ERECTILE DYSFUNCTION (ED)
- The inability to maintain or develop an erection of the penis during sexual activity in humans is termed as erectile dysfunction.
- The development of erectile dysfunction in men increases with age. It increases from 5% to 15% as the age increases from 40 to 70 years. It is also estimated that the prevalence of erectile dysfunction will double in the next 25 years.
- Mechanism of cause: An erection occurs when blood fills two chambers known as the corpora cavernosa. This causes the penis to expand and stiffen, much like a balloon as it is filled with air. The process is triggered by the action of free radical e. nitric oxide, impulses from the brain and genital nerves. Anything that blocks these actions or restricts blood flow to the penis can result in ED.
- Other causes of erectile dysfunction are:
- Cardiovascular disease
- Diabetes: Men with diabetes are more likely to have erectile dysfunction. They experience the problem as much as 10 to 15 years earlier than men without diabetes.
- Lifestyle: Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis.
- Surgery: Treatments such as surgery for prostate cancer, bladder cancer or BPH can damage nerves and blood vessels near the penis. This causes the lowering of blood flow and interferes with normal erection.
- Hormonal insufficiency
- Side effects from drugs such as including certain blood pressure drugs, antidepressants, and tranquilizers.
- Psychological causes: performance anxiety, stress or mental disorders
- Bicycling: according to the reported studies, the shape of the bicycle seats put pressure on the perineum. This area contains arteries and nerves which are damaged due to cycling for long time. This causes ED.
ROLE OF OXIDATIVE STRESS IN ERECTILE DYSFUNCTION
- Oxidative stress: It is the imbalance between the production of free radicals and their detoxification by antioxidants inside human body. Superoxide (O2–) is the most important among other free radicals such as hydrogen peroxide (H2O2), hypochlorous acid (HOCL) and peroxynitrite (OONO–) which are involved in pathophysiological mechanism of many diseases.
- Mechanism: Normal erectile function is dependent on the action of free radical e. nitric oxide. It acts as a neurotransmitter in the process. Under oxidative stress, the free radicals are started to produce in excess amount. The reaction of nitric oxide with other free radicals such as superoxide, leads to the disturbance in normal erection mechanism. During this imbalance, nitric oxide starts to deplete in the human body and the target action of nitric oxide i.e. penile smooth muscle relaxation, starts to fade away. This causes the ineffective relaxation in cavernosal tissue and lack of penile blood flow which results in erectile dysfunction.
ROLE OF ANTIOXIDANTS IN TREATING ERECTILE DYSFUNCTION
- Antioxidants: Antioxidants are those molecules which react with free radicals to stabilize them and inhibit their unwanted reaction at other sites in the human body. They are one of the treatment options for oxidative stress-generated erectile dysfunction.
- When free radicals cause erectile dysfunction through reacting with nitric oxide then, antioxidants work by one of the following two mechanisms:
- Antioxidants either interfere in the production cycle of free radicals i.e. they inhibit the production of free radicals.
- Or, they react with free radicals to stabilize them and block their reaction with nitric oxide.
- In any case, antioxidants inhibit the reaction of free radicals with nitric oxide due to which oxidative stress is released from the cells. This causes the smooth muscle relaxation and penile blood flow which results in cavernosal tissue relaxation. Thus, erectile dysfunction originated from oxidative stress is prevented. This has also been proved by animal studies that antioxidant therapy is a good pharmacological approach to prevent erectile dysfunction.
FENUGREEK TO TREAT ERECTILE DYSFUNCTION
Introduction to fenugreek: Fenugreek is an herb, which is used traditionally in many countries as a therapy against some diseases. The seeds & leaves of fenugreek are responsible for the therapeutic properties of it. Seeds and leaves provide various bioactive components such as steroidal saponins including diosgenin, yamogenin, gitogenin, tigogenin and neotigogens, other bioactive components including choline and trimethylamine, retinol, vitamin D, riboflavin, pyridoxine and essential oils which contribute to the antioxidant property of fenugreek.
DUAL ACTIVITY OF FENUGREEK IN ERECTILE DYSFUNCTION
Fenugreek helps in the treatment of erectile dysfunction by any of the following two mechanisms given below:
- As antioxidant
- As testosterone booster
Fenugreek as antioxidant: In-vitro studies prove that fenugreek has great antioxidant property. The phenolic and flavanoid compounds present in fenugreek seeds help to fight against oxidative stress. Thus, fenugreek is able to block the chain of the formation of free radicals inside body. Due to the chain inhibition, oxidative stress is also inhibited. Thus, free radicals do not react with nitric oxide in the cavernosal smooth muscles and make its availability for erection mechanism.
There are many published studies, which prove that antioxidants inhibit the reaction of excessive free radicals with other molecules in the body to reduce oxidative stress so that erectile dysfunction can be treated. Some of those studies are given below.
- Kaviarasan S et al. (2007) conducted an antioxidant analysis on fenugreek seeds. Their results showed that fenugreek was able to scavenge hydroxyl radicals and also inhibited hydrogen peroxide-induced lipid peroxidation. This proves that fenugreek inhibit the free radical chain reaction. Thus, according to Azadzoi et al. antioxidant therapy by fenugreek will help to inhibit the reaction of free radicals with nitric oxide. This will further help to carry out normal erection mechanism by nitric oxide.
- An in-vitro study conducted by Naidu MM et al. (2011) showed that fenugreek seeds are a valuable source of saponins, protein, dietary fiber and phenolic acids. These bioactive components are a natural source of antioxidants. Fenugreek was able to inhibit the activity of free radicals under in-vitro This analysis shows that fenugreek will be helpful in relieving body from oxidative stress. This in turn, will help to enhance the activity of nitric oxide.
- Achike FI & Kwa CI published a study showing the role of nitric oxide in many physiological pathways. They showed that polyphenols have a major role to boost the effect of nitric oxide. Fenugreek also contains polyphenols as one of its bioactive components which will be beneficial to boost nitric oxide activity. Boosting of nitric oxide activity will help in normal erection mechanism.
Fenugreek as testosterone booster: The erectile dysfunction also originate if the body does not have sufficient amount of testosterones. It has been proved by many clinical studies that fenugreek has the testosterone boosting activity. When the testosterones are boosted-up then, the body also shows improvements from erectile dysfunction.
- It is suggested that herbs for treating erectile dysfunction are better than testosterone replacement therapy. Natural treatment for erectile dysfunction does not give rise to side effects such as heart attacks or becoming dependent on therapy. Fenugreek is reported to restore the normal testosterone levels in the body by acting as an antioxidant.
- Fenugreek has the ability to treat erectile dysfunction originated from hormonal deficiencies. It helps to promote natural testosterone levels and improve libido. It contains phytochemicals such as saponins & sapogenins which are responsible for raising testosterone levels in men.
- It has been proved by a clinical study that standardized extract of fenugreek had positive effect on physiological aspects of libido of 60 male subjects with 25-52 years of age. Fenugreek extract helped to maintain normal testosterone levels in men. Fenugreek was able to increase muscle strength, energy and well‐being in males. Due to this, the erectile dysfunction originated from testosterone deficiency can be prevented.
- In a randomized, double blinded and placebo controlled clinical study on 16 male subjects, it was observed that fenugreek seed extract was able to increase free testosterone and total testosterone levels in the subjects. Fenugreek was also found to be safe and well-tolerated. This clinical study shows that fenugreek supplementation has potential androgenic benefits in males.
- CHEMFORCE is a natural and promising dietary supplement comprising Furosap® containing Protodioscin as the major fraction. It is reported to improve sperm count, sperm morphology and has a protective effect on male reproductive system. Protodioscin is known to increases levels of the hormones; testosterone, dihydrotestosterone and dehydroepiandrosterone. It boosts testosterone levels via stimulating pituitary gland. CHEMFORCE consists of a patented and clinically evaluated ingredient establishing its efficacy and safety for overall energy and vitality in men.
According to these reported studies, choosing fenugreek as a natural therapy to treat erectile dysfunction has proved to be safe and effective in men.