Journal of Pharmacopuncture (대한약침학회지)

KOREAN PHARMACOPUNCTURE INSTITUTE (대한약침학회)
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The Effect of the Combination of Ginseng, Tribulus Terrestris, and L-arginine on the Sexual Performance of Men with Erectile Dysfunction: a randomized, double-blind, parallel, and placebo-controlled clinical trial

  • Reza Tahvilian (School of Pharmacy, Pharmaceutical Sciences Research Center, Research Institute for Health, Kermanshah University of Medical Sciences) ;
  • Mohammad Amin Golesorkhi (Kermanshah University of Medical Sciences) ;
  • Farajollah Parhoudeh (School of Medicine Imam Reza Hospital Kermanshah University of Medical Sciences) ;
  • Fatemeh Heydarpour (School of Health, Medical Biology Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences) ;
  • Hossein Hosseini (Barij Essence Medicinal Plants Research Center) ;
  • Hojjat Baghshahi (Barij Essence Medicinal Plants Research Center) ;
  • Hossein Akbari (Social Determinants of Health (SDH) Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences) ;
  • Mohammad Reza Memarzadeh (Barij Essence Medicinal Plants Research Center) ;
  • Mehdi Mehran (Barij Essence Medicinal Plants Research Center) ;
  • Hosna Bagheri (Kermanshah University of Medical Sciences)
  • Received : 2023.08.16
  • Accepted : 2024.04.22
  • Published : 2024.06.30
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Abstract

Objectives: Nitric oxide is the most important mediator of penile erection after the onset of sexual excitement. It activates cyclic guanosine monophosphate (cGMP), increasing penile blood flow. Most pharmaceutical medications prevent enzyme phosphodiesterase type 5 (PDE-5) from breaking down cGMP, thus keeping its level high. However, due to the adverse effects of pharmacological therapies, herbal drugs that improve sexual function have gained attention recently. This study aimed to investigate the combined effects of ginseng, Tribulus terrestris, and L-arginine amino acid on the sexual performance of individuals with erectile dysfunction (ED) using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Methods: Over three months, 98 men with erectile dysfunction were randomly assigned to receive either 500 mg of herbal supplements or placebo pills. Each herbal tablet contained 100 mg of protodioscin, 35 mg of ginsenosides, and 250 mg of L-arginine. Results: The results showed that the changes in the average scores of ILEF-5 within each group before and after the intervention indicated that all parameters related to the improvement of sexual function in patients with erectile dysfunction improved in the herbal treatment group (p < 0.001). The herbal group significantly improved IIEF-5 scores in nondiabetics (p < 0.05). However, there was no significant difference in the changes of IIEF-5 scores between the two intervention and control groups in diabetic patients. Conclusion: In conclusion, ginseng, Tribulus terrestris, and L-arginine have properties that increase energy and strengthen sexual function, making them suitable for patients with sexual disorders.

Keywords

Acknowledgement

This study was conducted using Highsense Barij® tablets manufactured by Barij Essence Company in Iran, and this company was supported all financial support.

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