Efficacy Evaluation of Plant Products in the Treatment of Erectile Dysfunction Related to Diabetes

Erectile dysfunction affects more than 50% of diabetic male patients, with a higher prevalence compared with the general population. Age, clinical factors, and lifestyle habits have been suggested to contribute to the pathophysiology and worsening of erectile dysfunction in diabetic patients. First- and second-line standard treatments are represented by phosphodiesterase type 5 (PDE5) inhibitors and alprostadil, respectively. However, natural compounds have been suggested to ameliorate this clinical condition. This study aims to preclinically characterize the potential synergism among plant-derived products for the improvement of erectile dysfunction in the diabetic condition. The effects of a nutritional supplement composed of Panax ginseng, Moringa oleifera and rutin, as single agents or as a mixture, were evaluated in a streptozotocin (STZ)-induced diabetic rat model with erectile dysfunction. The treatment efficacy was evaluated by measuring sexual-related parameters (i.e., mount and intromission latencies, the mount and intromission frequencies and the ejaculation latency). Results showed that only the mixture was able to significantly reduce the diabetes-related delay in mount latency (p < 0.01). Substantial similar effects were observed by measuring the intromission latency and the mean number of mounts was very similar between rats treated with the mixture and controls. Single agent treatments showed very low effects in terms of intromission frequency, whereas the mixture was able to increase this parameter. Additionally, a statistically significant reduced ejaculation latency was observed in rats treated with the mixture compared with the STZ control. These results are in agreement with the available literature and suggest that the study mixture may ameliorate sexual behavior compared with the administration of the study natural compounds as single agents in diabetic rats. Further preclinical and clinical studies are needed to perform a more comprehensive evaluation of the efficacy and safety of the study mixture.

Effect of Topical Clove (Syzygium aromaticum (L.) Merr. & L.M.Perry) Gel on Premature Ejaculation: A Pilot Randomized Double-Blind Placebo-Controlled Clinical Trial

Premature ejaculation is one of the most common sexual disorders worldwide without a satisfying treatment. In this study, we investigated the efficacy of a topical formulation of clove oil in premature ejaculation patients. Eligible patients were randomly divided into two groups to use either Syzygium aromaticum (SA) 1% gel or placebo gel 10 minutes before the intercourse for a period of 8 weeks. Outcome measurement were Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function (IIEF) questionnaires in addition to Intravaginal Ejaculation Latency Time (IELT). A total number of 22 (11 patients in each group) participants completed the study. At the end of the intervention, the IELT scores changed from 29.84 ± 18.59 to 97.09 ± 91.86 and 42.51 ± 13.98 to 52.45 ± 32.7 seconds in SA gel and placebo groups, respectively (p-value = 0.003). Also, the changes of PEDT scores in the SA gel group (from 14 ± 3.55 to 9.2 ± 4.56) comparing to that of placebo gel group (from 14.63 ± 3.61 to 13.5 ± 3.78) was significantly different (p-value =0.001). Moreover, results of IIEF questionnaire revealed significant improvement of “Intercourse Satisfaction” in SA gel group (p-value = 0.016). No adverse event was observed. It seems that SA gel could be beneficial in the treatment of premature ejaculation; however, it should be further evaluated in larger studies.

The comparison of on-demand caffeine consumption with squeezing technique on treating patients with premature ejaculation; a randomized clinical trial

Background: The present study was aimed at evaluating the effect of on-demand caffeine consumption on treating patients with premature ejaculation (PE compared to squeezing technique. Methods: In this non-blind RCT, 42 otherwise healthy individuals with PE were divided into 2 groups of caffeine and squeezing technique group. The former received 100 mg of encapsulated caffeine for 3 weeks, 2 hours prior to each intercourse. Intra-vaginal ejaculation latency time and index of sexual satisfaction were calculated before and after treatment in both groups. Results: Mean age of the participants was 39.48±7.62 years. Despite the fact that there was no significant difference between pre-treatment and post-treatment values of both IELT and ISS between our 2 groups, significant difference was seen in both groups between pre-treatment and post-treatment values. Furthermore, no strong correlation was seen in pre-treatment IELT and ISS; however, statistically significant correlation was found in post-treatment values. Conclusion: Regarding the fact that caffeine is a well-known and widely-used drug in common disease, the use of this compound is highly unlikely to bear any stigma. Our study demonstrates that 100 mg of on-demand caffeine can equally increase both IELT and ISS significantly as squeezing technique. Further investigations are needed. Keywords: caffeine, premature ejaculation, squeezing technique, intra-vaginal ejaculation latency time, index of sexual satisfaction,

Comparative study between usage of medicine containing a mixture of Dapoxetine and Tadalafil with the usage of these drugs separately in treatment of rapid ejaculation

A study was conducted on 58 patients aged from 18-63 years old, they suffering from rapid ejaculation and all their Intravaginal ejaculation latency time (IELT) were less than 2 minutes. This study done at Erectile dysfunction unit in Al-Muthana teaching hospital for a period of 1 month (March/2019). The patients were divided into 2 groups: Group 1: Patient received 30 mg of Dapoxetine 1hr before coitus and 10 mg of Tadalafil 30 min before coitus. Group 2: Patient received Dapoxetine 20 mg + Tadalafil 10 mg mixed in one tablet 1 hr before coitus. The result of our study revealed that the IELT before treatment was less than 2 minutes in both groups, after treatment the IELT increased significantly (P≤0.05) in group 1 and group 2 (337.9±3.72 and 222.4±2.88 seconds) respectively. The IELT in group 1 was increased significantly (P≤0.05) compared to IELT in group 2 after treatment. In conclusion, the administration of Dapoxetine before 1 hr. of coitus and Tadalafil 30 min. before coitus (G1) gave a good results in increasing of IELT as compared to mixture of these drugs in one tablet.

The Effects of Morphine Dependence and Detoxification with Methadone and Buprenorphine on Sexual Behavior and Sex Hormones

Background: Opiate dependence, a great worldwide obstacle, is regularly treated by detoxification via opioid agonists and antagonist administration. However, different effects and severity of detoxification on the male reproductive system have not been evaluated so far. Objectives: Thus, the present study intended to investigate the impact of morphine dependence and detoxification with methadone and/or buprenorphine on sexual behavior and sex hormones in an animal model of opiate dependence. Materials and Methods: sixty-six adult male mice were randomly allocated into six groups of control (ctl40), morphine-dependent (Mrph40) (which received morphine for 40 days), another control (Ctrl80), morphine-dependent (Mrph80) (which received morphine for 80 days), methadone (Mtdn) detoxified, and buprenorphine (Bprn) detoxified groups (n = 11). Different aspects of sexual activities and Sex hormones were assessed at the end of the treatment period. Data were analyzed by ANOVA test and chi-squared test using SPSS version 16 software for Windows. Results: Testosterone level significantly decreased in all treated groups compared with its level in the Ctl40 group. Detoxification with buprenorphine was reduced following 80 days of treatment, the level of testosterone significantly reduced in all treated groups compared to its level in the Ctrl80 group. The highest and lowest levels of FSH were observed in the Bprn group and in the Mrph40 group, respectively, even lower than that of the Mrph80 and Mtdn groups. Either of the treatments has decreased the level of LH when compared with its level in the controls. Various sexual behaviors were differently disturbed in the treated groups. Duration of sexual activity, Mount frequency, ejaculation latency, and sexual activity duration was higher in the Bprn group than the Mtdn group, but the rate of pregnancy was much higher in the Mtdn group. Conclusions: Either Short or long-term dependence on morphine affects the sex hormones and activities. Following detoxification with methadone and/or buprenorphine, various aspects of sexual behaviors were differently altered, which could alert clinicians in detoxification programs.

Risk factors of premature ejaculation and its influence on sexual function of spouse

Background Premature ejaculation (PE) is a multifactorial problem with a complicated aetiology that has detrimental effects on female partners’ sexual function. However, there is a lack of studies on the relationship between the factors related to PE and female sexual dysfunction (FSD) in China. We aimed to identify and explore the relationship between the factors associated with PE and FSD. Results Ultimately, information was collected from 761 couples: 445 couples with PE complaints and 316 couples without PE complaints. The mean ages of the men with and without PE complaints were 36.29 ± 9.87 years and 31.48 ± 10.77 years, respectively. Female partners in the group with PE complaints reported lower total and subdomain female sexual function index (FSFI) scores, and approximately 65% of them were diagnosed with FSD (vs. control group: 31.96%). A PE duration of more than 14 months, a self-estimated intravaginal ejaculation latency time (self-estimated IELT) less than 2 min, a negative attitude towards PE problems, men’s introversion, and men’s depression were risk factors for FSD in the PE group. Conclusions PE affects not only the patient himself but also the spouse. Comprehensive analysis reveals a clear relationship and interaction between female sexual function and PE. Moreover, in PE treatment, we should not ignore the occurrence of FSD and its impact and should emphasize the treatment of couples together.

Silencing and stimulating the medial amygdala impairs ejaculation but not sexual incentive motivation in male rats

The medial amygdala (MeA) is a sexually dimorphic brain region that integrates sensory information and hormonal signaling, and is involved in the regulation of social behaviors. Lesion studies have shown a role for the MeA in copulation, most prominently in the promotion of ejaculation. The role of the MeA in sexual motivation, but also in temporal patterning of copulation, has not been extensively studied in rats. Here, we investigated the effect of chemogenetic inhibition and stimulation of the MeA on sexual incentive motivation and copulation in sexually experienced male rats. AAV5-CaMKIIa viral vectors coding for Gi, Gq, or no DREADDs (sham) were bilaterally infused into the MeA. Rats were assessed in the sexual incentive motivation test and copulation test upon systemic CNO or vehicle administration. We report that MeA stimulation and inhibition did not affect sexual incentive motivation. Moreover, both stimulation and inhibition of the MeA decreased the number of ejaculations in a 30 minute copulation test and increased ejaculation latency and the number of mounts and intromissions preceding ejaculation, while leaving the temporal pattern of copulation intact. These results indicate that the MeA may be involved in the processing of sensory feedback required to reach ejaculation threshold. The convergence of the behavioral effects of stimulating as well as inhibiting the MeA may reflect opposing behavioral control of specific neuronal populations within the MeA.