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Biology, Medicine, & Natural Product Chemistry ISSN: 2089-6514
Volume 4, Number 2, 2015 | Pages: 41-47 | DOI: 10.14421/biomedich.2015.42.41-47
Medicinal Plants: A Prospect in Developing Male Fertility Enhancing
Agent
Muhammad Ja’far Luthfi1*, Mahanem Mat Noor2and Jalifah Latip3
1Biology Department, Faculty of Science and Technology, UIN Sunan Kalijaga
Jl. Marsda Adisucipto No 1 Yogyakarta 55281, Indonesia. Tel. +62-274-540971, Fax. +62-274-519739
2The Study Center of BioScience and Biotechnology, 3The Study Center of Chemical Science and Food Technology,
Faculty of Science and Technology, UKM 43600 Bangi, Selangor, Malaysia
Author correspondency*:
jafarluthfi@yahoo.com
Abstract
Medicinal plants have been a revolutionary breakthrough in the treatment of male sexual dysfunction. Traditional medicine based on a
holistic philosophy is quite different with the practice of “western” medicine. Phytochemical substances focus their mechanisms of healing
to the root of cause, i.e. the inability of controlling the proper function of the whole body system. Hence, medicinal plants manage sexual
dysfunction and male fertility in the frame of sexual dysfunction as a whole entity. Some previous researches prove that the use of medicinal
plants have a good impact in the treatment of a variety of male sexual problems. This paper will discuss several important aspects of
aphrodisiac plants and preliminary study regarding them in Indonesia. Difficulties inherent to activity guided isolation and the specific
requirements of bioassays are also discussed.
Keywords: medicinal plants, male sexual problem, traditional medicine
Introduction
Male sexual dysfunction is a very serious problem.
(MacKay, 2004; Clourate, 2005). Approximately 10%
men are infetile, and 50% infertile couple are from male
factors. (Pei et al., 2005). The medical treatment for male
sexual problem has not succeeded yet although many
efforts have been done (Hamadeh, 2001; Kohn, 2001).
The existed modern methods, like assisted reproductive
technology (ART), need high cost while the result is not
consistent (Orgebin-Crist, 1998), even the methods have
side effects (Levie’vre et al., 2007).
People have used plants as medicine since the
beginning of human civilization, even probably have
been used before they evolved to be man, as shown in the
practice of using medicinal plants by non-human primates
(Newton, 1991). One of the use of medicinal plants is to
overcome sexual dysfunction.
Indonesia is one of the mega-biodiversity countries.
There are many potential plant as aphrodisiac agent.
However there is little scientific evidence supporting the
effectiveness of using aphrodisiac plants. Besides that,
there is still less studies of the action mechanism and its
active components. The profound research of the effect of
plants towards male reproductive system will support the
use and the effectiveness of the medicinal plants.
The paper will discuss about several important issues
of medicinal plants to cure male sexual problem covering
the characteristics, the research, and the development of
the medicinal plants. Those plants include aphrodisiac
plants and those which function to improve the fertility.
It also discusses about the research of several plants used
by local people.
The research of drug from plant sources
Plants is a main source of new drug discovery (Balandrin
et al., 1985), approximately 40% modern drugs are from
botanical substances (LaFrance Jr. et al., 2000).
However, recently many pharmaceutical industries have
reduced plant drugs studies. Compared with synthetic
drugs, plant drugs are not suitable for High-Throughput
Screening.The study and evaluation of plant drug are
very complicated, time-consuming, and more expensive
compared to conventional drugs (Cordell,. 2000; Etkin,
2000; Balunas & Kinghorn, 2005; Cordell & Colvard,
2005; WHO, 2005). It is believed that combinatorial
chemistry will be a the main source of synthetical
medicine in the future (Simmonds & Grayer, 1999) .
In fact, however, combinatorial chemistry fails to
provide a model for drug structure in several medical
treatment (Simmonds, 2003; Butler, 2004), whereas the
plants still provide more various structures than
combinatorial chemistry (Muller, 2004). It is assumed
that plants, as chemical factories, have continuously
evolved their biosynthetic programs for more than
400,000 million years. As long as evolutionary process,
these plants synthesize compounds in which the structural
variety is far beyond the imagination of synthetical
chemistry experts. It is really possible that the
evolutionary pathway of secondary metabolite produces
compounds enabling to cure diseases that cannot be
healed by conventional medication. (Simmonds &
Grayer, 1999).
Plants as a treatment for Male Sexual Problem
Environment is one of crucial factors affecting human
fertility. Contrast to infertility caused by genetical
42 Biology, Medicine, & Natural Product Chemistry 4 (2), 2015: 41-47
factors, infertility caused by environmental factor have
possibility to cure and prevent (Quallich, 2006). One of
the most important environment factors is nutrition
(Ebisch et al., 2005). In this prespective, a traditional
medicine using medicinal plant is very promising. Some
research has shown a positive effect of nutrition in
spermatogenesis. Recent studies show medicinal plant
potency in improving male fertility and aphrodisiac on
animal (Sinclair, 2000; MacKay, 2004).
The improvement of sexual function has been proven
through the use of medicinal plants, like ginseng,
yohimbe, tribulus terestis, and maca (Burkill, 1965;
Waddell et.al., 1980; Lewis & Elvin-Lewis, 2003). The
traditional medication that is orally done by drinking the
steeped water from the parts of the plant has been
practiced over hundred years ago. In a medical treatment,
the oral medication of sexual problem is a new thing.
Viagra, the first pill to heal impotence, had just been
launched in 1998. This medicine is a revolution in
medical treatment, in which the previous medication was
treated only by injection and operation. (Eardley, 1998;
Mulhall, 2000; Elferink, 2000; Morales, 2001).
However, the development of the plant research is
very slow. It happens because many researches conducted
by pharmacy industries depend on the patent to get the
profit. Plants cannot be patented therefore the industries
are reluctant to invest their money to prove that certain
plants are safe and effective (Foster & Duke, 2000).
There are no plants or botanical derivation compound that
are legally certified by Food and Drug Association or
other similar institutions to be used as a medication of
sexual dysfunction (Sinclair, 2000; Nickell, 2001;
MacKay, 2004).
The difference between traditional medicine and
modern medicine
In the medical world in America and other developed
countries, there is just a single chemical compound that is
recognized as a medicine, not in the form of mixed
chemical components existed in the plants. This
recognition is preferably caused by the drug regulations
and laws, not by the scientific consideration (Foster &
Duke, 2000) or philosophical belief that medicine works
as ‘one-target-one-disease’ (Adimoelja, 2000; Wermuth,
2004). A dominant belief indirectly puts minor beliefs
aside, consequently it reduces the supports towards
scientific fields based on different philosophies (Kuhn,
1996).
Modern medicine relies on the view that a disease is
caused by a very specific pathogen invaded to the body
therefore the healing must be done by eradicating the
source of the disease (Adimoelja, 2000). The medication
using medicinal plants uses holistic approach by
investigating the disease up to the main origin causing the
unbalancing and deficiency in the body function (Cracker
& Giblette, 2002). The whole body functions caused by
the synergy and the existence of individual actions from
body parts are the characteristics of living creatures
therefore the reductionist view of the disease concept, that
just blames an organ or a certain isolated mechanism, is
an incomplete approach (Rangel, 2005).
The Model of Medicinal Plant Study
Nowadays, in vitro test for screening pharmaceutical
agent is a main choice for many pharmacy companies but
the success of the effort is limited on the beginning of the
drug discovery program. This test has not yet fully
replaced the use of animals in many toxicology studies
and pharmacology experiments (White, 2001).
The understanding on molecular level cannot be
automatically applicated to show that the medical strategy
is effective. In vitro physiological reaction of a
pharmaceutical can have an inaccurate prediction of in
vivo physiological reaction. Many pharmaceutical agents
show off different activities in various cell population.
That ails in predicting the whole effect of giving an agent
in the body (Walsh, 1998; Barton & Andersen, 1998; Jobe
et al., 1994). In vitro data is indirectly equivalent with in
vivo data although in vitro test can provide the foundation
to determine the study objective. The studies are
continuously conducted to ensure how far in vitro data
can replace in vivo data (Rodrigues, 1997).
The drug discovery program is basically based on the
use of the experimental animals to determine the
pharmacological effect and the compound/chemical
metabolism (Briggs & Oehme, 1980). An experimental
model is important from a clinical point of view because
there are many aspects of human physiological and
biological reproduction that cannot be studied directly
(Plant & Marshall, 2001). A conventional test of
medicinal plants using rodensia as an experimental
animal model is really needed before pre-clinical and
clinical tests can be conducted (Farnsworth, 1992). The
result is often the only reference to determine the drug
development from the pre-clinical test (Greaves, 1990).
A rodent as an experimental animal has an important role
in screening chemical agents to study the
pharmacological effect covering the distribution,
mechanism, and toxicity (Briggs & Oehme, 1980).
Evaluation of the effect of an agent towards a male
reproduction system generally uses rodents as an animal
model. The wide use of mouse species in the research has
produced complete biology data. The research on fertility
and male reproduction is conducted using various
methods taken from toxicology, medical, ecology, and
epidemiology (Golden, 2002).
Bioassays for bioactive compound evaluation
The combination of chemical and biological screening is
the quickest method to get an active compound of the
plant. To get this, the bioassays provision or simple
pharmacological test is very important to focus on certain
activities from the plants or various plant fraction as a
guidance to obtain pure active component(s). This
bioassays must be very sensitive because the active
substance in the plants may be in a very low quantity. This
Muhammad Ja’far Luthfi, et.al. – Medicinal Plants: A Prospect in Developing Male … 43
bioassays must also be specific towards the desired target.
The main target for Biology test can be divided into six
groups, namely:
Low organisms: microorganism
Invertebrata: insects, crustacean, mollusca
Isolated sub-celullar system: enzyme, receptor
Animal and human cell culture
Isolated organ
Intact animal
Most bioassays are used in in vitro test in cells or sub-
cells and the low animal test. In vivo test in complete
animals is less conducted and less interested because of
ethical issue and it is time-consuming (Hawcroft et al.,
1987; Hamburger & Hostettmann. 1991; Hostettmann &
Marston, 2002; Preusch, 2004).
Determining a simple and quick bioaassay to evaluate
plant for improving sexual function is very difficult.
Reproduction system is a very complicated system having
existed complex interactions in the level of organs, cells
and sub-cells. Moreover, there are many aspects of
reproduction system that have not been studied and not
certainly known (Kierzenbaum, 1994; de Kretser &
Baker, 1999; Liska, 2003; Huggins, 2003; Lopez-Gatius,
2006). Because of that, it is quite difficult to find simple
and quick in vitro bioassays in those fields – those are not
always provided. The only bioassay, that are reliable to
test plants in improving sexual function, is in vivo test in
intact animal although the test is time-consuming and
expensive.
Bioassays offer an huge advantage in standardization
and quality control of plant based product. The products
are heterogen because there are a mixture of bio-active
components from both a plant and mixture of several
plants. The physical analysis method, like
chromatography, cannot be used for this purpose because
it is not sensitive towards the chemical complexity
existed in plant crude extracts. It often happens that the
desired biological activities are not evoked by single plant
component but a mixture of various plant components
therefore just relying on physical and chemical analyses
towards a single component on a mixture is not really
satisfying (Mclaughlin, 1998).
Unfortunately the objectives of many phytochemist is
just isolate, characterize and publish various new
compounds without testing their bio-activities. To attain
practical uses, natural chemical substances must combine
bioassays inside those substances. The extracts must be
screened for biological activities, active extracts must be
chosen, fraction must be directed to bioassays, bioactive
compounds are finally identified and exploited
(Mclaughlin, 1998).
Experiment on Fertility and Male Sexual Function
The researches conducted by Luthfi et al (2008) and Mat
Noor & Luthfi (2006) on tongkat ali (Eurycoma
longifolia), sanrego (Lunasia amara), ginger (Alpinia
galanga), dan clove (Syzygium aromaticum) show the
potency of aphrodisiac and sanrego to improve man
fertility. This study uses rat as tested animals. Rats are
divided into two groups for different plant extracts,
namely every group is given plant extracts in dose 3.33
mg/ml and 333 mg/ml each and control group is given
distilled water. Plant extracts or distilled water are given
through force feeding once a day at 11.00 a.m. for 50
days. After having given plants extraxts for 50 days, the
rat are sacrificed using chloroform and the epididymis
were dissected out.Cauda epididymis were separated
according to the Hamilton (1975). Sperm counts were
determined using Improve Neubauer Hemocytometer as
described previously (Prasad et al., 1972; NAFA &
ESHRE-SIGA, 2002) with some modification. In brief,
cauda epididimis was minced in 15 ml BWW medium
(Biggers et al., 1971) and incubated with 5 % CO2for 30
minutes at 370C. Data were expressed as number of sperm
per cauda epididymis. Progressive sperm motility was
assesed subjectively based on WHO laboratory manual
(1999). A study of sperm morphology is conducted by
providing three slides of sperm smear for each rat. After
fixated in methanol, the slide were stain with Giemsa. The
dry slide is observed in a light microscope. One hundred
sperms are counted randomly from every slide. The
percentage of morphology of normal/abnormal sperms is
determined referring to criteria stated by Wyobek and
Bruce (1975).
Table 1 shows the number of each rat sperm which has
been given aphrodisiac, sanrego, ginger and clove for 50
days. The average number of mouse sperms treated by
aphrodisiac extracts at 333 mg/ml dosage (46.23±1.77)
and sanrego extracts at 333 mg/ml dosage (47.30 x 106+
3.47) show that there is a significant improvement (p<
0.05) compared with the average number of sperms given
ginger, clove extracts and control (distilled water).
However, the intake of tongkat ali and sanrego extracts at
3.33 mg/ml dosage does not show any significant
different in sperm number. A statistical analysis does not
show any significant difference between groups treated
with ginger extract, clove extracts, and control.
The morphology analysis result of rat sperm shows
that the percentage of sperm with normal morphology in
treated rat group and control group exceeds 95%. A
statistical analysis using Turkey test shows that there is
no significant difference (p> 0.05) between control group
and a treated group from the percentage of formal
morphology sperm.
Table 1. Sperm number (x106) and percentage of normal morphology sperm a of rat group given aphrodisiac, sanrego, ginger and clove extracts each at
3.33 mg/ml and 333 mg/ml dosage compared to control group.
Treatment
Dosage
Sperm number (x 106)
% Normal morphology sperm
Tongkat ali
333 mg/ml
46.23±1.77
96.24±1.16
3.33 mg/ml
34.16±3.37
96.8±0.70
44 Biology, Medicine, & Natural Product Chemistry 4 (2), 2015: 41-47
Sanrego
333 mg/ml
47.30±3.47
96.66±0.80
3.33 mg/ml
38.43±3.09
96.04±1.10
Ginger
333 mg/ml
27.21±2.76
95.70±1.39
3.33 mg/ml
29.21±4.46
96.83±0.21
Clove
333 mg/ml
31.67±1.91
96.48±1.35
3.33 mg/ml
32.43±2.76
96.71±0.47
Control
Distilled Water
33.17±4.25
96.67±0.63
The effect of aphrodisiac, sanrego, ginger and clove
on sperm motility is shown in Table 2. A sperm motility
analysis shows that tongkat ali and sanrego have the best
effect in improving sperm movements compared with
groups given clove, ginger extracts and control group
(distilled water). The treatment of aphrodisiac and
sanrego at high dosage (333 mg/ml) shows that 80% of
sperm movements are in the a grade while control group
shows only 40% of sperms movements are in the a grade.
A group treated using ginger extracts at 333 mg/ml
dosage on the contrary shows the lowest level of sperm
motility, namely 80% in the level c. Sperm motility has
been considered as one of the most important predictors
of fertility. Several reports have demonstrated the
correlation of motion parameters with fertilization rates
(Liu et al., 1991). Further studies are required to confirm
the mechanisms of action of tongkat ali and sanrego on
sperm motility.
Table 2. Sperm motility grade in the treated group given aphrodisiac,
sanrego, ginger and clove extracts each at 3.33 mg/ml and 333
mg/ml dosage compared with a control group.
Motility grade (a-d)
Treatment
Dosage
Individual rat
1
2
3
4
5
Tongkat ali
333 mg/ml
a
a
b
a
a
33.3 mg/ml
a
a
a
b
a
Sanrego
333 mg/ml
a
a
a
b
a
33.3 mg/ml
a
a
b
b
a
Ginger
333 mg/ml
c
c
c
b
c
33.3 mg/ml
b
c
c
b
b
Clove
333 mg/ml
b
b
b
b
b
33.3 mg/ml
b
b
b
b
c
Control
Distilled Water
b
a
b
b
a
Note for the grade of motility WHO (1999)
(a): rapid progressive motility ; ≥ 25 μm/s, (b): slow or sluggish
progressive motility, (c): non progressive motility ; < 5 μm/s, (d):
immotile.
This study shows that cloves and gingers do not
improve the parameter of male fertility, namely the
numbers of sperms, the movements of sperms, and the
normal morphology of sperms.
Both plants on the contrary decrease the number of
sperms although it is not significant (P> 0.05). The report
written by Jaganath and Ng (2000) shows that gingers can
improve sperm number and sperm motility is
incompatible with the result of this study. This result is
difficult to compare because there are differences of
tested animals and there may be differences in providing
extracts that are not explicitly stated in detail in the report.
A study conducted by Luthfi and Mat Noor (2007)
also shows that sanrego increase sexual behavior of male
rat. Table 3 shows the aphrodisiac effect in male rat after
they are given sanrego at a certain dosage (the treatment
group) and distilled water (a control group). The 60
mg/kg dosage shows that the number of mounting is
increase significantly compared with other groups. The
numbers of mounting in the group using 60 and 90 mg/kg
dosages do not show any significant differences. The
decrease of mounting number at 90 mg/kg dosage is
difficult to explain with the data from the result of the
study. It may be caused by the limited number of tested
rat (sample). Hayes (2001) stated that the more number
of mice, the more consistent the result. The research is
still conducted to isolate active compounds from sanrego
that can improve aphrodisiac or male fertility.
Table 3. The average mounting number of male rat after treating
sanrego extract using various dosages.
Treatment Dosage
The average of mounting
number + SE
Kontrol
1.33 + 1.54
30 mg/kg
2.33 + 0.57
60 mg/kg
3.33 + 0.57
90 mg/kg
3.00 + 0.00
The early research on purwoceng (Pimpinella
pruatjan) also shows its potency as aphrodisiac herb
(Tambunan, 2005). The root of purwoceng can be used as
aphrodisiac, diuretic and tonic herbs. At this moment, the
information about bioactive content in purwoceng has not
been known yet. Some bioactive compounds that have
been identified are stigmaterol and sitosterol but no one
has reported the use of the single compounds.
Muhammad Ja’far Luthfi, et.al. – Medicinal Plants: A Prospect in Developing Male … 45
The Direction of the Medicinal Plant Development in
the Future
Most research synthetic organic and natural compounds
are conducted by pharmaceutical company and industries.
The research is focused to look for new and more
powerful compounds. In the university, a study must not
always be directed to find new compounds but the study
can also look for substances showing certain biological
activities that may help in understanding on physiological
effects.
The study of medicinal plants to treat sexual
dysfunction is ideally conducted using an experimental
approach that is wellknown reliable to find bioactive
compounds, that is bioassay-guided isolation. Plants are
chosen based on ethnopharmacology criteria, then the
plants are extracted. Extracts produced are tested using
relevant bioassays system. After biological activities are
determined, active extracts are fractionated and their
biological activities are monitored for each level of
fraction. Active isolat elucidation is finally conducted.
There are several possibility if extraxts and fractions
show bioactivity but each compound is not active. The
first possible reason is that there is a synergy effect in
those compounds. Bioactivity emerges because there is a
synergy among those compounds (Williamson, 2001) but
there is another possible reason that there are some
components that have not been isolated. It occurs
because a single plant extract can contain hundreds
components from various different groups, either primary
and secondary metabolit. Those group are isoprenoid,
fenol, lipid, cabohydrate and its derivations, amino acid
and mineral. All those subtances have possibilities to be
bioactive (Wildman, 2001). In this case, in a research of
plant having a potency to improve fertility, it has a slight
possibility to get active components because in vivo
testing needs more numbers of components to test.
In that case, a pharmacological testing to test extracts
that produces standardized extraxts can be conducted.
After a study of toxicity and safety of the extract are
conducted, the standardized extracts are formulated.
Then, a product can be developed. This product can be a
first step for an innovative local pharmaceutical industry
and it can compete with western pharmaceutical
industries, not only for common diseases but also for
severe diseases (Pieters and Vlietinck, 2005).
Conclusion
A number of medicinal plants show the promising
potency in treating male sexual problems. Medicinal
plants have their own characteristics that cannot fully
fulfilled the research methods of conventional medicines.
The results of the research show that some practices using
medicinal plants can validly healing male sexual
dysfunction and it can be improved in order to have a
cheap effective safe therapy of the disease. It is hoped
that the wide spread of the botanical medicine interest and
knowledge will reduce obstacles in using and developing
the medicinal plants.
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