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Medicinal herbs in the management of male infertility

Authors:

Abstract

Male infertility can range from neurohormonal imbalances, reproductive tissue disruptions, qualitative and quantitative deterioration of semen to sexual behavioral problems. The global deterioration of male reproductive health is a major concern and the modern therapeutic approaches to combat male infertility are expensive, less accessible, have long term treatment tenure and possess various side effects. Whereas, the herbal therapies, are better positioned to offer more holistic approaches to improve male reproductive health. In Ayurvedic pharmacology, there exists a special group of herbs, classified as vajikarana or aphrodisiacs, which nourishes and stimulates the sexual tissues. This review concentrates on the Ayurvedic approach to ameliorate male reproductive health referring to some of the most important scientifically tested herbs which have been reported to accentuate male fertility by imposing either stimulating or nourishing effects on the male reproductive organs.
Review Article
Journal of Pregnancy and Reproduction
J Pregnancy Reprod , 2018 doi: 10.15761/JPR.1000128 Volume 2(1): 1-6
ISSN: 2515-1665
Medicinal herbs in the management of male infertility
Sulagna Dutta and Pallav Sengupta*
Department of Physiology, MAHSA University, Malaysia
Abstract
Male infertility can range from neurohormonal imbalances, reproductive tissue disruptions, qualitative and quantitative deterioration of semen to sexual behavioral
problems. e global deterioration of male reproductive health is a major concern and the modern therapeutic approaches to combat male infertility are expensive,
less accessible, have long term treatment tenure and possess various side eects. Whereas, the herbal therapies, are better positioned to oer more holistic approaches
to improve male reproductive health. In Ayurvedic pharmacology, there exists a special group of herbs, classied as vajikarana or aphrodisiacs, which nourishes and
stimulates the sexual tissues. is review concentrates on the Ayurvedic approach to ameliorate male reproductive health referring to some of the most important
scientically tested herbs which have been reported to accentuate male fertility by imposing either stimulating or nourishing eects on the male reproductive organs.
Correspondence to: Pallav Sengupta, Ph.D., Senior Lecturer, Department of
Physiology, Faculty of Medicine, MAHSA University, Jalan SP 2, Jalan Saujana
Putra, 42610, Jenjarum, Selangor, Malaysia, Phone: +60 17 4523 780 E-mail:
pallav_cu@yahoo.com
Key words: aphrodisiac, erectile dysfunction, male infertility, testosterone
Received: February 03, 2018; Accepted: February 25, 2018; Published: February
28, 2018
Introduction
Organisms strive to exist and preserve own genetic characteristics
through subsequent progenies owing to their reproductive potencies.
In this aspect, human being is one of the most successful survivors
on earth. But the present scenario is alarming, as besides female
reproductive complications and dysfunctions, male reproductive
health is suering a deteriorating trend throughout the globe [1-
6]. Sexual dysfunction, an earnest medical issue marring social and
biological relationships, occurs in 25%-63% of women and 10%-52%
in men. Sexual dysfunction in men can be explained as the failure to
accomplish normal sexual intercourse, inability to respond to erectile
stimuli or sustain an erection, retarded ejaculation, decreased libido,
unregulated sexual behavior etc. [7]. Innumerable synthetic products
are abundantly oating in the global market with quick remedial
claims. But most of them are associated with suppressing symptoms
and side eects [8]. ereby people are again oriented back to herbal
and ayurvedic aphrodisiacs having the holistic approach to cure male
reproductive problems from the root of the causes.
Aphrodisiacs, agents to arouse sexual desire and performance, when
derived from herbs, have been observed to directly been able to excite
male sexual libido, contribute to sustenance of reproductive activities,
restore healthy tissue functioning and also aid the neuroendocrine
regulation for exhibiting required sexual strength with content state of
mind and body [9]. is review, with the aim to highlight the healthy long-
term remedy of male sexual problems, concentrates on the scientically
tested herbs which have been reported to accentuate male fertility.
Overview of male reproductive disruptions
Standard clinical and laboratory evaluations are not enough to
nd out the causes behind most of the male infertility cases [10]. It
can range from hormonal or neuronal imbalances, reproductive tissue
disruptions to qualitative and quantitative deterioration of semen.
Oxidative stress induced by reactive oxygen species (ROS) is a major
causative factor in male infertility [11,12]. e mature spermatozoa
are encased in polyunsaturated lipid membrane which is vulnerable to
the oxidative damage induced by ROS, and this, in turn, can impair
spermatogenesis and reduce sperm quality, motility and morphology
[10,14]. e regulation of hypothalamic-pituitary-gonadal (HPG)
axis is the main controller of male reproductive function where the
hypothalamus produces gonadotropin-releasing hormone (GnRH)
to stimulate the secretion of follicle-stimulating hormone (FSH) and
luteinizing hormone (LH) from the anterior pituitary. e secreted FSH
and LH act on the Sertoli cells and Leydig cells, respectively to stimulate
spermatogenesis and testosterone [11,14,15]. Spermatogenesis is
regulated by well-maintained crosstalk of FSH, LH, intratesticular
testosterone and other hormones. ereby, HPG axis disruptions are
detrimental to semen parameters [16,17].
Reproductive endocrinologist opts for injectable medications
including recombinant FSH, human menopausal gonadotropin (hMG),
human chorionic gonadotropin (hCG) and gonadotropin-releasing
hormone (GnRH) to treat men with abnormal semen parameters. An
oral medication, Clomiphene citrate which is an estrogen receptor
antagonist, is also given to the patient in order stimulate gonadotropin
release from the pituitary. But these options are expensive, less
accessible, having long term treatment tenure and possess various side-
eects [18]. Whereas, the herbal therapies, are better positioned to oer
more holistic approaches to improve male reproductive health.
Dutta S (2018) Medicinal herbs in the management of male infertility
Volume 2(1): 2-6
J Pregnancy Reprod , 2018 doi: 10.15761/JPR.1000128
Herbal therapy and male reproductive health
According to the Ayurvedic concept, health depends upon balance
between three fundamental bodily bio-elements or doshas referred to as
Vata, Pitta and Kapha [19]
Vāt a or Vat a (airy element), characterised by dry, cold, light,
minute, and movement.
Pitta (ery element) or bile, owing through the liver and
permeating the overall heating of the body.
Kapha (watery element) is characterised by heaviness, cold,
tenderness, slowness, lubrication, nutrient carrier, nourishment.
In Ayurvedic pharmacology, there exists a special group belonging
to rasayana herbs, classied as vajikarana, that aid nourishment and
also stimulate the sexual tissues. Moreover, they also help to promote
beauty and sex appeal. Further classications of herbs that increase
spermatogenesis, are known as shukrala. With the knowledge of the
possible causes and factors leading to male infertility, the appropriate
herb can be selected to meet the need [19].
In Sanskrit ‘vaji’ and ‘karana’ mean ‘horse’ and ‘power’ respectively,
in order to convey the notion about the power or strength that a horse
possesses. ese are the herbs which can be referred to in Western
term as aphrodisiacs. Vajikarana herbs can be used as stimulants or
tonics to improve male reproductive vitality. Stimulants to reproductive
functions are typically heating substances like fenugreek, garlic,
damiana, and onion. ey have an invigorating action on the male
sexual organs. Tonics provide better nourishment to the reproductive
tissues to rejuvenate the quality and quantity of the same. Some herbs
have both stimulating as well as nourishing properties, such as garlic,
fenugreek, shilajit, and ashwagandha (Withania somnifera).
e Ayurvedic herbal drugs can be classied in varied ways, and
one such simplied classication according to their functions on male
reproductive health is as follows [20]:
Herbs increasing the quantity of semen or stimulating semen
production, for example, Polygonatum verticillatum, Mucuna pruriens,
Microstylis wallichii, Roscoea procera, and Asparagus racemosus.
Herbs purifying and improving semen quality, for example,
Vetiveria zizanioides, Saussurea lappa, Myrica nagi, Sesamum indicum,
and Anthocephalus cadamba.
Herbs rejuvenating ejaculatory functions, for example, Strychnos
nux vomica, Myristica fragrans, Cannabis sativa, and Cassia
occidentalis.
Herbs improving sustenance and ejaculatory performance, for
example, Cinnamomum tamala, Anacyclus pyrethrum, Sida cordifolia,
Asparagus racemosus, Mucuna pruriens, and Cannabis sativum.
Herbs increasing libido, namely, Asparagus racemosus, Withania
somnifera, Datura stramonium, Anacyclus pyrethrum, Hibiscus
abelmoschus, and Opium.
Some common Ayurvedic herbs to improve male
fertility
Ashwagandha (Withania somnifera)
In Sanskrit, ashwagandha refers to ‘the smell of a horse’, owing to its
root’s strong odor resembling that of horse urine. Another reason for its
naming for mythological comparison of the sexual vitality it may impart
to men with that of a horse. Innumerable benecial qualities to alleviate
male reproductive disorders including induction of spermatogenesis,
improved blood ow to the reproductive tissues and regulated
endocrine functions. It relieves conditions such as spermatorrhea,
nocturnal emission, premature ejaculation, and enlarged prostate.
Withania somnifera is able to combat stress-induced male infertility
and protects against swimming-induced endocrine dysfunctions of
male reproduction in rat [21]. e aqueous extract of this herb has been
shown to improve spermatogenesis, owing to elevated interstitial cell
stimulating hormone and testosterone-mimicking eects together with
induction of nitric oxide synthase [22]. Yet another study showed that
Ashwagandha root extract administration resulted in a signicantly
greater improvement in spermatogenic activity and increase in serum
hormone levels in the oligospermic patients as compared to the placebo
treated [23]. is herb evidently combats against oxidative stress
by reducing lipid peroxidation as well as protein carbonyl content,
increasing sperm count and motility, rejuvenating the seminal plasma
levels of antioxidant enzymes. Withania somnifera root powder when
administered to normozoospermic infertile man in a dosage of 5 g/
day for 3 months showed a signicant reduction in stress, improved
antioxidants, and enhanced semen volume and levels of vitamins A,
C, and E and also corrected fructose. is herbs action at the HPG
axis level is also evident through various studies, one such showed
signicant increased serum testosterone and LH levels and decreased
levels of FSH and prolactin (PRL) in infertile men [24-26].
In terms of ayurvedic explanations, the grounding and deeply
nourishing qualities of Withania somnifera contribute for its being one
of the best vata appeasing medicines. Its warming energy provokes pitta
if used in excess and so it is recommended to combine it with cooling
vajikarana herbs such as licorice, vidari, shatavari, bala, while using as a
drug. Owing to it stress relieving, relaxing eect on the body and mind,
as well as fortifying of all the dhatus, it is considered as the best herb to
target many of the contributing factors that are associated with reduced
sexual energy.
Kapikacchu (Mucuna pruriens)
is sweet yet sometimes bitter tasted herb is quite heavy and oily.
Mucuna pruriens is mainly used to balance vata and pitta, as both
kapha and ama are increased in excess by this herb. Typical doses of the
powdered Mucuna pruriens range from 1.5 to 6 grams [27]. Alkaloids
derived from M. pruriens seeds were found to stimulate spermatogenesis
and overall weight of the testicles and accessory glands in the male
albino rat [28]. M. pruriens is capable of stimulating sexual activities
in male rats as inferred by increased mounting frequency, ejaculation
latency and also enhanced intromission frequency [29,30]. In a study,
M. pruriens has been shown to eciently recover the spermatogenic
loss which was induced in male rats by ethinyl estradiol administration
and the herbs benecial eects were mediated by mitigation of ROS,
apoptosis regulation, and increase in the number of germ cells. e
major constituent of M. pruriens, L-D O PA, largely contributes to its
pro-spermatogenic properties [31]. e seed extract of M. pruriens
showed marked improvement in sexual potency and behavior, libido,
sperm parameters, and endocrine levels [32]. M. pruriens has been able
to ameliorate the levels lipids, triglycerides, cholesterol, phospholipids,
vitamin A, C, and E and corrected fructose nullifying oxidative stress
induced lipid peroxidation in seminal vesicles and restored the levels of
SOD, catalase, GSH, and ascorbic acid in seminal plasma [33, 34]. From
the neuroendocrine perspective, M. pruriens elevates testosterone, LH,
dopamine, adrenaline, as well as noradrenaline levels and decreased
Dutta S (2018) Medicinal herbs in the management of male infertility
Volume 2(1): 3-6
J Pregnancy Reprod , 2018 doi: 10.15761/JPR.1000128
levels of FSH and PRL in infertile men. M. pruriens treatment to
infertile men indeed improves steroidogenesis and semen quality [35].
Shatavari (Asparagus racemosus)
Shatavari can serve as a powerful male tonic. With a bittersweet
taste, this herb renders cooling and purifying eect to the liver and
blood, and targets pitta at its main site in the small intestine. Its cooling
properties balance the heating herbs which are used to improve sperm
count, such as, garlic, onion, ashwagandha, etc. us, Shatavari prevents
depletion of sperm caused by burning via excess pitta. Owing to its
heavy and nourishing properties, it is useful for vata, especially when
combined with heating vajikaranas like ashwagandha or bala. As a drug,
it can be prepared as a milk decoction with 3 to 6 grams of the herb,
or can be taken alone or in combination with other herbs [19]. Sexual
desires are associated with emotional aspects and in such conditions,
this herb in combination with cooling nervine herbs like brahmi (gotu
kola) may enhance libido and help to overcome agonizing emotions like
anger and irritability. Shatavari is thus one of best pitta pratyanika herbs
which can be associated in several Ayurvedic formulas to balance pitta
and vata in mediating male reproductive functions. General fatigue,
low sexual energy, anger, stress, irritability, inammation, hyperacidity,
urogenital infections, burning sensations etc. are the conditions when
this herb can be used as drug in standardized dosage of 2 to 6 grams of
the powdered herb, 2 to 3 times daily. is herb is avoided in cases of
respiratory or sinus congestion [19].
Bala (Sida cordifolia)
Bala refers to ‘strength’ in Sanskrit, and being a rejuvenative tonic
herb for vata and pitta, this herb nds application in nourishment and
strengthening of all the bodily tissues, especially the muscle, plasma,
muscle, bone marrow and reproductive tissue. It is sweet, heavy and
oily and increase kapha when used in excess, and also is mildly cooling.
Bala is one of the best anti-vata herbs in Ayurveda which mitigates
disorders related to both body and mind. It plays a leading role as an
Ayurvedic herb in the treatment of balakshaya or chronic fatigue, to
rejuvenate overall health in exhaustion of physical or mental strength.
It serves as a tonic to restore sexual strength, promote spermatogenesis
and enhance male fertility [19,20].
is herb can be taken internally or even used as massaging oil in
combination with Ashwagandha onto penis to improve its tone and also
to prevent premature ejaculation. Its combination with herbs such as
gokshura, ashwagandha, vidarikandha, saw palmetto, and kapikacchu,
proved to be benecial for prostate health. A typical dose of Bala ranges
from 2 to 6 grams, to be taken 2 to 3 times daily [19].
Vidarikandha (Ipomoea digitata)
Vidarikandha is a starchy tuber, eective in promoting
spermatogenesis with faster action when taken as a milk decoction.
It is lighter for kapha types than shatavari and bala. Its combination
with kapikacchu is eective in the treatment of enlarged prostate. is
sweet and cool herb promotes ojas, muscle tone, motor coordination
and nullies sexual debility associated with nervousness and adrenal
stress when used in formulation with ginseng, licorice, gokshura, and
ashwagandha. It falls right between too warming and too cooling herbs
providing great value as both a vata and pitta balancing herb. A typical
dose of Vidarikandha ranges from 2 to 6 grams, 2 to 3 times daily [19].
Shilajit (Asphaltum, mineral pitch)
Shilajit is immensely important Ayurvedic herb which, with its
heating energy, increases virility and sexual stamina via removing excess
kapha, while maintaining the normal genital tone. In kapha related
reproductive imbalances, it is used in combination with Ashwagandha.
For enlarged prostate, its combination with saw palmetto, punarnava,
gokshuradiguggulu, ashwagandha, or vidhari, are eective herbal
remedies. is herb should be used in doses ranging from 250 to 500
mg twice daily [19].
Pippali (Piper longum)
Pippali is a rejuvenating herb with a warming, stimulating and
kapha reducing action. Its oily nature prevents it from drying making
it suitable for vata and its pleasant post digestive eect makes it more
calming to pitta than other hot spices and herbs. It aids blood ow to
the reproductive tissues when taken in combination with Ashwagandha
[19,20].
According to the Ayurveda, Pippali enhances life energy and expels
impurities via respiration. It also improves digestion, absorption,
assimilation, respiration and reduces arthritic agonies. e typical
dosage of this herb is 1 to 3 parts in complex formulas, or ranges
from 250 mg to 1.5 grams. Pippali should be avoided in high pitta or
inammatory conditions [19].
Butea superba
Buteasuperba Roxb (Leguminosae) or the ‘Red KwaoKrua’, has long
been consumed as a stimulant of male sexual vigor. Its alcoholic extract
(0.01, 0.1 or 1.0 mg/kg BW/day) for 6 months signicantly elevted the
sperm concentration and enhanced sperm motility with no disruptive
signs to sperm or testis [36]. Powdered crude extract of this herb at the
doses of 2, 25, 250, and 1250 mg/kg body weight in male rats for 8 weeks
increased testis weight and sperm counts [37]. Moreover, the ethanol
extract of B. superba has been shown to increase penile erection acting
through cAMP/cGMP pathways [38].
Curculigo orchioides
Curculigo orchioides Gaertn (Amaryllidaceae), or Kali Musli or
Syah (black) Musli, is an aphrodisiac or rejuvenator ameliorating
sexual arousal and performance by inducing penile erection, mating
sustenance, orientation behavior, etc. is herb also promotes
anabolic and spermatogenic eect by pronounced increased weight of
reproductive organs. Rats that received Curculigo orchioides treatment
displayed reduction in mount latency, increment in penile erection index,
and increase in mount frequency and anity towards female [39,40].
Its lyophilized aqueous extracts are shown to improve the
pendiculatory activity in male rats aer as well as preserve the in vitro
sperm aer 30 min. of incubation [41]. e aqueous extract of the herb
is eective at a dose of 200 mg/kg. In case of physically induced or heat
induced sexual dysfunction, this herb is useful in ameliorating the
decreased spermatogenesis and mitigated disruptions owing to the heat
shock protein [42].
Cynomorium coccineum
Cynomorium coccineum Linn. (Cynomoraceae) is a black leaess
parasitic plant without chlorophyll. Aqueous extract of this herb has
been shown to induce signicant elevation in the sperm count, the
percentage of viable sperm and sperm motility, reduced the number of
abnormal sperm, increased spermatogenesis [43].
Chlorophytum borivilianum
Safed Musli (Chlorophytum borivilianum) of family Liliaceae is
claimed to be an eective aphrodisiac and sexual stimulant. Ethanolic
Dutta S (2018) Medicinal herbs in the management of male infertility
Volume 2(1): 4-6
J Pregnancy Reprod , 2018 doi: 10.15761/JPR.1000128
roots extract of this herb or sapogenins extracted from the roots showed
anabolic and spermatogenic eect in treated male rats evidenced by
total body weight increase and also increment in weight of reproductive
organs. e herb could also aect sexual behavior of animals by
reducing mount ejaculation, post-ejaculatory latency, and intromission
latency, increasing mount frequency and anity towards female [44].
Moreover, the aqueous extract of dried roots of this herb enhanced
sexual arousal, strength, and libido as well as sperm count in Wistar
male rats [45]. is herb also reportedly improves male reproductive
functions in diabetic scenario [46,47].
Epimedium koreanum
Epimedium L. (Berberidaceae), is a popular Chinese herb and
botanical supplement used as health tonic. Most important species
of this herb used for medicinal purposes are E. pubescensMaxim., E.
brevicornum Maxim, E. koreanumNakai, E. sagittatum (Sieb. EtZucc)
Maxim, and E. wushanense T.S. Ying [48]. Hydroalcholic extract of
the herb shown to display aphrodisiac eects and are commonly used
to enhance erectile function [49]. e primary active component
of Epimedium extracts, Icariin, is a type of avonoid and selectively
inhibits phosphodiesterase-5 (PDE5) improving erectile function
[50]. Icariin also can mimic the eects of testosterone inducing
spermatogenesis [51].
Eurycoma longifolia
Eurycoma longifolia Jack (Simaroubaceace) or Tongkat Ali, is one
of the major aphrodisiac herb from Malaysia [52]. E. longifolia extract
treatment showed successful induction of sexual motivation in naive
male rats [53]. Ethanol extract of this herb increased the sexual libido
and performance of the treated male rats by increasing the duration of
coitus and copulation frequency [54].
Tribulus terrestris
Tribulus terrestris Linn. (Zygophyllaceae) or puncture vine, a
perennial creeping herb, has worldwide distribution and is regarded
as an aphrodisiac since ancient times besides being used for various
ailments such as inammations, leucorrhoea, urinary infections, edema,
and ascites [55]. Administration of T. terrestris to animals showed to
improve plasma testosterone level and induced spermatogenesis [56]. It
also increases the levels of testosterone as well as luteinizing hormone
[57] and the activities of dehydroepiandrosterone, dihydrotestosterone,
and dehydroepiandrosteronesulphate [58]. e corpus cavernosal
tissues of New Zealand white rabbits following treatment with this
herb were tested in vitro with various pharmacological agents as well as
electrical eld stimulation and the herb was shown to have proerectile
eect [59]. It increases sexual behavior evident through increase in
mount frequency and intromission frequency, reduction in mount
latency, intromission latency, and penile erection index as well as
increase in prostate weight and intracavernosal pressure [60,61]. is
herb also possesses androgen, testosterone, dihydrotestosterone (DHT),
and Ddehydroepiandrosterone (DHEA) increasing property having
stimulating eects on reproductive functions and thus used in mild to
moderate cases of endocrine disruptions [62,63]. e ability of to induce
nitric oxide release may also account for its claims as an aphrodisiac [64].
Mechanism of action
Male reproductive functions are restored and controlled
by induction or inhibition of neurochemicals, regulation of
neuroendocrine axis and their cross talks as well as by local mediators
acting within the reproductive tissues [65-67]. e herbal therapies
may ameliorate male reproductive functions possibly at three levels. (1)
Herbs may act on the central or peripheral nervous system improving
the responsiveness of male reproductive tissues. e neuronal control
over the male reproductive organs is mediated by an orchestra of
neurochemicals/neurotransmitters, among which the serotonin and
dopamine are the prime controllers of sexual behavior with serotonin
mediating inhibitory functions and dopamine playing an excitatory role
[68]. (2) e eects of herbal therapies to regulate the level of the nitric
oxide support their contribution towards treating erectile dysfunctions.
Nitric oxide (NO) is an established endogenous mediator of penile
erection [64] and its synthesis via NO synthase is mainly concentrated
in structures of the brain that are involved in sexual behavior (olfactory
bulb, amygdala, septal structures, supraoptic and paraventricular
nuclei, etc.) [69,70]. NO is a known vasodilator which can increase
blood ow to the penis inducing penile erection and to other male
reproductive organs facilitating better hormonal accessibility in the
same to promote robust reproductive functioning [71]. (3) Herbs can
favourably interfere in the HPG axis in the regulation of sex hormones
importantly testosterone, LH, FSH and interstitial hormones as well as
their cross- talks which synchronise male reproductive functioning,
such as, the development of secondary male sexual organs, accentuate
pubertal changes and increase overall male fertility [72].
Conclusion
Vajikarana or aphrodisiac herbs can be used as stimulants or tonics
to improve male reproductive vitality. Stimulants to reproductive
functions are typically heating herbs having an invigorating action
on the male sexual organs. Herbal tonics provide better nourishment
to the reproductive tissues to rejuvenate the quality and quantity of
the same. Some herbs have both stimulating as well as nourishing
properties. Owing to the health complications, partial impact and high
cost of modern therapies for male infertility, the herbal aphrodisiacs
are regaining popularity and laying their long-term impact on
male reproductive health by improving sexual behavior, vigor,
neuroendocrine control as well as structural and functional aspects
of reproductive tissues, qualitative and quantitative improvement in
semen and also sperm morphology and motility. Biomedical research
should pierce deeper to emerge with more hidden mechanisms by
which innumerable herbs may act to eradicate male infertility which is
becoming a major threat to upcoming progenies.
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... behavior [5]. Several diseases have been reported affecting different male reproductive organs that have been the cause of the overall increase in male reproductive dysfunction worldwide. ...
... Herbal medicines have risen as the popular alternative therapy for better results and fewer side effects. In Indian traditional medicine (ITM), a separate group of herbal extracts known as vajikarna is classified that have the property to aid, nourish, and stimulate sexual tissues [5]. Other herbal medicines also show a promising effect to improve male reproductive health. ...
Chapter
The reproductive system comprises a series of internal and external organs that function collaboratively to produce male germ cells that fuse with female germ cells to produce offspring. Reproductive health encompasses the proper functioning of the reproductive system at all stages of life. The male reproductive system is susceptible to various diseases, disorders, and dysfunction, which may develop during multiple phases of life. Adverse and life-threatening effects of modern therapies targeting reproductive conditions are widespread. Recently, an alternative to modern medicine that takes advantage of nature's benefits has been investigated. Herbal medicine has long been used to treat various diseases in different countries, especially among rural and ethnic peoples, due to its profitability, easy availability, low cost, ease of use, and little to no adverse effect. Various medicinal plants have been evaluated for their therapeutic efficacy in the treatment of various reproductive dysfunctions. This chapter summarizes multiple medicinal plants and their extracts used to treat common reproductive disorders in this chapter.
... There are plenty of synthetic remedies in drug market world widely; however, these drugs may exert some side effects. Thus, common people tend towards the usage of herbal/medicinal plants which may safely cure the issues related with the reproductive organs (Dutta and Sengupta, 2018). The most common reproductive tract infections i.e., cervicitis and vaginitis cause severe reproductive disorders in women. ...
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Neisseria gonorrhea and Escherichia coli are urogenital infection causing bacteria which leads to gynaecological problems like vaginitis and cervicitis and impaired sperm motility leading to infertility in male and female. Crude ethanolic extracts of Acorus calamus, Cichorium intybus and Fumaria indica, the ethnomedicinal plants of Balochistan (Pakistan), were screened for their phytochemical composition i.e., alkaloids, anthraquinones, flavonoids, saponins, steroids, tannins, and terpenoids. Moreover, these selected plants were also tested for their antibacterial activity against ATCC strains of E.coli and Neisseria gonorrhoeae, by agar well diffusion assay with the tested concentrations of 10, 15, and 20 µL , and Kirby-Bauer disk diffusion method with the tested concentrations of 04, 06 and 08 µL. Streptomycin and dimethyl Sulphoxide (DMSO) were used as a positive and negative control, respectively against the bacterial strains. It was observed that C.intybus produced comparatively more effective results in disk diffusion method against E.coli (15.67±0.58, 17.34±0.58, 19±0, respectively) but A.calamus was found effective against N.gonorrhoeae (12.41±0.60 and 13.41±0.61 at 10 and 15 µL , respectively). According to agar well diffusion assay, A.calamus expressed most antimicrobial activity against N.gonorrhoeae (14±11±0.43, 16.67±0.58, 19.34±0.58, respectively) whereas, C.intybus was found to be most toxic for E.coli. These findings favored the traditional medicinal usages of tested plants against urogenital infections and a cure for infertility.
... As per the Traditional system of medicine it is one of the most significant medicinal plants for mitigation of various ailments in human beings. The plant having therapeutic potential for diabetes, high blood pressure, arthritis, chronic leucorrhoea, delayed menopause, dysentery, diarrhea, general debility and boosts the immune system [20,21]. To the best of the authors' knowledge, there are no previous scientific reports on the antidiabetic activity of C. borivilianum. ...
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This study focused on antidiabetic effect methanolic extract of Chlorophytum borivilianum leaves in Dexamethasone-induced diabetic rats. The effect of the optimal dose of methanolic extract was measured over 21 days. During the study, diabetic rats were treated with two doses of extract (250 and 500 mg/kg). The percentage of Fasting Blood Glucose (FBG) was measured immediately after administration of the extract and at 2h, 4h and 8h after administration. The leaf extract of Chlorophytum borivilianum showed significant blood glucose reduction in the normoglycemic model and glucose loaded test at doses of 500 mg/kg. The results showed that the extract was rich with flavonoids, phenols and tannins. Levels of FBG and DPP-4 were significantly lower in the extract-treated group in comparison with the control group; however, the level of insulin was significantly elevated in the extract-treated group compared to the control group. This effect may be caused by two factors. First, the antioxidant effects of flavonoids that protect pancreatic beta cells from damage caused by Dexamethasone, supports regeneration of pancreatic beta cells, and therefore insulin production.
... However, more study is required to determine risks associated with ART offsprings. 58 59,60 There is still requirement of clinical trials to explore molecular and cellular mechanism of these medicinal plants. Research on validation of these plants will expose a new approach in treating male infertility. ...
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Infertility is one of the major health issues and a socially destabilizing condition for couples often causing marital disharmony. Infertility refers to the biological inability of an individual to contribute to conception over the course of one year of continuous unprotected intercourse. There are numerous factors such as anatomical, physiological, environmental, lifestyle and genetic factors that cause infertility. Male infertility can be diagnosed by different tools, for instance, physical examination, semen analysis, testicular biopsy, hormonal tests, urine test, immunobead test, sperm functional tests, sperm chromatin and abnormal deoxyribonucleic acid (DNA) assays, chromosome and genetic studies. There are diverse treatment options available for male infertility inclusive of hormonal, pharmacological, non-pharmacological, antioxidants, anti-inflammatory therapy, surgical, assisted reproductive technologies (ART), combination and herbal supplement with lifestyle changes. The infertility of known etiology has ample treatment success rate that vary by age, accurate diagnosis and effective therapy along with shared decision-making which can facilitate achievement of fertility goals. Thus, the review summarizes classification, causes, and diagnosis with treatment modalities of male infertility.
... Traditionally. C. borivilianum root has been used to treat male impotence. oligozoospermia and erectile dysfunction 14 . ...
Article
Full-text available
Chlorophytum borivilianum (Liliaceae) usually known as 'Safed Musli'. As per the Traditional system of medicine it is one of the most significant medicinal plant for mitigation of various ailments in human beings. The plant having therapeutic potential for diabetes. high blood pressure. arthritis. chronic leucorrhoea. delayed menopause. dysentery. diarrhoea. general debility and boosts the immune system. Pharmacognostic ponders have not been done as such far on the leaves part of the plant. In this way. the present investigation was endeavored to evaluate pharmacognostic characters of the leaf of C. borivilianum. Leaves organoleptic and macroscopic analysis revealed about its size and texture. Transverse section of leaf showed the presence of stomata covered with guard cells followed by epidermal cells. Preliminary phytochemical analysis revealed the present of carbohydrates. flavonoids. glycosides. phenolic compounds. and steroids. Macroscopic. microscopic fluorescence characteristics and physical parameters resulted in valuable data to establish standards for the plant. TLC profile provides the number of constituents present in the extracts with their respective Retention Factor (Rf) while the FTIR analysis of extracts represents the presence of various functional groups in extracts.
... In the current scenario, neutraceuticals that can able to protect the male reproductive health against environmental toxicants is one of the major areas of Ethnopharmacology [22][23][24]. The rhizome of ginger plant (Zingiber officinale) is one of the widely used food commodities all over the world. ...
Article
Aims: The present study was aimed to investigate the protective role of ginger against acephate-induced testicular toxicity in adult rats. Methodology: Rats were allocated into four groups where animals in group I served as controls, while animals in group II, III and group IV were treated as experimental rats. Rats in groups II, III and IV were treated with acephate (50mg/kg body weight), ginger (100mg/kg body weight) and combination of both acephate and ginger, respectively over a period of 60 days. After completion of experimental period sperm count, sperm viability, sperm motility, sperm membrane integrity, testicular steroidogenic marker enzymes (3β-HSD and 17β-HSD, serum testosterone and testicular architecture was performed in both control and experimental rats. Results: Relative weights of reproductive organs, sperm count, sperm viability, sperm motility and sperm membrane integrity were significantly decreased in acephate treated rats over controls. Acephate administration also reduced the circulatory levels of testosterone associated with a significant reduction in the testicular steroidogenic marker enzymes (3β-HSD and 17β-HSD) in rats. The testicular architecture was disrupted in acephate intoxicated rats. In contrast, ginger administration significantly recovered the acephate-induced suppressed selected reproductive parameters with increased circulatory levels of testosterone and restoration of sperm endpoints in as compared to acephate alone treated rats. No significant changes were observed in any of the selected reproductive endpoints in ginger treated rats as compared to controls. Conclusion: The results can be concluded that supplementation of ginger mitigates the negative effects of acephate on male reproductive health via amelioration of testicular setroidogenesis and spermatogenesis and epididymal sperm maturation events in rats.
... Many believe that herbal treatment is a promising therapy effective for sexual dysfunction and has shown to improve men's infertility [12]. The journey of literature survey in these lines highlighted the efficacy of Moringa oleifera (family Moringaceae), an indigenous tree of the Indian sub-continent. ...
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Spermatogenesis is extremely sensitive to fluctuations in the environment, particularly temperature and hormones. Sperm dysfunction, a root cause of male infertility, is a commonly allied complication of diabetes mellitus. Our previous studies cogitate that cold stress (15°C) exacerbates the complications and the resultant oxidative stress plays a major role in testicular and epididymis dysfunction in diabetic rats. Despite the strong biologic prospect for this postulation, establishing a direct link between free radicals and specific disease is an in-dire need, and in this context, this study focuses on investigating the sperm quality parameters and their relationship to testicular oxidative stress indices of cold stress diabetes in Wistar rats. The results indicate a cumulative impact by diminishing sperm parameters, viz. sperm density, viability, motility, mortality, and acrosome intactness in cold-stressed diabetic rats. The findings also reveal a strong positive Pearson's correlation between the sperm quality parameters and testicular lipid peroxidation, which reflects the influence of oxidative stress on sperm dysfunction. Together with duel stressor effects, the efficacy of Moringa oleifera leaf ethanolic (MOLE) extract is appended to assess its therapeutic role. The apparent effectiveness of MOLE therapy at 250 and 500 mg/kg bw for 60 days aided in suppressing oxidative stress and improved semen quality demonstrating the causative nature of these associations; hence, Moringa usage is recommended as a therapeutic agent for male reproductive dysfunctions in population residing in colder climates.
... Due to this cooling property balance it also used to improve sperm count same as onion, and ashwagandha. 23 After the excess secretion of pitta the sperm is depleted by burning, but the shatavari is prevent the depetion process. It produces the better effect with the ashwagandha and vajikaranas. ...
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The human infertility is a major problem at this time in entire world. Some important factors that responsible for this cause like as Daily routine, Food contents, less physical activity etc. About 40% infertility cases count due to male factors. The spermatogenetic failure is one of the major causes of male infertility while the in female infertility is due to Pelvic inflammatory disease (PID), uterine problems, previous tubal ligation, Endometriosis etc. A number of medicinal plants used in the treatment of this disorder. So in this review, we have summarized most of the data dealing with the positive effects of plant extracts on spermatogenesis.
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The oral administration of Tribulus terrestris and Lepidium meyenii extracts on reproductive, biochemical and body parameters was evaluated in rats. Thirty-six male Wistar rats weighting 210 ± 18 g were divided into six experimental groups (n = 6). Each group received, daily for 28 days, different solutions: T. terrestris (100 mg/kg), L. meyenii (1 g/kg) and T. terrestris at doses of 75, 50 and 25 mg/kg combined with L. meyenii at doses of 0.25, 0.5 and 0.75 g/kg, respectively, and distilled water (control). T. terrestris increased (p < 0.05) the serum testosterone, regardless of dose. Combined use of the extracts increased (p < 0.05) the diameter of the epididymal duct and epididymis lumen. The combinations of T. terrestris (75 and 50 mg/kg) with L. meyenii increased (p < 0.05) the sperm concentration. There were no differences (p > 0.05) in the other semen characteristics; relative weight of organs; and serum levels of urea, creatinine, alanine and aspartate transaminase, gamma glutamyl transferase, cholesterol, triglycerides, glucose, follicle-stimulating hormone and luteinizing hormone. No histopathological changes were observed (p > 0.05). It is concluded that the association of T. terrestris and L. meyenii has positive effects on serum testosterone, sperm concentration and epididymal morphology, with no evidence of effects in the testis, liver, spleen and kidneys.
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Objective: To reveal the trend in alterations of sperm counts in Asian men over the past 50 years. Methods: This study reviewed all the published reports to unveil the specific pattern of alterations of sperm concentrations in Asian men from 1965 till 2015. The time-related changes in sperm concentration were studied using linear regression analyses. Results: The present study elucidated the trend using the reports from Carlsen et al (1965-1990) and non-Carlsen studies published until 2015, on fertile Asian men. In the reports of Carlsen et al., no overall declining trend in Asian men (r = 0.509, P = 0.760) was observed during this tenure, but non- Carsen reports showed a significant time-dependent decline of sperm concentration (r = -0.754, P = 0.005) in Asian men. This present review also showed a mild time-dependant decline in sperm concentration (-0.44×106/mL/year, 95% CI: -0.65 to -0.23; r = -0.473, P = 0.040) which accounted for an overall 22.17% decrease in past 50 years. Conclusions: This study brings to the forefront that sperm concentration among Asian men follows a mild declining trend over the period of 50 years, and further studies addressing the causes of this decline are required.
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To manage male infertility caused by hormonal imbalance, infections and other predicaments, multifarious treatment strategies are emerging worldwide. Contemporary treatments, such as assisted reproductive techniques, are costly with low success rates of only 10-30%; however, herbal remedies are gaining more attention as an alternative or supplementary therapeutic modality for male infertility. The beneficial effects induced by oral intake of the roots of a small evergreen shrub, Withania sominifera (Ashwagandha) on semen quality of infertile men have previously been studied. Oral intake of Ashwagandha roots has been found to inhibit lipid peroxidation, improve sperm count and motility, and regulate reproductive hormone levels. The molecular mechanisms of these effects, however, are yet to be unveiled. In this review, we will discuss the role of herbal medicines in male infertility; provide a detailed analysis of various human and animal studies involving Withania somnifera; describe a proposed direct oxidative mechanism involving mitigation of oxidative stress as well as an indirect mechanism consisting of a gamma-aminobutyric acid-like-mimetic pathway ameliorating hormonal balance through crosstalk among different endocrine glands to improve male fertility; and how Withania somnifera supplementation mitigates risk factor-induced male infertility as well as ameliorates male fertility.
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Purpose: This meta-analysis, following our previous reports those documented an overall 57% diminution in mean sperm concentration around the globe over past 35 years and 32.5% decline in past 50 years in European population, attempts to report the declining trend of sperm concentrations in African population between 1965 and 2015. Methods: In the course of retrieval of data following MOOSE guidelines and PRISMA checklist, we found a total of fourteen studies that have been conducted during that period on altering sperm concentration in the African male. Results: Following analysis of the data, a time-dependent decline of sperm concentration (r = -0.597, p = 0.02) and an overall 72.6% decrease in mean sperm concentration was noted in the past 50 years. The major matter of concern is the present mean concentration (20.38×106/ml) is very near to WHO cut-off value of 2010 of 15×106/ml. Several epidemic diseases, genital tract infection, pesticides and heavy metal toxicity, regular consumption of tobacco and alcohol are reported as predominant causative factors. Conclusion: This comprehensive, evidence-based meta-analysis and systematic review concisely presents the evidence of decreased sperm concentration in the African male over past 50 years with possible causative factors to serve the scientific research zone related to male reproductive health. Keywords: Semen quality, sperm concentration, sperm count
Article
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Purpose: To investigate whether the sperm concentration of European men is deteriorating over the past 50 years of time. Materials and methods: We analysed the data published in English language articles in the past 50 years in altering sperm concentration in European men. Results: A time-dependent decline of sperm concentration ( r = -0.307, p = 0.02) in the last 50 years and an overall 32.5% decrease in mean sperm concentration was noted. Conclusion: This comprehensive, evidence-based meta-analysis concisely presents the evidence of decreased sperm concentration in European male over the past 50 years to serve the scientific research zone related to male reproductive health.
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Reports regarding the changes in sperm concentration in different counties of the world are inconsistent. Furthermore, the reports that sprung up from specific epidemiological and experimental examinations did not include data of prior studies or geographical variations. The current study, following a previous report of massive fall in semen volume over the past 33 years, attempts to delineate the trend of altering sperm concentrations and factors responsible for this by reviewing article published from 1980 to July 2015 with geographic differences. The current study identified an overall 57% diminution in mean sperm concentration over the past 35 years (r= -.313,p= .0002), which, when analyzed for each geographical region, identified a significant decline in North America, Europe, Asia, and Africa. An increasing trend of sperm concentration was identified only in Australia. The association of male age with such a trend (R(2)= .979) is reported. The authors also correlated male fertility with sperm concentration. Thus, this comprehensive, evidence-based literature review aims to concisely and systematically present the available data on sperm concentration from 1980 to 2015, as well as to statistically analyze the same and correlate male health with the declining pattern of sperm count in a single scientific review to serve the scientific research zone related to reproductive health. It points to the threat of male infertility in times ahead.
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This review critically evaluates the current trends of male reproductive health problems in relation to semen quality. Increasing trend in male reproductive disorders observed in recent years, are principally found to associate with lifestyle and environmental factors. Lifestyle-allied diseases could be controlled with modification in diet, living and working environment etc. This review outlines the changing trends in male reproductive health and highlights the alterations in semen quality, in scientific manner. Though scientific and public concern regarding the changes on male reproductive health has grown in past few decades but the demonstration of a geographical differences in sperm concentration, still appears to be controversial. The amplitude of the difference observed cannot only be explained by methodological or confounding factors, and must to some extent be attributed to ethnic, genetic or environmental factors. However, there are numerous reports indicating the chronologically declining sperm count and standard semen parameters in various population indicating the increasing trend of male reproductive health disorders.
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Since several decades numerous experimental and epidemiological experiments tend to establish that in humans the semen volume declines with progression of age. This literature review is intended to report the association between male age and semen volume. Review of English language-published research over the last 33 years, from January 1, 1980, up to December 31, 2013, has been conveniently constructed using MEDLINE database. Studies with inadequate numbers of subjects and case reports were excluded. Among the methodologically stronger studies, declines in semen volume of 3%–22% were likely when comparing 30-year-old men to 50-year-old men. The report suggests that increased male age is associated with a decline in semen volume, i.e. there has been a genuine diminution in semen volume over the past 33 years. As male fertility is to some extent correlated with semen volume the results may reflect an overall reduction in male fertility.
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