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Testosterone replacement sexual function, bone turnover, and muscle gene expression in therapy for hypogonadal men with major depressive disorder: healthy older men. Transdermal testosterone dysfunctions: results from basic research and clinical studies. Erectile dysfunc- nary tract symptoms in obese men with hypogonadism and tion in patients with hyper- and hypothyroidism: how common and metabolic syndrome. Hyperthyroidism and erectile safety of two different testosterone undecanoate formula- dysfunction: a population-based case-control study. The problem of infertility in couples is distributed equitably between the two sexes. Among different methods, medicinal plants Key Words: have been used in many Nations to treat male infertility problems. These medicinal herbs are used to treat sperm disorders, dysfunctioning of the libido, 2 sexual asthenia and erection. Male Infertility, Herbs provide a therapeutic option, which is affordable and available for infertile couples, Herbal Medicine, and herbalism is the main form of treatment in our health system. So in this review, we have Reproductive System, summarized most of the data dealing with the positive effects of plant extracts on mammalian Sperm reproductive system. Studies have shown that semen parameters in Infertility is recognized as the inability to con- 25 to 40% of young males are below the standard of the ceive after 12 months of sexual practice with- World Health Organization [5]. Infertility is one of surgery, chemicals and herbal drugs and laboratory meth- I the problems of human society. Herbal plants has been fertility problems which 40% of these problems are due famous from ancient times among people and in recent to male factor [2, 3]. Reproductive ability in the male years, a multilateral approach has been appeared on using contain the production of semen containing normal sper- herbal medicines along with medical care they get from matozoa (quality) in the adequate number (quantity) , to- their health care provider [7, 8]. Different such as herbal plants have more benefts since they are reasons are involved in the occurrence of male infertility less invasive and less costly physical and emotional treat- such as genetic disorders, genital duct obstruction, vari- ment compared with other methods. The aim of this pa- cocele, decreased sperm production, decreased semen per is to critically review the available literature on herbal * Corresponding Author: Hossein Nikzad, PhD Address: Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan- Iran Tel/Fax:: +98 (31) 55621158 E-mail:nikzad_h@kaums. We searched in Google scholar, Science direct and These studies showed that the antioxidant defense sys- Pubmed for different types of plants, which have effect tems of testicular tissue protect the testes against oxi- on fertility process using their scientifc names. Then we dative damage and can reduce free radicals effectively chose the plants that have positive effect on fertility and and decrease the damage of spermatogenic cells [13]. Information from selected articles was ity, in cases where oxidative stress is involved [15]. Results & Discussion consumption of 6 g of green tea in 600 mL of water for 7 days could increase plasma glutathione and improve Tea the post exercise increase in lipid hydroperoxidase [17]. The main reason for harmful effects to increase the number and motility of this interest is the awareness of people about the thera- spermatozoa especially after 28 days of treatment [18]. Tea contains, group of cat- echins that includes catechin, epicatechin, gallocatechin, Carrot epigallocatechin, catechin gallate, epicatechin gallate, gallocatechin gallate, and epigallocatechin gallate and Daucus carota commonly known as "Carrot" belongs vitamins, minerals polyphenols, favonols (theafavins, to the family of Apiaceaeis, a useful vegetable being used thearubigens) , adenine, theobromine, theophylline, xan- worldwide. Many studies have been done on chemical thine, gallotannin, small amounts of aminophylline and composition of this plant and a large number of active a yellow volatile oil which is solid at room temperatures ingredients such as volatile oils, steroids, tannins, favo- and has strong aromatic smell and favor [9]. It has been re- rent researches have shown that both green and black ported that carrot can increase the potency in men, while tea contain favenoids such as quercetin, kaempferol and in women it stimulates menstruation, and seeds are more myricetin, which have strong anti-toxic and anti-carci- effective than other parts of the plant [19]. Both antioxidative and androgenic Garlic (Allium sativum) has been used as a medicine activity of Z. Ginger has been shown that decreases lipid phide is the bioactive organosulphur component of gar- peroxidation and increases glutathione content in blood lic, which have antioxidant effects [23]. Some studies have reported that garlic nale have a benefcial effect on male reproductive func- harmsthe function of testes and has spermicidal effects tions in rats, which are confrmed by other studies on the on spermatozoa but some others demonstrated the op- increased sperm counts, motility,testosterone, and de- posite effect [25]. It increase in the number of empty seminiferous tubules in was also observed that the administration of ginger can testes and a decrease in the level of testosterone. Also,a decreased prostate productive organ which might be due to the androgenic weight was associated with a reduction in citric acid con- activity of ginger [31]. Rats fed with a clearly increased level of testosterone in the rats even garlic water extract over 3 months showed an increase in in spite of receiving 5 mg/kg/day gentamicin comparing epididymis spermatozoa [27]. It has spermatogenesis stop at the primary spermatocyte stage been demonstrated that, ginger have an antioxidant and with 50 mg of oral administration of garlic powder for androgenic activity in dose of 50 mg/kg/rat, which have 70 days [28]. Some of these different results In another study, administration of 50 mg/kg/cock and might be due to the type of preparations used like garlic 100 mg/kg/cock ginger to 28, 32, 36, 40 and 44 week- powder [26, 28] , water extract [27] , aged garlic, raw age rats, signifcantly increased the concentration and garlic juice and heated garlic juice [30] or the doses and motility of sperms in ejaculation volume. Zingiber Offcinale commonly called ginger belongs In the other study, administration of 1000mg/kg to to the family of Zingiberaceae. It contains several com- rats for 28 days showed a signifcant weight increase pounds including acid, resins,vitamin C compounds, fo- compared to the control group. This activities of testicular antioxidant enzymes and restore 5 November 2013, Volume 10, Number 4 sperm motility of cisplatin-treated rats beside protec- crease in the weight of testes, cauda epididymis dies and tion against cisplatin-induced testicular damage [41]. Cinnamomum (family of Lauraceae) species con- Rose Oil tain volatile oils, tannins, terpenoids, mucilage, oxa- lates and starch. Different chemical constituents of Rose oil is extracted from rose fowers by steam dis- C. Rose oil is a lucid, light yellow, and volatile antiulcerogenic andcytotoxic effects. There are fve major constituents in oil such as citro- tract of Cinnamomum increased the weight of testes, nellol, geraniol, nerol, linalool, and phenylethyl alcohol caudae epididymidies and seminal vesicles in the treated [43]. Based on the results of aldehyde/carboxylic acid male mice, indicating a possible stimulation of hormon- test that is used to show long-term antioxidant activity, al levels in the animals. Also, the sperm count and motil- Wei & Shibamo to have reported that rose oil has an ity of the treated animals were signifcantly higher than antioxidant activityalmost equal to a-tocopherol, which the control group [48]. The increase in number and motility of sperm and Leydig cell counts, seminif- In another study, oral administration of erous tubule diameters, and decreasing the number of C. Another study showed vesicles, improved semen quality and quantity, and in- signifcant histopathological improvement in testes and creased serum insulin and testosterone levels. Koul and Kapil, reported that vent adriamycin-induced cytogenetic and damages of piperine, isolated from P. The antioxidant effect of fenugreek is ascribed (ginsenosides Rb1, Rb2, Rc, Re and Rg1) which are more to the presence of favonoids and polyphenols. Flavonoids, the effect of fenugreek against testicular toxicity of carben- main group of total phenolic constituents, are found in dazim may be associated with the antioxidant activity of greater concentration in the ginseng [58]. It has been reported that the polyphe- different effects like protecting muscle from exercise in- nolic extract of fenugreek seeds has an antioxidation effect duced by oxidative stress, improving erectile parameters in vitro [52]. A study showed that in rabbits, a fenugreek such as penile rigidity, girth, erection duration, libido and seed powder containing diet (30%) for 3 months could sig- patient satisfaction [59]. Ginseng causes a signifcant de- nifcantly decrease male testis weight [~25%] and sperm crease in total chromosomal aberrations, sperm abnormal- concentration [~43%] , indicating a toxic effect of fenu- ities and increase in testosterone concentration and sperm greek seeds on seminiferous tubules and the interstitial numbers and motility [57, 60]. Their spermatogenesis hypoplasia when compared with that in protective effect may be due to the higher ability to elimi- the control group [53]. In an- duced higher relative weights of the accessory sex gland, other study, the epididymal sperm count was increased all prostate lobes, the seminal vesicle, and the testes [54]. Tou et al `suggested that it is impor- chemotherapeutics, such as 5-fuorouracil, mitomycin tant to establish the age of exposure and dose of faxseed C, vinblastine, and cyclophosphamide [59]. The ginseng that will provide the most health benefts with the fewest extract could give effective protection against radiation- risks [56]. Administration of ginseng before gamma radiation treatment signifcantly protected Ginseng the germ cell population against the gamma radiation in mice [60]. Ginseng roots contain different pharmaceuti- thenospermic patients were increased by treatment with cal constituents ginsenosides (saponins) , polyacetylenes, P. Until now, 38 ginsenosides have been separated from ginseng roots, with fve main ginsenosides 7 November 2013, Volume 10, Number 4 can effectively prevent the testicular toxicity induced by increases fertility. Piacente et al, found that Maca also contained (1R, 3S) -1-methyltetrahydro?- In another study, it was found that the sperm count in carboline-3 carboxylic acid [69]. Maca has been found the testes and epididymides of the male rats treated with to have antioxidant properties in vitro and in vivo [67]. Flavonoids, the major group of total phenolic com- pounds, are found in parsley which either scavenge free Pumpkin (Cucurbita pepo L. The protein level is high cated that parsley oil contain favonoids (apiin, luteolin-, in seeds [25–51%] [72] and in seed oil [40% to 60%].
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Changes in sexual Avoid serotenergic anti-depressants [633 erectile dysfunction pills images buy avana 200 mg lowest price, 634 erectile dysfunction treatment pumps generic 200mg avana amex, functioning associated with duloxetine insulin pump erectile dysfunction cheap avana line, escitalopram bisoprolol causes erectile dysfunction purchase avana 100mg line, and 614, 641]: Grade A. Mult Assessment Survey to Justify Establishing a Reproductive Scler 1999;5:428-431 Health Clinic at a Comprehensive Center. Erectile dysfunction 2009; 6:149-163 and mental health in a general population of older men. Coronary Artery Sex Med 2009;6:505-512 Calciications in hemodialysis patients and their correlation 22 Penield W, Rasmussen T. Pleasure response of human subjects to direct Therapy Insight: sexual dysfunction in patients with stimulation of the brain: physiologic and psychodynamic chronic kidney disease. 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However, in the 56- to 65-year-old group, the the authors’ study identified that sildenafil citrate response rate dropped to 45% in the group with two could salvage erectile function in roughly 70% of impo- nerves spared and to 0% in those with one nerve pre- tent, motivated patients if a bilateral nerve-sparing served. In the older age group (>65 years old), 33% procedure is performed and in 50% of patients if a uni- of the patients responded when two bundles were lateral nerve-sparing procedure is done. The dropout rate was 29%, with 50% sildenafil at any time after surgery and that they (6/12) discontinuing because of the return of natural should not be hesitant to increase the dose to 100 mg. A study conducted by Nehra and col- patient discontinued the drug at 3 years because of leagues (2000) reported that a combination of silde- side effects. New Oral Therapies Three-Year Update of Sildenafil Myriad new therapeutic agents are emerging for the treatment of sexual dysfunction. Apomorphine Citrate Efficacy and Safety: sublingual has a central mechanism of action; it is Cleveland Clinic Series administered sublingually 20 min prior to expected Data from 41 patients who responded to sildenafil sexual activity. Sildenafil was prescribed at a dose of 50 mg inhibitors with increased potency and selectivity. The drug significantly improved partner satisfaction, and side effects were assessed. Thirty-one percent (9/29) of (2004) studied the efficacy of tadalafil in different these respondents had augmented their dose from 50 doses in a placebo-controlled trial; they reported a Treatment of Erectile Dysfunction / Raina et al. The results of the study identified advantage to this form of therapy (Fraiman et al. Further clinical trials are required to assess the advantage of increasing tissue oxygenation during selectivity, pharmacokinetics, and period of respon- the erection. Porst (1997) compared intraurethral drugs injected into the human corpus cavernosum penis. The efficacy and safety doses compared with intraurethral application of of tadalafil: an update. Minidoxil versus nitroglycerine: both treatments favor the injections and find that they Prospective double blind control trial in transcutaneous produce firmer erections. Minidoxil and capsacin: An association ally consider penile prosthesis implantation. Efficacy and solutions consistent with their pathophysiology and Safety of transurethral alprostadil in patients with erectile personal needs. Most patients are prescribed sildenafil dysfunction following radical prostatectomy. Diagnostic realistically advise patients of the long-term efficacy steps in the evaluation of patients with erectile dysfunc- and compliance of our pre-Viagra treatment options tion. Nonoral therapies should be consid- devices for erectile dysfunction: A long-term, prospective ered in the early postoperative period to enhance study of patients with mild, moderate, and severe dys- function. This century will witness Changes in penile morphometrics in men with erectile many additional agents designed for patients with spe- dysfunction after nerve-sparing radical prostatectomy. Effects of sildenafil on the sparing radical prostatectomy lead to better long term relaxation of human corpus cavernosum tissue in vitro return of natural function? Paper presented and on the activities of cyclic nucleotide phosphodi- at the Society for the Study of Impotence Meeting, esterase isoenzymes. Tadalafil in the Study Group: Oral sildenafil in the treatment of erectile treatment of erectile dysfunction following bilateral nerve dysfunction. New England Journal of Medicine, 338, sparing radical retropubic prostatectomy: A randomized, 1397-1404. World Journal at bedtime significantly increases nocturnal erectile activ- of Urology, 10, 68-70. Prostaglandin Leukot Essent Fatty Acids, 60, rethral prostaglandin E1 and sildenafil in the salvage of 169-174. Norepinephrine involvement International Journal of Impotence Research, Suppl 1: in response to intracorporeal injection of papaverine in psy- S38-42. Minimally invasive therapy for tion therapy for post-prostatectomy impotence: an out- erectile dysfunction: Intracavernosal, oral, transdermal/ come analysis. Treatment of men ernosal injection of vasoactive intestinal polypeptide with erectile dysfunction with transurethral alprostadil. Intracavernosal therapy for erectile failure—Impact of Patient acceptance of and satisfaction with an external treatment and reasons for dropout and dissatisfaction. Nitic oxide as a mediator of the corpus cav- Intracavernosal drug-induced erection therapy versus ernosum in response to non cholenergic non adrenergic external vacuum devices in the treatment of erectile dys- neurotransmission. Successful non-invasive management of the 97th Annual Meeting of the American Urological erectile impotence in diabetic men. Treatment of erectile dysfunction after sildenafil citrate after radical prostatectomy. Current Urology Three year update of sildenafil citrate (Viagra) efficacy and Reports, 2(6), 495-503. They can be useful to help diagnosis and to provide a baseline against which to monitor changes in symptoms and response to therapeutic interventions. Dr Hackett provides a guide to the most useful questionnaires in the sexual health area. While generally regarded conditions frequently co-exist in the same as too time-consuming for use in the clinic, patient. Confdence in getting and maintaining for penetration and 4 is a rigid erection erection (Figure 2). Assessment of change with treatment means that no paperwork is involved and an answer is obtained in seconds. Incomplete emptying 0 1 2 3 4 5 How often have you had the sensation of not emptying your bladder? Frequency 0 1 2 3 4 5 How often have you had to urinate less than every two hours? Intermittency 0 1 2 3 4 5 How often have you found you stopped and started again several times when you urinated? We Geoffrey Hackett has been an occasional and impact of therapeutic interventions. Itraconazole possesses structural similarities to ® ketoconazole (Nizoral ) and the mechanism of pharmacological action is similar. The Netherlands Pharmacovigilance Centre Lareb has received reports of erectile dysfunction associated with the use of itraconazole. Reports Until September 30, 2005 Lareb received four reports of erectile dysfunction associated with the use of itraconazole, listed in table 1. In patient B the erectile disturbance persisted during the medication-free interval. Patient D had also experienced erectile dysfunction during previous treatment with terbinafine. No cases of erectile dysfunction have been reported to Lareb in association with the use of ketaconazole. Nederlands Bijwerkingen Centrum Lareb November 2005 Other sources of information Literature A literature search revealed a few reports in which impotence and a decrease in libido have been reported during oral itraconazole therapy [4-6]. No reports on erectile dysfunction as adverse drug reaction of itraconazole were discovered. The literature does not support a similar interference with testosterone synthesis as described for ketoconazole. The mechanism of the antifungal action of itraconazole, like ketoconazole, involves prevention of ergosterol synthesis in fungal cell membranes via inhibition of cytochrome P450. Itraconazole, compared to ketoconazole, has a much higher affinity for fungal cytochrome P450 and binds only weakly to human P450 enzymes. In a study of limited size no clinical or laboratory evidence of impaired human testosterone synthesis could be found in patients treated with itraconazole [8]. Conclusion Lareb received reports of sexual dysfunction specified as erectile dysfunction associated with the use of oral itraconazole for onychomycosis. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in superficial and systemic mycoses. Use of oral ketoconazole to prevent postoperative erections following penile surgery. Adrenal response to corticotrophin and testosterone during long-term therapy with itraconazole in patients with chromoblastomycosis.