Alternative treatments for erectile dysfunction Original paper

Although erectile dysfunction (ED) is typically treated with phosphodiesterase-5 inhibitors, which prevent the outflow of blood from the penis (e.g., Viagra or Cialis), some people prefer to use complementary and alternative medicines, including dietary supplements and herbal remedies.

This systematic review of randomized controlled trials assessed traditional and herbal remedies for ED. The included studies used the International Index of Erectile Function (IIEF), a validated self-reported questionnaire, to assess erectile function.

The authors reviewed 42 studies. The interventions were categorized as follows:

• Single herbs (14 studies)
• Combination herbal formulas (5 studies)
• Combinations of herbal formulas and nonherbal nutraceuticals (7 studies)
• Nonherbal neutraceuticals (5 studies)
• Acupuncture and moxibustion (2 studies)
• Nutrition (3 studies)
• Exercise (5 studies)
• Topical treatments (1 study)

Panax ginseng, Pycnogenol and Prelox, Tribulus terrestris, L-arginine, nutrition, and exercise were effective for ED.

Specifically, 3 of 4 studies investigating Panax ginseng alone found it to be effective, and both studies assessing Pycnogenol alone found it effective. Prelox (a combination of Pycnogenol, L-arginine, L-citrulline, and roburins) was effective in all 4 studies assessing it. Both studies assessing Tribulus terrestris found it to be effective, and 1 study that assessed L-arginine as a sole intervention found it to be effective. All 3 studies that assessed nutrition and all 5 that assessed exercise interventions found them to be effective.

Although the mechanisms of action were unclear, the above compounds might increase nitric oxide synthesis, thereby improving blood flow.