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

Kristian Leisegang,Renata Finelli

doi:10.1080/2090598x.2021.1926753

Kristian Leisegang, Renata Finelli

Open Access

https://doi.org/10.1080/2090598x.2021.1926753

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Abstract

ABSTRACT 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.

Highlights

Erectile dysfunction (ED) is defined as the inability to achieve and/or maintain an appropriate penile erec tion that is sufficient for sexual intercourse, and clini cally classified as psychogenic or organic [1,2]
A systematic review of the literature for placebocontrolled clinical trials investigating traditional and herbal medicine was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [22]
Randomised controlled trials in patients diagnosed with ED

Summary

Introduction

Erectile dysfunction (ED) is defined as the inability to achieve and/or maintain an appropriate penile erec tion that is sufficient for sexual intercourse, and clini cally classified as psychogenic (such as relationship dissatisfaction, societal pressures, anxiety or depres sion) or organic (underlying causes or comorbidities) [1,2]. This is a common and increasing male sexual health concern, with a prevalence of up to 31% [2] and projected to affect up to 322 million men by 2025 [3]. Endocrine, immune and metabolic interactions underlie the pathogenesis [1], ED is considered a multidimensional and complex pathology [4]

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