Plant drugs and natural products for erectile dysfunction

Introduction: Male sexual dysfunction refers to the inability to achieve satisfactory sexual relationships, including erectile dysfunction (ED), decline, and abnormal ejaculation. ED is the most common form of sexual dysfunction, defined as an erection that persists or repeatedly fails to achieve or maintain satisfactory sexual performance, also known as erectile dysfunction.

Since the birth of medicine, natural products have been a valuable source of new therapeutic agents for treating various diseases. So far, natural products remain an important starting point for the development of new therapies. In order to overcome the problem of ED, aphrodisiac plants have been used for centuries to enhance sexual ability. The use of natural products has also attracted patients, as they are claimed to have health benefits that go beyond ED related health benefits, have fewer side effects, and are said to be more cost-effective than Western medicine. For distributors, legal patent issues and certification thresholds for chemical drugs can be avoided.

According to reports, the ability of medicinal plants to enhance sexual ability is attributed to a wide range of mechanisms. These include:

(1) An increase in testosterone levels

Testosterone has been shown to play an important role in male erectile function, mediating erection at the central and peripheral levels. Male rats treated with testosterone and castrated successfully restored their mating behavior through the release of medial preoptic dopamine. Nitric oxide (NO) synthase has also been shown to be affected by testosterone, and changes in male reproductive tract activity after castration in male rats can be prevented by testosterone replacement. NO is considered the main factor responsible for the relaxation and erection of the smooth muscle of the corpus cavernosum. It directly originates from the non adrenergic and non cholinergic parasympathetic nerves, and indirectly from the cavernous sinus and vascular endothelium under cholinergic stimulation. When it spreads to smooth muscle cells of the corpus cavernosum, it activates soluble guanylate cyclase, thereby catalyzing the production of cGMP. Elevated intracellular cGMP levels lead to relaxation of spongy smooth muscle, leading to erections. NO is synthesized by L-arginine through the catalytic action of NO synthase subtypes, neuronal nitric oxide synthase, endothelial nitric oxide synthase (eNOS), and inducible NOS. Therefore, by enhancing NOS activity or NO release, medicinal plants may contribute to ED. It was also observed that male testosterone levels are the main determinant of frequency, indicating their promoting role in sexual function. Plants that have been proven to improve sexual ability by increasing testosterone levels include ginseng, Polygonatum, Angelica sinensis, and Tribulus terrestris; Animal species include seahorses, seal kidneys, deer antlers, deer whips, deer antler glue, and so on. These traditional Chinese medicines contain a large amount of animal androgens and amino acids, which can effectively supplement testosterone.

(2) PDE5 inhibitors

Oral phosphodiesterase type 5 (PDE5) inhibitors are recommended as first-line treatment and are also the most widely used drugs. So far, four types of PDE5 inhibitors have been approved by the US Food and Drug Administration, namely sildenafil, tadalafil, vardenafil, and avanafil. Other PDE5 inhibitors include Mirodenafil (South Korea), Udenafil (South Korea, Russia, Philippines), and Lodenafil (Brazil). Although various clinical studies have demonstrated the efficacy of PDE5 inhibitors, up to 35% of patients may still be unresponsive to treatment. The tolerance of PDE5 inhibitors is also limited due to adverse reactions such as headache, flushing, and visual impairment. One of our important research directions is plant PDE5 inhibitors, which have been tested in hundreds of experiments on extracts of Epimedium and Black Ginger.

(3) Mediation of related pathways

The mediation of related pathways is through new pathways, and several new signaling pathways have been proposed to regulate erectile response, such as phosphatidylinositol 3-kinase/protein kinase B (Akt)/eNOS/NO and erythroid 2 related factor 2 (Nrf2)/heme oxygenase-1 pathways. Shear stress and various growth factors activate and stimulate phosphatidylinositol 3-kinase phosphorylation Akt. This in turn phosphorylates eNOS to activate it, thereby increasing the rate of NO formation. The plants with this mechanism of action are Eucommia ulmoides and ginseng. The pharmacological activation of transcription factor Nrf2 leads to the activation of the heme oxygenase-1 pathway, which plays a major role in the male reproductive system. Plants that activate this pathway include M Pruriens and T Terrestris.

(4) Antioxidant effects.

Oxidative stress has been recognized as the main contributing factor to the development of ED, so it is not surprising that reducing oxidative stress has been proposed as one of the anti ED mechanisms. Examples of medicinal plants used as antioxidants include Curculigo pilosa, Hunteria umbellata, and Microdesmis keayana.

Proportional extracts and low-purity composite compounds often take effect in treatment. This indicates that plants may act through multiple pathways and may therefore be useful for ED patients who are difficult to treat with current treatment plans. However, for most medicinal plants, their mechanisms of action have not been determined or are only hypothetical. This may be partly due to the complexity of medicinal plants, as the environment in which plants grow plays an important role in determining the presence and concentration of plant components. Factors such as temperature, humidity, light intensity, and soil composition may affect the type and concentration of secondary metabolites in plants.

The good news is that scientific research on these medicinal plants and natural products related to ED treatment has not reported any adverse reactions or toxicity to their respective plants. And some traditional plants used for aphrodisiac purposes, such as ginseng (Asian ginseng, Korean ginseng), saffron (saffron), L Meyenii, E Longifolia has achieved good results in testing. So in terms of formulation, it is not only about treating ED, but also very effective for the overall recovery of the patient’s body. In this regard, traditional Chinese medicine theory is very effective because it regards the human body as a system, not a separate organ.

We use PDE5 inhibitors as the main ingredient in the plant formula, along with other active ingredients as adjuncts. If you have any better suggestions, please communicate with us. Hard capsules auto-filling: https://youtu.be/dGR669YOk_c, we have advantage in formula developing and OEM service, please checked here.