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Ginseng and male reproductive function


Abstract and Figures

Ginseng is often referred to as the King of all herbs, and is found to be a promising agent to improve general well-being. Ginseng has also been reputed as an aphrodisiac, and is used to treat sexual dysfunction as well as to enhance sexual behavior in traditional Chinese medical practices. Data from animal studies have shown a positive correlation among ginseng, libido, and copulatory performances, and these effects have been confirmed in case-control studies in human. In addition, ginseng is found to improve the sperm quality and count of healthy individuals as well as patients with treatment-related infertility. These actions are mostly attributed to ginsenosides, the major pharmacological active components of ginseng. This review compiles the current knowledge about the multifaceted effects of ginseng on male reproductive function, and also focuses on its mechanisms of action that may represent novel therapeutic strategies for the treatment of male reproductive diseases or disorders.
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REVIEW Spermatogenesis e26391-1
Spermatogenesis 3:3, e26391; July/August/September 2013; © 2013 Landes Bioscience
Infertility is a growing problem in the world. In 2010, an esti-
mated 48.5 million couples worldwide were infertile.1 In approxi-
mately 40% of these couples, the male partner has been either
the sole or a contributing cause of infertility.2,3 Herbal therapy is
increasingly popular worldwide as a way to treat infertility. In the
United States, 17% constantly visited herbal therapist in the past
18 mo out of the 29% of infertile couples who use complementary
and alternative medicine.3 In a clinic-based survey conducted in
Jordan, 44% of infertile patients use herbal medicine as part of
their infertility treatment.4 Among them, 8% went for Chinese
medication.4 In South Australia, 29% of interviewed infertile
subjects use herbal remedies, in which 4.2% uses ginseng.5
Ginseng is one of the most precious herbs in traditional
Chinese medicine. There are at least nine species of ginseng and
are mostly named by their geographical origins, such as Asian
ginseng (Panax ginseng), American ginseng (Panax quinquefo-
lium), and Japanese ginseng (Panax japonicus). The genus name
“Panax” is given to ginseng by the Russian botanist Carl A Meyer
in 1843. “Panax” means “all-healing” in Greek, and Panax gin-
seng is conventionally referred to the Asian ginseng. Ginseng has
been reported to have diverse physiological effects in multiple
systems, including cardiovascular, immune, and neuronal. It has
also been used to enhance sex performance and satisfaction. In
this review, we will summarize the effects of ginseng on male sex
performance and spermatogenesis. Recent evidences on its mech-
anisms of action that may represent novel therapeutic strategies
for the treatment of male reproductive diseases or disorders will
be discussed.
Sex Performance
Ginseng is commonly taken by itself or with an herbal for-
mula to enhance sexual performance in traditional Chinese
medical practices. The beneficial effects have been scientifically
evaluated and confirmed in meta-analyses of randomized clinical
trials.6 For example, in a double-blind, placebo-controlled study,
45 men with moderate to severe erectile dysfunction had found
improvement in their scores on erectile performance and sexual
satisfaction after treated with three times daily doses of 900 mg
Korean red ginseng for 8 wk.7 A similar study on 60 men with
erectile dysfunction also reported marked improvement in erec-
tile function including rigidity, penetration, and maintenance of
erection after taking Korean red ginseng (1000 mg) three times
daily for 12 wk.8
In animal studies, treatment with Korean red ginseng and
ginseng berry extract has been shown to significantly relax the
pre-contracted penile corpus cavernosum smooth muscles of rab-
bits in vitro, and increase the intracavernosal pressure of rats in
vivo.9,10 Data from studies on ginseng berry extract suggest that
this action is nitric oxide (NO) dependent. The pharmacologi-
cally active components of ginseng, ginsenosides, are known to
be able to induce NO synthesis in endothelial cells and perivascu-
lar nerves, and to augment vascular smooth muscle cell’s sensitiv-
ity to NO.11,12 This release of NO causes smooth muscle to relax,
thus allowing more blood to enter the erectile bodies known as
corpus cavernosum and causing erection.13 Among the ginsen-
osides, Rg1 has been found for NO production in endothelial
cells by glucocorticoid receptor (GR)-dependent, non-genomic
*Correspondence to: Alice ST Wong; Email:
Submitted: 09/04/2013; Accepted: 09/05/2013
Ginseng and male reproductive function
Kar Wah Leung and Alice ST Wong*
School of Bi ological Sciences; Uni versity of Hong Kong; H ong Kong, PR China
Keywords: ginseng, ginsenosides, sexual behavior, sperm, spermatogenesis, steroid receptor
Abbreviations: ACh, acetylcholine; AR, androgen receptor; cGMP, cyclic guanosine monophosphate; CREM, cAMP-responsive
element modulator; CP, cyclophosphamide; DA, dopamine; ER, estrogen receptor; GABA, gamma-aminobutyric acid; GDNF,
glial cell-derived neurotrophic factor; GR, glucocorticoid receptor;LH, luteinizing hormone; NO, nitric oxide; NOS, nitric oxide
synthase; PR, progesterone receptor; ZEA, zearalenone
Ginseng is often referred to as the King of all herbs, and is
found to be a promising agent to improve general well-being.
Ginseng has also been reputed as an aphrodisiac, and is used
to treat sexual dysfunction as well as to enhance sexual behav-
ior in traditional Chinese medical practices. Data from animal
studies have shown a positive correlation among ginseng,
libido, and copulatory performances, and these effects have
been confirmed in case-control studies in human. In addition,
ginseng is found to improve the sperm quality and count of
healthy individuals as well as patients with treatment-related
infertility. These actions are mostly attributed to ginsenosides,
the major pharmacological active components of ginseng.
This review compiles the current knowledge about the multi-
faceted effects of ginseng on male reproductive function, and
also focuses on its mechanisms of action that may represent
novel therapeutic strategies for the treatment of male repro-
ductive diseases or disorders.
e26391-2 Spermatogenesis Volume 3 Issue 3
mechanisms,14 and administration of Rg1 (10 mg/kg) signifi-
cantly enhances NO release and cyclic GMP (cGMP) accumula-
tion in corpus cavernosum of mice.15
Studies on rodents reveal that both Asian ginseng (Panax
ginseng)16 and American ginseng (Panax quinquefolium)17 can
facilitate copulatory behavior. Daily treatment of Asian ginseng
(25–100 mg/kg) or ginsenoside Rg1 (2.5–10 mg/kg) demon-
strates a dose-dependent increase in mounting, intromission, and
penis licking in mice which are exposed to estrous females.18 Such
effects are not observed in mice treated with ginsenoside Rb1,
Rb2, and Ro.
Sex drive in higher mammals involves a complex coordina-
tion between the hormonal and neuronal components. The male
sex steroid, testosterone, is synthesized in the Leydig cell under
the control of luteinizing hormone (LH), which is produced by
the anterior pituitary.19 Testosterone levels are strongly correlated
with libido and testosterone is therefore one of the main forms of
prescription given to men with reduced sex drive.20 Interestingly,
rats fed with 5% Panax ginseng in their diet for 60 d have shown
significantly increased blood testosterone levels, whereas treat-
ment with 1% Panax ginseng had no effect.21 Ginsenoside Rg1
(10 mg/kg), the major active constituent in Panax ginseng,
is responsible for the increase of serum testosterone levels and
improvement of copulatory behavior observed.15 Ginsenoside
Rb1 (10 µg/kg), a key ginsenoside found in American ginseng,
is found to increase the secretion of LH by acting directly on
the anterior pituitary gland.22 In a clinical study that involves 66
participants, the use of Asian ginseng extract has been shown to
significantly increase the levels of plasma total and free testos-
terone, follicle stimulating hormone, and LH.23 However, oral
administration of American ginseng (10–100 mg/kg) for 28 d
does not seem to alter testosterone and LH levels in rats,18 sug-
gesting that type of ginseng and treatment duration could make
a difference in the libido-enhancing ability.
Several neurotransmitters have been implicated in libido, such
as dopamine (DA) for desire, acetylcholine (ACh) for arousal,
and (GABA) for orgasm. Ginsenoside Re has been shown to
increase extracellular DA and ACh levels in rat brain.24 The
action of ginsenoside Rb1 on ACh release is associated with an
increase of choline uptake into nerve endings.25 American gin-
seng extracts were shown to modulate GABAgeric neurotrans-
mission in rat brainstem neurons.26 Receptor-ligand binding
assays have demonstrated that ginsenosides Rb1, Rb2, Rc, Re,
Rf, and Rg1 are agonists of GABA(A) receptor, and Rc is also
an agonist for GABA(B) receptor.27 These findings suggest that
ginseng may regulate the pituitary-testis axis at both hormonal
and neuronal levels.
Sperm Production and Quality
Researches over the past 20 y have shown sperm counts
declining in many countries across the world. For instance, a
study on 26000 French males has shown a continuous decrease
in sperm concentration over a 17-y period.28 A 32% reduction is
found when comparing the average sperm level of a 35-y-old man
between 1989 and 2005.28 The reasons are not fully known, but
the reduction in fertility worldwide could indicate a general dete-
rioration of male’s well-being, which is becoming a major health
concern. Thus, there is a need to further understand the causes
and to establish measures to prevent it.
Sperm count and motility
The initial evidence that ginseng may have positive effects on
spermatogenesis was first published in 1977. Here it was demon-
strated that the stimulatory effect of ginseng extracts on DNA
and protein syntheses in rat testes.29 Later studies in both rodents
and humans have shown that ginseng can increase sperm count.
Ginseng-treated rats have demonstrated an increased rate of sper-
matogenesis via glial cell-derived neurotrophic factor (GDNF)
expression elevation in Sertoli cells,30 and activation of testicu-
lar cAMP-responsive element modulator (CR EM).31 GDNF is a
possible regulator of the survival and cell fate decision of undif-
ferentiated spermatogonial cells,32,33 and CREM is essential for
spermatid maturation.34 Men with little or no CREM protein/
mRNA show specific arrest of round spermatids, which could be
a possible cause of infertility.35 Both oligoastenospermic patients
and age-matched healthy counterpart showed an increase in sper-
matozoa density and motility after the use of Panax ginseng.23
Asthenospermia patients treated with ginseng also showed a sig-
nificant increase in progressive sperm motility.36 The aqueous,
organic, and polysaccharide fractions of Panax notoginseng have
been shown to enhance the directional motility of human sperms
in 60–120 min.37 Similarly, ginsenosides Rc and Rb2 (0.01 mg/
ml) have been shown to enhance sperm progression in vitro.38
To pinpoint on specific active components for this action, these
effects are found to be mediated through induction of nitric oxide
synthase (NOS) activities and NO production.39 NO is also
closely related to sperm function. Ginsenoside Re (1–100 µM)
has been shown to facilitate human sperm capacitation and acro-
some reaction through enhancing intracellular NO production.40
Sperm preservation
Ginseng is also found to help preserve the ejaculated sperms.
It has been shown that the sperm count of ejaculated sperms that
were incubated with ginseng extract was significantly higher
than those treated with vehicle.41 Treatment with ginsenoside
Rg1 (50 µg/ml) significantly increases sperm motility and mem-
brane integrity of post-thawed sperms as compared with fresh
and untreated thawed sperms.42 These findings suggest that the
addition of ginseng extract to the cryogen for sperm storage could
en h a nc e fertility.
Effects of Ginseng on Spermatogenesis
During Disease States
It is known that conventional cancer treatments often lead to
various degrees of reproduction impairment, and that these effects
could be either temporary or permanent. Cyclophosphamide
(CP) is an alkylating agent that shows cytostatic effects by form-
ing covalent DNA adducts. Since CP targets rapidly dividing
cells, it is extensively used to suppress tumor malignancy, and
as an immunosuppressant for organ transplantation patients.
However, this drug often leads to gonadal toxicity, and infertility Spermatogenesis e26391-3
as a consequence discourages many patients from choosing CP
treatment. It has been shown that intake of American ginseng
(500 mg/kg/day) can protect sperms, in particular by increasing
the sperm count, reducing sperm death and abnormalities, and
resuming sperm motility from CP insult in adult male Wistar
rats as compared with CP treatment alone.43 Furthermore, treat-
ment of protopanazatriol saponin is shown to markedly reduce
the chemotherapeutic agent (busulfan)-induced structural defect
of the testis in mice, suggesting that ginseng may have applica-
tions in the recovery of male infertility after cancer treatments.44
Radiation therapy is sometimes given to patients as part of
the cancer therapy. However, the unselective action of radiation
therapy can also damage normal cells, leading to side effects.
Amifostine (WR-2721) is one of the radioprotectants that is
registered for human use, but its usage leads to many negative
side effects, such as hypertension, nausea, and vomiting.45 This
compound is also cytotoxic to stem spermatogonia, thus limit-
ing its clinical use.46 It is interesting to note that intraperitone-
ally injection of Panax ginseng extract (10 mg/kg) given to adult
male Swiss albino mice for 4 d can protect germ cell popula-
tion and function against γ-radiation, and dramatically reduce
γ-radiation-associated sickness, including anorexia, diarrhea,
weight loss, lethargy, and epilation.47
Zearalenone (ZEA) is an estrogenic mycotoxin that commonly
contaminates the environment as its presence in the crops, which
causes reproductive disorders in farm animals. The consumption
of Korean red ginseng (300 mg/kg) for 4 wk every other day has
been shown to be able to prevent ZEA-induced spermatogenesis
impairment in rats via modulating Fas/Fas-L expression.48
Males with non-insulin-dependent diabetes mellitus (type 2
diabetes) often suffer from sexual dysfunction.49 Studies have
found the benefits of ginseng intake. For example, the admin-
istration of standardized ginseng extract (100 mg/kg) daily for
90 d in streptozotocin-induced diabetic rats has been shown to
result in a significant improvement of fertility parameters and
decrease in testicular pathological signs, such as degenerative
changes of the seminiferous tubules.50 Furthermore, the con-
sumption of Korean red ginseng (30 mg/kg, three times a week
for 1 mo) can help streptozotocin-induced type 2 diabetic male
rats to improve on libido and sexual performance.51 In addition,
ginseng has been shown to be able to stabilize diabetes disease
progression. In a double-blinded, placebo-controlled study, it has
been shown that daily ginseng intake (100 or 200 mg) among
type-2 diabetic patients demonstrated significant reduction in
fasting blood glucose and body weight, and improvement in gly-
cated hemoglobin, serum N-terminal propeptide concentration,
psychological performance, and physical activities.52 Si m i l a rly,
Korean red ginseng has been shown to be able to enhance cGMP
levels of the corpus cavernosum in rats with metabolic syndrome
and may therefore improve erectile function.53
A continuous exposure to environmental toxins is considered
to be a cause of fertility decline. Ginseng has been demonstrated
to have a cytoprotective effects against these toxins, in which
administration of Panax ginseng extract is reported to signifi-
cantly reduce the 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced
pathological and genotoxical damages in rat testes.54 In addition,
treatment of Panax ginseng is found to protect Sertoli cells from
the cytotoxic effects of bisphenol A.55
Mechanisms of Action on Spermatids
Ginsenosides are triterpenoid saponins that structurally
resemble the steroid hormones. Thus, it is tempting to spec-
ulate that the effects of ginsenosides on sexual function and
spermatogenesis are a result of activation of steroid receptors.
Androgens are sex steroids that are essential for the develop-
ment and maintenance of male sexual characteristics, and
regulate normal spermatogenesis. Androgen receptor (AR) is
abundantly expressed in male genital tissues and in spermato-
zoa,56 and its expression is significantly decreased in infertile
men.57 Ginsenoside Rb1 and Re have been reported to be AR
agonists, through which these ginsenosides stimulate NO pro-
duction via the activation of NOS.58,59 Ginseng berry extract
GB0710, of which ginsenoside Re is the key ingredient, could
improve erectile dysfunction in rats by inducing NO produc-
tion.10 Re-induced NO production in sperm has also been
shown to be involved in capacitation and acrosome reaction,
and that these effects could be a result of the non-genomic
activities of the Re-AR interaction.40
Estrogen is another hormone with profound effects on sexual
function of both male and female. Estrogen supplements have
been shown to improve sexual function of testosterone defi-
ciency men.60 In this regard, although estrogen receptor (ER)
α-knockout mice have undisrupted reproductive tract develop-
ment, these mice display less masculine sexual behavior61 and
have a much lower fertility rate.62 Several ginsenosides, including
Rb1, Re, Rg1, Rg3, and Rh1, are agonists of ERα that have been
shown to elicit both receptor-dependent transcriptional and non-
transcriptional estrogenic actions in multiple cell types.58,63-66 In
this regard, ER has been reported on human spermatozoa and
that it is located mainly on the plasma membrane,67-70 suggesting
that ginsenosides may modulate male sexual function through
non-genomic interactions of ER.
Expression of progesterone receptor (PR) was observed on
human sperms, and a strong correlation between PR expres-
sion and sperm function has been demonstrated.71 Intriguingly,
unlike estrogens, progesterone promotes the capacitated sperm
to undergo acrosomal reaction.72,73 In concordance, a handful of
in vitro studies have demonstrated an inhibitory action of pro-
gesterone on estrogens and vice versa. For example, the estro-
gen-induced forward movement of human spermatozoa into the
oviduct could be effectively suppressed by progesterone.74-7 7 In
addition, it was shown that progesterone, which was secreted by
the culumus cells surrounding the oocyte to induce sperm hyper-
activation, was inhibited in the presence of estrogen.78 On the
other hand, estrogen and progesterone may cooperate to opti-
mize their effects on fertilization.79,80 Ginseng extracts contain a
mixture of ginsenosides that can activate either or both ER and/
or PR, and, hence, may modulate different aspects of sperm func-
tion. The ginsenoside Re-induced motility enhancement effect in
spermatozoa could be related to the findings that Re is found to
be both ER and PR agonists.58
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Concluding Remarks and Future Perspectives
Ginseng is a vital constituent of traditional Chinese medi-
cine and has been used to treat various physical conditions for
thousands of years, importantly as an aphrodisiac and is used to
treat sexual dysfunction as well as to enhance sexual behavior
and gonada l functions (Fig. 1). Therefore, use of ginseng appears
to be important for the development of novel therapeutics or to
increase the effectiveness of the current treatment strategies for
male reproductive diseases or disorders. However, its molecu-
lar mechanisms of action remain elusive. Research in this area
should be carried further. A versatile assay for high-throughput
expression profiling will prove useful to reveal the molecular
functions of different ginsenosides and how the different signal
networks are orchestrated. Further evaluations are also needed
to validate some of the medicinal benefits using modern analyt-
ical tools and technology-based analyses. Different approaches
to synthesize and/or modify natural ginsenosides can also be
considered to increase the efficacy/potency, metabolic stability,
and oral bioavailability for clinical applications.
Disclosure of Potential Conflicts of Interest
No potential conf licts of interest were disclosed.
This work was supported by the Health and Medical
Research Fund 11121191, Hong Kong Jockey Club Charities
Trust (HKJCCT), HKU Strategic Research Theme on
Drug, and Croucher Senior Research Fellowship to Alice ST
Figure 1. Summary of the ginseng’s effects on male sexual function.
Ginseng enhances sexual per formance, improves male fertility through
modulating the neuronal and hormonal systems, promotes spermato-
genesis, and acts directly on sperms via steroid receptors. Ginseng also
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... Oxidative stress is one of the most accused of causing infertility (Mokhimar et al., 2020), hypothesizing that Ginseng is a proven potent antioxidant and might protect from the adverse effects of Ciprofloxacin. Ginseng is always referred to be the King of all herbs and is used to treat sexual dysfunction also enhancing sexual behavior (Leung and Wong, 2013). Ginseng is a potent antioxidant that has a wide range of actions such as; antiaging, immune-enhancing, anti-stress, and anti-cancerous (Cheng et al. (2006); (Kang et al., 2006). ...
... So, studying infertility as one of the most acute side effects of drugs is needed. Hypothesizing that Ginseng is a proven potent antioxidant, and it might protect from the adverse effects of Ciprofloxacin, we used Ginseng to treat sexual dysfunction as well as to enhance sexual behavior (Leung and Wong, 2013). Therefore, this study has been performed to evaluate the possible protective effect of Ginseng against infertility induced by Ciprofloxacin using Ginseng in concomitant with ciprofloxacin standard dose 78.23 mg/kg and double standard dose 156.46 mg/kg for 14 days by dosing 100 and 200 mg/kg ginseng in parallel study design. ...
... Increased copulatory behaviour and dose-dependent increase in mounting, intromission and penis licking in mice. Oremosu et al. (2013), Leung and Wong (2013) Boesenbergia rotunda Rhizome Flavonoids, Polyphenols essential oils (Nerol, camphor, cineole) -Bulls Improvement in semen ejaculate at 70 g/kg of the diet of locally bred chickens had increased semen pH, volume and progressive motility. What goes unanswered in the literature is the dose of this extract that would be suitable to enhance the reproductive parameters. ...
... The Panax species of the ginseng plant have been studied well. The plant has been reported to demonstrate aphrodisiac effects in both animals and humans (Leung and Wong 2013). In addition, De Jong et al. ...
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Our review condensed evidence on the potential of medicinal plants to improve the reproductive performance of livestock. The success of any livestock farming operation is highly dependent on the reproductive performance of animals. However, infertility has limited the proficiency of livestock and resulted in economic losses. For centuries, farmers utilised medicinal plants extensively in managing reproductive disorders. These plants have few to no side effects, are cheap, easily accessible and readily available. Among others, the inclusion of Moringa olifera leaf extracts for 14 days at levels of 100–300 mg/kg body weight improved sperm characteristics. Zingiber officinale root extracts at levels of 500–1000 mg/kg body weight for 3 weeks increased sperm count, viability and mobility and testosterone. Furthermore, the increase in the volume of ejaculate and sperm concentration has been observed in sheep when Leucaena spp were added to their diets at 100–300 g/sheep/day for 60 days. However, there is little literature regarding the use of medicinal plants on ruminants, as the majority of studies have been laboratory-based and have used experimental animals, including rats and mice. Thus, future research is required through in vivo and in vitro studies to ascertain the efficacy of these medicinal plants in male ruminants.
... It was also not surprising that ginseng was one of the most used SESs in our study as ginseng is reported to improve sperm quality and count among healthy individuals and in males with treatment-related infertility (Fallah et al., 2018). Our findings of 25.4% were appreciably higher than seen in South Australia where only 4.2% of interviewed infertile subjects used ginseng supplements (Leung & Wong, 2013). Consequently, there is a need to improve the knowledge of individuals toward different types of SES and the risk of overconsuming SES. ...
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Sexual enhancement supplements (SESs) that have illegal additions of pharmaceuticals or analogues pose a significant health risk, particularly with long-term usage. When supplements are adulterated with phosphodiesterase type 5 (PDE-5) inhibitors, dosages can vary widely and there may be an increase in adverse effects and drug-drug interactions which cannot be avoided. Consequently, there is a need to evaluate the public risk awareness toward SES and the associated adverse events as well as explore significant factors associated with knowledge and risk awareness. A cross-sectional community-based study was conducted among University male students and staff at Ajman University, United Arab Emirates (UAE), using a self-administered survey via a web-based electronic link to explore key issues. A total of 1,101 male subjects participated in the study and completed the questionnaire. Four hundred and thirty-three(39.3%) (95% confidence interval [CI]: 33.2-44.5) participants reported using SES products. Of these, 137 (31.6%) [95% CI: 28.6-37.2] experienced adverse effects from SES product use. SES use was more prevalent among participants aged 60 to 69 years (odds ratio [OR]: 2.94; 95% CI: 1.63-5.28), diabetic patients (OR: 2.61; 95% CI: 1.75-3.90), hypertension patients (OR: 2.12; 95% CI: 1.45-3.1), and those overweight or obese (OR: 1.84; 95% CI: 1.44-2.35). This study indicates that SES is a popular practice among the UAE university staff and students. However, there is a need to implement risk awareness programs to raise public awareness regarding SES use and safety. Regulatory bodies are encouraged to provide additional advice on the proper use and possible risks of consuming SES.
... Male sex steroid testosterone is synthesized in the Leydig cells of the testes under the influence of LH from the anterior pituitary (Leung, Wong, 2013). The MEBC caused a reduction in the serum levels of gonadotropic hormones LH and FSH, and this reduction was dose-dependent. ...
... In the field of Chinese medicine, Ginseng is considered one of the most important herbs. Nine species of ginseng are available, which are named according to their geographical origins, like Asian or Korean ginseng (Panax ginseng), Siberian ginseng (Eleutherococcus senticosus), Thai ginseng (Kaempferia parviflora), American ginseng (Panax quinquefolium), and Japanese ginseng (Panax japonicus; Leung & Wong, 2013). For thousands of years, Panax ginseng has been used widely across Asia, as a medicine as well as a restorative and prophylactic remedy (Kim et al., 2015). ...
This review sought to assess the dose-response, i.e., low (<300 mg/day) and high (>300 mg/day), and temporal effects of ginseng, i.e., immediate, short-term (up to 4 weeks) and long-term (>4 weeks) in comparison to placebo on physical performance [visual analogue scale (VAS) level, vertical jump(VJ), rating of perceived exertion (RPE), peak power output (PPO)] and physiological measures [VO2 max, creatine kinase(CK), heart rate(HR)], in athletes and active participants. Search in four databases with English language constraints yielded 492 studies. Fourteen studies were shortlisted through PEDro scale by methodological quality evaluation. Ginseng exhibited significant short-term effect at high dosage for VJ improvement (SMD: -8.17, 95% CI: -16.28 to -0.06, p= 0.05). Ginseng had no effect on VAS (SMD: -0.65, 95% CI: -1.35 to 0.06, p= 0.07), RPE (SMD: -1.11, 95% CI: -2.57 to 0.35, p= 0.14), PPO (SMD: -0.70, 95% CI: -1.78 to 0.38, p= 0.20), HR (SMD: -0.54, 95% CI: -2.05 to 0.96, p= 0.48), CK (SMD: 0.33, 95% CI: -0.18 to 0.84, p= 0.21) and VO2 max (SMD: 0.08, 95% CI: -0.69 to 0.85, p= 0.08).The ginseng supplementation was found to have significant short-term effect at high dose only for VJ in athletic and active participants. Methodologically strong research is warranted to further consolidate these findings.
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Testicular failure or male hypogonadism is an uncommon disorder in which the body does not synthesized enough of the hormone testosterone, which is important for male growth and development throughout puberty, or enough sperm, or both. This paper will review the symptoms, cause, diagnosis and possible management of the condition by modern science and herbs.
As famous health food, roots of Panax quinquefolium L. possessed immune regulation and enhancement of the central nervous system, in which ginsenosides are the main active component with different numbers and positions of sugars, causing different chemical polarities with a challenge for the separation and isolation. In this study, a fast and effective bilinear gradient counter-current chromatography was proposed for preparative isolation ginsenosides with broad partition coefficient range from roots of Panax quinquefolium L. In terms of the established method, the mobile phases comprising n-butanol and ethyl acetate were achieved by adjusting the proportion. Coupled with the preparative HPLC, eleven main ginsenosides were successfully separated, including ginsenoside Rg1 (1), Re (2), acetyl ginsenoside Rg1 (3), Rb1 (4), Rc (5), Rg2 (6), Rb3 (7), quinquefolium R1 (8), Rd (9), gypenoside X VII (10) and notoginsenoside Fd (11), with purities exceeding 95% according to the HPLC results. Tandem mass spectrometry and electrospray ionization mass spectrometry were adopted for recognizing the isolated compound architectures. Our study suggests that linear gradient counter-current chromatography effectively separates the broad partition coefficient range of ginsenosides compounds from the roots of Panax quinquefolium L. In addition, it can apply to active compound isolation from other complicated natural products. This article is protected by copyright. All rights reserved.
Infertility is a universal health problem affecting 15% of couples, out of which 20–30% cases are due to male infertility. The leading causes of male infertility include hormonal defects, physical reasons, sexual problems, hazardous environment, stressful lifestyle, genetic factors, epigenetic factors, and oxidative stress. Various physiological functions involve reactive oxygen species (ROS) and nitrogen species at appropriate levels for proper smooth functioning. ROS control critical reproductive processes such as capacitation, acrosomal reaction, hyperactivation, egg penetration, and sperm head decondensation. The excessive free radicals or imbalance between ROS and endogenous antioxidant enzymes damages sperm membrane by inducing lipid peroxidation causing mitochondrial dysfunction and DNA damage that eventually lead to male infertility. Numerous synthetic products are available in the market to treat infertility problems, largely ending in side effects and repressing symptoms. Ayurveda contains a particular group of Rasayana herbs, called vajikarana, that deals with nourishment and stimulation of sexual tissues, improves male reproductive vitality, and deals with oxidative stress via antioxidant mechanism. The present study aims to describe oxidative stress and the role of herbal drugs in treating male infertility.KeywordsOxidative stressVajikaranaAntioxidantHerbal drugsMale infertility
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Chemical investigation of the crude extract of the aerial part of Zygophyllum album L. (Z. album) led to the isolation of a new saponin, Zygo-albuside A (7), together with seven known compounds, one of them (caffeic acid, compound 4) is reported in the genus for the first time. NMR (1D and 2D) and mass spectrometric analysis, including high-resolution mass spectrometry (HRMS), were utilized to set up the chemical structures of these compounds. The present biological study aimed to investigate the protective antioxidant, anti-inflammatory, and antiapoptotic activities of the crude extract from the aerial part of Z. album and two of its isolated compounds, rutin and the new saponin zygo-albuside A, against methotrexate (MTX)-induced testicular injury, considering the role of miRNA-29a. In all groups except for the normal control group, which received a mixture of distilled water and DMSO (2:1) as vehicle orally every day for ten days, testicular damage was induced on the fifth day by intraperitoneal administration of MTX at a single dose of 20 mg/kg. Histopathological examination showed that pre-treatment with the crude extract of Z. album, zygo-albuside A, or rutin reversed the testicular damage induced by MTX. In addition, biochemical analysis in the protected groups showed a decrease in malondialdehyde (MDA), interleukin-6 (IL-6) and IL-1β, Bcl-2-associated-protein (Bax), and an increase in B-cell lymphoma 2 (Bcl-2) protein, catalase (CAT), superoxide dismutase (SOD) in the testis, along with an increase in serum testosterone levels compared with the unprotected (positive control) group. The mRNA expression levels of nuclear factor-kappa B (NF-κB), tumor necrosis factor-α (TNF-α), p53, and miRNA-29a were downregulated in the testicular tissues of the protected groups compared with the unprotected group. In conclusion, the study provides sufficient evidence that Z. album extract, and its isolated compounds, zygo-albuside A and rutin, could alleviate testicular damage caused by the chemotherapeutic agent MTX.
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OBJECTIVE To investigate the effect of ginseng on newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM) patients. RESEARCH DESIGN AND METHODS In this double-blind placebo-controlled study, 36 NIDDM patients were treated for 8 weeks with ginseng (100 or 200 mg) or placebo. Efficacy was evaluated with psychophysical tests and measurements of glucose balance, serum lipids, aminoterminalpropeptide (PIIINP) concentration, and body weight. RESULTS Ginseng therapy elevated mood, improved psychophysical performance, and reduced fasting blood glucose (FBG) and body weight. The 200-mg dose of ginseng improved glycated hemoglobin, serum PIIINP, and physical activity. Placebo reduced body weight and altered the serum lipid profile but did not alter FBG. CONCLUSIONS Ginseng may be a useful therapeutic adjunct in the management of NIDDM.
The binding of steroids to human ejaculated spermatozoa and the effect of steroids bound to spermatozoa on sperm migration and motility in vitro was examined. A correlation between progestogens that bind to steroid-binding sites on human spermatozoa and progestogens that inhibit sperm migration was established. The results indicated that there is a direct and specific steroid effect on human spermatozoa, as some steroids such as progesterone, lynestrenol, and norethynodrel markedly inhibited sperm migration and motility, whereas other steroids such as estrone had no detectable effect on sperm migration and motility. The significance of these findings was discussed in relation to the contraceptive action of steroids applied directly to the lumen of the female genital tract.
The effects of steroid hormones on motility and selective migration of X- and Y-bearing human spermatozoa were studied. Speed of migration was measured in a modified Kremer tube. To a 50 mcl sample of ejeculate physiologic levels of sex steroid hormones (17betaestradiol; estriol .5 ng/ml; testosterone; progesterone; lynestrenol; and norgestrel 5 ng/ml) or 200-fold higher concentrations were added and the maximal distance of migration was evaluated after 15 30 and 60 minutes. Estrogens and testosterone accelerated spermatozoal migration while gestagens had an inhibitory effect. 17-beta-estradiol was most effective (p less than .0005) in stimulating the motility of human sperm atozoa while norgestrel caused the strongest inhibition of forward movem ent (p less than .005 at 15 minutes and p less than .0005 at 30 and 60 minutes). Migration of X- and Y-bearing spermatozoa was most altered after longer distances of migration shown by an increase in the percentage of Y-bearing spermatozoa from 43.7% to 63.3% at a distance of 90 mm. Prolongation of migration time to 36 hours caused a reduction in the percentage of Y-bearing spermatozoa at the 90-mm distance from 63.3% to 46%. Specific differential effects of hormones on the pattern of spe rmatozoa were not observed.
Expression of progesterone receptor (PR) localization on spermatozoa was determined in men with normal and abnormal spermiograms. Studies were also carried out to evaluate the potential of PR as a marker of sperm function. Progesterone receptor expression on spermatozoa from men with normozoospermia (n = 8), oligozoospermia (n = 7), asthenozoospermia (n = 8), oligoasthenozoospermia (n = 7), and teratozoospermia (n = 11) was analyzed using an immunocytochemical method with monoclonal antibodies against PR, and flow cytometry using a cell-impermeable fluorescein-tagged progesterone coupled to BSA complex (P-FITC-BSA). Both methods revealed significantly fewer (P < 0.05) PR-positive spermatozoa in men with oligozoospermia, asthenozoospermia, oligoasthenozoospermia, and teratozoospermia compared with men with normozoospermia, thereby suggesting that down-regulation of PR expression in spermatozoa may be one of the causes of male infertility. Spermatozoa from men with normozoospermia (n = 12), oligozoospermia (n = 12), asthenozoospermia (n = 12), oligoasthenozoospermia (n = 9), and teratozoospermia (n = 10) were exposed to low osmotic conditions in the hypoosmotic swelling (HOS) test and then analyzed for PR expression using P-FITC-BSA complex. A significantly higher percentage (P < 0.05) of spermatozoa with physiologically active plasma membrane (HOS+) lacked PR expression (HOS+PR−) in all categories of men with infertility, thereby suggesting that compared to the HOS test, PR expression is a better indicator of sperm function. Furthermore, PR expression in spermatozoa showed a strong (P < 0.05) positive correlation with their ability to undergo an in vitro acrosome reaction. This was observed in all study groups (i.e., normozoospermia, r = 0.8545; oligozoospermia, r = 0.8711; asthenozoospermia, r = 0.7645; oligoasthenozoospermia, r = 0.9003; and teratozoospermia, r = 0.8676). This suggests a potential role for PR in the events leading to the acrosome reaction in sperm.
The cAMP-responsive element modulator (CREM) is involved in regulating gene expression in haploid spermatids. Transcriptional activity of the CREM protein is thought to be regulated by activator of CREM in the testis (ACT). Applying RT‐PCR and in situ hybridization, cell-specific gene expression of ACT was demonstrated in man, cynomolgus monkey and mouse. During normal spermatogenesis, RT‐PCR revealed a strong signal in all three species. We sequenced monkey ACT cDNA and demonstrated that the putative amino acid sequence is highly conserved between these species. In situ hybridization demonstrated ACT mRNA in mid and late pachytene spermatocytes and in round spermatids. Among four infertile men with round spermatid maturation arrest (RSMA), only one patient revealed a strong signal for ACT, while three patients displayed a weak signal for both RT‐PCR and in situ hybridization, although germ cells normally expressing ACT were present in these patients. In addition, CREM knockout mice known to be infertile due to RSMA also exhibited only a weak amplification product for ACT cDNA. ACT mRNA was barely detectable in some round spermatids, but was completely absent in pachytene spermatocytes. Database search revealed two and one CRE within the putative human and mouse ACT promoters respectively. Our findings indicate a conserved function of ACT during the evolution of mammalian spermatogenesis and suggest a role for CREM in ACT transcriptional regulation.
In Brief Erectile dysfunction is one of the most common complications of diabetes and also one of the most underdiagnosed. Providers need to understand the pathophysiology of this condition in their diabetic patients and make an effort to diagnose and treat it. By doing so, they will improve their patients' quality of life.
In this study, we used flow a cytometric assay to evaluate plasma membrane integrity and mitochondrial activityin post-thawed sperm that was supplemented with ginsenoside-Rg 1. Varying concentrations of ginsenoside-Rg 1 (0, 25,50 and 100 μM/ml) were used in the extender during cryopreservation to protect the DNA of thawed sperm, therebyincreasing the viability and motility rate as evaluated using a computer-assisted sperm analysis (CASA) method. Theresults derived from CASA were used to compare the fresh, control, and ginsenoside-Rg 1 groups. Sperm motility andthe number of progressively motile sperm were significantly (p<0.05) higher in the 50 μM/ml ginsenoside-Rg 1 group(61.0±4.65%) than in the control (46.6±7.02%), 25 μM/ml (46.2±4.76%), and 100 μM/ml ginsenoside-Rg 1 (52.0±1.90%) groups. However, the velocity distribution of post-thawed sperm did not differ significantly. Membraneintegrity and MMP staining as revealed using flow cytometry were significantly (p<0.05) higher (91.6±0.82%) in the50 μM/ml ginsenoside-Rg 1 group than in the other groups. Here, we report that ginsenoside-Rg 1 affects the motility and viability of boar spermatozoa. Moreover, ginsenoside-Rg 1 can be used as a protective additive for the suppression of intracellular mitochondrial oxidative stress causedby cryopreservation.
The purpose of the study was to investigate the effects of two constituents of Panax notoginseng flower extract, Ginsenoside Rb2 and Rc, on human sperm motility and proression in vitro. Semen samples were collected from 20 patients with sperm motility between 20% and 40% of normal. All samples had sperm counts of over 20 million per milliliter, in accordance with the World Health Organization standard. Sperm were separated by a Percoll discontinuous gradient technique, and divided into a Percoll sperm control group, and three Ginsenoside Rb2 experimental groups (0.1, 0.01 and 0.001 mg/ml) and three Ginsenoside Rc experimental groups (0.1, 0.01 and 0.001 mg/ml). The results showed that at concentrations of 0.01 mg/ml and 0.001 mg/ml, Ginsenoxide Rc enhanced both sperm motility and sperm progression significantly at the end of the 1st and 2nd hour. However, the three concentrations of Ginsenoside Rb2 did not increase sperm motility at the 1st or 2nd hour, but promoted sperm progression at the 2nd hour, when compared to the Percoll group.