Male sexual dysfunction is a prevalent condition with significant impacts on quality of life. In recent years, there has been growing interest in the use of nutritional supplements and medicinal plant extracts as alternative approaches for managing this condition. This review article provides a comprehensive overview of the role and potential benefits of herbal extracts and nutrients commonly used in the Nano Leo formulation. The proposed mechanisms of action for each component are discussed, along with supporting scientific evidence from relevant studies. Key components such as L-arginine, Tribulus terrestris extract, Hypericum perforatum extract, Mucuna pruriens extract, Pinus gerardiana extract, Ginkgo biloba extract, zinc, and vitamin D3 are highlighted for their ability to improve erectile function, ejaculation latency, libido, and overall sexual satisfaction. The findings suggest that these supplements may offer promising alternatives to conventional pharmacological therapies while addressing underlying physiological pathways. This review underscores the importance of exploring integrative approaches to enhance male sexual health and satisfaction.
References
[1]
Malviya, N., Malviya, S., Jain, S. and Vyas, S. (2016) A Review of the Potential of Medicinal Plants in the Management and Treatment of Male Sexual Dysfunction. Andrologia, 48, 880-893. https://doi.org/10.1111/and.12677
[2]
Mutha, A.S. (2015) An Observational Study to Evaluate the Prevalence of Erectile Dysfunction (ED) and Prescribing Pattern of Drugs in Patients with ED Visiting an Andrology Specialty Clinic, Mumbai: 2012-14. Journal of Clinical and Diagnostic Research, 9, PC08. https://doi.org/10.7860/jcdr/2015/14520.6174
[3]
Sathyanarayana Rao, T., Darshan, M. and Tandon, A. (2015) An Epidemiological Study of Sexual Disorders in South Indian Rural Population. Indian Journal of Psychiatry, 57, 150-157. https://doi.org/10.4103/0019-5545.158143
[4]
Kant, S., Singh, A., Abdulkader, R., Lohiya, A., Silan, V., Nongkynrih, B., et al. (2018) Prevalence and Correlates of Sexual Health Disorders among Adult Men in a Rural Area of North India: An Observational Study. Journal of Family Medicine and Primary Care, 7, 515-521. https://doi.org/10.4103/jfmpc.jfmpc_348_17
[5]
Sarkar, S., Chawla, N., Tom, A., Pandit, P.M. and Sen, M.S. (2021) A Systematic Review of Indian Studies on Sexual Dysfunction in Patients with Substance Use Disorders. Indian Journal of Psychiatry, 63, 326-334. https://doi.org/10.4103/psychiatry.indianjpsychiatry_716_20
[6]
Masuku, N.P., Unuofin, J.O. and Lebelo, S.L. (2020) Promising Role of Medicinal Plants in the Regulation and Management of Male Erectile Dysfunction. Biomedicine & Pharmacotherapy, 130, Article 110555. https://doi.org/10.1016/j.biopha.2020.110555
[7]
Leisegang, K. and Finelli, R. (2021) Alternative Medicine and Herbal Remedies in the Treatment of Erectile Dysfunction: A Systematic Review. Arab Journal of Urology, 19, 323-339. https://doi.org/10.1080/2090598x.2021.1926753
[8]
Shankhwar, S.N., Mahdi, A.A., Sharma, A.V. and Pv, K. (2020) A Prospective Clinical Study of a Prosexual Nutrient: Nano Leo for Evaluation of Libido, Erection, and Orgasm in Indian Men with Erectile Dysfunction. Evidence-Based Complementary and Alternative Medicine, 2020, Article 4598217. https://doi.org/10.1155/2020/4598217
[9]
Koolwal, A., Manohar J., S., Rao, T.S.S. and Koolwal, G.D. (2019) L-Arginine and Erectile Dysfunction. JournalofPsychosexualHealth, 1, 37-43. https://doi.org/10.1177/2631831818822018
[10]
Burnett, A.L. (2006) The Role of Nitric Oxide in Erectile Dysfunction: Implications for Medical Therapy. The Journal of Clinical Hypertension, 8, 53-62. https://doi.org/10.1111/j.1524-6175.2006.06026.x
[11]
Menafra, D., de Angelis, C., Garifalos, F., Mazzella, M., Galdiero, G., Piscopo, M., etal. (2022) Long-term High-Dose L-Arginine Supplementation in Patients with Vasculogenic Erectile Dysfunction: A Multicentre, Double-Blind, Randomized, Placebo-Controlled Clinical Trial. Journal of Endocrinological Investigation, 45, 941-961. https://doi.org/10.1007/s40618-021-01704-3
[12]
Rhim, H.C., Kim, M.S., Park, Y., Choi, W.S., Park, H.K., Kim, H.G., et al. (2019) The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis. The Journal of Sexual Medicine, 16, 223-234. https://doi.org/10.1016/j.jsxm.2018.12.002
[13]
Qureshi, A., Naughton, D.P. and Petroczi, A. (2014) A Systematic Review on the Herbal Extracttribulus Terrestrisand the Roots of Its Putative Aphrodisiac and Performance Enhancing Effect. Journal of Dietary Supplements, 11, 64-79. https://doi.org/10.3109/19390211.2014.887602
[14]
Gama, C.R.B., Lasmar, R., Gama, G.F., Abreu, C.S., Nunes, C.P., Geller, M., et al. (2014) Clinical Assessment of Tribulus Terrestris Extract in the Treatment of Female Sexual Dysfunction. Clinical Medicine Insights: Women’s Health, 7, CMWH.S17853. https://doi.org/10.4137/cmwh.s17853
[15]
Do, J., Choi, S., Choi, J. and Hyun, J.S. (2013) Effects and Mechanism of Action of Atribulus Terrestrisextract on Penile Erection. Korean Journal of Urology, 54, 183. https://doi.org/10.4111/kju.2013.54.3.183
[16]
Dehghan, A., Esfandiari, A. and Bigdeli, S.M. (2011) Alternative Treatment of Ovarian Cysts with Tribulus Terrestris Extract: A Rat Model. Reproduction in Domestic Animals, 47, e12-e15. https://doi.org/10.1111/j.1439-0531.2011.01877.x
[17]
Kamenov, Z., Fileva, S., Kalinov, K. and Jannini, E.A. (2017) Evaluation of the Efficacy and Safety of Tribulus Terrestris in Male Sexual Dysfunction—A Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Maturitas, 99, 20-26. https://doi.org/10.1016/j.maturitas.2017.01.011
[18]
Milasius, K., Dadeliene, R. and Skernevicius, J. (2009) The Influence of the Tribulus Terrestris Extract on the Parameters of the Functional Preparedness and Athletes’ Organism Homeostasis. Fiziologichnyi Zhurnal, 55, 89-96.
[19]
Iacono, F., Prezioso, D., Illiano, E., Romeo, G., Ruffo, A. and Amato, B. (2012) Sexual asthenia: Tradamixina versus Tadalafil 5 mg Daily. BMCSurgery, 12, S23. https://doi.org/10.1186/1471-2482-12-s1-s23
[20]
Kaufman, J.H. and Cannon-Smith, T. (2007) Improved Ejacultory Control and Sexual Satisfaction in Pilot Study of Men Taking Hypericum perforatum Extract. The Internet Journal of Nutrition and Wellness, 3, 1-6.
[21]
Richardson, D. and Goldmeier, D. (2005) Pharmacological Treatment for Premature Ejaculation. International Journal of STD & AIDS, 16, 709-711. https://doi.org/10.1258/095646205774357352
[22]
Arafa, M. and Shamloul, R. (2006) Efficacy of Sertraline Hydrochloride in Treatment of Premature Ejaculation: A Placebo-Controlled Study Using a Validated Questionnaire. International Journal of Impotence Research, 18, 534-538. https://doi.org/10.1038/sj.ijir.3901469
[23]
Thomas, C.A., Tyagi, S., Yoshimura, N., Chancellor, M.B. and Tyagi, P. (2007) Effect of Hyperforin-Enriched Extract on Pro-Ejaculatory Effect of 8-Hydroxy-2-(di-N-Propylamino) Tetralin in Anesthetized Rats. Urology, 70, 813-816. https://doi.org/10.1016/j.urology.2007.05.016
[24]
Woelk, H. (2000) Comparison of St John’s Wort and Imipramine for Treating Depression: Randomised Controlled Trial. British Medical Journal, 321, 536-539. https://doi.org/10.1136/bmj.321.7260.536
[25]
Di Carlo, G., Borrelli, F., Ernst, E. and Izzo, A.A. (2001) St John’s Wort: Prozac from the Plant Kingdom. Trends in Pharmacological Sciences, 22, 292-297. https://doi.org/10.1016/s0165-6147(00)01716-8
[26]
Kasper, S., Anghelescu, I., Szegedi, A., Dienel, A. and Kieser, M. (2006) Superior Efficacy of St John’s Wort Extract WS5570 Compared to Placebo in Patients with Major Depression: A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Trial [isrctn77277298]. BMC Medicine, 4, Article No. 14. https://doi.org/10.1186/1741-7015-4-14
[27]
Alzahrani, M.A., Ofisan, S.B., Alshumaymiri, N.I., Alghuwainem, M., Altamimi, M., Alali, A.Y., et al. (2023) Effect of St. John’s Wort (Hypericum perforatum L.) on Male Sexual and Reproductive Health: A Narrative Review. Biomedicines, 11, Article 2800. https://doi.org/10.3390/biomedicines11102800
[28]
Asgari, S.A., Falahatkar, S., Sharifi, S.H.H., Enshaei, A., Jalili, M.F. and Allahkhah, A. (2010) Safety and Efficacy of the Herbal Drug Hypericum perforatum for the Treatment of Premature Ejaculation. UroToday International Journal, 3. https://doi.org/10.3834/uij.1944-5784.2010.06.21
[29]
Korzeniowska, K., Malesza, K. and Pawlaczyk, M. (2019) The Phototoxic Properties of Hypericum perforatum—Case Report and Review of the Literature. FarmacjaWspółczesna, 12, 107-112.
[30]
Schulz, H., Schürer, M., Bässler, D. and Weiser, D. (2011) Investigation of the Effect on Photosensitivity Following Multiple Oral Dosing of Two Different Hypericum Extracts in Healthy Men. Arzneimittelforschung, 56, 212-221. https://doi.org/10.1055/s-0031-1296713
[31]
Borrelli, F. and Izzo, A.A. (2009) Herb-Drug Interactions with St John’s Wort (Hypericum perforatum): An Update on Clinical Observations. The AAPS Journal, 11, 710-727. https://doi.org/10.1208/s12248-009-9146-8
[32]
Deepthika, S.H.K. and Karunagoda, K.P.K.R. (2021) Effect of Mucuna Pruriens on Sperm Parameters with Idiopathic Infertility: A Systematic Review. International Ayurvedic Medical Journal, 5, 2802-2810. https://doi.org/10.46607/iamj06p5032021
[33]
Shukla, K.K., Mahdi, A.A., Ahmad, M.K., Shankhwar, S.N., Rajender, S. and Jaiswar, S.P. (2009) Mucuna Pruriens Improves Male Fertility by Its Action on the Hypothalamus-Pituitary-Gonadal Axis. Fertility and Sterility, 92, 1934-1940. https://doi.org/10.1016/j.fertnstert.2008.09.045
[34]
Ahmad, M.K., Mahdi, A.A., Shukla, K.K., Islam, N., Jaiswar, S.P. and Ahmad, S. (2008) Effect of Mucuna Pruriens on Semen Profile and Biochemical Parameters in Seminal Plasma of Infertile Men. Fertility and Sterility, 90, 627-635. https://doi.org/10.1016/j.fertnstert.2007.07.1314
[35]
Shukla, K.K., Mahdi, A.A., Ahmad, M.K., Jaiswar, S.P., Shankwar, S.N. and Tiwari, S.C. (2007) Mucuna pruriens Reduces Stress and Improves the Quality of Semen in Infertile Men. Evidence-Based Complementary and Alternative Medicine, 7, 137-144. https://doi.org/10.1093/ecam/nem171
[36]
Ayurvedic Pharmacopoeia Committee (2001) The Ayurvedic Pharmacopoeia of India. Government of India, Ministry of Health and Family Welfare. Department of AYUSH, 144-145.
[37]
Singh, G., Kumar, D. and Dash, A.K. (2021) Pinus Gerardiana Wallichex. D. Don. A Review. Phytomedicine Plus, 1, Article 100024. https://doi.org/10.1016/j.phyplu.2021.100024
[38]
Safari, S., Yousefi, M., Khawari, A., Sajjadi, M., Latif Nazari, M., Alipour, A., et al. (2017) Effect of Afghan Chehelghoza (Pinus gerardiana L.) on Sperm Parameters of Male Rats. Journal of Food and Nutritional Disorders, 6, Article 5. https://doi.org/10.4172/2324-9323.1000237
[39]
Mashhadi, Z.N., Irani, M., Mask, M.K. and Methie, C. (2021) A Systematic Review of Clinical Trials on Ginkgo (Ginkgo Biloba) Effectiveness on Sexual Function and Its Safety. AvicennaJournalofPhytomedicine, 11, Article 324.
[40]
Wu, Y., Li, S., Zu, X., Du, J. and Wang, F. (2008) Ginkgobiloba Extract Improves Coronary Artery Circulation in Patients with Coronary Artery Disease: Contribution of Plasma Nitric Oxide and Endothelin‐1. PhytotherapyResearch, 22, 734-739. https://doi.org/10.1002/ptr.2335
[41]
Lima, V.B.A., Almeida, J.M.D. and Monteforte, P.T. (2022) Estudo do efeito de extratos do Ginkgo biloba e da quercetina no ducto deferente de camundongo. Research, Society and Development, 11, e88111233441. https://doi.org/10.33448/rsd-v11i12.33441
[42]
Sohn, M. and Sikora, R. (1991) ginkgo Bilobaextract in the Therapy of Erectile Dysfunction. Journal of Sex Education and Therapy, 17, 53-61. https://doi.org/10.1080/01614576.1991.11074006
[43]
Cohen, A.J. and Bartlik, B. (1998) Ginkgo Biloba for Antidepressant-Induced Sexual Dysfunction. Journal of Sex & Marital Therapy, 24, 139-143. https://doi.org/10.1080/00926239808404927
[44]
Prasad, A.S., Mantzoros, C.S., Beck, F.W.J., Hess, J.W. and Brewer, G.J. (1996) Zinc Status and Serum Testosterone Levels of Healthy Adults. Nutrition, 12, 344-348. https://doi.org/10.1016/s0899-9007(96)80058-x
[45]
Nematollahi-Mahani, S.N., Azizollahi, G.H., Baneshi, M.R., Safari, Z. and Azizollahi, S. (2013) Effect of Folic Acid and Zinc Sulphate on Endocrine Parameters and Seminal Antioxidant Level after Varicocelectomy. Andrologia, 46, 240-245. https://doi.org/10.1111/and.12067
[46]
Mahajan, S.K., Abbasi, A.A., Prasad, A.S., Rabbani, P., Briggs, W.A. and Mcdonald, F.D. (1982) Effect of Oral Zinc Therapy on Gonadal Function in Hemodialysis Patients. Annals of Internal Medicine, 97, 357-361. https://doi.org/10.7326/0003-4819-97-3-357
[47]
Hunt, C., Johnson, P., Herbel, J. and Mullen, L. (1992) Effects of Dietary Zinc Depletion on Seminal Volume and Zinc Loss, Serum Testosterone Concentrations, and Sperm Morphology in Young Men. The American Journal of Clinical Nutrition, 56, 148-157. https://doi.org/10.1093/ajcn/56.1.148
[48]
Wu, X., Zhang, Y., Zhang, W., Liu, G., Jiang, H., Huang, H., et al. (2022) The Relationship between Serum 25-Hydroxy Vitamin D and Arteriogenic Erectile Dysfunction. Andrologia, 54, e14568. https://doi.org/10.1111/and.14568
[49]
Horsanalı, M.O., Eren, H., Dil, E., Caglayan, A., Erdogan, O. and Ekren, F. (2020) Novel Predictive Risk Factor of Erectile Dysfunction: Serum 25-Hydroxy Vitamin D. Andrologia, 52, e13767. https://doi.org/10.1111/and.13767
[50]
Demirci, A., Çakan, M. and Topçuoğlu, M. (2021) Whether Adding Vitamin D to Tadalafil 5 mg Treatment Is Useful in Patients with Erectile Dysfunction and Vitamin D Deficiency? Urologia Internationalis, 105, 514-519. https://doi.org/10.1159/000514056
[51]
Shah, G.R., Chaudhari, M.V., Patankar, S.B., Pensalwar, S.V., Sabale, V.P. and Sonawane, N.A. (2012) Evaluation of a Multi-Herb Supplement for Erectile Dysfunction: A Randomized Double-Blind, Placebo-Controlled Study. BMC Complementary and Alternative Medicine, 12, Article No. 155. https://doi.org/10.1186/1472-6882-12-155
