| dc.description.abstract | Objectives: To systematically review and discuss the current evidence from placebo-controlled
clinical trials that investigated the use of alternative medicines and herbal remedies in the
management of erectile dysfunction (ED).
Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-
based systematic review using specific keyword combinations was conducted on the PubMed
and Scopus databases. Randomised controlled trials investigating herbal medicine in at least
one group and using the International Index of Erectile Function (IIEF) as an outcome in
patients primarily diagnosed with ED were included for review.
Results: Following the literature search, screening and eligibility analysis, a total of 42 articles
were included. The 42 articles were categorised as single herb extractions (n = 14), combination
herbal formula (n = 5), combination of herbal formula and non-herbal nutraceuticals (n = 7),
non-herbal nutraceuticals (n = 5), acupuncture and moxibustion (n = 2), diet and nutrition
(n = 3), exercise (n = 5), and topical treatments (n = 1). Based on the results, Korean ginseng,
Pygnogenol and Prelox, Tribulus terrestris, Lepidium meyenii, L-arginine, acupuncture and lifestyle
interventions were the more predominantly investigated treatments interventions for ED.
Conclusions: Panax ginseng, Pygnogenol, Prelox and Tribulus terrestris have promising evidence
as herbal products, alongside L-arginine as a nutritional supplement, for ED based on
IIEF outcomes, and warrant further clinical investigation. The mechanisms of action remain
unclear, but each of these appears to in part increase nitric oxide synthesis. Importantly,
improved diet and exercise should be considered, particularly in patients with obesity or
diabetes mellitus. | en_US |
