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Clinical trial of Butea Superba, an alternative herbal treatment for erectile dysfunction
Abstract
To study the effect of Butea superba on erectile dysfunction (ED) in Thai males.
A 3-month randomized double-blind clinical trial was carried out in volunteers with ED, aged 30 years approximately 70 years, to evaluate the therapeutic effect of the crude preparation of Butea superba tubers on ED.
There was a significant upgrading in 4 of the 5 descriptive evaluations of the IIEF-5 questionnaire. Estimation of the sexual record indicated that 82.4% of the patients exhibited noticeable improvement. Haematology and blood chemistry analysis revealed no apparent change.
The plant preparation appears to improve the erectile function in ED patients without apparent toxicity.
... Butesuperins A (1) and B (2), isoflavonolignans that contain a 1,4-benzodioxane moiety, were isolated from the tuberous roots of Butea superba by Ishikawa and coworkers ( Figure 1). 1 Butea superba tubers are considered to be aphrodisiacs in Southeast Asian countries, and dietary supplements containing tuber extracts or powders are widely sold and advertised as male enhancement supplements. Several human clinical trials have been performed to prove the efficacy of Butea superba tubers for the treatment of erectile dysfunction and as an aphrodisiac, but the results led to conflicting conclusions and placebo effects were not assessed in these clinical trials. ...
... Several human clinical trials have been performed to prove the efficacy of Butea superba tubers for the treatment of erectile dysfunction and as an aphrodisiac, but the results led to conflicting conclusions and placebo effects were not assessed in these clinical trials. [2][3][4] Even though the use of Butea superba root as a traditional medical herb hints its safety, its safety has not been rigorously evaluated. Several toxicological studies revealed that the dried roots were mutagenic at high doses in mice, 5 and caused increases in spleen weight and increases in the levels of several blood parameters in rats. ...
... Reference standards are needed to establish and operate screening systems for detecting dietary supplements that contain these extracts or powders. Butesuperins A (1) and B (2) have been considered to be marker compounds for Butea superba tubers because both of these compounds have been reportedly identified only in this plant. Recently, butesuperin A (1) was also isolated in Sophora tonkinensis. ...
... Penile erection can be effectively improved by B. superba ethanol extract. According to a study by Cherdshewasart and Nimsakul (2003), ethanol extract raised intracavernous pressure (ICP) in vivo [141]. Moreover, a study has demonstrated how C. orchioides helps people recover from sexual dysfunction brought on by physical testicular injury [142]. ...
... Penile erection can be effectively improved by B. superba ethanol extract. According to a study by Cherdshewasart and Nimsakul (2003), ethanol extract raised intracavernous pressure (ICP) in vivo [141]. Moreover, a study has demonstrated how C. orchioides helps people recover from sexual dysfunction brought on by physical testicular injury [142]. ...
Men of all ages frequently experience erectile dysfunction (ED) or impotence, and it is a difficult health issue that adversely affects the quality of life of those who experience it. There are multiple types of treatment strategies for ED available, depending on the origin and severity of ED, as well as any underlying medical issues. However, these therapeutics are known to have a number of negative health effects. In contrast, plant-based treatments are more effective for managing diseases due to their ability to modulate biological processes like inflammation, oxidative stress, and cell signaling molecules. Many medicinal plants have been reported to be quite helpful in the improvement of ED. In this review, ED and its causes, diagnostic methods, treatment strategies, and some of the most potent plant-based interventions against ED are discussed in greater detail, along with a description of their mechanisms of action and a brief discussion of approaches to increase their efficacy, with a focus on the management of ED using herbal interventions as complementary and alternative medicines. While there is hope that medicinal plants could provide lead substances for erectile dysfunction medications, additional investigation is necessary to ascertain the efficacy and security of these prospective treatments.
... B.superba, a plant in the family Leguminosae, a herb used for rejuvenation, improve sexual performance, or prevent erectile dysfunction function, in Southeast Asian nations since ancient times [20]. e potential medicinal applications of B. superba to treat erectile dysfunction in mature human males have been reported [21]. Furthermore, it could promote penile blood flow [22] and enhance penile erection via the inhibition of cAMP phosphodiesterase activity [23,24]. ...
... Furthermore, it could promote penile blood flow [22] and enhance penile erection via the inhibition of cAMP phosphodiesterase activity [23,24]. Moreover, the antioxidative activity of BSE has been reported [25] to increase serum testosterone [21,26] and it could ameliorate cognitive and emotional deficits in olfactory bulbectomized mice by inhibiting AChE [27]. erefore, from the evidence of BSE activities, it may potentially ameliorate cognitive and memory disorders and develop to be a health product for AD prevention. ...
Butea superba Roxb. (B. superba) is a herb that has been used for rejuvenation, to improve sexual performance, or to prevent erectile dysfunction function. Alzheimer’s disease (AD) is a chronic neurodegenerative disorder that is the main cause of progressive dementia. This study aimed to investigate the amelioration for cognitive and memory dysfunction of B. superba ethanolic extract (BSE), a possible mechanism of action, and its toxicity. The results from the Y-maze test, novel object recognition test, and passive avoidance test exhibited that the administration of BSE at 50 mg/kg (BSL) and 200 mg/kg (BSH) could ameliorate scopolamine-induced cognitive impairment in all behavior testing. Moreover, BSE could prevent the cognitive deficit in a dose-dependent manner in a passive avoidance test. Furthermore, BSE inhibited acetylcholinesterase’s (AChE) ex vivo activity in the cerebral cortex and hippocampus. Also, the in vitro and ex vivo antioxidative effects of BSE revealed that BSE had free radical scavenging activities in both DPPH and FRAP assay. Furthermore, male rats treated with BSE at 200 mg/kg/day for two weeks could significantly increase serum testosterone compared with control (P0.05). These results suggest that BSE may not be toxic to the vital organ and blood. In conclusion, BSE has the potential to be developed as a health supplement product or medicine for AD prevention and treatment.
... belonging to the family Fabaceae is a herb distributed in the deciduous forests of Thailand. B. superba has been used in Thai traditional medicine to remedy several symptoms; for example, the bark and flowers are used for antibacterial and antifungal activities, and the root is used to improve physical strength, male sexual performance, and erectile dysfunction [3,4]. The tuberous root has a long cylindrical shape. ...
... B. superba contained genistin, genistein, and daidzein that possessed potent antioxidant properties [7] and showed strong antimicrobial ability [3]. B. superba exhibited the ability to improve erectile function in erectile dysfunction patients without apparent toxicity [4] and showed inhibition activity of acetylcholinesterase in the brains of mice [8]. Alone and in combination, genistein and daidzein from B. superba could improve sperm numbers and motility, cholesterol, and testosterone levels [9]. ...
This study investigated total phenolics content (TPC), total flavonoids content (TFC), antioxidant, toxicity, and cytotoxicity of B. superba ethanolic extract (BSE), which the plant is used in Thai traditional medicine. The toxicity was evaluated using a brine shrimp lethality assay and the cytotoxicity was done through Michigan Cancer Foundation (MCF-7) and prostate cancer (PC-3) cancer cell lines, particularly nuclear morphological changes and Deoxyribonucleic acid (DNA) fragmentation. The result found that BSE had low TPC and TFC (87.16 µg gallic acid equivalent (GAE)/mg and 38.29 µg CE/mg). The effective concentrations at 50% (EC50) and 99% (EC99) through 2,2-diphenyl-l-picrylhydrazyl (DPPH) and Ferric thiocyanate (FTC) assays were 3,610.10 (EC50/DPPH), 215.11 (EC50/FTC), 7,304.05 (EC99/DPPH), and 401.88 (EC99/FTC) µg/mL, respectively. Lethal concentration at 1% (LC1) and 50% (LC50) were 54.63 and 184.24 µg/mL Therapeutic index (TI) and margin of safety (MOS) assessment of BSE by DPPH and FTC assay were 0.051 (TIDPPH), 0.856 (TIFTC), 0.007 (MOSDPPH), and 0.136 (MOSFTC). BSE demonstrated an antiproliferative effects on MCF-7 and PC-3 cells in a dose-dependent manner, and induced apoptosis and DNA fragmentation in both cancer cells. In conclusion, BSE proposed to develop anticancer agents that could contribute to medicinal benefits.
... Following abstract screening, 41 studies were considered potentially eligible and the full text was read. After exclusion of another 17 full-text articles [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34], 24 articles were included in the systematic review . One trial, although originally designated as controlled, was excluded because no patients in the placebo group continued the study [18]. ...
... After exclusion of another 17 full-text articles [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34], 24 articles were included in the systematic review . One trial, although originally designated as controlled, was excluded because no patients in the placebo group continued the study [18]. [35][36][37][38][39][40][41][42][43][44][45][46] evaluated the effect of herbal monopreparations (five ginseng, three saffron, two Tribulus terrestris, and one each Pinus pinaster and Lepidium meyenii), seven evaluated herbal formulations [47][48][49][50][51][52][53], and five evaluated herbal monopreparations/formulations in combination with pure compounds (e.g., L-arginine, paraaminobenzoic acid, glucosamine oligosaccharide, roburin, citrulline, vitamin E) [54][55][56][57][58]. Table 1 shows the composition of the herbal formulations and herbal monopreparations/formulations containing pure compounds. ...
Purpose:
Erectile dysfunction (ED) is a common condition that significantly affects quality of life and interpersonal relationships.
Objective:
Our objective was to perform a systematic review and meta-analysis to evaluate the efficacy of herbal dietary supplements in the treatment of ED.
Materials and methods:
We searched five databases to identify randomized controlled trials (RCTs) that evaluated the clinical efficacy of herbal medicines in ED. Quality was assessed and risk of bias was estimated using the Jadad score and the Cochrane risk-of-bias tool.
Results:
In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15-0.70; P < 0.01; I2 = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies.
Conclusions:
Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.
... 16 In Africa, several plants are being identified as a possible fertility regulating herbs with various other properties 17,18 and only very few of them have been tested and proven for such effects while others are under test. 19,20 This has led to explore the need to test the level of antioxidant in the bark of Ficus vogelii as a woody shrub that is used as food for both human and animals 21,22 and its potency in reducing uterine and ovarian toxicity. The fruit of most other species are also edible though they are usually of only local economic importance. ...
p> Background and Objectives: Toxicity is fast becoming a major cause of infertility in this century unknowingly and researchers can no longer be mute over this situation. In this work, we aimed at exploring the potency of the bark of Ficus vogelii as an herbal product in protecting against female toxicity.
Methods: The twenty 25 female Wistar rats used weighed between 140 – 180g and were randomly assigned into five groups of five rats per group with group A servicing as control which received normal saline. Groups B and C received 3.5 mg/kg of Lead acetate 14 days and later received low and high dose of extract respectively. Group D served as lead acetate group while group E received extract only.
Results: There were changes in body, uterine and ovarian weight (P > 0.01). Superoxide Dismutase (SOD) enzyme levels were reduced significantly in B and C (P > 0.01) group animals while there was an increase in its levels in group D. Several alterations were seen in the ovary and uterus which includes reduced folliculogenesis with a marked increase in the number of atretic follicles, oedema and necrotic zones. These effects were seen to be restored near normal in the groups that were administered with extract.
Conclusions: This work showed that the bark of Ficus vogelii could be a good herbal remedy for infertility.</p
... All the remaining 11 RCTs in this group of RCTs were studies on efficacy. The authors reported that T. terrestris extract alone did not improve erectile dysfunction, nor affected blood testosterone level (Santos et al., 2014); extracts from Butea superba tubers (Cherdshewasart and Nimsakul, 2003), Korean red ginseng (de Andrade et al., 2007), T. terrestris (Kamenov et al., 2017), multi-herb HK-204 (Lee et al., 2020b), KBMSI-2 (Park et al., 2019) and VigRX Plus (Shah et al., 2012) improved erectile function without affecting testosterone levels. In contrast, Rosa damascena oil (Farnia et al., 2017), NRL/MW/201901 , a mixed extract of T. foenum-graecum seed and Lespedeza cuneata (Park et al., 2018) and a mixture of L-arginine aspartate with Pycnogenol (an extract from the bark of Pinus pinaster Aiton) (Stanislavov et al., 2008) improved both erectile function and blood testosterone levels. ...
Background
: Male factor infertility often results from testicular disorders leading to inadequate sperm quantity and quality. Both beneficial and detrimental effects of botanical products, especially herbal medicines, on testicular functions and male fertility have been reported in the literature.
Purpose
: This scoping review aims to map the main clinical evidence on the different impacts of botanical entities on the testis and to critically appraise relevant randomized controlled trials (RCTs) published in the recent 5 years, so as to inform the future.
Methods
: Systematic reviews, meta-analyses and RCT reports on botanical impacts on testicular functions and male fertility were retrieved and synthesized from Pubmed, Web of Science, Scopus, Embase, ProQuest, Cochrane Library and Google Scholar up to 10th May 2022. RCTs published since 2018 were critically appraised against good practice guidelines for RCT and for reporting herbal studies.
Results
: We identified 24 systematic reviews and meta-analyses published since 2005, by authors from Iran (25%), China (21%), USA (12.5%) and 9 other countries. All but two were published in English. Only 3 systematic review protocols were identified, all published in English from China in the recent 3 years. We identified 125 RCTs published in six languages, mainly English (55%) and Chinese (42%). They were published since 1994 from 23 countries on all the six inhabitable continents, with China (46%), Australia (8%), USA (8%), India (7%) and Iran (5%) being the leading contributors. 72% and 28% RCTs published in English were on efficacy (botanicals vs placebo) and comparative effectiveness (one botanical vs other treatments), respectively. In contrast, 98% RCT reports in Chinese were on comparative effectiveness, with merely 2% on efficacy. Among all the 125 RCTs, 57% were studies in men with semen abnormality and/or male infertility, 22% investigated herbal effects in healthy men, 14% were in men with male sexual dysfunction and hypogonadism, and 7% were conducted in men with non-sexual disorders. Since 2018, 32 RCTs have been published, in English (69%) or Chinese (31%). Nineteen RCT reports from China, India, Japan and Korea all studied herbal formulae while the 13 RCT reports from Australia, Brazil, Czech and Italy, Iran, Malaysia, Spain, the UK and the USA all exclusively studied extracts of a single species. Putting geo-cultural differences aside, gossypol and extracts of Tripterygium wilfordii Hook. f. were found to be detrimental to the testis and male fertility, while the extracts of Withania somnifera (L.) Dunal and traditional Chinese medicine Qilin Pill, etc., might improve testosterone levels and semen parameters, thus could be therapeutic for male sexual dysfunction and infertility. However, all still require further evaluation in view of recurring weaknesses in quality control of herbal materials, RCT design and reporting. For example, only 9%-23% of the RCTs published since 2018 provided information on voucher samples, chemical profiling, herbal authentication and herbal extraction.
Conclusion
: Research on botanicals and the testis has been reported worldwide, demonstrating clear geo-cultural differences in studied plant species, botanical types, study objectives and quality of research design, implementation and reporting. Due to a few recurring weaknesses in the literature, this study is unable to recommend the use of any specific botanicals, however, current evidence does indicate that botanicals can be double-edged swords to the testis and male fertility. To secure better clinical evidence, future studies must faithfully implement existing and emerging good practice guidelines.
... [22] Clinical trials have also demonstrated its effectiveness against erectile dysfunction in Thai males. [23] One of the chemical compounds found in M. macrocarpa is L-dopa, which is effective against neurodegenerative disorders. [24] M. macrocarpa is also documented to be a promising anticancer agent, antioxidant, and antimicrobial. ...
... Common adverse effects include headache, sweating, agitation, hypertension and insomnia. Other plants that can arouse sexual activity, such as Korean red ginseng (43)(44)(45)(46) , Tribulus terrestris, Horny Goat Weed (Epimedium spp.), Tongkat Ali (Eurycoma longifolia Jack) (26) , Ginkgo biloba (47,48) , Saffron: Crocus sativus Linn (49,50) , Red Kwao Krua (Butea superba) (51) , and Andrographis paniculata (52) . ...
Erectile dysfunction is a common problem in people with epilepsy(PWE). The etiology is multifactorial involving most epilepsy, antiepileptic drugs, and co-morbidity. It is an extensive influence on the quality of life and well-being of patients and their partners. Apart from epileptic disease and antiepileptic drugs (AEDs) use, the general medical history with the question of other possible risk factors and the specific sexual history play the most important roles in the guideline-based diagnostics. In addition, a thorough clinical examination and specific laboratory tests should be carried out. The appropriate treatment to be provided for epileptic patients with erectile dysfunction (ED) requires evaluation according to patient requirements, the epileptic condition and comorbidities and the medicines available for managing epilepsy. Various approaches might be helpful for treatment of ED in PWEs. Contemporary treatment algorithms for ED involve the use of non-pharmacological therapies; psychotherapy, changes of AEDs and pharmacological therapies such as phosphodiesterase type 5 (PDE5) inhibitors and intra-cavernosal injection therapy of vasoactive agents, as well as vacuum erection devices and penile prosthesis implants in PWEs. The success rates are high in most cases. Every neurologist, urologist, andrologist and other practitioners of sexual medicine should have detailed knowledge in this field. This state-of-the art article evaluates current and emerging therapeutic options for ED problems in PWEs.
... The roots of B. superba contain flavonoids, tannins, alkaloids, glycosides, and phenols (Vijayan, Seethalakshmi, Jayanthi, & Ragunathan, 2016). These phytochemicals, especially flavonol and flavonoid glycoside, isolated from Red kwao krua function as phytoandrogens, with similar effects as testosterone (Cherdshewasart & Nimsakul, 2003;Manosroi & Manosroi, 2005). The presence of flavonoid glycoside stimulates testosterone production, which augments sex shift to male individuals. ...
Control of prolific reproduction is vital for a profitable tilapia aquaculture enterprise. All‐male tilapia culture is a popular method used to control prolific breeding, because the male individuals grow faster than female and mixed‐sex populations. Presently, most farmers use 17α‐methyl testosterone (MT) to produce all‐male tilapia individuals, although synthetic hormones are linked to human health and environmental risks. Recently, considerable attention has focused on plant‐based products as alternatives to MT, because they are affordable, safe, and eco‐friendly. Despite the growing interest in using plant extracts to prevent frequent spawning in tilapia production, the available information is not collated to standardize application guidelines. Accordingly, this review article consolidates existing knowledge on the use of plant extracts to control prolific breeding in tilapia culture systems. In addition, limitations to commercial application of the extracts are identified. To date, seed, root, and leaf extracts of 20 plant species, most notably, Tribulus terrestris, Mucuna pruriens, and Carica papaya, exhibit potential for controlling unwanted breeding in tilapia production systems. The extracts are mainly administered orally, incorporated in fish feeds. Saponins and flavanoids are the main bioactive compounds in the phytoextracts, which induce sex inversion and fertility impairment in tilapia. The commercialization of plant extracts is, however, hampered by lack of standardized information on extract preparation, optimal dosages, and mechanism of action. Thus, future studies should address these technical limitations and highlight economic incentives for commercial use of plant extracts in tilapia aquaculture.
... 16 In Africa, several plants are being identified as a possible fertility regulating herbs with various other properties 17,18 and only very few of them have been tested and proven for such effects while others are under test. 19,20 This has led to explore the need to test the level of antioxidant in the bark of Ficus vogelii as a woody shrub that is used as food for both human and animals 21,22 and its potency in reducing uterine and ovarian toxicity. The fruit of most other species are also edible though they are usually of only local economic importance. ...
... 8 The tubers of Butea superba have been found to contain estrogenic substances similar to follicle hormones. 9 . Roots of Butea superba show rejuvenating activity. ...
Butea monosperma (lam.) family: leguminosae is deciduous trees, to 10m high, bole crooked, irregular; bark5-6 mm thick, grey to grayish-brown color tree this plant species has been foun to display a wide variety of biochemical activities like antistress,
... Butea monosperma (commonly called Flame of forest, Dhak or Palash), native to Indo-Malayan region is an economically important species with great medicinal value. The tree is of great medicinal value e.g. the leaves have astringent and aphrodisiac properties (Cherdshewasart W and Nimsakul N., 2003), flowers possess antistress properties (Bhatwadekar et al., 1999), seeds are anthelmintic (Prashant et al 2001) and bark have antifungal properties (Bhandara et al 1989). Despite its great medicinal uses, little is known about the genetic diversity of B. monosperma. ...
... Powdered crude extract of this herb at the doses of 2, 25, 250, and 1250 mg/kg body weight in male rats for 8 weeks increased testis weight and sperm counts [37]. Moreover, the ethanol extract of B. superba has been shown to increase penile erection acting through cAMP/cGMP pathways [38]. ...
Male infertility can range from neurohormonal imbalances, reproductive tissue disruptions, qualitative and quantitative deterioration of semen to sexual behavioral problems. The global deterioration of male reproductive health is a major concern and the modern therapeutic approaches to combat male infertility are expensive, less accessible, have long term treatment tenure and possess various side effects. Whereas, the herbal therapies, are better positioned to offer more holistic approaches to improve male reproductive health. In Ayurvedic pharmacology, there exists a special group of herbs, classified as vajikarana or aphrodisiacs, which nourishes and stimulates the sexual tissues. This review concentrates on the Ayurvedic approach to ameliorate male reproductive health referring to some of the most important scientifically tested herbs which have been reported to accentuate male fertility by imposing either stimulating or nourishing effects on the male reproductive organs.
... For instance, androgenic effects of Buteasuperba, a Thai herb used in traditional medicine, have been reported in male and female rats. [5,6] Green tea extract and a specific green Trichosanthes kirilowii Exerts Androgenic Activity via Regulation of PSA and KLK2 in 22Rv1 Prostate Cancer Cells tea catechin, (-) epigallocatechin-3-gallate can control the production and biological activities of androgens as well as other hormones. [7] In our preliminary work, we performed in vitro screening using over 30 kinds of herbal extracts to detect any androgenic or anti-androgenic effect in human prostate cancer 22Rv1/MMTV cells. ...
Background:
The androgen comprises a group of hormones that play roles in male reproductive activity as well as personal characteristics.
Objective:
We investigated the androgenic activity of various herbal medicines in human prostate cancer 22Rv1 cells.
Materials and methods:
Herbal extracts of Trichosanthes kirilowii (TK), Asarum sieboldii (AS), Sanguisorba officinalis (SO), and Xanthium strumarium (XS) were selected to have androgenic effects based on a preliminary in vitro screening system.
Results:
TK, AS, SO, and XS enhanced the proliferation of 22Rv1 cells without having cytotoxic effects. All tested herbal extracts increased androgen receptor (AR)-induced transcriptional activity in the absence or presence of dihydrotestosterone (DHT). In an AR-binding assay, TK, but not AS, SO, or XS, produced a significant inhibition of AR binding activity, indicating it has androgenic activity. Additionally, TK treatment positively regulated mRNA expression of the AR-related molecular targets prostate-specific antigen (PSA) and kallikrein 2 (KLK2) compared with untreated control.
Conclusion:
Taken together, TK-enhanced AR-mediated transcriptional activity might be an attractive candidate drug for treating androgen-related diseases.
Summary:
Trichosantheskirilowii (TK), Asarumsieboldii (AS), Sanguisorbaofficinalis (SO), and Xanthium strumarium (XS) enhanced the proliferation of 22Rv1 cells without having cytotoxic effects.TK, AS, SO, and XS increased androgen receptor (AR)-induced transcriptional activity.TK, but not AS, SO, or XS, produced a significant inhibition against AR-binding activity.TK treatment positively regulated mRNA expression of the AR-related molecular targets prostate-specific antigen and kallikrein 2. Abbreviations used: BPH: benign prostatic hyperplasia; AR: androgen receptor; DHT: dihydrotestosterone; PSA: prostate-specific antigen; TK: Trichosanthes kirilowii; AS: Asarum sieboldii; SO: Sanguisorba officinalis; XS: Xanthium strumarium; ATCC: American Type Culture Collection; FBS: fetal bovine serum; PBS: phosphate-buffered saline; SD: standard deviation; ARE: androgenresponsive element; KLK: kallikrein.
... In addition, the plant crude extracts were also shown to act as antimicrobial agents [4], antioxidant [5], acetylcholinesterase (AChE) inhibitor for protection of Alzheimer's disease [6] and anti-proliferation agents for retarding growth of human breast adenocarcinoma cells (MCF-7) [1]. The male potency benefits of the plant tubers were proven in the Thai human clinical trial in which the consumption of the tuberous powder could be the alternative treatment for erectile dysfunction [7]. The mechanism of action of the tuberous chemical constituents might need endogenous testosterone to work synergistically to stimulate the accessory male sex organ of intact animals [8]. ...
Seasonal changes are major factors affecting environmental conditions which induce multiple stresses in plants, leading to changes in protein relative abundance in the complex cellular plant metabolic pathways. Proteomics was applied to study variations in proteome composition of Butea. superba tubers during winter, summer and rainy season throughout the year using two-dimensional polyacrylamide gel electrophoresis coupled with a nanoflow liquid chromatography coupled to electrospray ionization quadrupole-time-of-flight tandem mass spectrometry. A total of 191 protein spots were identified and also classified into 12 functional groups. The majority of these were mainly involved in carbohydrate and energy metabolism (30.37 %) and defense and stress (18.32 %). The results exhibited the highest numbers of identified proteins in winter-harvested samples. Forty-five differential proteins were found in different seasons, involving important metabolic pathways. Further analysis indicated that changes in the protein levels were due mainly to temperature stress during summer and to water stress during winter, which affected cellular structure, photosynthesis, signal transduction and homeostasis, amino-acid biosynthesis, protein destination and storage, protein biosynthesis and stimulated defense and stress mechanisms involving glycolytic enzymes and relative oxygen species catabolizing enzymes. The proteins with differential relative abundances might induce an altered physiological status within plant tubers for survival. The work provided new insights into the better understanding of the molecular basis of plant proteomes and stress tolerance mechanisms, especially during seasonal changes. The finding suggested proteins that might potentially be used as protein markers in differing seasons in other plants and aid in selecting B.
superba tubers with the most suitable medicinal properties in the future.
... The plant is known to have aphrodisiac (6), larvicidal, insecticidal (7), antiproliferative (8), acetylcholinesterase inhibitor activities (9). It is also used in the treatment of erectile dysfunction (10). Local tribal groups of Davanagere district use the aqueous extracts of stem bark with limejuice in healing the wounds, aqueous leaf extract and stem bark extract are mixed with honey and cows urine (in the proportion of 2:1:1) is used in treating jaundice (11). ...
... An RCT analyzing the effects of B. superba on men with ED showed that 82.4% of the patients exhibited noticeable improvement by using the International Index of Erectile Function (IIEF) scoring system [38]. In this study, 39 men were randomized assigned to groups, but only 17 completed the study with B. superba. ...
... It also significantly Smallanthus sonchifolius Yacon (Asteraceae) ferulic acid, chlorogenic acid [202] enhanced the effects of cGMP and isobutylmethylxanthine. This suggests that B. superba may act through cAMP/cGMP pathways [39]. ...
The use of plant or plant-based products to stimulate sexual desire and to enhance performance and enjoyment is almost as old as the human race itself. The present paper reviews the active, natural principles, and crude extracts of plants, which have been useful in sexual disorders, have potential for improving sexual behaviour and performance, and are helpful in spermatogenesis and reproduction. Review of refereed journals and scientific literature available in electronic databases and traditional literature available in India was extensively performed. The work reviews correlation of the evidence with traditional claims, elucidation, and evaluation of a plausible concept governing the usage of plants as aphrodisiac in total. Phytoconstituents with known structures have been classified in appropriate chemical groups and the active crude extracts have been tabulated. Data on their pharmacological activity, mechanism of action, and toxicity are reported. The present review provides an overview of the herbs and their active molecule with claims for improvement of sexual behaviour. A number of herbal drugs have been validated for their effect on sexual behavior and fertility and can therefore serve as basis for the identification of new chemical leads useful in sexual and erectile dysfunction.
... The tuberous roots of this plant have been used for centuries as a folk medicine not only to improve physical and mental conditions but also to prevent impaired sexual performance in middle-aged or elderly males (Suntara, 1931;Tocharus et al., 2006). Clinical studies demonstrated that oral administration of powdered tubers of this plant elicited noteworthy amelioration in middle-aged males with erectile dysfunction, which might be related to the fact that BS has some isoflavonolignans such as butespurerins A and B, which have inhibitory activities against phosphodiesterase type 3A and type 5, enzymes targeted for erectile dysfunction therapy (Cherdshewasart and Nimsakul, 2003;Ma et al., 2005;Tocharus et al., 2006). In addition, our previous study using olfactory bulbectomized (OBX) mice as an animal model of dementia and depression clarified that this plant can ameliorate cognitive dysfunction of OBX animals via normalizing synaptic plasticity-related signaling and facilitating central cholinergic systems (Mizuki et al., 2014). ...
Ethnopharmacological relevance:
Butea superba (BS) is a Thai medicinal plant that has been used as a folk medicine to improve physical and mental conditions and to prevent impaired sexual performance in middle-aged or elderly males. We have previously reported that this plant extract could improve cognitive deficits and depression-like behavior in olfactory bulbectomized mice, an animal model of dementia and depression.
Aim of the study:
In this study we examined the effect of BS on depression-like behavior in mice subjected to unpredictable chronic mild stress (UCMS) to clarify the antidepressant-like activity of BS and the molecular mechanism underlying this effect.
Materials and methods:
UCMS mice were administered BS daily (300 mg of dried herb weight/kg, p.o.) or a reference drug, imipramine (IMP, 10 mg/kg, i.p.), 1 week after starting the UCMS procedure. We employed the sucrose preference test and the tail suspension test to analyze anhedonia and depression-like behavior of mice, respectively. Serum and brain tissues of mice were used for neurochemical and immunohistochemical studies. The UCMS procedure induced anhedonia and depression-like behavior, and BS treatment, as well as IMP treatment, attenuated these symptoms. UCMS caused an elevation of serum corticosterone level, an index of hyper-activation of the hypothalamic-pituitary-adrenal (HPA) axis, in a manner attenuated by BS and IMP treatment. BS treatment also attenuated UCMS-induced decrease in the expression levels of brain-derived neurotrophic factor (BDNF) mRNA, cyclic AMP-responsive element binding protein (CREB) and a phosphorylated form of N-methyl-d-aspartate receptor subunit NR1, synaptic plasticity-related signaling proteins. Moreover, the UCMS procedure reduced doublecortin-positive cells in the dentate gyrus region of the hippocampus. BS administration reversed these UCMS-induced neurochemical and histological abnormalities.
Conclusion:
These results suggest that BS can ameliorate chronic stress-induced depression-like symptoms and that the effects of BS are mediated by restoring dysfunctions of the HPA axis and synaptic plasticity-related signaling systems and neurogenesis in the hippocampus.
... The authors believe that B. superba may act primarily by increasing the relaxation capacity of the corpus cavernosum smooth muscles via cAMP phosphodiesterase inhibition and may also affect the brain, triggering the improvement of the emotional sexual response. [77] Icarrin (ICA) is the major active extract of many Epimedii species including Herba epimedii and Epimedium sagittatum, also called "Horny Goat Weed". Both species have been demonstrated to play an important role in treatment of erectile dysfunctions. ...
The concept of phytoandrogens, plants that contain androgens or those that stimulate androgenic activity in men, is relatively new. In traditional Chinese medicine a number of phytoandrogens are classified in medicinal plant restoratives for reinforcing yang, and they find their application in the treatment of the kidney yang deficiency diseases. In this review, the phytoandrogens used in traditional Chinese medicine are listed, and their proven applications in the treatment of kidney yang deficiency diseases, such as sexual disorders, cancer, and obesity and associated metabolic syndromes are presented. As a background, the mechanism of action of androgens, their synthesis and metabolism, the interrelations of androgens and estrogens, as well as the state of art methods to detect and analyze these hormonal activities in medicinal plants are discussed.
... The tuberous roots of this plant have long been taken as a folk medicine not only to increase physical and mental strength but also to prevent aging-related symptoms such as impaired sexual performance in middle-aged or elderly males (1,2). Evidence from a randomized double-blind clinical trial (3) showed that oral administration of powdered tubers of this plant to patients with erectile dysfunction (ED), aged 30 to 70 years, caused noticeable improvement without apparent toxicity. In fact, this clinical finding was supported by pharmacological (2) and chemical studies of this plant (4), demonstrating that BS enhances penile erection in rats and that some isoflavonolignans such as butesuperin A and B are chemical constituents with inhibitory activities against phosphodiesterase type 3A and type 5, enzymes targeted for ED therapy. ...
This study investigated the effects of alcoholic extract of Butea superba (BS) on cognitive deficits and depression-related behavior using olfactory bulbectomized (OBX) mice and the underlying molecular mechanisms of its actions. OBX mice were treated daily with BS (100 and 300 mg/kg, p.o.) or reference drugs, tacrine (2.5 mg/kg, i.p.) and imipramine (10 mg/kg, i.p.) from day 3 after OBX. OBX impaired non-spatial and spatial cognitive performances, which were elucidated by the novel object recognition test and modified Y maze test, respectively. These deficits were attenuated by tacrine and BS but not imipramine. OBX animals exhibited depression-like behavior in the tail suspension test in a manner reversible by imipramine and BS but not tacrine. OBX down-regulated phosphorylation of synaptic plasticity-related signaling proteins: NMDA receptor, AMPA receptor, calmodulin-dependent kinase II, and cyclic AMP-responsive element-binding protein. OBX also reduced choline acetyltransferase in the hippocampus. BS and tacrine reversed these neurochemical alterations. Moreover, BS inhibited ex vivo activity of acetylcholinesterase in the brain. These results indicate that BS ameliorates not only cognition dysfunction via normalizing synaptic plasticity-related signaling and facilitating central cholinergic systems but also depression-like behavior via a mechanism differing from that implicated in BS amelioration of cognitive function in OBX animals.
... The plant preparation appears to improve an erectile function in patients with erectile dysfunction (ED) without any apparent toxicities (Cherdshewasart and Nimsakul, 2003). ...
Butea superba has been used to enhance sexual performance in men with unknown long-term effects on spermatozoa. This study aimed to investigate effects of chronic treatment of B. superba on sperm motility and concentration in rats and mice in correlation with testicular damage. Adult male rats and mice were orally administered distilled water or B. superba alcoholic extract (0.01, 0.1 or 1.0 mg/kg BW/day) for 6 months. At the end of the treatment the animals were sacrificed and the spermatozoa recovered from the distal cauda epididymis were analyzed for sperm concentration and motility in vitro. The testes were processed for histological examination. The results show that long-term treatment with B. superba extract significantly increased the sperm concentration and delayed the decreased motility with time. None of signs of sperm anomalies and testicular damages were observed. This suggests that chronic use of B. superba increases the number of sperm, prolongs sperm motility in vitro while produces no changes on sperm morphology. Therefore, chronic use of B. superba alcoholic extract may be useful in fertilization.
... Similarly, the extracts of Butea superba bark have shown significant ROCK-II inhibition while it was reported that the ethanolic extract of root core and bark increased rat intracavernous pressure (ICP) (Tocharus et al., 2006). The powdered root of Butea superba increased male sexual function (Cherdshewart and Nimsakul, 2003) which was suggested to be due to cAMP phosphodiesterase inhibition mediated corpus cavernosal smooth muscle relaxation (Roengsamran et al., 2000). ...
The aim of the study:
Activation of Rho-kinase 2 (ROCK-II) results in contraction of corpus cavernosum smooth muscle and ROCK-II inhibitors relax corpus cavernosum in vitro and in vivo hence, plant extracts capable of inhibiting ROCK-II enzyme may be useful in management of erectile dysfunction (ED). The aim of the study was to screen selected Indian medicinal plants, having similar ethnopharmacological use for ROCK-II inhibition.
Materials and methods:
Some Indian medicinal plants reported as aphrodisiacs in Ayurveda and modern scientific literature were collected, authenticated and extracted. Direct methanol and successive aqueous extracts of these plants were screened for ROCK-II inhibitory activity using HTRF(®)KinEASE™ STK S2 Kit (Cisbio Bioassays). Relaxant effect of potent extract was recorded on isolated rat corpus cavernosum.
Results:
Methanolic and successive aqueous extracts of 30 plants were screened for ROCK-II inhibition and 15 herbal extracts showed inhibition ranging between 50 and 88% at 50 μg/mL. While IC(50) of Y-27632, a standard ROCK-II inhibitor, was found to be 163.8 ± 1.2 nM. The Methanolic extract of Terminalia chebula (METC) with IC(50) value of 6.09 ± 0.17 μg/mL was found to be most potent and relaxed isolated rat corpus cavernosum significantly (p<0.01). Chebulagic and chebulinic acid of METC were found to inhibit ROCK-II and might be responsible for the inhibitory potential of the extract. The traditional use of plants like Butea frondosa, Syzygium aromaticum, Butea superba, Chlorophytum borivilianum and Mucuna pruriens, as aphrodisiacs and for male sexual disorder (MSD) might be in part due to the ROCK II inhibitory potential of these plants.
Conclusion:
Some of the Indian medicinal plants have ROCK-II inhibitory potential and those deserve further investigation.
... Second, it is useful as material for a variety of products and constructions. Third, it has multiple applications in medicine and raises pharmacological interests (Razdan et al. 1969; Dastur 1997; Mehta et al. 1983; Bandara et al. 1989; Chaudhury 1993; Agarwal et al. 1997; Cherdshewasart and Nimsakul 2003). Fourth, it may dominate dry forests and determines their net productivity (Kale and Roy 2012). ...
The Fabaceae tree Butea monosperma (TAUB.; syn. Erythrina monosperma (LAM.)) is widely distributed in Central and West-India. We studied it at three sites, i.e. at two locations with contrasting exposure (NE and SW, respectively) in a small mountain range with poor soil on highly drained rocky slopes and at a third location in a plane with deeper soils and better water supply. The two mountain range sites differed in the light climate where the NE-slope obtained more day-integrated irradiance. Chlorophyll fluorescence was measured with a portable fluorometer and leaf samples for stable isotope analyses (δ(13)C, δ(15)N, δ(18)O) were collected. No differences were seen in carbon and nitrogen contents of leaves at the three sites. N and O isotope signatures of the leaves were similar at the two rocky hill slope sites. More positive values for both signatures were obtained in the leaves in the plane. For all sites saturation of ETR was only achieved well above a PPFD of 1,000 μmol m(-2) s(-1) indicating that the leaves were sun-type leaves. The photosynthetic performance of Butea at the plane was very similar to that at the SW-slope of the mountain range and higher ETRs were obtained at the NE-slope. Ecophysiological flexibility allows Butea to perform well in a variety of habitats and yet gives it particular fitness at specific sites. The best performance was observed in the highly insolated steep rocky hill site (NE-slope) underlining the suitability of the tree for reforestation.
... In a study on rats, B. superba has been shown to cause an increase in ICP as well as cavernosal smooth muscle relaxation [37]. An RCT analyzing the effects of B. superba on men with ED showed that 82.4% of the patients exhibited noticeable improvement by using the International Index of Erectile Function (IIEF) scoring system [38]. In this study, 39 men were randomized assigned to groups, but only 17 completed the study with B. superba. ...
... An RCT analyzing the effects of B. superba on men with ED showed that 82.4% of the patients exhibited noticeable improvement by using the International Index of Erectile Function (IIEF) scoring system [38]. In this study, 39 men were randomized assigned to groups, but only 17 completed the study with B. superba. ...
Herbal medicine long has been used in the management of sexual dysfunction, including erectile dysfunction. Many patients have attested to the efficacy of this treatment. However, is it evidence-based medicine? Studies have been done on animal models, mainly in the laboratory. However, randomized controlled trials on humans are scarce. The only herbal medications that have been studied for erectile dysfunction are Panax ginseng, Butea superba, Epimedium herbs (icariin), Tribulus terrestris, Securidaca longipedunculata, Piper guineense, and yohimbine. Of these, only Panax ginseng, B. superb, and yohimbine have published studies done on humans. Unfortunately, these published trials on humans were not robust. Many herbal therapies appear to have potential benefits, and similarly, the health risks of various phytotherapeutic compounds need to be elucidated. Properly designed human trials should be worked out and encouraged to determine the efficacy and safety of potential phytotherapies.
... Cherdshewasart et al. studied the effect of Butea superba on erectile dysfunction (ED) in Thai males. The plant preparation appears to improve the erectile function in patients without apparent toxicity (25). Gauthaman et al. studied the aphrodisiac properties of Tribulus Terrestris extract (Protodioscin) in normal and castrated rats. ...
An aphrodisiac is a type of food or drink that has the effect of making those who eat or drink it more aroused in a sexual way. Aphrodisiacs can be categorized according to their mode of action into three groups: substances that increase libido (i.e., sexual desire, arousal), substances that increase sexual potency (i.e., effectiveness of erection) and substances that increase sexual pleasure. Some well-known aphrodisiacs are Tribulus terrestrins, Withania somnifera, Eurycoma longifolia, Avena sativa, Ginko biloba, and Psoralea coryifolia. Ethnobotanical surveys have indicated a large number of plants as aphrodisiacs. The paper reviews the recent scientific validation on traditionally used herbal plants as aphrodisiac herbs for the management of sexual disorder erectile dysfunction.
... Many products based on B. superba, such as a capsule formulation or gel cosmetic are claimed to support normal sexual function and to enhance sexual stamina, erectile capacity, sensitivity, and sexual performance, and are widely sold in local markets. It has also been reported that B. superba can improve erectile dysfunction in mature human males (2). It can increase intracavernous blood flow (3) and lead to erection via the inhibition of cGMP and cAMP phosphodiesterase activity (3)(4)(5). ...
To determine if Butea superba Roxb., a traditional Thai male potency herb, has androgenic activity in 60-day-old male Wistar rats, we measured its effects on the pituitary-testicular axis and sex organs. Intact and orchidectomized adult male rats were subdivided into five groups (10 rats/group): distilled water, Butea superba (BS)-10, BS-50, BS-250, and testosterone propionate (TP). They received 0, 10, 50, and 250 mg·kg body weight(-1)·day(-1) BS in distilled water by gavage and 6 mg·kg body weight(-1)·day(-1) TP sc, respectively, during the 30-day treatment period. Blood was collected every 15 days and luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone were measured. Changes of weight and histological appearance of sex organs were determined at the end of the 30-day treatment and 15-day post-treatment periods. TP treatment reduced serum FSH and LH levels and significantly increased the weight of the seminal vesicles and epididymis, in accordance with histopathological changes, in both intact and orchidectomized rats. No changes in serum testosterone, LH, and FSH levels were observed in any of the intact rats treated with BS, but a significant increase in seminal vesicle weight was observed only in the BS-250 group. Although a significant reduction in serum LH was detected in the BS-50 and BS-250 groups of orchidectomized rats, no significant change in weight or histology of sex organs was observed. Thus, we conclude that B. superba needs endogenous testosterone to work synergistically to stimulate the accessory sex organ of intact animals and can potentially exhibit an LH reduction effect in orchidectomized animals.
... 20 This group of patients usually request 'natural' health products to improve their EF. 21 In addition, a growing number of the world's population in different communities are turning to plantderived remedies and medicines for many reasons. A survey revealed that 71% of Canadians and 19% of the adult population in the United States were using natural health products. ...
Saffron (Crocus sativus Linn.) have been perceived by the public as a strong aphrodisiac herbal product. However, studies addressing the potential beneficial effects of saffron on erectile function (EF) in men with ED are lacking. Our aim was to evaluate the efficacy and safety of saffron administration on EF in men with ED. After a 4-week baseline assessment, 346 men with ED (mean age 46.6+/-8.4 years) were randomized to receive on-demand sildenafil for 12 weeks followed by 30 mg saffron twice daily for another 12 weeks or vice versa, separated by a 2-week washout period. To determine the type of ED, penile color duplex Doppler ultrasonography before and after intracavernosal injection with 20 microg prostaglandin E(1), pudendal nerve conduction tests and impaired sensory-evoked potential studies were performed. Subjects were assessed with an International Index of Erectile Function (IIEF) questionnaire, Sexual Encounter Profile (SEP) diary questions, patient and partner versions of the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and the Global Efficacy Question (GEQ) 'Has the medication you have been taking improved your erections?' No significant improvements were observed with regard to the IIEF sexual function domains, SEP questions and EDITS scores with saffron administration. The mean changes from baseline values in IIEF-EF domain were +87.6% and +9.8% in sildenafil and placebo groups, respectively (P=0.08). We did not observe any improvement in 15 individual IIEF questions in patients while taking saffron. Treatment satisfaction as assessed by partner versions of EDITS was found to be very low in saffron patients (72.4 vs 25.4, P=0.001). Mean per patient 'yes' responses to GEQ was 91.2 and 4.2% for sildenafil and saffron, respectively (P=0.0001). These findings do not support a beneficial effect of saffron administration in men with ED.
... 112 Degrees™ contains (per serving) 50 mg vitamin C (from magnesium ascorbate), 186 IU vitamin E (as mixed tocopherols), 8 mg vitamin B6 (from pyridoxine HCl), 80 lg folic acid, 400 lg vitamin B12 (as cyanocobalamin), 58 mg calcium (from dicalcium phosphate), 44 mg phosphorus (from dicalcium phosphate), 5 mg zinc (from zinc oxide), 100 lg selenium (from selenium yeast) and a proprietary blend (970 mg) of the following ingredients; the amino acid L-tyrosine; and the herbs Euterpe oleracea (Açai) fruit, Tribulus terrestris seed extract, Panax ginseng root extract, Butea superba root and Pueraria mirifica root. The ingredients were selected based on scientific evidence and/or traditional use suggesting benefits for general male health, reproductive health, and/or adaptogenic function (Choi et al., 1999; Ryu et al., 2005; Jang et al., 2008; Malaivijitnond et al., 2004; Adimoelja, 2000; Gauthaman and Ganesan, 2008; Schauss et al., 2006; Honzel et al., 2008; Cherdshewasart and Nimsakul, 2003; Anon, 2007; Dollins et al., 1995). The product was supplied by Lifespan Labs (Portland, OR, USA) as a pre-mixed powder for the individual studies. ...
The dietary supplement, 112 Degrees, was formulated with the goal of supporting sexual functioning in men. Due to rampant problems with drug adulteration for this category of products, a comprehensive screening for active pharmaceutical agents, with an emphasis on drugs prescribed for erectile dysfunction such as type 5 phosphodiesterase (PDE-5) inhibitors, and known unapproved PDE-5 drug analogues, was performed along with preclinical toxicology studies prior to the introduction of this product into the marketplace. 112 Degrees was found to be free of all pharmaceutical adulterants tested, and was not mutagenic, clastogenic, or genotoxic as demonstrated by the Ames test, chromosomal aberration assay, and mouse micronucleus assay, respectively. The LD(50) in the 14-day acute oral toxicity study was greater than 5000 mg/kg, the highest dose tested.
Metabolites of Medicinal Plants: Insightful Approaches provides a comprehensive exploration of the bioactive compounds found in medicinal plants and their pharmacological significance. The book covers key topics such as the economics of medicinal and anticancer plants, phytochemistry, therapeutic potential, and advanced applications like nanotechnology-based drug delivery systems and CRISPR-Cas techniques. It also examines the role of these plants in combating diseases like diabetes and metabolic syndrome and their role in traditional medicine systems. This resource is essential for students, researchers, and professionals in phytochemistry, pharmacology, drug discovery, and healthcare practices. Key Features: 1. Wide range of topics from medicinal plant economics to pharmacological applications. 2. Latest discoveries in plant bioactive compounds and their therapeutic uses. 3. Novel drug delivery methods to enhance efficacy. 4. Linking genes to metabolites through advanced omics approaches.
Phosphodiesterase-5 inhibitors (PDE5-i) have been widely used in clinical practice for the treatment of erectile dysfunction (ED). However, due to its suboptimal therapeutic effects and side effects, it is necessary to develop new medicines for ED treatment. Botanical drugs have been widely investigated as potential ED treatment drugs and have shown promising therapeutic effects. This review summarized 34 studies, including five botanical drugs with PDE5 inhibitory activity, seven botanical drugs without PDE5 inhibitory activity, and six mixed botanical drugs. The results of clinical studies regarding the aforementioned botanical drugs and relevant mechanisms are summarized in this study. It is necessary to conduct high-quality clinical trials to verify the dosage, targeted patients and therapeutic effects, and further pharmacology experiments are also needed to identify the active compounds.
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.
Introduction
Erectile dysfunction is the persistent or recurrent inability to achieve or maintain an erection sufficient for intercourse. Despite various treatment options, not all patients respond adequately and their usefulness is limited by adverse effects and cost. Botanical medicine and natural products have been and continue to be invaluable and untapped sources of new drugs, including potentially those to treat erectile dysfunction.
Objectives
To review the current literature on botanical medicine traditionally used as aphrodisiacs and treatment of erectile dysfunction, in particular, scientific and clinical investigations that have been performed, possible active phytoconstituents, and mechanisms of action and to identify gaps in current knowledge to better guide future research efforts.
Methods
A comprehensive literature search was conducted via PubMed, Scopus, Science Direct, and Web of Science on English publications, using various keywords, for example, “herb”, “natural product”, combined with “erectile dysfunction”, “aphrodisiac”, and “sexual performance”.
Results
369 relevant articles studying medicinal plants used for erectile dysfunction were analyzed. A total of 718 plants from 145 families and 499 genera were reported to be used traditionally as aphrodisiacs and treatment of erectile dysfunction. Top plants used include Pausinystalia johimbe, Lepidium meyenii, and Panax ginseng. Different plant parts are used, with roots being the most common. Less than half of these plants have been evaluated scientifically, using various research methodologies. Clinical trials conducted were collated. Current scientific investigation shows mixed results about their usefulness in enhancing sexual performance. A limited number of studies have attempted to elucidate the mechanisms of action of these medicinal plants.
Conclusion
A comprehensive literature review on botanical medicine and natural products used for treatment of erectile dysfunction was successfully conducted. Although medicinal plants serve as a potential source of lead compounds for erectile dysfunction drugs, further studies are warranted to further evaluate their efficacy and safety.
Sin VJ-E, Anand GS, Koh H-L. Botanical Medicine and Natural Products Used for Erectile Dysfunction. Sex Med Rev 2020;XX:XXX–XXX.
Abstract
Introduction
The plant Pueraria candollei var. mirifica (Airy Shaw & Suvat.) Niyomdham (PM), known by its common Thai name as white Kwao Krua, is sometimes misidentified because it presents similar botanical characteristics to those of Butea superba (red Kwao Krua). The phytochemicals in PM are phytoestrogens in the class of isoflavonoids, but Butea superba contains flavonoids that exhibit androgenic and antiestrogen effects.
Objectives
This research aims to develop a simple analytical method for identification and to differentiate PM from red Kwao Krua and other Pueraria species.
Methods
A gold nanoparticle‐based immunochromatographic assay (ICA) was developed for the detection of kwakhurin (Kwa), a unique compound found in PM. The parameters, including sensitivity, accuracy, precision, and specificity, were validated. All samples were analyzed using ICA and high‐performance liquid chromatography with UV detector (HPLC‐UV). The results of the two methods were compared for consistency checking.
Results
The cutoff limit of Kwa detection was 160 ng/mL, which was lower than in the HPLC‐UV method. The repeatability and reproducibility of the ICA preparation and assembly showed high precision. The cross‐reactivity to related isoflavonoids was less than 0.32%, which implied high specificity of the ICA for Kwa. Moreover, false‐positive and false‐negative results from other plant extracts were not observed.
Conclusion
The developed ICA is applicable for distinguishing PM from red Kwao Krua and other Pueraria species. This simple analytical method can be applied for the identification of raw PM materials in the industrial and agricultural sectors.
Boesenbergia rotunda (Family: Zingiberaceae) as known as fingerroot is a daily food ingredient and traditional medicinal plant in Southeast Asia and Indo-China. It has been shown to possess anti-allergic, antibacterial, anticancer, anti-inflammatory, antioxidant, and antiulcer activities and also shown wound healing. Its common phytochemical components include alkaloids, essential oils, flavonoids, and phenolics. This plant is rich in boesenbergin, krachaizin, panduratin, and pinostrobin, all of which has been reported to contribute to its remedial properties including aphrodisiac property. Based on established literature on the aphrodisiac property of B. rotunda and possible mode of action, this review article has attempted to compile that B. rotunda could be further explored for the development of potential aphrodisiac treatment.
Reports on traditional use of medicinal plants may be used as starting points for phytochemical and pharmacological research. As has recently been shown, publications, letters, diaries and reports of exploring botanists are a valuable source of historical ethnopharmacological information. In this study, the heritage of the British botanist Arthur Francis George Kerr (1877-1942), mainly working in Thailand, was screened for information about traditionally used medicinal plants. Information given was compared to state-of-the-art scientific knowledge about these species. Many historical uses could be confirmed, some did not, while a number of species reported to be traditionally used have not been sufficiently investigated so far. These, strongly suggested for further research, include Kurrimia robusta, Alpinia siamensis, Amomum krervanh (= A. testaceum), Trichosanthes integrifolia (= Gymnopetalum scabrum), Croton cumingii (= C. cascarilloides), Lobelia radicans (= L. chinensis), Willughbeia sp., Nyctanthes arbor-tristis (against “floodings”), Pluchea indica, Heliotropum indicum, and some fungi and woods.
Male sexual dysfunction is a common disorder that appears to be a consequence of a wide range of physical and psychological conditions. Due to mental stress, insufficient physical exercise and various aetiological factors, human being's life is becoming less pleasant, which leads to incapability to have sexual pleasure. The allopathic drugs used for sexual dysfunction are believed to produce a variety of side effects and affect other physiological processes and, ultimately, general health. Therefore, the search for natural supplement from medicinal plants is being intensified probably because of less side effects availability and affordability. Ethnobotanical surveys have indicated a large number of plants traditionally used as aphrodisiacs but only few of them are scientifically validated for the management and treatment of male sexual dysfunction. This article has summarised the medicinal plants traditionally recommended and scientifically validated for the management and treatment of male sexual dysfunction.
OBJECTIVE:Anthocleista vogelii Planch, is a plant that has been widely used by Traditional medicine
practitioners either singly or in combination with other plant materials to treat several diseases or ailments in
humans, including infertility problems both in male and female.
DESIGN: Ethanolic extract of Anthocleista vogelii were administered orally for 14 days to rats placed in
different groups. Temporary infertility in female rats was induced with Micronor (norethisterone) or Nacetylcysteine
(NAC) which was given orally for seven (7) days prior to other treatment. The rats were sacrificed
after the completion of extract administration. Blood samples from experimental animal groups were collected
through cardiac puncture and transferred into potassium ethylene diamine tetra acetate (K3EDTA) tubes and
plain tubes. The absolute counts of clusters of differentiation CD4+ and CD8+ was performed using the Becton
Dickinson’s (BD) FACS Count Automated technique. The haematological parameters were performed using the
Sysmex® Automated Hematology Analyzer KX-21N. Oestradiol analysis was performed on sera obtained from
the experimental animals using commercial standard enzyme-linked immunosorbent assay kit.
RESULT / OUTCOME: The extract was found to possess Anthraquinones, Terpenoids, Flavonoids, Saponins,
Alkaloids, Phenols and Phytosterols The obtained results of the ethanolic extract of Anthocleista vogelii
administered group compared with control showed a statistically significant decrease (P<0.05) in CD4+ and
CD8+ counts, from (851.33±96.34) to (451.00±21.02) and from (1058.67±93.31) to (636.00±28.93) for CD4+
and CD8+ cells respectively. The haematological parameters showed a significant increase (P<0.05) in absolute
middle cells (basophils, eosinophils and monocytes) count. The obtained results showed a significant increase of
estradiol concentration in the female rats, from (184.65±30.06 pg/ml) in the control group compared to
(288.29±30.06pg/ml) in the extract treated group.
These findings suggest that Anthocleista vogelii may have a role in creating the environment required for
successful pregnancy by decreasing the levels of CD4+ and CD8+ cytokines production and increasing
monocytes and granulocytes activation. The plant can be used to induce oestrogen production therefore, supports
the claims on the traditional use of Anthocleista vogelii to enhance fertility in female.
KEY WORDS: Ethanolic extract, Anthocleista vogelii, WBC, RBC, female fertility, CD4+ and CD8+, `Oestradiol.
Butea monosperma (Lam.) Kuntze (Syn. Butea frondosa; Family Fabaceae), This is a moderate sized deciduous tree which is widely distributed throughout India, Burma and Ceylon, popularly known as 'dhak' or 'palas', commonly known as 'Flame of forest'. The family Fabaceae compromises of 630 genera and 18,000 species. It finds use both medicinally and commercially with each part of the plant having utility. This plant species has been found to display a wide variety of biological activities. The plant is traditionally reported to possess astringent, bitter, alterative, aphrodiasiac, anthelmintic, antibacterial and anti-asthamatic properties. Bark yields red juice known as 'Butea gum'or'Bengalkino'. Previous phytochemical examination of this plant indicated the presence of various constituents some of these are Cajanin and isoformononetin; Stigmasterol; Butin; two known flavonoids, isobutrin (3, 4, 2', 4'-tetrahydroxychalcone-3, 4'- diglucoside), and the less active butrin (7, 3', 4'-trihydroxyflavanone-7, 3'-diglucoside); free sugars and free amino acids and (-)-3-hydroxy-9- methoxypterocarpan (medicarpin) which were isolated from stem-bark extract; bark; seeds; flower; the petroleum ether extract of flowers and petroleum and ethyl acetate extract of stem bark. Its reported pharmacological properties include anthelmintic, anticonceptive, anticonvulsive, antidiabetic, antidiarrhoeal, antiestrogenic and antifertility, antiinflammatory, antimicrobial, antifungal, antibacterial, antistress, chemopreventive, haemaggultinating, hepatoprotective, radical scavenging, Thyroid inhibitory, antiperoxidative and hypoglycemic effects and wound healing activities. It is powerful astringent and is given in many forms of chronic diarrhoea. Seeds have anthelmintic property especially for roundworms and tapeworms. Flowers yields a brilliant yellow coloring matter due to presence chalcones. Such herbal medicines may provide potential effect as of compared to the conventional available synthetic drugs, with less or no side effects.
Erectile dysfunction is an important male problem that can be seen around the world. It is usually a problem of the elderly male and cause an unhappy sex life. Here, we summarise the most important and relevant recent Thai publications on the subject of erectile dysfunction. We hope that this work can be a reference for the situation in the tropical world.
Red kwao krua, Butea superba Roxb., is a herbal leguminous plant endemic in Thailand whose tuberous roots are used for male rejuvenation and the prevention of erectile dysfunction. Different populations from different provinces vary in their bioactivities, raising the need to evaluate the causes prior to optimal population selection and growth. Morphometric analysis of leaves collected from 34 populations from 24 provinces throughout Thailand using nine parameters for factor and cluster analyses were correlated with latitude and longitude revealing a clinal pattern. From the North to the South, leaf length increased in size in factor 1 but decreased in size in factor 2. Genetic analysis on the same samples, using DNA sequence analysis from the chloroplast rbcL, trnLF-cd, and trnLF-cf regions and maximum parsimony and neighbourjoining phylogenetic analysis, revealed essentially no genetic variation in the rbcL region, as expected. However, some between-population genetic variation was revealed by trnLF-cd and trnLF-cf sequences, suggesting potentially considerable genetic polymorphism. This was supported by preliminary RAPD analyses using five primers which indicated high genetic variation within and between populations.
Despite progress made in modern medical science herbal drugs constitute a major share of all the officially recognized systems of health in India viz. Ayurveda, Yoga, Unani, Siddha, Homeopathy and Naturopathy. More than 70% of India's 1.1 billion populations still use these non-allopathic systems of medicine. Various synthetic drugs like Sildenafil citrate, Tadalafil citrate, Vardenafil, etc are used to treat ED but these drugs also have fatal side effects. The use of synthetic aphrodisiacs results in the dilation of blood vessels in other parts of the body causing headache and fainting. Other side effects include facial flushing, stomach upset, blurred vision and sensitivity to light which usually occur at higher doses. Thus, there is growing need to look for aphrodisiacs more of herbal origin as opposed to synthetic compounds which are known to cause severe unwanted side effects. Unlike the old-time aphrodisiacs, which were meant only to increase sex drive and/or sexual pleasure, modern stimulants including Viagra, may rightly be called medications, since their purpose is to correct problems that make sex difficult or impossible. Besides of the fact that several plant sources contain aphrodisiac ingredients (phytochemicals) which can be beneficial as an immune modulator, sex stimulant and also as medication in erectile dysfunctions, there is very low range of research work carried out in this field. This review contains a collection of more than 200 medicinally important plants which are not only aphrodisiac in nature but also used to treat ED. All the herbal plants in this review are verified from the Current Scientific Literature as well as traditional book.
Article presents the latest knowledge on the pathophysiology of erectile dysfunction (ED), the influence of xenoestrogens on ED and fertility in men and the possibilities of the blocking xenoestrogen actions with natural ingredients as well as treatment options for ED with medicinal plants. With the rising phenomenon of ED in the world there is rising a market with ED treatment products. Especially in menu of internet online shops come increasingly to light new natural over the counter products for ED treatment. Sale and use of medicinal plants and their extracts in the treatment of ED is based according to the declaration of the producers first of all on a number of the thousand-year-old traditions in some nations, based on the efficacy and safety of these plants, verified in the healing practice. Aim of this article was to make an extensive review of the scientific and professional literature and to find out which medical plants, sold in the herbal products for ED, was evaluated for efficacy and safety in relevant clinical trials. The review of the literature shows, that by some marketed medicinal plants lack clinical studies, the results of some clinical studies related to the same medicinal plant are controversial and some bring significantly positive effects, but their number is minimal. The future is therefore open to starting the number of new clinical trials testing the medicinal plants in the treatment of ED with possible inclusion of some of these plants in evidence based medicine, if confirming their efficacy and safety.
The objective of the present study was to investigate the effect of ethanolic extract of Butea superba (Roxb.) on erectile dysfunction in diabetic rats by the measurement of intracavernous pressure (ICP) and on cavernosal smooth muscle relaxation. Male Sprague-Dawley rats were induced to become diabetic by a single intravenous injection of Streptozotocin (55 mg kg(-1) body weight). The ethanolic extract at the concentration of 1, 10 and 100 mg kg(-1) BW was administered orally once a day to diabetic rats in each group for 4 weeks. Diabetic rats showed a significant decrease in both ICP and the relaxation of the cavernosal smooth muscle compared with the normal rats. The extract of B. superba significantly increased the ICP with the effective dose of 10 mg kg(-1) BW (61.00 ± 11.11 mmHg versus 39.61 ± 11.01 mmHg in the diabetic control group). Moreover, the B. superba-treated group also showed enhanced relaxation of the cavernosal smooth muscle with EC(50) of 1.17 mg ml(-1). These results suggest that the extract of B. superba enhanced penile erection in diabetic rats by increasing the ICP. This might be explained by the increased blood flow as a result of the relaxation of the cavernous smooth muscle.
This study evaluated the estrogenic and antiestrogenic activities of native and in vitro hepatic metabolized tuberous extracts of wild Butea superba collected from 23 out of the 76 provinces in Thailand by yeast estrogen screening (YES). The YES screen used consisted of the human estrogen receptors hERα and hERβ and the human transcriptional intermediary factor 2 or human steroid receptor coactivator 1, respectively, together with the β-galactosidase expression cassette as the reporter. The relative potency, effectiveness and relative inductive efficiency were evaluated by determining the β-galactosidase activity (EC(50)) of each tuberous extract in relation to that induced by 17β-estradiol. Six pure compounds isolated from B. superba were tested in parallel and exhibited a maximum relative potency compared to 17β-estradiol of 15.5% and 5.27% in the respective hERα and hERβ assays. Eighteen and seventeen plant extracts were respectively found to interact with the hERα and hERβ receptors in the YES assays with higher relative potency and relative inductive efficiency with hERβ than with hERα. The selected plant extracts tested exhibited antiestrogenic activity. Coincubation with the rat liver S9 mixture also elevated the estrogenic potency of these plant extracts.
The activity and subunit amounts of V-ATPase and V-PPase in various plants of Butea monosperma Taub. (Fabaceae) (ver. Dhak; Palas) growing as a natural inhabitant in varying stress conditions in southeast Rajasthan were studied. Western blot analysis followed by immunological quantification of V-ATPase subunits using specific polyclonal antibodies showed that the subunits A, B, D, E, and c are clearly detectable in all plants, with A, B, and c appearing as intense bands. The other subunits of V-ATPase, viz., C, a, and d, were also detected in majority of the plants. Various subunits exhibited variations in their protein amount in different plants. Besides, a few other clear bands were also detected. Of these, the 30- and 29-kD bands may possibly be Di and Ei. Furthermore, a clear band of V-PPase corresponding to 67-70 kD was also detected. A comparison of the V-ATPase and V-PPase activity revealed that Butea plants in the upper region of the study site showed 70% and 39% higher activity, respectively. Furthermore, the immunological quantification showed that the V-ATPase and V-PPase protein amounts are also higher in the upper Butea plants which have drought stress and, moreover, are also exposed to stronger light intensities for relatively longer duration.
Butea superba is a traditional tuberous Thai plant enriched with flavonoids that is used for treating erectile dysfunction. We investigated the mutagenic and antimutagenic potentials of a B. superba extract by using the pre-incubation method of the Ames test. Salmonella typhimurium strains TA 98 and TA 100 were applied as the tester strains in the presence and absence of an S9 mixture. Prior to the mutagenic and antimutagenic tests, the survival of the tester strains was measured by treating with the B. superba extract. The results show that the B. superba extract exhibited dose-dependent cytotoxic effects. Data from the Ames test revealed that the B. superba extract to be non-mutagenic in the presence and absence of the S9 mixture. In contrast, the B. superba extract showed antimutagenic potential towards either or both of the tested mutagens: 2-(2-furyl)-3-(5-nitro-2-furyl)-acrylamide (AF-2) and benzo(a)pyrene (B(a)P) in the respective presence and absence of the S9 mixture, respectively. The plant antimutagenic activity was confirmed by a rec assay. A further study by micronucleus test demonstrated that the B. superba extract at the maximum loading volume could induce acute micronucleus formation in the tested animals. The in vitro mutagenic and antimutagenic assays confirmed the safe consumption of B. superba products at low dose (not more than 781.25 microg/ml of the plant extract), but the in vivo genotoxic assay demonstrated the unsafe consumption at a high dose (300 mg/kg of the BW plant extract or 16 g/kg of the BW plant powder).
Ten isoflavonoids including daidzein, daidzin (daidzein-7-O-glucoside), puerarin (daidzein-8-C-glucoside), genistein and coumestrol have been isolated from a methanolic extract of Pueraria mirifica roots. Apart from these known compounds and mirificin, a novel apioside derivative of puerarin, the roots have also been found to contain three minor coumestans and one 5-deoxyisoflavone for which only limited spectroscopic data are currently available. © 1986, Verlag der Zeitschrift für Naturforschung. All rights reserved.
A flavonoid (3, 7, 3'-Trihydroxy-4'-methoxyflavone) (1) and a flavonoid glycoside (3, 3'-dihydroxy-4'-methoxyflavone-7-O-β-D-glucopyranoside) (2) were isolated from the tuber root of Butea superba Roxb. The structures were determined on the basis of spectral analysis, including 2D-NMR techniques. These compounds show higher inhibitory effects on cAMP phosphodiesterase than caffeine and theophylline.
The new flavonoid 3,7-dihydroxy-8-methoxyflavone 7-O-α-L- rhamnopyranoside (1) was isolated from B. superba stems and identified by spectral analysis and chemical degradation.
The mammogenic potency of miroestrol, an oestrogenic substance isolated from the tuberous roots of the leguminous plant Pueraria mirifica, was estimated as 0·70 (with 5% fiducial limits of 0·40 and 1·18) relative to oestradiol in the ovariectomized rat, and as 2·2 (with 5% fiducial limits of 1·2 and 4·9) relative to oestrone in the mouse. The effects of miroestrol on the body weight and weights of the endocrine glands, with the exception of the thyroid in the rat, were qualitatively similar to those of oestradiol and oestrone. In the rat oestradiol (0·1 μg/day) inhibited the increase both in body weight and thyroid weight that occurred after ovariectomy, whereas miroestrol (0·1 μg/day) inhibited only the increase in body weight.
A new bio-active flavonol glycoside was isolated from the stems of Butea superba Roxb, and its structure was determined by spectral analysis and chemical degradations as 3,5,7,3',4'-pentahydroxy-8-methoxy-flavonol-3-O-beta-D-xylopyranosyl(1-->2) -alpha-L-rhamnopyranoside. The compound 1 showed antimicrobial activity against plant pathogenic fungi Trich viride, Asprgillus fumigatus, A. niger, A. terreus, Penicillium expansum, Helmitnhosporium oryzae, Botxitis cinerea, Rhizopus oligosporus, R. chinensis, Kelbsiella pneumoniae, Fusearium moniliforme and gram-positive bacteria Streplococcus pyogenes, Staphylococcus aureus, Bacillus subtilis gram-negative bacteria Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae, Pseudomonas aeruginosa. The maximum inhibitory effect was shown by H. oryzae, A. niger, B. cinera and gram-positive bacteria.
To observe the alterations in the biochemical and biophysical changes in the sperm membrane during sperm maturation in male rats treated with the water extract of the fruit pericarp of S. mukorossi.
Adult male Sprague-Dawley rats were gavaged the aqueous extract of the fruit pericarp of S. mukorossi at a dose of 50 mg/kg/d for 45 days. On day 46, the sperm parameters were observed in different sections of the epididymis and the sperm superoxide dismutase and the lipid peroxidation was determined and compared with the controls. The testis and epididymis were routinely prepared for histological examination under the light microscope.
No significant differences in the sperm number and morphology were observed between the control and treated groups. However, a significant inhibition (P<0.05-0.01) of sperm motility in the caput, corpus and cauda regions of the epididymis was seen in the treated group. No significant histopathological changes were found in the testis and epididymis. The important finding was that in the treated animals, the spermatozoa showed an abnormal distribution of the superoxide dismutase activity, being minimum in the caput and maximum in the corpus, which was just opposite to that of the controls.
The study provides a unique observation where the plant extract alters the sperm membrane physiology without change the testicular and epididymal morphology.