**4. Management and treatments of erectile dysfunction**

Erectile dysfunction is a defect of penis reaching and or sustaining erection because of physiological or psychological factors [2]. Different treatments have been proposed including: **•** Psychological/behavioural therapy with a trained counsellor aimed at helping people to address feelings of anxiety, fear and guilt that may have an impact on sexual function;

be remembered that most of the pharmacological options for ED treatment do not influence

Potentials of Phytotherapeutic Treatment of Erectile Dysfunction

http://dx.doi.org/10.5772/57174

287

Testosterone therapy has been shown to normalize serum testosterone levels in patients with hypogonadism. Testosterone therapy was aimed at maintaining or restoring libido and erectile function; improving or maintaining virilization, muscle mass, strength, and bone density; and to alleviate other symptoms related to hypogonadism. There is some evidence that the addition of type 5 phosphodiesterase inhibitor can potentiate the effects of testosterone replacement in some hypogonadal men [8]. If this is unsuccessful, one should consider other treatments for ED. Because there are a wide range of pharmacotherapy options available, it would be desirable, in many instances, to offer patients an alternative to current pharmacotherapy.

A wide variety of human disorders is currently being treated with the use of plant materials due to their decreased toxicity levels, cost-effectiveness as well as minimized side effects in

Plants and herbs are persistently being studied for the identification of novel therapeutic agents. Among the 250,000 higher plant species on earth, more than 80,000 plants have medicinal values [62]. Herbal medicine is still the mainstay of about 75-80% of the global population, mainly in developing countries, for primary health care because of better cultural acceptability, better compatibility with the human body and lesser side effects. The chemical constituents presenting the herbal medicine or plant are a part of the physiological functions of living flora and hence they are believed to have better compatibility with human body [64]. A traditional system of Indian medicine called Ayurveda deals with the sexual dysfunctions in a special category of treatment under the name "*Vajikarna*" or virilification. The system includes the use of aphrodisiacs for erectile dysfunction, spermatogenesis, semenogenesis, and methods of improving defective semen, causes of infertility, reproduction and sexual satis‐

About 317 phytochemicals are listed for antioxidant potential; 340 plants as aphrodisiac and antioxidants and 40 plants are listed for adaptogenic nature. Ethnobotanical plants contain

Natural antioxidants are located in different parts of a plant such as wood, bark, stems, pods, leaves, fruit, roots, flowers, pollen, and seeds [67]. Natural products, mainly phytomedicine, or diet ingested by human, are antioxidants capable of terminating the free radical chain

Antioxidant properties in plants are due to the presence of cinnamic acids, coumarins, diterpenes, flavonoids, lignans, monoterpenes, phenylpropanoids, tannins and triterpenes [69]. Phytochemicals like carotenoids, tocopherols, ascorbates and phenols presentin plants are considered strong natural antioxidants and have an important role in health care system. Phenols, a major group with antioxidant properties, comprise subclasses suchphenolic acid, flavonoid, biflavonoid, anthocyanin andisoflavonoid [70]. Adaptogens found in plants modulate response to stress (physical, environmental, or emotional) and help regulate the

the progress of the underlying pathophysiology and do not cure the disease [55].

**4.3. Effects of phytomedicinal plants on erectile dysfunction**

antioxidant, aphrodisiac and adaptogenic properties [66].

faction [65].

reactions [68].

order to avoid drug resistance caused by pharmacological agents 61- 63].

