetic use for treating premature ejaculation: a double‐blind, randomized, placebo‐controlled study. BJU Int. 2004;93:1018-21. doi: 10.1111/j.1464-410X.2003.04773.x. PMCID: PMC15142155.
  3. Sun Y, Luo D, Yang L, Tang C, Yang T, Hu X, Shen H. Efficacy of phosphodiesterase-5 inhibitor in men with premature ejaculation: a new systematic review and meta-analysis. Urology. 2015;86:947-55. doi: 10.1016/j.urology.2015.06.051. PMCID: PMC26278825.
  4. Montague D, Jarow J, Broderick G, Dmochowski R, Heaton J, Liu T, et al. AUA guideline on the pharmacologic management of premature ejaculation. J Urol. 2004;172:290-4. doi: 10.1097/01.ju.0000132159.61156.ea. PMCID: PMC15201797.
  5. Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57:804-14. doi: 10.1016/j.eururo.2010.02.020. PMCID: PMC20189712.
  6. Serefoglu EC, Saitz TR. New insights on premature ejaculation: a review of definition, classification, prevalence and treatment. Asian J Androl. 2012;14:822. doi: 10.1038/aja.2012.108. PMCID: PMCPMC3720102.
  7. Lotti F, Maggi M. Sexual dysfunction and male infertility. Nat Rev Urol. 2018;15:287-307. doi: 10.1038/nrurol.2018.20. PMID: 29532805; PMCID: PMC29532805.
  8. Avasthi A, Grover S, Rao TS. Clinical practice guidelines for management of sexual dysfunction. Indian J Psychiatry. 2017;59:S91. doi: 10.4103/0019-5545.196977. PMCID: PMC5310110.
  9. Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200:633-41. doi: 10.1016/j.juro.2018.05.004. PMCID: PMC29746858.
  10. Donatucci CF. Etiology of ejaculation and pathophysiology of premature ejaculation. J Sex Med. 2006;3:303-8. doi: 10.1111/j.1743-6109.2006.00305.x. PMCID: PMC16939474.
  11. Corona G, Jannini EA, Mannucci E, Fisher AD, Lotti F, Petrone L, et al. Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med. 2008;5:1991-8. doi: 10.1111/j.1743-6109.2008.00803.x. PMCID: PMC18399946.
  12. Arthur SS, Dorfman CS, Massa LA, Shelby RA, editors. Managing female sexual dysfunction. Urologic oncology: seminars and original investigations; 2021: Elsevier.
  13. Baghbani F, Alidousti K, Parvizi MM, Ahmadi A, Moradi Alamdarloo S, Jaladat AM, Atarzadeh F. Efficacy of Dry Cupping versus Counselling with Mindfulness-based Cognitive Therapy Approach on Fertility Quality of Life and Conception Success in Infertile Women due to Polycystic Ovary Syndrome: A Pilot Randomized Clinical Trial. Int J Community Based Nurs Midwifery. 2024;12:57-69. doi: 10.30476/ijcbnm.2023.100249.2351. PMID: 38328008; PMCID: PMC10844878.
  14. Wassersug R, Wibowo E. Non-pharmacological and non-surgical strategies to promote sexual recovery for men with erectile dysfunction. Transl Androl Urol. 2017;6:S776. doi: 10.21037/tau.2017.04.09. PMCID: PMC5715194.
  15. Bossini L, Fortini V, Casolaro I, Caterini C, Koukouna D, Cecchini F, et al. Sexual dysfunctions, psychiatric diseases and quality of life: a review. Psychiatr Pol. 2014;48:715-26. PMCID: PMC25314799.
  16. Oyekunle OA, Raji Y. Assessment of complementary and alternative medicine (CAM) usage to enhance male sexual performance in Ogbomoso metropolis. J Public Health Epidemiol. 2011;3:271-4. doi: 10.1016/j.maturitas.2011.06.011.
  17. Tansaz M, Adhami S, Mokaberinejad R, Namavar Jahromi B, Atarzadeh F, Jaladat AM. An overview of the causes and symptoms of male infertility from the perspective of traditional persian medicine. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2016;18:11-7. doi: 10.22038/IJOGI.2016.6634.
  18. Daneshfard B, Jaladat A-M. Male infertility and diet: a perspective of traditional persian medicine. Galen Med J. 2016;5:103-4. doi: 31661/gmj.v5i2.614.
  19. Daneshfard B, Jaladat A-MJ, Sanaye MRS, Dalfardi B. Cardiac Infertility in Persian Medicine: Avicenna’s View. Galen Med J. 2017;6:356-7. doi: 31661/gmj.v6i4.1073.
  20. Nimrouzi M, Jaladat A-M, Zarshenas MM. A panoramic view of medicinal plants traditionally applied for impotence and erectile dysfunction in Persian medicine. J Tradit Complement Med. 2020;10:7-12. doi: 10.1016/j.jtcme.2017.08.008. PMCID: PMC6957810.
  21. Tansaz M, Chaichi-Raghimi M, Kaveh S, Dar FA, Mojahedi M. Principle of Hot and Cold and Its Clinical Application in Persian Medicine. Hot and Cold Theory: The Path Towards Personalized Medicine: Springer; 2022. p. 21-37.
  22. Jahan N. Exir-e-azam. Tehran: Iran University of Medical Sciences. 2008:218.
  23. Ibn Sina H. Al Ghanoon fi Al Teb. Beirut: Dar-u İhya’ut Turas’ il Arabi. 2005.
  24. Jorjani S. Zakhireye Khwarazmshahi. Tehran, Iran: Research Institute for Islamic and Complementary Medicine. 2012.
  25. Arzani M. Tibb-e-Akbari. Tehran: Iran University of Medical Sciences; 2008.
  26. Kermani N. Sharh Al-Asbab va Al-Alamat (Al-Mouhshi). Tehran: Research Institute for Islamic and Complementary Medicine; 2004.
  27. Aghili Khorasani M. Makhzan-al-advia. Tehran: Tehran University of Medical Sciences; 2009.
  28. Salehi Ghayeni M. Qarabadin-e Salehi. Tehran: Islamic medicine and complementary medicine institute press; 2004.
  29. Andersson K-E. Mechanisms of penile erection and basis for pharmacological treatment of erectile dysfunction. Pharmacol Rev. 2011;63:811-59. doi: 10.1124/pr.111.004515. PMCID: PMC21880989.
  30. Toda N, Ayajiki K, Okamura T. Nitric oxide and penile erectile function. Pharmacol Ther. 2005;106:233-66. doi: 10.1016/j.pharmthera.2004.11.011. PMCID: PMC15866322.
  31. Komuro M, Kamiyama M, Furuya Y, Takihana Y, Araki I, Takeda M. Gene and protein expression profiles of prostaglandin E2 receptor subtypes in the human corpus cavernosum. Int J Impot Res. 2006;18:275-81. doi: 10.1038/sj.ijir.3901408. PMCID: PMC16239896.
  32. Stief C, Benard F, Bosch R, Aboseif S, Nunes L, Lue TF, Tanagho EA. Acetylcholine as a possible neurotransmitter in penile erection. J Urol. 1989;141:1444-8. doi: 10.1016/s0022-5347(17)41342-5. PMCID: PMC2566691.
  33. Hamzehnejadi M, Tavakoli MR, Homayouni F, Jahani Z, Rezaei M, Langarizadeh MA, Forootanfar H. Prostaglandins as a Topical Therapy for Erectile Dysfunction: A Comprehensive Review. Sex Med Rev. 2022;10:764-81. doi: 10.1016/j.sxmr.2022.06.004. PMCID: PMC36210096.
  34. Ali B, Al-Wabel NA, Shams S, Ahamad A, Khan SA, Anwar F. Essential oils used in aromatherapy: A systemic review. Asian Pac J Trop Biomed. 2015;5:601-11. doi: 1016/j.apjtb.2015.05.007.
  35. IsHak WW, Clevenger S, Pechnick RN, Parisi T. Sex and Natural Sexual Enhancement: Sexual Techniques, Aphrodisiac Foods, and Nutraceuticals. The Textbook of Clinical Sexual Medicine. 2017:413-32.
  36. Prabsattroo T, Wattanathorn J, Iamsaard S, Somsapt P, Sritragool O, Thukhummee W, Muchimapura S. Moringa oleifera extract enhances sexual performance in stressed rats. J Zhejiang Univ Sci B. 2015;16:179-90. doi: 10.1631/jzus.B1400197. PMCID: PMC4357367.
  37. Afroz S, Yagi A, Fujikawa K, Rahman MM, Morito K, Fukuta T, et al. Lysophosphatidic acid in medicinal herbs enhances prostaglandin E2 and protects against indomethacin-induced gastric cell damage in vivo and in vitro. Prostaglandins Other Lipid Mediat. 2018;135:36-44. doi: 10.1016/j.prostaglandins.2018.01.003. PMCID: PMC29462674.
  38. Dhariwala MY, Ravikumar P. An overview of herbal alternatives in androgenetic alopecia. J Cosmet Dermatol. 2019;18:966-75. doi: 10.1111/jocd.12930. PMCID: PMC30980598.
  39. Shridharani AN, Brant WO. The treatment of erectile dysfunction in patients with neurogenic disease. Transl Androl Urol. 2016;5:88. doi: 10.3978/j.issn.22234683.2016.01.07. PMCID: PMC4739980.
  40. Mohammadzadeh-Moghadam H, Nazari SM, Shamsa A, Kamalinejad M, Esmaeeli H, Asadpour AA, Khajavi A. Effects of a topical saffron (Crocus sativus L) gel on erectile dysfunction in diabetics: a randomized, parallel-group, double-blind, placebo-controlled trial. J Evid Based Complementary Altern Med. 2015;20:283-6. doi: 10.1177/2156587215583756. PMCID: PMC25948674.
  41. Mahboubi M, Mohammad Taghizadeh Kashani L, Mahboubi M. Squill (Drimia maritima L.) and its novel biological activity. Orient Pharm Exp Med. 2019;19:227-34.
  42. Manganyi MC, Tlatsana GS, Mokoroane GT, Senna KP, Mohaswa JF, Ntsayagae K, et al. Bulbous Plants Drimia:“A Thin Line between Poisonous and Healing Compounds” with Biological Activities. Pharmaceutics. 2021;13:1385. doi: 10.3390/pharmaceutics13091385. PMCID: PMC8465487.
  43. Amini F, Jaladat AM, Atarzadeh F, Mosavat SH, Parvizi MM, Zamani N. A review on the management of asthma in the Avicenna's Canon of Medicine. J Complement Integr Med. 2019;16. doi: 10.1515/jcim-2018-0148. PMCID: PMC31527294.
  44. Esmaeili H, Esmailidehaj M, Entezari Zarch S, Azizian H. Role of the potassium channels in vasorelaxant effect of asafoetida essential oil. Avicenna J Phytomed. 2020;10:407-16. doi: 0.22038/AJP.2020.41755.2401. PMID: 32850297; PMCID: PMC7430957.
  45. Kassis E, Fulder S, Khalil K, Hadieh B, Nahhas F, Saad B, Said O. Efficacy and safety assessments of Ferula assa-foetida L., traditionally used in Greco-Arab herbal medicine for enhancing male fertility, libido and erectile function. Open Complement Med J. 2009;1. doi: 10.2174/1876391X00901010102.
  46. Eser N, Yoldaş A, Yigin A, Yumusak N, Bozkurt AS, Kokbas U, Aslan M. The protective effect of Ferula elaeochytris on age-related erectile dysfunction. J Ethnopharmacol. 2020;258:112921. doi: 10.1016/j.jep.2020.112921. PMCID: PMC32387466.
  47. Huynh HK, Willemsen AT, Lovick TA, Holstege G. Pontine control of ejaculation and female orgasm. J Sex Med. 2013;10:3038-48. doi: 10.1111/jsm.12300. PMCID: PMC23981195.
  48. Nasiri Lari Z, Atarzadeh F, Ghoreishi PS, Hosseinkhani A, Jaldat AM. Effects of Aromatherapy on Sexual Dysfunction: A Review of Persian Traditional Medicine. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2018;21:79-86. doi: 10.22038/IJOGI.2018.11230.
  49. Morakinyo A, Adeniyi O, Arikawe A. Effects of Zingiber officinale on reproductive functions in the male rat. Afr J Biomed Res. 2008;11. doi: 10.4314/ajbr.v11i3.50750.
  50. Mares A, Abid W, Najam W. The effect of Ginger on semen parameters and serum FSH, LH & testosterone of infertile men. Tikrit Med J. 2012;18:322-9.
  51. Santos HO, Howell S, Teixeira FJ. Beyond Tribulus (Tribulus terrestris L.): The effects of phytotherapics on testosterone, sperm and prostate parameters. J Ethnopharmacol. 2019;235:392-405. doi: 10.1016/j.jep.2019.02.033. PMCID: PMC30790614.
  52. Masoudi R, Javaheri Barfourooshi H, Hosseini S, Zarei F, Abdollahi Z. Effect of Tribulus terrestris, Ceratonia silique and Zingiber officinale on reproductive potential of Ross broiler breeder roosters. Veterinary Researches & Biological Products. 2021;34:177-86. doi: 10.22092/VJ.2020.351390.1750.
  53. Cohen D, Gonzalez J, Goldstein I. The role of pelvic floor muscles in male sexual dysfunction and pelvic pain. Sex Med Rev. 2016;4:53-62. doi: 10.1016/j.sxmr.2015.10.001. PMCID: PMC27872005.
  54. Mintsa BAE, Kenguele H, Mickala P, Yala JF, Ibrahim B, Lepngue AN, Souza A. Uterotonic activity of an aqueous extract of leaves of Helichrysum mechowianum commonly used for vaginal tightening by native populations in south east Gabon. Journal of Basic Pharmacology and Toxicology. 2017;1:14-20.
  55. Soltani A. Encyclopedia of traditional medicine, medical plants. vol. 3. Arjmand Press. Tehran. pp; 2005.
  56. Parvizi MM, Saki M, Handjani F, Heydari M. Olive in traditional Persian medicine: an overview. Olives and Olive Oil in Health and Disease Prevention. 2021:175-92. doi: 1016/B978-0-12-819528-4.00002-X.