Herbal Ginseng and Erectile Dysfunction

 Kyle J. Norton(Draft Article)

In finding a whole food and herb, comparing to the presently pharmaceutical medicine in use with little and no adverse effect(4), scientific communities have looking into herbal ginseng which has been used extensively in traditional Chinese medicine for treatment of sexual dysfunction of both sex.

According to statistic, in US alone, more than18 Million Men over 20 of ages are affected by Erectile Dysfunction and approximately 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience ED on a long-term basis)National Institutes of Health). Astonishingly, lifetime use of ED medications was reported by 24% of men. Almost 69% of ED medication users reported obtaining ED medications from a physician. Fifty-nine percent of ED medication users reported taking the medications to enhance their sexual experience rather than to treat ED, which was marginally associated with stimulant use. according to Department of Veterans Affairs Puget Sound Health Care System, Seattle(1).

In comparison of the effect of erectile dysfunction with diabetes and men with erectile dysfunction due to other causes study indicated that the diseases not only affect Sexual Experience-Psychological Impact domains but also Emotional Life-Psychological Impact domain(2).

Ginseng, the King of Chinese herb, according to the literature in Chinese medicine found by Emperor Shen-Nung, the second of China's mythical emperors (3500-2600 BCE), through his treatise 'Shen Nung Benchau Jing', expressed the efficacy of herbal ginseng well being as a resemblance of human form and its rejuvenative and aphrodisiac properties. The use of ginseng for erectile dysfunction by Emperor Shen-Nung was unique for its time. It continues to hold parallels as a modern-day herbal aphrodisiac 5000 years on(3).

Panax notoginseng saponins (PNS), a major ingredient found in ginseng,  in the study of erectile dysfunction and the underlying mechanism by using a rat diabetic erectile dysfunction model in diabetic rat, showed a positive effect in deduction of oxidative stress cause of erectile dysfunction and and restored functions of endothelial cells and smooth muscle cells in the penis, through reduced level of malondialdehyde and increased levels of superoxide dismutase, glutathione and Akt(5) and possibly via the NO/cGMP pathway and restores the function of endothelium in corpus cavernosum(6).

In root-derived Korean red ginseng (KRG; Panax ginseng) study, researchers at the Yonsei University College of Medicine, found that GB0710  relax the penile corpus cavernosum smooth muscle (CCSM), through ntracellular NO production in human microvascular endothelial cells by  N(G)-monomethyl-L-arginine induction and inhibition(7).

In a 119 men with mild-to-moderate ED participated in a multicenter, randomized, double-blind, parallel, placebo-controlled clinical study, oral administration of the SKGB extract improved all domains of sexual function(8)(9).

According to Chinese medicine has been prescribed ginseng over 5000 years of history to promote yang and to improve cardiac function, short of breath, blood pressure. Panax ginseng can generates fluids and reduce thirst, to treat anxiety, insomnia, dizziness/headache, forgetfulness, impotence, diabetes, bleeding in the vagina not during period, etc.

Dr. Shergis JL and the researcher team at the School of Health Sciences and Health Innovations Research Institute-HIRi, RMIT University, told PubMed " Overall, the quality of Panax ginseng (andomized controlled trials ) RCT methodology has improved since the CONSORT checklist was introduced. However, more can be done to improve the methodological quality of, and reporting in, RCTs"(10)

But the use of herbal medicine in treating erectile dysfunction should be taken with care. Dr Ho CC and Dr. Tan HM. said" Many herbal therapies appear to have potential benefits, and similarly, the health risks of various phytotherapeutic compounds need to be elucidated. Properly designed human trials should be worked out and encouraged to determine the efficacy and safety of potential phytotherapies"(11). As the herb has shown mild adverse events, such as dyspepsia, hot flash, insomnia, and constipation in dose depending manner(12).

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Reference
(1) Erectile dysfunction medication use among men seeking substance abuse treatment.

Horvath KJ, Calsyn DA, Terry C, Cotton A.(PubMed)

(2) Do impotent men with diabetes have more severe erectile dysfunction and worse quality of life than the general population of impotent patients? Results from the Exploratory Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database by Penson DF, Latini DM, Lubeck DP, Wallace KL, Henning JM, Lue TF; Comprehensive Evaluation of Erectile Dysfunction (ExCEED) database(PubMed) 

(3) The history of ginseng in the management of erectile dysfunction in ancient China (3500-2600 BCE) by Nair R, Sellaturay S, Sriprasad S.(PubMed) 

(4) Erectile dysfunction: Viagra and other oral medications(Mayo clinic)

(5) Panax notoginseng Saponins Improve Erectile Function through Attenuation of Oxidative Stress, Restoration of Akt Activity and Protection of Endothelial and Smooth Muscle Cells in Diabetic Rats with Erectile Dysfunction by Li H, He WY, Lin F, Gou X.(PubMed)

(6) Panax notoginseng saponins improve the erectile dysfunction in diabetic rats by protecting the endothelial function of the penile corpus cavernosum by Lin F, Gou X.(PubMed) 

(7) Effects of Korean ginseng berry extract (GB0710) on penile erection: evidence from in vitro and in vivo studies by Cho KS, Park CW, Kim CK, Jeon HY, Kim WG, Lee SJ, Kim YM, Lee JY, Choi YD.(PubMed) 

(8) Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study by Choi YD, Park CW, Jang J, Kim SH, Jeon HY, Kim WG, Lee SJ, Chung WS(PubMed) 

(9) Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction by Kim TH, Jeon SH, Hahn EJ, Paek KY, Park JK, Youn NY, Lee HL.(PubMed) 

(10) Quality and risk of bias in Panax ginseng randomized controlled trials: a review by Shergis JL, Zhang AL, Zhou W, Xue CC.(PubMed)

(11) Rise of herbal and traditional medicine in erectile dysfunction management by Ho CC, Tan HM.(PubMed)
(12) Safety and tolerability of Panax ginseng root extract: a randomized, placebo-controlled, clinical trial in healthy Korean volunteers by Lee NH, Yoo SR, Kim HG, Cho JH, Son CG.(PubMed)