Abstract
Erectile dysfunction affects more than 50% of diabetic male patients, with a higher prevalence compared with the general population. Age, clinical factors, and lifestyle habits have been suggested to contribute to the pathophysiology and worsening of erectile dysfunction in diabetic patients. First- and second-line standard treatments are represented by phosphodiesterase type 5 (PDE5) inhibitors and alprostadil, respectively. However, natural compounds have been suggested to ameliorate this clinical condition. This study aims to preclinically characterize the potential synergism among plant-derived products for the improvement of erectile dysfunction in the diabetic condition. The effects of a nutritional supplement composed of Panax ginseng, Moringa oleifera and rutin, as single agents or as a mixture, were evaluated in a streptozotocin (STZ)-induced diabetic rat model with erectile dysfunction. The treatment efficacy was evaluated by measuring sexual-related parameters (i.e., mount and intromission latencies, the mount and intromission frequencies and the ejaculation latency). Results showed that only the mixture was able to significantly reduce the diabetes-related delay in mount latency (p < 0.01). Substantial similar effects were observed by measuring the intromission latency and the mean number of mounts was very similar between rats treated with the mixture and controls. Single agent treatments showed very low effects in terms of intromission frequency, whereas the mixture was able to increase this parameter. Additionally, a statistically significant reduced ejaculation latency was observed in rats treated with the mixture compared with the STZ control. These results are in agreement with the available literature and suggest that the study mixture may ameliorate sexual behavior compared with the administration of the study natural compounds as single agents in diabetic rats. Further preclinical and clinical studies are needed to perform a more comprehensive evaluation of the efficacy and safety of the study mixture.
Highlights
Recent data estimate that the global diabetes prevalence in 2019 was 9.3%, and a progressive increase is expected in the 10 and 25 years [1]
The mount frequency was stimulated by both rutin and P. ginseng extracts administered as single agents and to a higher extent by the mixture (Figure 4 and Table 4)
The phosphodiesterase type 5 (PDE5) inhibitors are efficacious in a high percentage of patients and randomized clinical trials [27,28] and open label trials [29] have shown the efficacy and substantial good tolerability of first-generation PDE5 inhibitors in diabetic patients
Summary
Recent data estimate that the global diabetes prevalence in 2019 was 9.3%, and a progressive increase is expected in the 10 and 25 years [1]. Normal sexual function may be impaired in both male and female diabetic patients and erectile dysfunction is one of the most common diabetes-related sexual dysfunctions in men [2]. Erectile dysfunction affects more than 50% of diabetic male patients, with a higher prevalence compared with the general population (i.e., odds ratio about 3.5) [3]. Age and duration of diabetes have been associated with a higher prevalence of erectile dysfunction in type 2 diabetic patients [4]. Several clinical factors, mainly related to vascular, neurological and hormonal conditions, have been suggested to contribute to the pathophysiology of erectile dysfunction in these types of patients [2]. The impairment of corpus cavernosum smooth muscle relaxation due to the endothelial-derived nitric oxide (EDNO) induced by end products of glycosylation [5,6], diabetic neuropathy [7], low levels of testosterone [8], and obesity [9] may play a role in this condition
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