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Ginkgbiloba for antidepressant-induced sexual dysfunction
Abstract
In an open trial ginkgo biloba, an extract derived from the leaf of the Chinese ginkgo tree and noted for its cerebral enhancing effects, was found to be 84% effective in treating antidepressant-induced sexual dysfunction predominately caused by selective serotonin reuptake inhibitors (SSRIs, N = 63). Women (n = 33) were more responsive to the sexually enhancing effects of ginkgo biloba than men (N = 30), with relative success rates of 91% versus 76%. Ginkgo biloba generally had a positive effect on all 4 phases of the sexual response cycle: desire, excitement (erection and lubrication), orgasm, and resolution (afterglow). This study originated from the observation that a geriatric patient on ginkgo biloba for memory enhancement noted improved erections. Patients exhibited sexual dysfunction secondary to a variety of antidepressant medications including selective serotonin reuptake inhibitor (SSRIs), serotonin and nonrepinephrine reuptake inhibitor (SNRIs) monoamine oxidase inhibitor (MAOIs), and tricyclics. Dosages of ginkgo biloba extract ranged from 60 mg qd to 120 mg bid (average = 209mg/d). The common side effects were gastrointestinal disturbances, headache, and general central nervous system activation. The article includes a discussion of presumed pharmacologic mechanisms, including effects on platelet activating factor, prostaglandins, peripheral vasodilatation, and central serotonin and norepinephrine receptor factor modulation.
... It is recommended to use Ginkgo biloba to cure a variety of ailments, from high blood pressure to Alzheimer's disease. There is evidence that it improves memory in elderly populations [119], claudication distance and cutaneous ulcers in patients with peripheral vascular disease [120], and overall cognitive performance [121]. ...
... populations [119], claudication distance and cutaneous ulcers in patients with peripheral vascular disease [120], and overall cognitive performance [121]. ...
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.
... Ginkgo intake reduced the manifestations of SSRI-ASD and also had a general tonic effect. In addition, many patients spontaneously reported improvements in cognitive function, mental clarity, and memory [40]. It is worth noting that this study had no control group and was not blinded. ...
... Ginkgo can cause mild gastrointestinal side effects, headaches, and allergies [40]. After a year-long project by the University of California in collaboration with the FDA (U.S. Food and Drug Administration) to study adverse events associated with dietary supplementation, the toxicity of Ginkgo was found to be unlikely. ...
Since time immemorial, people have been trying to influence different aspects of their sexuality. They seek ways to increase sexual activity or sexual desire in themselves and their partners. In addition to resorting to all sorts of mystical rituals, people were looking for various effects from the use of natural raw materials. Some plant, animal, or fungal products have been shown to affect libido, sexual arousal, erectile function, orgasm or erogenous zone sensitivity. Such substances have been called "aphrodisiacs" in honor of the ancient Greek goddess of love - Aphrodite. Most often, aphrodisiacs were taken orally, but some were smoked while others applied to the genitals. In modern clinical practice, phosphodiesterase type 5 inhibitors are used. These are substances, which enhance erection and prevent detumescence in the presence of sexual arousal. Another group of drugs is selective serotonin reuptake inhibitors, which reduce sexual arousal and sexual afferent from the genitals, thus preventing the premature onset of orgasm in men and prolonging sexual intercourse. However, drugs from other pharmacological groups have not found widespread clinical application. Another issue now is a trend among people taking drugs of natural origin, therefore, all kinds of traditional aphrodisiacs are actively used to the present day. Very little is known about almost all of them. Clinical trials are in most cases limited to a few, often not randomized, studies. In this regard, it is very difficult to evaluate the adequate therapeutic and toxic doses of remedies. The situation is complicated by the fact that those few clinical studies were based on questionnaires, that is, the indicators taken into statistical calculations were extremely subjective. Moreover, it was uncertain whether all patients could adequately assess their dynamics in terms of parameters such as sexual satisfaction, or clearly distinguish between libido and sexual arousal. Since the majority of the studies were not blinded, a psychogenic influence on the results of the investigations could not be eliminated, which in the sexual area may be huge. It is worth emphasizing the toxicity of many traditional aphrodisiacs. Of course, there is a serious deficit in the spectrum of pharmacotherapy for sexual disorders. Perhaps further large, randomized, placebo-controlled trials would add some of the traditional aphrodisiacs or their modifications to the arsenal of the clinical specialist.
... Five years later, they did the same RCT on premenopausal, perimenopausal, and postmenopausal women and reported improvements in sexual desire, sexual satisfaction, frequency of sexual desire and frequency of intercourse (Ito et al., 2006). Cohen and Bartlik, (1998) explained the mechanism of G. biloba's effect on sexual activity. In summary, G. biloba improves sexual activity by increasing blood flow to the genitalia through inhibiting plateletactivating factor, inducing direct effects on prostaglandins to improve erectile function, creating relaxation in smooth muscle cells and affecting the nitric oxide (NO) system (Cohen and Bartlik, 1998). ...
... Cohen and Bartlik, (1998) explained the mechanism of G. biloba's effect on sexual activity. In summary, G. biloba improves sexual activity by increasing blood flow to the genitalia through inhibiting plateletactivating factor, inducing direct effects on prostaglandins to improve erectile function, creating relaxation in smooth muscle cells and affecting the nitric oxide (NO) system (Cohen and Bartlik, 1998). NO plays an important role in perception of sexual impulses in the brain and causing erections in penile and clitoris (Culotta and Koshland Jr, 1992). ...
Objective:
During recent years, evidence-based practice as a way to support higher standards of care was emphasized by health care policymakers. Sexual dysfunction (SD) is a common problem that affects the quality of life in individuals. Today, the use of Ginkgo biloba extract (GBE) for treating SD has been considered, so this study was performed to evaluate the current evidence for the efficacy and safety of ginkgo in treating SD.
Materials and methods:
In this review study, electronic databases of PubMed, Scopus, Cochrane, Google Scholar, Web of science and Persian databases such as SID and Magiran were searched up to March 2020, to identify all the studies reporting the effect of GBE for effectiveness on sexual function and its safety. The search was performed using the keywords of Ginkgo, Ginkgo biloba, Complementary and alternative medicine, women sexual dysfunction, and male sexual dysfunction. The quality of included studies was assessed using the Oxford Center for Evidence Based Medicine checklist.
Results:
Among 156 articles found in the initial search, 5 randomized controlled trials (475 participants) were selected for this study. After a meticulous review, we found that G. biloba can have positive effects on the sexual function of postmenopausal women, while evidence shows that it has no effect on the sexual function of antidepressants users. Headaches and gastrointestinal disturbance were among the adverse events mentioned in several trials.
Conclusion:
We concluded that G. biloba has limited positive effects on sexual function and more studies are needed to confirm these findings.
... A capsule containing 40-60 mg G. biloba extract (together with antidepressants such as fluoxetine, nefazodone, bupropion, sertraline, paroxetine, venlafaxine, phenelzine, and vivactil) when taken orally twice daily for 4 weeks turned out to be 84% effective in improving sexual function including erection in patients suffering from erectile dysfunction [62]. Oral supplementation of another capsule of 80 mg G. biloba extract thrice daily for 6 months (along with other intracavernosal drugs such as papaverine and phentolamine) was capable of sufficiently regaining the rigidity of penis in patients of < 70 years age [63]. ...
... The active compounds of G. biloba-ginkgolides, terpenoids, and flavonoids-inhibit platelet aggregation, neutrophil degranulation, and ROS production. They may be able to cause erection by enhanced vascular flow to the genitals through the inhibition of platelet-activating factor and prostaglandins to attain adequate erection, or serotonin-and norepinephrinereceptor-induced effects on the brain [47,62]. G. biloba increases nitric oxide synthase (NOS) expression which is associated with better noncontact erection [73]. ...
Among Asian populations, including that of the Indian subcontinent, herbal remedies have been practiced since ancient times for the management of many complex diseases, including andrological problems. The efficacy of herbal medicines has largely been attributed to the synergistic interactions of the individual components because they are used mostly as whole extracts. In recent times, investigative studies have been taken up to validate the clinical efficacy and safety of individual herbal extracts, discrete chemical ingredients as well as their active principles apart from elucidating their mechanism of action in the management of such disorders. In this chapter, we discuss various pharmacological effects of three such herbs Ginkgo biloba, Curcuma longa, and Camellia sinensis that may be useful in the management of a wide array of andrological disorders such as male infertility, hypogonadism, erectile dysfunction, testicular cancer, prostate cancer, and benign prostatic hyperplasia. We have also attempted to provide their potential molecular mechanisms of action, to have a better understanding of how these herbal medicines exert their effects. Supplementation of G. biloba, C. longa, and C. sinensis has the potential to reduce oxidative stress levels and may uplift the health of reproductively compromised men posing as low-cost alternatives. By combining these herbs with lifestyle modification and standard medical treatment, the clinician may be able to maximize the chances of restoring normal reproductive functioning in such men. We have summarized the outcomes of already published reports on G. biloba, C. longa, and C. sinensis; however, not carried out any dose-response relationship or toxicological study. As such, more clinical intervention trials are needed to elucidate the exact mechanism of action of these herbs in humans. Carefully designed dose-response human studies may be able to incorporate G. biloba, C. longa, and C. sinensis as potential alternatives in the clinical management of andrological problems.
... A capsule containing 40-60 mg G. biloba extract (together with antidepressants such as fluoxetine, nefazodone, bupropion, sertraline, paroxetine, venlafaxine, phenelzine, and vivactil) when taken orally twice daily for 4 weeks turned out to be 84% effective in improving sexual function including erection in patients suffering from erectile dysfunction [62]. Oral supplementation of another capsule of 80 mg G. biloba extract thrice daily for 6 months (along with other intracavernosal drugs such as papaverine and phentolamine) was capable of sufficiently regaining the rigidity of penis in patients of < 70 years age [63]. ...
... The active compounds of G. biloba-ginkgolides, terpenoids, and flavonoids-inhibit platelet aggregation, neutrophil degranulation, and ROS production. They may be able to cause erection by enhanced vascular flow to the genitals through the inhibition of platelet-activating factor and prostaglandins to attain adequate erection, or serotonin-and norepinephrinereceptor-induced effects on the brain [47,62]. G. biloba increases nitric oxide synthase (NOS) expression which is associated with better noncontact erection [73]. ...
... Clinical studies have also reported that the co-therapy of patients with major depression by ginkgo extract (240 mg/d) and trimipramine (200 mg) resulted in a significant reduction in the sleep disorders induced by trimipramine (29). The ginkgo extract also improves sexual dysfunctions caused by antidepressants in patients with major depression (30). ...
... Some plants such as L. angustifolia and E. amoenum are effective in combination with antidepressant drugs (22,41). In addition, some like C. sativus, G. biloba, and M. recutita are useful in reducing the disorders such as sexual disorders and insomnia caused by chemical antidepressants drugs (7,30,32) Clinical studies conducted on the antidepressant effects standard herbal medicines with a specific and constant combination with the potential for reproduction. In general, the amount and type of chemical compounds of plants are influenced by various factors such as genetic differences, geographic area, harvest time, soil quality, plant part used, and preparation methods. ...
Depression is a life-threatening chronic illness which affects people worldwide. Drugs used to treat this disease have multiple side effects and may cause drug-drug or drug-food interactions. Additionally, only 30% of patients respond adequately to the existing drugs and the remaining do not achieve complete recovery. Thus, finding effective treatments that have adequate efficacy, fewer side effects and lower cost seem to be necessary. The purpose of this study was to review animal and double-blind clinical studies on the anti-depressant effects of medicinal herbs. In this study, validated scientific articles indexed in PubMed, SID, Web of Science and Scopus databases were reviewed. A database search was performed using the following terms: clinical trials, depression, major depressive disorder, essential oil, extract and medicinal plant. Positive effects of a number of herbs and their active compounds such as St John’s-wort, saffron, turmeric, ginkgo, chamomile, valerian, Lavender, Echium amoenum and Rhodiola rosea L. in improvement of symptoms of mild, moderate or major depression have been shown in clinical trials. The above plants show antidepressant effects and have fewer side effects than synthetic drugs. Hence, they have the potential to treat patients with depression.
... Ginkgo Biloba (Mabet Ağacı) yapraklarının özü flavonoid glikozidleri içermektedir (32)(33)(34). Her ne kadar tartışmalı yönleri olsa da Alzheimer, vertigo ve dikkat eksikliği açısından yararları olduğuna iliş-kin veriler bulunmaktadır (35,36). ...
... Yan etkileri arasında kanama, gastrointestinal bozukluklar, bulantı, ishal, baş ağrısı ve huzursuzluk bulunmaktadır. Yan etkilerin sürmesi durumunda ginkgo kullanımı durdurulmalıdır (32)(33)(34). ...
Sexual dysfunction is an important health problem deteriorating the quality of life of increasing number of elderly people worldwide. Many drugs like phosphodiesterase inhibitors and herbal remedies can be used in sexual dysfunction. In this paper, we aimed to review the cardiovascular effects of drugs and herbal remedies that are used for sexual dysfunction.
... Some studies suggest that it may also have a protective effect on the prostate. Icariin, the active component, has been shown to have anti-inflammatory and antioxidant effects, and it is also a PDE5 inhibitor, similar to drugs used for erectile dysfunction (Cohen and Bartlik 1998;Gauthaman and Ganesan 2008), (Kang et al. 2012) Ginkgo Biloba herb is traditionally used to improve blood flow and memory, it is also thought to improve erectile dysfunction due to its blood flow-enhancing properties (Estrada-Reyes et al. 2013;Kakavandi et al. 2023), (Estrada-Reyes et al. 2009) Besides, Tribulus terrestris was used in traditional medicine systems such as Ayurveda and traditional Chinese medicine and it was used to improve urinary flow and supporting prostate health (Tai and Rowland 2010), (Usiobeigbe et al. 2021) Damiana (Turnera diffusa) (Meletis 2000;Chung et al. 2015), Ashwagandha (Withania somnifera), Ginseng (Panax ginseng) (Bella and Shamloul 2014;Wagner et al. 2020), Muira Puama (Ptychopetalum olacoides) (Kucio et al. 1991;Hz et al. 2018), yohimbe (Pausinystalia yohimbe) (Ahmad et al. 2008), Cistanche (Cistanche deserticola) (Kang et al. 2022), Cnidium monnieri (Zhaojian et al. 2006;Wu 2013), Mucuna pruriens (Lampariello et al. 2012;Ismail et al. 2012), Epimedium (Epimedium spp.) (Fernandes et al. 2007;Gauthaman and Ganesan 2008), Tongkat Ali (Eurycoma longifolia) (Hosseinzadeh et al. 2007;Zhang et al. 2018), Catuaba (Erythroxylum catuaba) (Shamsa et al. 2009), and Saffron (Crocus sativus) [202], [203]. These are used to treat BPH because to their characteristics and historical usage in managing blood flow and testosterone levels, which promote sexual activities. ...
Infertility affects 8-12% of couples globally, with male factors contributing to around 40% of cases. Common male infertility issues include erectile dysfunction (ED) and low sperm count or quality, which account for over 90% of cases. These problems often result from anatomical, hormonal, or genetic abnormalities. This review focuses on natural aphrodisiac herbs commonly used to address ED, providing detailed information on their botanical characteristics, metabolic pathways, recommended dosages, phytochemical properties, side effects, origins, and traditional uses. It also reviews recent studies on medicinal herbs that boost sexual desire and treat urological conditions. By compiling reliable findings from the past decade, the study aims to serve as a comprehensive resource for individuals dealing with sexual health issues. Through careful evaluation of each herb, it offers insights into their effectiveness and limitations, emphasizing the potential of natural treatments as complementary alternatives to conventional therapies for male infertility and related conditions. HIGHLIGHTS • Anatomy, hormone abnormalities and genetic flaws may contribute to male infertility. • The most popular natural aphrodisiac herbs used in the treatment of infertility were revised. • Unique and reliable references to sexual desire and urological problems were provided. • Safe aphrodisiac herbs including phytochemical products were emphasized. • Plants were investigated for their potential as aphrodisiacs and fertility enhancers ARTICLE HISTORY
... Previous research has stated that Ginkgo biloba can exert neuroprotective effects on PC12 cells damaged by paraquat [37] and can also ameliorate dyskinesia in a 6-OHDA-induced PD model [38] and neurodegeneration of the SNc in an MPTP-induced PD model [39]. However, Bacopa monnieri causes abdominal cramps and nausea [40], and Ginkgo biloba has side effects, including gastrointestinal upset and headache [41]. Therefore, it is still di cult to replace existing PD treatments. ...
Background
Parkinson's disease (PD) is a neurodegenerative disorder caused by dopamine neuronal dysfunction. Although dopamine agonists and N-methyl-D-aspartate (NMDA) receptor antagonists are used to treat PD, chronic use causes severe side effects. Therefore, puerarin (PUE) affects the dopamine system and is a considerable candidate for PD; however, its therapeutic effects on PD-associated motor dysfunction remain unclear. Therefore, this study aimed to investigate the effects of PUE treatment on motor dysfunction in a 6-hydroxydopamine (6-OHDA) rodent PD model.
Methods
Adult male ICR mice received unilateral 6-OHDA microinfusion into the right medial forebrain bundle. After a 2-week recovery period, PUE (20 or 50 mg/kg) or the vehicle (saline, VEH) was intraperitoneally administered once daily for 3 weeks. Motor dysfunction was assessed using the locomotion, rotation, and gait cycle tests 2 weeks after PUE administration. Local field potential (LFP) was measured in the substantia nigra compacta (SNc), striatum (STR), subthalamic nucleus (STN), and primary motor cortex (M1).
Results
PD animals showed higher unidirectional rotation and abnormal gait cycle without locomotion change compared with sham surgery (control, CTR) animals. PUE treatment ameliorated the abnormal gait cycle of PD animals. These effects were different with DA agonist and NMDA receptor antagonist treatments. Moreover, PUE treatment induced no changes in attenuated LFPs of beta wave in the STR, STN, and M1, and coherence of delta wave between SNc-STN was shown in PD animals.
Conclusions
This study suggests that PUE is a beneficial co-therapeutic agent for alleviating gait disturbances via dopaminergic and non-dopaminergic neurocircuitry in PD.
... The extract also has anti-asthmatic properties. 170 Anti-oxidant, 171 anti-inflammatory, 172 anti-radical 173 and neuroprotective capabilities against neurodegenerative diseases as AD 174,175 and PD. 176 This plant alters cerebral blood flow, which may lessen weariness and inattentiveness. ...
Traditional medicine has received more attention in recent years. Numerous plants have been employed in medicine to treat neurological disorders like AD and other memory-related problems. Traditional uses for dietary, spice, and food additive medicinal purposes included the use of, Nigella sativa, Crocus sativus, Ferula assafoetida, Coriandrum sativum, Zataria multiflora, Thymus vulgaris Cats Claw, and Carotenoids, monoterpenes, and polyphenol chemicals, which are the main ingredients in these plants, improved neurological processes. These healing plants improved antioxidant production, reduced oxidative stress, and prevented the neurological system's acetylcholinesterase enzyme from working. Reduced production of proinflammatory cytokines such IL-6, TNF-an ,IL-1b, NF-Kβ, Bax Protein, Bcl-2,Caspase-3 and total nitrite is another way that plants are neuroprotective. As a result, the effects of the aforementioned medications and their active ingredients improved neurodegenerative diseases, indicating their therapeutic promise in diseases like AD and depression that are linked to neuro-inflammation and neurotransmitter deficit.
... No side effects have been reported with the use of G. biloba and it appears to be compatible with antidepressant treatment. In addition, many patients have reported an improvement in their mental clarity and memory with the use of G. biloba (Cohen & Bartlik, 1998). ...
The history of the Ginkgo biloba L. species' history dates back to very ancient times. It can live for approximately a thousand years and it is quite resistant to adverse conditions. Its leaves contain important components that make them useful for medicinal purposes. In addition, its seeds have also been used as a therapeutic agent in traditional Chinese medicine. G. biloba extracts are usually used in standardized dosage forms in medicinal preparations. Today, the preffered form is a standardized extract of G. biloba called Tebonin Egb761. Studies have shown that G. biloba leaf extract is effective in treating symptomatic relief of mild to moderate cerebral insufficiency in humans. It provides effective treatment in both Alzheimer's and vascular dementia patients. The herbal extract can also have positive effects on the quality of life in healthy individuals. G. biloba is effective against inner ear disorders and provides protection against endothelial damage. Besides, scientific studies have demonstrated that it has antioxidant, anti-inflammatory, antiviral, antibacterial, antidiabetic, anticancer, neuroprotective, cardioprotective, and many other effects. G. biloba is considered an important nutraceutical due to its scientifically proven effects.
... Methylphenidate [119], VML-670 [120], Maca root (Peruvian Ginseng) [121], and Gingko Biloba [122] were associated with no strong evidence that supports an effect on antidepressantinduced SD [25]. Further drug agents, i.e. buspirone and mir-570 tazapine, were also reported for treatment of antidepressantinduced SD in males; however, clinical evidence of efficacy was insufficient. ...
Introduction:
Sexual dysfunction (SD) and depression have a bidirectional relationship. The rising prescription of antidepressants, especially those with a serotonergic effect, is associated with increased SD. Sexual dysfunction reduces compliance and increases risk of recurrence of depressive episodes. Various strategies have been studied to manage antidepressant-induced SD.
Areas covered:
: This review covers the identification of symptoms of antidepressant-induced SD, prevalence of symptoms in association with commonly used antidepressants, and the main lines of management, with a focus on pharmacological strategies.
Expert opinion:
: The management of antidepressant-induced SD aims to reduce the unwanted sexual adverse effects while maintaining an acceptable control of depressive symptoms. It should implicate a multidisciplinary approach and determination of baseline sexual function and SD risk factors. In spite of several methodological issues, antidepressants can be divided into low and high-risk categories with regard to the possibility of developing SD. In patients interested in sexual activity, it is recommended to start with low-risk antidepressants. Otherwise, encourage the patient to wait for tolerance and then switch to low-risk. In selected cases, dose reduction or a drug holiday may be applied. The adjunctive use of a PDE5i can help in a significant number of patients. Randomized controlled trials are needed to set high-level-evidence based recommendations.
... Ginkgo is effective in preventing altitude sickness. Cohen et al has reported that Ginkgo biloba is for antidepressant-induced sexual dysfunction 10 . Hemmeter and his colleagues conducted a study to investigate the efficacy of Ginkgo biloba in patients with depression. ...
... Ginkgo is effective in preventing altitude sickness. Cohen et al has reported that Ginkgo biloba is for antidepressant-induced sexual dysfunction 10 . Hemmeter and his colleagues conducted a study to investigate the efficacy of Ginkgo biloba in patients with depression. ...
... Ginkgo biloba contains terpene lactone, which facilitates blood flow and aids smooth muscle relaxation in the genitalia, thereby increasing sexual arousal (Cohen and Bartlik, 1998). Ginkgo biloba also increases the secretion of neurotransmitters such as dopamine and adrenaline, which are important in the modulation of sexual desire by increasing pleasure, arousal, and alertness (Lim, 2017). ...
Background
: Female sexual dysfunction (FSD) includes female orgasmic disorder, female sexual interest or arousal disorder, and genito-pelvic pain or penetration disorder. FSD affects 40% of women worldwide, but it is understudied and likely undertreated. Natural products are frequently used by women to treat FSD, but scientific evidence of their efficacy is lacking.
Objective
: This systematic review and meta-analysis focused on the study of the efficacy of natural products on FSD.
Study design
: Systematic review and meta-analysis of existing studies on natural products in the treatment of FSD.
Methods
: The literature search included MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trial databases for studies published from January 2000 to February 2020. The quality and the level of evidence of the studies were assessed. The association between natural products and FSD was summarized using standardized mean differences (SMD) with a 95% confidence interval (CI).
Results
: A total of 536 studies were identified, with 20 of them meeting the criteria. According to this meta-analysis, Tribulus terrestris showed a significant positive effect in improving overall female sexual function (SMD = 1.12, 95% CI = 0.46 - 1.79, p = 0.001) and individual sexual arousal (SMD = 1.03, 95% CI = 0.22 - 1.84, p = 0.013), sexual desire (SMD = 1.08, 95% CI = 0.52 - 1.63, p = <0.001) and sexual orgasm (SMD = 0.51, 95% CI = 0.02 - 1.00, p = 0.040) domains compared to placebo. Panax ginseng was found to be effective in treating sexual arousal (SMD = 0.54, 95% CI = 0.11 - 0.97, p = 0.014) and sexual desire (SMD = 0.59, 95% CI = 0.27 - 0.90, p < 0.001) compared to placebo. Meanwhile, other natural products reviewed in this study, such as Trifolium pretense, did not differ significantly from placebo in terms of improving FSD.
Conclusion
: Preliminary evidence suggests that Tribulus terrestris and Panax ginseng may be effective as alternative treatments for FSD in a clinical setting.
... The extract reduces serum amylase as well as lipase level. This action of the extract is dependent on the free radical scavenging effect [25]. ...
In the present review, we are highlighted various pharmacognostic and pharmacological aspects of the different parts of plant Ginkgo biloba. Leaves are mainly potential source of phytochemical constituents. The plant encompasses variety of pharmacological activities namely antioxidant, hypolipidemic, antibacterial, etc. The pharmacological profile of plant is mainly attributed to the presence of chemicals such as Ginkgolide A, Ginkgolide B, Ginkgolide C, Bilobalide, Ginkgotoxin, ginkgolides and bilobalide are the major constituents. The pills with the highest concentration of plant extract (100 mg) allow the intake of the highest antioxidants concentration. It is also used along with 5-flurouracil in cancer treatment. There is need to explore more activities of the plant.
... In recent years, research to find herbal remedies as a complementary and even alternative drug for the treatment of depression has become particularly important. In this regard, the effectiveness of numerous plant extracts and fragrances against depression in animal models have been demonstrated in double-blind clinical trials (3)(4)(5)(6)(7)(8)(9)(10)(11). In 2003, Mozaffarian introduced the mountain celery belonging to the Apiaceae family, scientifically referred to as K. odoratissima Mozaffarian, as a species of the Kelussia genus (12,13). ...
Background and aims: Depression is one of the most common psychiatric disorders with serious impacts on individuals, and is often associated with physiological symptoms. In this study, we investigated the antidepressant effects of Kelussia odoratissima Mozaffarian extract in male mice. Methods: A total of 56 male mice (weight: 25-35 g; age: 6-8 weeks) were used. K. odoratissima Mozaffarian hydroalcoholic extract was prepared by maceration method. The forced swim test, open field test, and splash test were used to investigate the antidepressant effects. The mice were assigned into eight equal groups (n=7 each) as follows: receiving 25, 50, 75, and 100 mg/kg of K. odoratissima Mozaffarian extract; receiving 5 mg/kg reserpine; receiving 5 mg/kg reserpine along with 20 mg fluoxetine; and normal saline. All injections were done intraperitoneally for one week before the test. Malondialdehyde (MDA) levels and antioxidant capacity of serum and brain were also measured in all groups. Statistical analysis was performed by one-way ANOVA and Tukey’s test. Results: Extract of K. odoratissima Mozaffarian significantly decreased the immobility time in forced swim test (P<0.001). The extract also significantly increased splash time and elapsed time in the open field test, which was statistically significant compared with reserpinated mice (P<0.001). Reserpine increased MDA levels and decreased the antioxidant capacity of serum and brain, whereas hydroalcoholic extract of K. odoratissima decreased MDA dose-dependently and increased antioxidant capacity (P<0.001). Conclusion: The results of this study showed that hydroalcoholic extract of K. odoratissima has antidepressant effects, but further studies are necessary to investigate the involved mechanisms.
... Ginkgo is effective in preventing altitude sickness. Cohen et al has reported that Ginkgo biloba is for antidepressant-induced sexual dysfunction 10 . Hemmeter and his colleagues conducted a study to investigate the efficacy of Ginkgo biloba in patients with depression. ...
... In the open-label study, patients with antidepressant-induced sexual dysfunction refractory to ≥1 prior intervention (N = 63), received adjunctive ginkgo (40-120 mg bid) for 4 weeks. 58 Eighty-four percent of patients had improved sexual function, although more women (91%) benefited compared to men (76%). In addition, all phases of the sexual response cycle improved. ...
Background
Despite the prevalence of antidepressant-related sexual side effects, comparisons of treatments for these problematic side effects are lacking.
Methods
To address this, we performed a systematic review and Bayesian network meta-analysis to compare interventions for antidepressant-induced sexual dysfunction in adults. Using PubMed and clinicaltrials.gov, we identified published and unpublished prospective treatment trials from 1985 to September 2020 (primary outcome: the Arizona sexual experience scale [ASEX] score). The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework.
Results
We identified 57 citations (27 randomized controlled trials, 66 treatment arms, 27 open-label trials, and 3 crossover trials) that evaluated 33 interventions (3108 patients). In the systematic review, 44% (25/57) of trials reported successful interventions; this was more common in open-label (70%, 19/27) compared to placebo-controlled studies (22%, 6/27). In the meta-analysis of placebo-controlled studies that used the ASEX (N = 8), pycnogenol was superior to placebo (standardized mean difference: −1.8, 95% credible interval [CrI]: [−3.7 to 0.0]) and there was evidence that, at a 6% threshold, sildenafil improved sexual dysfunction (standardized mean difference: −1.2, 95% CrI [−2.5 to 0.1]). In the meta-analysis including single-arm studies (15 studies), treatment response was more common with sildenafil, tianeptine, maca, tiagabine, and mirtazapine compared to placebo, but these differences failed to reach statistical significance.
Conclusions
While heterogeneity across randomized controlled trials complicates identifying the single best intervention, multiple trials suggest that sildenafil ameliorates antidepressant-induced sexual dysfunction. More randomized controlled trials are needed to examine the putative efficacy of other interventions.
... The herbal preparation ginkgo biloba, recently reported to be effective in reversing memory difficulties in the elderly, has been claimed to enhance sexual function. Anecdotal reports suggest it might play a role in reversing dysfunction due to antidepressants [73]. ...
Depression has always been at center stage of psychiatry with many resources allocated and a significant progress made in its study and treatment. Still, it remains a wide-spread condition afflicting about 5-10% of the world population and is the leading cause of disability. Depression is a heterogeneous condition with multiple manifestations, symptoms, comorbidities, and degrees of severity compounding the challenge to its treatment. In this chapter, I suggest that progress in understanding the nature of depression and development of its general theory may assist further advancements in its therapy. Evolutionary theory of depression has developed over several decades and is currently entrenched in the clinical thinking. More recently, a novel paradigm known as predictive coding (or predictive processing framework, PPF) has been proposed as a theoretical frame for understanding psychopathology including depression. PPF has been used as a conceptual bridge linking evolutionary and stress theories to explain mood/affective psychopathology. This emerging Integrative Evolutionary-Stress response-PPF (iESP) theory may offer useful insights for clinical practice. I review the rationale and recent developments in this integrative endeavor and discuss how the integrated perspective on depression can guide its treatment. To illustrate this with a clinical example, I present a novel evolutionary-based integrative therapy for depression.
... Women (n = 33) were more responsive to the sexually enhancing effects of G. biloba than men (N = 30), with relative success rates of 91% versus 76%. G. biloba generally had a positive effect on all 4 phases of the sexual response cycle: desire, excitement (erection and lubrication), orgasm, and resolution (afterglow) [191]. Improvements in penile endothelial L-arginine-nitric oxide activity appear to be a unifying explanation for the actions [192]. ...
Plant plethora is a rich source of natural products having fertility regulating activity. The development of a new fertility regulating drug from medicinal plants is an attractive proposition, due to the use of natural products as source of drugs and therapeutic agents from ancient times. 330 Ansari, A.S. et al. into an ideal male contraceptive. The Pippalyadi Vati (seed extract of Embelia ribes and Piper longum mixed with borax powder) and Praneem polyherbal cream (prepared from Azadirachta indica, Sapindus mukorossi and Mentha citrata oil) have already undergone phase II clinical trials, respectively, as female contraceptive and vaginal pessary with spermicidal and antimicrobial agent. Consap (saponins extracted from Sapindus mukorossi), developed by the Central Drug Research Institute, Lucknow, has successfully completed phase III clinical trials as a spermicidal agent. Recently, it has been licensed to Hindustan Latex Ltd., Mumbai for marketing. Chloroform extract of the seeds of Carica papaya and its benzene chromatographic fraction and methanol and ethyl acetate sub-fractions have shown promising results in rats, rabbits and langur monkeys as male fertility regulating agents. Preclinical investigations with the seed extracts of this plant indicated no acute and chronic toxicity and carcinogenicity in rats up to 10 times the contraceptive dose regimens. Several plants have also been screened for fertility enhancing properties. Aphrodisiac and fertility-enhancing properties of Lepidium meyenii Walp have been proved in clinical trials. Catha edulis, Panax ginseng, Pausinystalia yohimbe, Saw palmetto, Tribulus terrestris, and Ginkgo biloba are the common herbs used for sexual health and problems. Xpectinol ® (bark of the stems and principle branches of various trees available from Syria to Spain) and Touchfire HIS (extracts of Ptychopetalum olacoides, Juniperis brasiliensis, Turnera aphrodisiaca, Smilax papyracea and Urtica dioica) are available herbal drugs for fertility enhancement. However, despite the extensive work carried out on natural products, the efforts have not yet been successful in developing a universally acceptable contraceptive. In the present review, constraints for the development of herbal based fertility regulating agent and to overcome the problems are discussed.
... In an open-label investigation, Ginkgo Biloba was reported to have beneficial effects in managing antidepressants including SSRIs induced sexual dysfunction, providing its effects on all four phases of the sexual response cycle: desire, excitement, orgasm, and resolution. 58 Interestingly, the investigators found more successful for female patients compared to male ones in that study. Nevertheless, the opposite results were also obtained. ...
Any type of sexual dysfunction is an important problem in half of the patients with depressive disorder. On the other hand, one to a quarter of people without any depressive disorder experience sexual dysfunction. Antidepressant agents can lead to all types of sexual side effects including arousal, libido, orgasm and ejaculation problems. Selective serotonin reuptake inhibitors (SSRIs) are a widely used class of drugs which are prescribed for the treatment of a variety of disorders, including major depressive disorder, obsessive-compulsive disorder, posttraumatic stress disorder, panic disorder, generalized anxiety disorder, and impulse control disorders. It has been reported that one in eight people have utilized one of the SSRIs in the past 10 years. Some studies reported up to 80% of SSRI-induced sexual side effects. Management of SSRI-induced sexual dysfunction seems to be complex and hard. In this paper, SSRI-induced sexual dysfunction and new perspectives in the management of this problem were reviewed.
... Occasionally, these drugs can be administered a few hours before sexual relations or as a permanent measure. They act through different mechanisms, namely dopaminergic agonists [77] (amantadine [78], dextroamphetamine and pemoline, ropinirole), serotoninergic antagonists (cyproheptadine) [79,80], 5HT1A receptor stimulants (buspirone [81]), adrenergic agonists (yohimbine [82], pentoxifylline [83], fluparoxan), cholinergic agonists (neostigmine, bethanechol) [84], antioxidant pathways (pycnogenol [85]), or through poorly understood mechanisms (Gingko biloba extract [86]). However, these methods present clear inconveniences, with very dissimilar results regarding efficacy, and some can even cause other, less well-tolerated, adverse effects. ...
Major depressive disorder is a serious mental disorder in which treatment with antidepressant medication is often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) has a low rate of spontaneous reports by patients, and this side effect therefore remains underestimated in clinical practice and in technical data sheets for antidepressants. Moreover, the issue of TESD is rarely routinely approached by clinicians in daily praxis. TESD is a determinant for tolerability, since this dysfunction often leads to a state of patient distress (or the distress of their partner) in the sexually active population, which is one of the most frequent reasons for lack of adherence and treatment drop-outs in antidepressant use. There is a delicate balance between prescribing an effective drug that improves depressive symptomatology and also has a minimum impact on sexuality. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antidepressant with a low rate of TESD) to possible pharmacological interventions aimed at improving patients' tolerability when TESD is present. The suggested recommendations include the following: for low sexual desire, switching to a non-serotoninergic drug, lowering the dose, or associating bupropion or aripiprazole; for unwanted orgasm delayal or anorgasmia, dose reduction, "weekend holiday", or switching to a non-serotoninergic drug or fluvoxamine; for erectile dysfunction, switching to a non-serotoninergic drug or the addition of an antidote such as phosphodiesterase 5 inhibitors (PD5-I); and for lubrication difficulties, switching to a non-serotoninergic drug, dose reduction, or using vaginal lubricants. A psychoeducational and psychotherapeutic approach should always be considered in cases with poorly tolerated sexual dysfunction.
... RE can be experimentally induced using many drugs [7][8][9] and treated pharmacologically [10,11] or with alternative medicines [12,13]. Medicinal plants are widely used in sub-Saharan Africa for pharmacological and pharmaceutical purposes. ...
Objective: Hypothyroidism has been claimed to generate sexual dysfunctions such as ejaculatory disorders. Aframomum melegueta is an aphrodisiac plant with pro-ejaculatory properties. We investigated the protective effects of aqueous extract (AE) and methanolic extract
(ME) of A. melegueta on the ejaculatory function of hypothyroid male rats. Methods: Forty sexually experienced male rats were partitioned into 8 groups (5 rats per group) and treated for 28 d as follows: Group 1, Control; Group 2, propylthiouracil (PTU, 10 mg/kg) + distilled water (DW, 10 mL/kg); Group 3, PTU + 5% Tween 80 (10 mL/kg); Group 4, PTU + bromocriptine (6 mg/kg); Group 5, PTU + AE (20 mg/kg); Group 6, PTU + AE (100 mg/kg); Group 7, PTU + ME (20 mg/kg), and Group 8, PTU + ME (100 mg/kg). On days 0, 7, 14 and 28 of treatment, each male rat was paired with primed receptive female for measurement of ejaculatory latency time (ELT) and post-ejaculatory interval (PEI) for 1.5 h. On day 29, each male rat was urethane-anaesthetized and the spinal cord was transected. Thereafter, following urethral/penile stimulations and intravenous injection of dopamine, contractions of the bulbospongiosus muscles and the intraseminal pressure were registered. After these recordings, blood was collected through the catheterization of abdominal artery and plasma was used for thyroid-stimulating hormone (TSH), prolactin and testosterone assays. Results: PTU-induced hypothyroidism was characterized by a significant elevation (P < 0.001)2 / 17 of plasmatic TSH and prolactin levels, but a decline (P < 0.001) in plasmatic testosterone,
compared to untreated group. ELT, PEI, contractions of the bulbospongiosus muscles and the intraseminal pressure were also altered by PTU treatment. On the contrary, A. melegueta extracts
elevated testosterone (AE, 100 mg/kg, P < 0.01; ME, 100 mg/kg, P < 0.05) and decreased prolactin (AE, 100 mg/kg, P < 0.05; ME, 20 mg/kg, P < 0.05) levels, compared to corresponding controls. With regard to DW + PTU group, prolactin concentration was lowered (P < 0.05) in
rats administered with bromocriptine. Treatment with A. melegueta extracts significantly prevented the lengthening of ELT (P < 0.05) and PEI (P < 0.001). Hypothyroid state also altered the fictive ejaculation by increasing the latency and decreasing the number and frequency of
bulbospongiosus muscle contractions. There was also a decrease of the intraseminal pressure. These alterations were significantly (P < 0.05) alleviated in plant extract-treated groups. Conclusion: This study highlighted the ejaculatory disturbance of hypothyroidism in male rats
and its prevention with A. melegueta extracts.
... Ginkgo biloba is one of the most commonly herbal supplements were used in the world originating from China [2]. In medicine there are many reported for the clinical uses of dry extracts of Ginkgo biloba leaves, known as Egb761 [3] such as Alzheimer's disease or senile dementia [4], cardiovascular disease [5], cerebral vascular insufficiency and impaired cerebral performance [6], premenstrual syndrome [7], antidepressant-induced sexual dysfunction [8], vascular diseases [9], liver fibrosis [10], macular degeneration [11], tinnitus [12], Vertigo or equilibrium disorders [13], memory [14], cancer [15] and etc,. Ginkgo contains a number of biologically active components for its defense against insects, bacteria, and fungi [16]. ...
Objective(s): In this work, Ginkgo biloba extract (GBE) loaded solid lipid nanoparticles (SLNs) were synthesized via high pressure homogenization method and their physicochemical properties, as well as cytotoxicity and antibacterial activities were evaluated. Methods: Ginkgo biloba extract SLNs (GBE-SLNs) were prepared using high pressure homogenization method. The morphology and size of SLNs were evaluated by scanning electron microscopy (SEM) and dynamic light scattering (DLS) techniques. The drug release of SLNs was also investigated using synthetic dialysis membrane. The antibacterial activity of nanoparticles was tested against both gram negative and gram positive bacteria strains. The probability of having toxicity of SLNs was studied on the rabbits. Results: The spherical structure of GBE-SLNs was confirmed by SEM images. The mean particle size of the obtained SLNs was ranging from 104 to 621 nm for different formulations using DLS technique. An in-vitro study of synthesized SLNs illustrated that the percentage of ginkgo biloba released from the solid lipid nanoparticles was 85% of loaded GBE after 72 hours. There was no report of significant skin toxicity via in-vivo studies. Conclusions: According to the above results, SLNs loaded with ginkgo extract showed acceptable particle size and shape, suitable loading of active substance and sustained release profile as well as appropriate antimicrobial effects without any significant skin toxicity.
... Ginkgo biloba is one of the most commonly herbal supplements were used in the world originating from China [2]. In medicine there are many reported for the clinical uses of dry extracts of Ginkgo biloba leaves, known as Egb761 [3] such as Alzheimer's disease or senile dementia [4], cardiovascular disease [5], cerebral vascular insufficiency and impaired cerebral performance [6], premenstrual syndrome [7], antidepressant-induced sexual dysfunction [8], vascular diseases [9], liver fibrosis [10], macular degeneration [11], tinnitus [12], Vertigo or equilibrium disorders [13], memory [14], cancer [15] and etc,. Ginkgo contains a number of biologically active components for its defense against insects, bacteria, and fungi [16]. ...
Objective(s): In this work, Ginkgo biloba extract (GBE) loaded solid lipid nanoparticles (SLNs) were synthesized via high pressure homogenization method and their physicochemical properties, as well as cytotoxicity and antibacterial activities were evaluated. Methods: Ginkgo biloba extract SLNs (GBE-SLNs) were prepared using high pressure homogenization method. The morphology and size of SLNs were evaluated by scanning electron microscopy (SEM) and dynamic light scattering (DLS) techniques. The drug release of SLNs was also investigated using synthetic dialysis membrane. The antibacterial activity of nanoparticles was tested against both gram negative and gram positive bacteria strains. The probability of having toxicity of SLNs was studied on the rabbits. Results: The spherical structure of GBE-SLNs was confirmed by SEM images. The mean particle size of the obtained SLNs was ranging from 104 to 621 nm for different formulations using DLS technique. An in-vitro study of synthesized SLNs illustrated that the percentage of ginkgo biloba released from the solid lipid nanoparticles was 85% of loaded GBE after 72 hours. There was no report of significant skin toxicity via in-vivo studies. Conclusions: According to the above results, SLNs loaded with ginkgo extract showed acceptable particle size and shape, suitable loading of active substance and sustained release profile as well as appropriate antimicrobial effects without any significant skin toxicity.
... The potential health benefits of this plant include ability to tolerate low oxygen level in the brain, reduce neuroinflammation and act as antioxidant. G. biloba has also been reported for depression-induced sexual dysfunction [58]. G. biloba was administered in depression patient and sleep pattern in such patient were prominently improved as compared to trimipramine group [59]. ...
There is enough data available now to believe that nature has provided cure of almost every ailment through herbal medicine or management. Therefore, now there is lot of emphasis on identification, evaluation, development and characterization of numerous plants and their active constituents against several diseases including depression. Depression is not only one of the most common ailments but also a highly complex condition to study. Even though several antidepressant drugs are available now, yet their effectiveness and usefulness are highly questionable especially because of their side effects. As herbal remedies are generally associated with favourable safety profiles therefore they have the possible potential to deliver effective replacements to currently available synthetic antidepressants. More recently, efforts have been focused on characterization of pharmacologically active ingredients and to identify the mode of action of herbal antidepressant medicines. This review describes a brief introduction of different animal models for depression and discusses the advantages and disadvantages for each approach. Then we have summarized possible plant phytochemicals as antidepressant drug and the underlying mechanisms. In the main body of the review, we have discussed in detail the most frequently used plants (21) being investigated for the treatment of depression. Additionally, we have provided the list of medicinal plants (92) representing their origin, parts used, extraction method, evaluation method and possible active ingredient. In the final part of the review we have presented the summary of clinical trials on the use of medical plants for depression and their active constituents.
... 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]. ...
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.
... Le gingko biloba pourrait être utilisé pour traiter les dysfonctions sexuelles chez les femmes traitées par les inhibiteurs de la recapture de la sérotonine. En effet, il a une action positive sur les différentes phases du cycle de réponse sexuelle (désir, excitation, orgasme, résolution) (Cohen and Bartlik 1998). Les femmes schizophrènes traitées par antipsychotiques rapportent des dysfonctions sexuelles dans 3 à 96% des cas selon les études réalisées (Tardieu, Micallef et al. 2006). ...
La libido chez la femme est influencée par de nombreux facteurs dont les médicaments. Ceux-ci peuvent exercer des effets indésirables tels qu'une diminution du désir sexuel voire une augmentation. Des médicaments sont également utilisés pour traiter les dysfonctionnements sexuels. L'exploration des données recueillies dans la banque nationale de pharmacovigilance permet de se donner une idée de l'impact des médicaments sur la libido féminine.
... Some studies have suggested that ginkgo may alleviate antidepressant-induced sexual dysfunction (139,140). In an open trial of ginkgo in 63 patients with antidepressantinduced sexual dysfunction (from SSRIs, SNRIs, TCAs, and MAOIs) (140), 91% of women and 76% of men reported improvement in all aspects of the sexual cycle with doses of 60-180 mg BID. ...
Natural and herbal remedies, also known as "alternative" or "complementary" medicines, have grown tremendously in popularity over the past two decades, becoming a major component of health care and general wellness in the United States and worldwide. The ready availability of these remedies over the counter and their generally good tolerability and safety contribute to this popularity, and many people have benefited from them, often in cases when conventional treatments have failed or caused intolerable side effects. Despite many Food and Drug Administration (FDA)-approved psychotropic medications on the market, efficacy has been inconsistent for some, and many treatment responders will eventually relapse. Continued research on the efficacy and safety of these alternative therapies is, therefore, important. This article reviews six of the most commonly used natural remedies for psychiatric conditions, including the antidepressants St. John's wort, omega-3 fatty acids, and S-adenosyl methionine (SAMe); the sedative-hypnotics valerian and melatonin; and the nootropic ginkgo biloba. We outline the general indications for use, suggested doses, possible mechanisms, and adverse effects to give clinicians a good summary of the benefits and liabilities of each. Although there is growing evidence of efficacy and safety to support the use of these remedies, clinicians must be aware of the limitations of the evidence base and take that into account with all the other factors that contribute to clinical decision making.
... It was reported that EGb 761 was a herbal agent which has a suppressive role against the sexual function dysfunction (37) and increased the sexual performance by increasing their testosterone levels in the young rats (38). In addition, it was stated that the testosterone level decreasing the result of Leydig cell damage in diabetic rats gradually increased with EGb 761 (39). ...
In this study, the protective effect of ginkgo biloba extract 761 (EGb 761)'s on testicular damage caused analyzed by giving the same dose di-(2-ethylhexyl) phthalate (DEHP) to rats at different times was investigated. 72 Wistar Albino rats at 28 days of age were divided into groups of control, DEHP, DEHP+EGb 761 and EGb 761. On the 7 th ,14 th and 28 th days of the study, the animals were decapitated. DEHP administration was determined to cause significant decreases in testes weights, diameter of seminiferous tubules, germinal cell layer thickness, serum testosterone levels, glutathione (GSH) levels wherease it caused significant increases in malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and catalase (CAT) levels, apoptotic indices along with degeneration, necrosis, atrophy, disorganization, Leydig cell hyperplasia and thickening of the basal membrane in testicular tissue when compared with the control group. EGb 761 administration provided significant improvements in disturbed oxidant/antioxidant balance, decreased testosterone concentration, induced testicular apoptosis and gradually improvements in the histopathological view of the testicular tissue in DEHP-treated rats. It was determined that DEHP is highly toxic to the testis tissue for the application duration and dose and cause to severe structural damage and EGb 761 which has antioxidant effect prevents this damage.
Key Words: Apoptosis, di-(2-ethylhexyl) phthalate, ginkgo biloba extract 761, testicular toxicity, TUNEL.
Parkinson’s disease (PD) is a neurodegenerative disorder caused by dopamine (DA) neuronal dysfunction. Although DA agonists and N-methyl-D-aspartate receptor (NMDAR) antagonists are used to treat PD, chronic use causes severe side effects. Puerarin (PUE) is a natural bioactive compound that affects the DA system; however, its effect on PD-associated motor functions is unknown. Therefore, we investigated whether PUE treatment in a 6-hydroxydopamine (6-OHDA) PD mouse model affects motor dysfunction.
Adult male ICR mice received unilateral 6-OHDA microinfusion into the right medial forebrain bundle. After a 2-week recovery period, PUE (20 or 50 mg/kg) or the vehicle (saline, VEH) was administered intraperitoneally once daily for 21 days. Motor dysfunction was assessed using the locomotion, gait cycle, and rotation tests. Local field potentials (LFPs) were measured in the substantia nigra compacta (SNc), striatum (STR), subthalamic nucleus (STN), and primary motor cortex.
6-OHDA-lesioned PD mice showed increased gait cycle disturbance and unidirectional rotation. PUE treatment ameliorated the gait cycle disturbance, but not unidirectional rotation of PD mice. These effects differed with DA agonist treatment (which improved PD symptoms) and NMDAR antagonist treatment (which aggravated PD symptoms). Moreover, locomotion was increased only in NMDAR antagonist treatment. PUE treatment induced no changes in the attenuated LFP of the beta wave in the STR and STN, and SNc-STN delta-wave coherence was shown in PD animals.
This study suggests that PUE is a beneficial co-therapeutic agent for alleviating gait cycle disturbance in PD symptoms.
Antidepressants (ADs) are among the most commonly prescribed drugs worldwide. Persons with mental illness taking ADs commonly report sexual dysfunction (SD) related to treatment. A brief discussion on the neurobiology of sexual functioning and mechanism of treatment-emergent SD (TESD) was performed. The incidence of prevalence of TESD in various studies has been reviewed. TESD impacts patients as it frequently leads to nonadherence, while psychiatrists have challenges in proceeding forward with treatment in such patients. Assessment of patients with suspected TESD is described with a focus on practical tips for clinicians. Five strategies (watchful waiting, drug holiday, downward titration, switching, and add-on therapy) to manage TESD have been extensively discussed with evidence in the literature. Each strategy comes with its own bag of advantages and drawbacks, which have been pointed out for simplicity. A detailed discussion on individual pharmacological strategies is given, and options for non-pharmacological management that can be tried are enlisted. Common clinical case scenarios have been discussed to incorporate the implementation of this literature.
Herbal components have been explored as a potential alternative treatment for neurological disorders due to the limitations and potential adverse effects of conventional treatments. Alzheimer’s disease is the most prevalent progressive human neurodegenerative condition marked by senile plaques and neurofibrillary tangles as well as gradual cognitive impairments; the most prominent of which is memory loss. Different therapy techniques incorporating synthetic and herbal approaches are being employed against AD based on the knowledge of the disease process. Commonly used herbal components, such as Ginkgo biloba, Bacopa monnieri, Withania somnifera, Passiflora incarnata, Rhodiola rosea, and Curcuma longa, have been shown to improve symptoms and cognitive function in individuals with neurological disorders, such as Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. However, more research is needed to fully understand the efficacy, safety, and potential interactions with other medications. By continuously exploring and researching the use of herbal components for neurological disorders, we can develop a better understanding of their potential to offer safe and effective alternative treatments.
Sexual or erectile dysfunction (ED) is the ineptitude to get or keep a hard penile erection. ED can have a detrimentaleffect on physical and psychological health. This review helps in understanding the detailed etiology of ED and variousapproaches for the management of ED. The occurrence and incidence of erectile dysfunction are on the rise among men.Various other factors greatly impact the progression of ED, including individual general health and physiological conditions suchas psychiatric or psychological problems, diabetes mellitus, genitourinary disease, cardiovascular disease, and chronic diseases.Erectile dysfunction occurs when the release of nitric oxide (NO) triggers the activation of the guanylate cyclase enzyme in thespongiosum and corpora cavernosa, leading to relaxation of the vascular smooth muscle and an increase in cyclic guanosinemonophosphate (cGMP) levels. This physiological process is essential for achieving and maintaining a firm penile erection. Somecommon and advanced methods, such as the physical method, sexual history, laboratory testing, apomorphine test, NPTR test,and color duplex Doppler ultrasound test, are used to diagnose erectile dysfunction. This review also focuses on emergingtreatments that address the medical need for effective ED management. This comprehensive review bridges gaps in the currentliterature, offering superior insights into ED management and improving the quality of life for individuals with ED.
Background
Herbal remedies are used by 80% of the Asian population in primary health care as per WHO. According to current research, the herbal medicine market was valued at nearly USD 166 billion in 2021 and is expected to reach approximately USD 348 billion by 2028. Increased incidence of chronic conditions such as diabetes, asthma, coronary artery disease, osteoarthritis, has fueled the growing interest in traditional herbal and plant-derived treatments among researchers. In addition, rural communities in developing nations have renewed interest in herbal treatments due to lower cost and easy availability.
Objective
Aim of the paper is to highlight the role of five of more commonly used herbal medicines that are Ginkgo biloba, Garlic, Flaxseed, Ginseng, Salvia miltiorrhiza in cardiovascular disorders.
Methods
A PubMed search was done using the keywords Herbal Medicine, Ginkgo biloba, Garlic, Flaxseed, Ginseng, Salvia miltiorrhiza. Articles which were available for free access were utilized. No formula inclusion or exclusion criteria was followed. A total of 42 papers were included for the study.
Conclusion
Although there have been encouraging outcomes with the use of these herbal medications, many of these products are poorly monitored and are yet to be studied in detail regarding their adverse effects. Moreover, these medicinal products are known to interact with various drugs. To compete with the expanding pharmaceutical industry, more medicinally helpful herbal items must be used and scientifically validated
Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.
Since ancient times, humans across diverse cultures have shown keen interest in traditional herbal products which enhance sexual abilities, pleasure and libido, and improve sexual functions and potency. Herbal aphrodisiacs have been claimed to possess antistress as well as adaptogenic properties that assist in combating disease-associated stress and improving physical strength ultimately helping to alleviate the anxiety linked with lack of sexual desire and performance. Even in the modern era, particularly due to social or cultural reasons, some men still prefer the use of traditional herbal aphrodisiac products to counter sexual and/or reproductive dysfunctions. Important herbal aphrodisiacs—such as Panax ginseng, Tribulus terrestris, Eurycoma longifolia, Chlorophytum borivilianum, Ginkgo biloba, and Turnera diffusa var. aphrodisiaca have been discussed in this chapter in accordance with their effects and the potent molecules/compounds that manifest their activity. In fact, the constituent biomolecules present as the active principles of the herbal preparations behind their noticeable effects. However, there can be various pathways through which they may affect the sexual and reproductive functions, ranging from enhancement of spermatogenesis; modulation of hormonal levels (particularly testosterone) and steroidogenesis; erectogenic properties including improvement in sexual motivation, copulatory behavior, and modulation of neurotransmitters; to reduction of oxidative stress. For their potential incorporation into the clinical management of male reproductive and/or sexual disorders such as erectile dysfunction or male infertility in future, these herbal aphrodisiac biomolecules have to pass through stringent confirmatory studies including proper assessment of their safety and regulatory issues together with any side effect and associated toxicity for safe human administration.
Several medicinal plants are traditionally used in different regions of Africa for the treatment of male infertility, sexual asthenia, erectile dysfunction, and impotency or used as an aphrodisiac. Scientific studies, mostly conducted in vitro or in animals, have proven the acclaimed traditional use of these plants to enhance sexual activities or sperm concentration, motility, and viability. Some of the mechanisms of actions associated with these plants include increased level of testosterone and the relaxation of the smooth cavernosal muscles. However, some plants were also shown to have detrimental effects on the male reproductive system. This may be due to the varying modes of plant extraction, duration of treatment, experimental design, dosage used, quality of the plant, or toxic effects. There is a need to standardize the protocols as well as to better understand the mechanism of actions of the respective plants. Further studies should be conducted using human subjects.
Over the past decades, along with progressive economic development, significant changes in environment, society and people’s lifestyles have been observed. A marked shift in the dietary pattern worldwide together with the physical inactivity due to the urbanization and sedentary nature of many forms of work, resulted in an increasing prevalence of chronic metabolic diseases. Overweight and obesity are the major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems. Psychosocial stress, anxiety and depression were associated not only with weight gain but also with sexual dysfunction, a serious medical and social symptom that occurs both in men and women. This chapter focuses on natural remedies, herbs and dietary supplements used in weight management (slimming products) and sexual enhancement (natural aphrodisiacs). Due to the higher interest of consumers in a holistic approach of traditional medicines, the popularity of natural products registered a significant increase and the global market of herbal food supplements has grown and diversified spectacularly. Besides the description of botanical species most frequently used as active ingredients in herbal formulations, the main results of human trials have been reviewed. The efficacy of natural products and their mechanism of action, as well as an adverse reaction, side effect or drug-herb interactions, were discussed. Special attention was paid to adulteration with pharmaceutically active substances of those products marketed as natural which is associated with potential health risks for consumers.
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.
The effects of Ginkgolide B (BN52021) on in vitro activation responses of human peripheral blood mononuclear cells (PBMC) from asthmatic patients was measured using 2-channel flow cytometric analysis of activation-associated cell surface antigens or ELISA assays for cytokines known to be expressed by PBMC during T1 or T2 immunological activation. BN52021 is an anti-inflammatory extract of Ginkgo biloba and has been used therapeutically. It is a known inhibititor of platelet activating factor (PAF), which is important in the pathogenesis of asthma, and may synergise with cyclosporin A (CyA) to inhibit pathogenic immune activation in asthmatics. We compared the inhibitory effects of BN52021 and CyA (1 μM each) on activation of PBMC of asthmatic patients stimulated by phorbol myristate acetate and calcium ionophore. Inhibition of production of the cytokines IL-4 and IL-5 by BN52021 was insignificant compared to CyA. However, BN52021 significantly reversed the increase in activation-associated CD45RA expression, with a trend towards decreased expression of HLA-DR. Lymphocyte activation markers were not significantly altered by CyA. Since they appear to have differing effects on activated cells, the anti-inflammatory effects of CyA and BN52021 in atopic asthma is potentially additive. The present approach may be useful for preliminary evaluation of novel therapeutic modalities for asthma treatment.
Introduction
Erectile dysfunction (ED) is the inability to attain or sustain an erection for sexual intercourse. Affected men endorse difficulties with intimacy and feelings of guilt and shame. Although medical treatments are available, patients are reluctant to discuss ED with physicians and often use dietary supplements to attempt to treat their ED. As such, there is a need to better understand the effects of ingredients used in nutraceuticals for ED treatment.
Objectives
To summarize the literature on the efficacy and safety of the most common ingredients used in ED supplements.
Methods
10 of the most common ingredients in ED supplements were reviewed using PubMed-indexed literature to assess their efficacy and safety in treating ED. Key findings were summarized to include historical use, active ingredients, prior animal studies, human studies, and toxicity.
Results
Nutraceuticals used in ED treatment include a variety of ingredients. Although L-arginine is a safe supplement with clinical data supporting improved erectile function, limited data exist on the efficacy of other ingredients in the treatment of ED.
Conclusion
Despite the growing use of supplements for treatment of sexual dysfunction, ED supplements remain poorly studied, with limited data demonstrating efficacy of individual ingredients. Further study is required to definitively determine the efficacy of nutraceuticals in ED treatment.
Srivatsav A, Balasubramanian A, Pathak UI, et al. Efficacy and Safety of Common Ingredients in Aphrodisiacs Used for Erectile Dysfunction: A Review. J Sex Med 2020;XX:XXX–XXX.
l-arginine, being a natural precursor of nitric oxide, is one of the more commonly used adjuvants to regular medicines in the treatment of erectile dysfunction.
Objectives: Here, in this review article, we aim to highlight various studies and the research studies done on l-arginine in the treatment of erectile dysfunction.
Method: Reviewing the databases such as Medline (PubMed), Cochrane Library, Excerpta Medica dataBASE, Trip, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and the British Nursing Index.
Results:l-arginine has been studied alone as well as in combination with various other molecules for the treatment of erectile dysfunction, but the studies are very limited in number and have very small sample sizes.
Conclusion: Positive evidence is available for the efficacy of l-arginine and its various combinations. Further research with larger sample sizes and standardized tools are required to recommend the routine use of these products in erectile dysfunction.
Sexual functioning is complex, and sexual dysfunction may involve any component of the sexual response cycle including libido, arousal, or orgasm. The etiology of most forms of sexual dysfunction is multifactorial and may be physical or psychological. Those suffering from depression may note a change in sexual functioning secondary to their underlying psychiatric condition or quite often, to the antidepressants prescribed to treat their depression. In such situations, patients often become noncompliant with their antidepressant treatment, potentially increasing their risk for serious complications of untreated depression. It is therefore of great importance for clinicians to recognize this side effect and treat it appropriately.
Sexual dysfunction, which may affect any part of the sexual response cycle (e.g., libido, arousal, and orgasm), is a highly prevalent condition among women and is associated with significant negative consequences for quality of life. Unfortunately, few effective traditional agents are available to treat this condition, especially in the postmenopausal cohort. It is therefore not surprising that many women seek alternative treatments for relief. The authors review popular alternative treatments for sexual dysfunction, emphasizing randomized, placebo-controlled trials when possible.
Sexual dysfunction affects both men and women and is responsible for 1 in 5 visits to urologist and/or gynecologists. It is important that treating providers use a logical and methodical approach to the diagnosis and treatment of this disorder. Behavioral therapy, coupled with oral medications, are very successful in treating erectile dysfunction. Complex and invasive therapies are used for more severe cases of sexual dysfunction and are best deployed by specialists.
Trotz wirksamer Verfahren sind Patienten mit erektiler Dysfunktion unter Therapie häufig unzufrieden. Gründe sind unter anderem die Nebenwirkungen der einzelnen Wirkstoffe, die meist selbst zu tragenden Kosten, die Informationsflut des Internets mit seinen Versprechungen und der Verlust von Spontanität bei einer symptomatischen Therapie. Dieser Artikel stellt alternative Optionen und in den Algorithmen der täglichen Praxis oft weniger beachtete Therapieansätze vor und durchleuchtet diese anhand der aktuellen Datenlage kritisch.
Trotz wirksamer Verfahren sind Patienten mit erektiler Dysfunktion unter Therapie häufig unzufrieden. Gründe sind unter anderem die Nebenwirkungen der einzelnen Wirkstoffe, die meist selbst zu tragenden Kosten, die Informationsflut des Internets mit seinen Versprechungen und der Verlust von Spontanität bei einer symptomatischen Therapie. Dieser Artikel stellt alternative Optionen und in den Algorithmen der täglichen Praxis oft weniger beachtete Therapieansätze vor und durchleuchtet diese anhand der aktuellen Datenlage kritisch.
Evidence concerning pharmacological effects on human sexuality suggests that dopaminergic receptor activation may be associated with penile erection. Erection also appears to involve inhibition of alpha-adrenergic influences and beta-adrenergic stimulation plus the release of a noncholinergic vasodilator substance, possibly vasoactive intestinal peptide. Ejaculation appears to be mediated primarily by alpha-adrenergic fibers. Serotonergic neurotransmission may inhibit the ejaculatory reflex. An understanding of the neurobiological substrate of human sexuality may assist clinicians in choosing psychotropic agents with minimal adverse effects on sexual behavior and may also contribute to the development of pharmacological interventions for sexual difficulties.
Sexual dysfunction secondary to selective serotonin re-uptake inhibitors (SSRIs) is an almost universal, yet pooly understood phenomenon. Not uncommonly, this unpleasant side effect leads to noncompliance. Since SSRIs have been so successful clinically, it is time to find a safe and effective treatment for this side effect. This paper reports on five cases in which low dosages of the psychostimulants, dextroamphetamine and methylphenidate, administered on a p.r.n. basis, reversed the sexually inhibiting side effects of the SSRIs fluxetine, setraline, and paroxetine in patients with and without attention deficit hyperactivity disorder. In addition, the women experienced enhanced levels of arousal, orgasmic sensation and excitement during the resolution phase (afterglow) of the sexual response cycle on psychostimulants, and the men noted firmer erections.
Antidepressant-induced adverse sexual effects are becoming more frequently reported by patients who require pharmacotherapy. A MED-LINE search was conducted to generate articles reporting such events. We report here on the sexual side effects associated with tricyclics, monoamine oxidase inhibitors including moclobemide, selective serotonin reuptake inhibitors, bupropion, and on the newer antidepressants venlafaxine and nefazadone. We conclude that adverse sexual effects are an increasingly important side effect of antidepressant medications, and patients must be routinely asked about their occurrence.
Ginkgo biloba. The Lancet
- J Kleijnen
- Knipschild
Kleijnen J, Knipschild P: Ginkgo biloba. The Lancet, 340: 1136-1139, 19xx. Braquet P: Cinkgolides: Chemistry, biology, pharmacology and clinical perspectives (Vol. 1). Barcelona: JR Prous, 1988. Downloaded by [Selcuk Universitesi] at 18:06 07 February 2015