C borivilianum (family Liliaceae) is native to India. Analysis of C borivilianum root revealed a composition of 12% to 17% saponins, 1.9% to 3.5% stigmasterol, 0.79% arabinose, 3.8% galactose, 0.73% glucose and 0.78% rhamnose [31]. For dried root powder, the recommended dose is 5 g and the extract dose is 500 mg. It is used as an aphrodisiac and to cure ED, improve semen quality and volume. It eliminates premature ejaculation, improves general well-being and vitality, and increases stamina and libido. Visavadiya and Narasimhacharya [31] have demonstrated that administration of C borivilianum (0.75 g and 1.5 g root powder per rat per day for four weeks) to hypercholesteremic rats significantly increased highdensity lipoprotein cholesterol levels and decreased plasma and hepatic lipid profiles. Furthermore, the treatments also resulted in increased excretion of fecal cholesterol, sterols and bile and increased superoxide dismutase levels. Kenjale et al [32] evaluated the aphrodisiac and spermatogenic potential of the aqueous extract of dried roots of C borivilianum in rats. C borivilianum was given orally at doses of 125 mg/kg/day and 250 mg/kg/day. Viagra 4 mg/kg/day (sildenafil citrate) was administered as a control. Sexual behaviour was monitored 3 h later using a receptive female. Their sexual behaviour was monitored on days 1, 7, 14, 21 and 28 of treatment by pairing with proestrous female rats. For sperm count, the treatment was continued further in all groups except for the Viagra group for 60 days. At 125 mg/kg, C borivilianum had marked aphrodisiac action, as demonstrated by increased libido, sexual vigour and sexual arousal in the rats. Similarly, at the higher dose (250 mg/kg), all the parameters of sexual behaviour were enhanced, but showed saturation effect after 14 days. On day 60, the sperm count increased significantly in both the C borivilianum-treated groups (125 mg/kg/day and 250 mg/kg/day) in a dose-dependent manner. The administration of C borivilianum extract has been found to be useful for the treatment of premature ejaculation and oligospermia [32]. Supplementation with C borivilianum root 250 mg/kg/day and 500 mg/kg/day to streptozoticin-induced diabetic male rats for 28 consecutive days improved sperm morphology, and reduced oxidative stress and formation of free radicals [33]. In case of streptozotocin- and alloxan-induced hyperglycemia, the aqueus extracts from C borivilianum resulted in improved sexual performance compared with diabetic control [34,35].
W somnifera (ashwagandha), also referred to as winter cherry (family Solanaceae), grows in Africa, the Mediterranean, India, Pakistan, Bangladesh, Afghanistan, South Africa, Egypt, Morocco, Congo and Jordan [36]. The roots of the plant contain steroid alkaloids and steroidal lactone, which are the main constituents of ashwagandha; these compounds are referred to as withanolides. Among the various alkaloids, withnine is the main constituent. The other alkaloids are somniferin, somnine, somniferine, withananine, pseudowithanine, tropine, pseudotropine, cuscohygrine, anferine and anhydrine. Two acyl steryl glucosides (sitoindoside VII and sitoindoside VIII) have been isolated from the root. The withanolides contain a C28 steroidal nucleus with a C9 side chain and six-membered lactone rings. Ashwagandha root also contains flavonoids and many ingredients of the withanolide class. It has several medicinal applications (aphrodisiac, liver tonic, anti-inflammatory agent, astringent), and is used to treat bronchitis, asthma, ulcers, insomnia, senility and dementia. Clinical trials and studies involving animal models support the use of ashwagandha for anxiety, cognitive and neurological disorders, inflammation and Parkinson’s disease. It also provides cryoprotective benefits to patients undergoing radiation and chemotherapy, and shows beneficial effects for nervous exhaustion. W somnifera is used as an aphrodisiac, sedative and rejuvenative, and is also used to treat chronic fatigue, dehydration, bone weakness, muscle weakness, loose teeth, impotency, premature ejaculation, debility, constipation, senility, rheumatism, nervous exhaustion, memory loss, drug withdrawal symptoms, anxiety and arthritis pain in the knee. Extracts from W somnifera inhibit transcription factor nuclear factor kappa B (NF-κB); thus, it acts as an anti-inflammatory agent. This has been attributed to its ability to interact with IKKB, a kinase that is responsible for the nuclear translocation of NF-κB and activation of inflammatory signalling pathways [37].
The estimated range of men worldwide suffering from ED is from 15 million to 30 million23. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. This is in USA, where statistics are clearly compiled, the level of awareness and education is high as compared to sub Saharan countries like Uganda. This is a clear indication that there are many silent men, particularly couples affected by ED.
C borivilianum (family Liliaceae) is native to India. Analysis of C borivilianum root revealed a composition of 12% to 17% saponins, 1.9% to 3.5% stigmasterol, 0.79% arabinose, 3.8% galactose, 0.73% glucose and 0.78% rhamnose [31]. For dried root powder, the recommended dose is 5 g and the extract dose is 500 mg. It is used as an aphrodisiac and to cure ED, improve semen quality and volume. It eliminates premature ejaculation, improves general well-being and vitality, and increases stamina and libido. Visavadiya and Narasimhacharya [31] have demonstrated that administration of C borivilianum (0.75 g and 1.5 g root powder per rat per day for four weeks) to hypercholesteremic rats significantly increased highdensity lipoprotein cholesterol levels and decreased plasma and hepatic lipid profiles. Furthermore, the treatments also resulted in increased excretion of fecal cholesterol, sterols and bile and increased superoxide dismutase levels. Kenjale et al [32] evaluated the aphrodisiac and spermatogenic potential of the aqueous extract of dried roots of C borivilianum in rats. C borivilianum was given orally at doses of 125 mg/kg/day and 250 mg/kg/day. Viagra 4 mg/kg/day (sildenafil citrate) was administered as a control. Sexual behaviour was monitored 3 h later using a receptive female. Their sexual behaviour was monitored on days 1, 7, 14, 21 and 28 of treatment by pairing with proestrous female rats. For sperm count, the treatment was continued further in all groups except for the Viagra group for 60 days. At 125 mg/kg, C borivilianum had marked aphrodisiac action, as demonstrated by increased libido, sexual vigour and sexual arousal in the rats. Similarly, at the higher dose (250 mg/kg), all the parameters of sexual behaviour were enhanced, but showed saturation effect after 14 days. On day 60, the sperm count increased significantly in both the C borivilianum-treated groups (125 mg/kg/day and 250 mg/kg/day) in a dose-dependent manner. The administration of C borivilianum extract has been found to be useful for the treatment of premature ejaculation and oligospermia [32]. Supplementation with C borivilianum root 250 mg/kg/day and 500 mg/kg/day to streptozoticin-induced diabetic male rats for 28 consecutive days improved sperm morphology, and reduced oxidative stress and formation of free radicals [33]. In case of streptozotocin- and alloxan-induced hyperglycemia, the aqueus extracts from C borivilianum resulted in improved sexual performance compared with diabetic control [34,35].
Six herbs for treating erectile dysfunction Erectile dysfunction can be an embarrassing condition that can leave men unable to achieve an erection or a full orgasm. This MNT Knowledge Center article talks about six different herbal supplements that could help people with erectile dysfunction, including ginkgo biloba, horny goat weed, and red ginseng. Read now
Men can judge themselves pretty harshly when it comes to their performance in between the sheets. The unsettling fear of not being able to rise to the occasion becomes a reccurring nightmare for men that is often equated with failure, loss of dignity, and masculinity. If you suffer from erectile dysfunction (ED), don’t be so hard on yourself, since impotence can almost always be improved with treatment, without having to rely on Viagra or other medications. Whether you suffer from ED, or hope to prevent the condition, here are six tips to overcome impotence without the side effects of the little blue pill.

The Science: Male rats with damaged penile nerves had better erectile responses after they were given large doses of purified icariin, but as of yet no one has done the experiments to see whether the compound works in humans. Still, as far as the herb goes, it doesn’t really matter: horny goat weed doesn’t contain enough icariin to get even the smallest rise out of a rat.
Much of the evidence shows high rates of vitamin D deficiency in patients with erectile dysfunction. In fact, one study of 3,400 participants found that men with vitamin D deficiency were 32% more likely to have trouble with erections when all other risk factors were controlled for. It’s a little on the nose that you need vitamin D for your “D,” but hey—science can be funny too.
The key respondents were mainly old men, male traditional healers, traditional birth attendants and young women and all in total about 160 traditional healers were interviewed. To document male related ailments men are particularly more knowledgeable and most men share their problems with men. In addition, the old men and healers are the ones in charge of administering these herbal remedies. Young women through the informal discussions, interviews and market surveys are particularly more dynamic in the use of herbs for themselves, husbands and children besides being the most active reproductive age group. The medical ethnobotanical data collected has been analysed, medicinal plants from the study areas have been listed and methods of administering the herbal drugs were also documented. In checking for the proper updated naming, spellings and authors of the medicinal plants, besides using voucher specimens in Makerere University Herbarium, several reference books were used1,3,9,15,16,20,22,27.
Catuaba (Erythroxylum catuaba): in Brazil, Catuaba Extract is considered to be a central nervous system stimulant (5), without the side effects of caffeine. This is used in some Asian remedies for sexual weakness and lowered libido. European herbalists have found that Catuaba may have aphrodisiac properties and can be used to combat sexual weakness.
Ginseng is generally indicated for daily, consistent use in moderate doses. Do not use ginseng as a short-term stimulant. Ginseng and other adaptogens work best after long-term (one–three months) use by regulating hormone levels and other biological functions to protect us against the damaging effects of chronic stress,” says herbalist Christopher Hobbs, author of The Ginsengs. A typical dose is 4,000–6,000 mg per day.
Ginkgo biloba. Known primarily as a treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."
In modern medication of erectile dysfunction, the oral prescription medication of popular Viagra (Sildenafil) is effective, but in some men it is not compatible and Sildenafil works in less than 70% of men with various etiologies and has certain side effects23. The availability of Viagra has brought millions of couples to ED treatment. Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage34. Other drugs such as Yohimbine, papaverine hydrochloride [used under careful medical supervision]5, phentolamine, and alprostadil (marketed as Caverject) widen blood vessels. However, this available modern medication for the ED in men is very expensive for most of the rural people in Ugandan and other developing countries. Yet, in traditional medicine, there are several medicinal plants that have been relied on for use in the treatment of ED. This ethnobotanical indigenous knowledge has not been earlier documented and scientifically validated for efficacy and safety, future drug discovery and development.
Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
Counselling or sex therapy (58% of people find this works for them) –mind-related causes of erectile dysfunction can affect anyone. They are more likely if you experience erectile dysfunction at a younger age. Talking to a counsellor or therapist can help some people overcome erectile dysfunction related to these problems, possibly for good. They can also help you if your erectile dysfunction is causing you stress, as this can make matters worse.

Red Ginseng — One small randomized trial found evidence that red ginseng may offer modest improvements in ED symptoms (as compared with placebo). A meta-anaylsis published in the British Journal of Clinical Pharmacology states, “Traditionally red ginseng has been used to restore and enhance normal well-being, and is often referred to as an adaptogenic….Possible mechanisms of action of red ginseng include hormonal effects similar to those of testosterone. Others have postulated that red ginseng might induce relaxation of the smooth muscles.”  (5)

Counselling or sex therapy (58% of people find this works for them) –mind-related causes of erectile dysfunction can affect anyone. They are more likely if you experience erectile dysfunction at a younger age. Talking to a counsellor or therapist can help some people overcome erectile dysfunction related to these problems, possibly for good. They can also help you if your erectile dysfunction is causing you stress, as this can make matters worse.

Ginkgo biloba. Ginkgo is an herb that is used in Chinese medicine that’s thought to improve blood flow. "Any ED treatment that improves blood flow may help," explains Dr. Harris. "An erection is just blood in and blood out." However, the evidence that ginkgo can improve blood flow in ED is limited, and most experts say the jury is still out. In addition, ginkgo can increase the risk for bleeding problems if combined with certain medications, such as warfarin (Coumadin).


In the East, many herbal tonics and preparations are used to assist the aging male improve his ability to have sexual drive or perform penetrative sex by increasing sexual stimulation, erectile, ejaculatory, orgasmic and other responses for sexual function and satisfaction. Currently available herbals, tonics and therapies range from Tongkat Ali, Ginseng, Tribulus etc. Those that act as testosterone releasers have some value especially if the male has andropause and those containing some pick-me-ups II and energizers like ginseng help the tired and fatigued male and possibly those with asthenia. Deer horn contains growth factors and taking these may help improve nocturnal erections in the male with somatopause. Popular in historic Singapore were remedies such as “Penis Soup II” (Figure 2) and Snake Meat, whilst Surabaya was known for Cobra meat (Figure 3) and Cobra Blood which had claims of improving erectogenic prowess-these myths including that of taking dog, cow, wild boar, bull and ostrich testicles (Figures 10,​,11)11) are mainly Village doctor remedies still being practiced widely in the developing regions of Asia. In China, the horny goat weed (Figure 9) is currently still popular and may have some scientific merit (11) for enhancing sexual drive.

3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 
Although there are few men who are born absolutely impotent, the number of men with erectile problems are many especially those tending to 50 years and above. Pfizer28 reported that about 40% of men above years, 50% of men above 50 years, 60% of men above 60 years and in any population are affected by ED. ED has profound effect on psychological well being, it can be devastating, it can lead to low self-esteem, depression, negative effect on relationships and reduced life satisfaction28. Among several other causes, aging is one of the factors leading to ED. There are some other social causes of ED such as high unemployment rates, and diseases like diabetes, hypertension, HIV/AIDS, high cholesterol levels, stress, smoking and obesity28. ED is slowly creating adverse problems in homes in Uganda and particularly, among the mid-aged and old men. The men with sexual impotence and erectile dysfunction deserve proper diagnosis of the conditions and treatment. Thus, the plant remedies described may be healthy if administered
Men can judge themselves pretty harshly when it comes to their performance in between the sheets. The unsettling fear of not being able to rise to the occasion becomes a reccurring nightmare for men that is often equated with failure, loss of dignity, and masculinity. If you suffer from erectile dysfunction (ED), don’t be so hard on yourself, since impotence can almost always be improved with treatment, without having to rely on Viagra or other medications. Whether you suffer from ED, or hope to prevent the condition, here are six tips to overcome impotence without the side effects of the little blue pill.

Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.
According to Uganda's health policy priorities8,25, men's reproductive health is not given any mention. The national health policy focuses on services like family planning, diseases control like STI/HIV/AIDS, malaria, perinatal and maternal conditions, tuberculosis, diarrhoeal diseases and acute lower respiratory tract infections that are given priority8,25. The sexual and reproductive health rights in Uganda focus on maternal and child mortality, family planning and the like exclusive of men's sexual needs and rights8.
If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own. This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms. With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED. These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels.
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