Traditional, Complementary and Alternative Medicines in the Treatment of Ejaculatory Disorders: A Systematic Review

Overview

Journal Medicina (Kaunas)

Publisher MDPI

Specialty General Medicine

Date 2023 Sep 28

PMID 37763726

Authors

Kristian Leisegang

Chinyerum Sylvia Opuwari

Faith Moichela

Renata Finelli

Affiliations

Soon will be listed here.

Abstract

: Ejaculatory dysfunction (EjD) is a common male sexual disorder that includes premature ejaculation, delayed ejaculation, retrograde ejaculation, and anejaculation. Although psychological and pharmacological treatments are available, traditional, complementary, and alternative medicine (TCAM) is reportedly used. However, the clinical evidence for TCAM in EjD remains unclear. Therefore, this study aims to systematically review human clinical trials investigating the use of TCAM to treat EjD. : A systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted by searching Scopus and PubMed databases. Controlled clinical trials investigating a cohort of male patients diagnosed primarily with EjD and undergoing any TCAM intervention compared to any comparison group were included. Quality of the studies was assessed using the Cochrane Risk of Bias tool for randomized controlled trials. : Following article screening, 22 articles were included. Of these, 21 investigated TCAM in premature ejaculation, and only 1 investigated TCAM in retrograde ejaculation. Different TCAM categories included studies that investigated lifestyle, exercise and/or physical activities (n = 7); herbal medicine supplements (n = 5); topical herbal applications (n = 4); acupuncture or electroacupuncture (n = 3); vitamin, mineral and/or nutraceutical supplements (n = 1); hyaluronic acid penile injection (n = 1); and music therapy (n = 1). Only 31.8% (n = 7) of the included studies were found to have a low risk of bias. The available studies were widely heterogenous in the TCAM intervention investigated and comparison groups used. However, the included studies generally showed improved outcomes intra-group and when compared to placebo. : Different TCAM interventions may have an important role particularly in the management of PE. However, more studies using standardized interventions are needed.

References

Sunay D, Sunay M, Aydogmus Y, Bagbanci S, Arslan H, Karabulut A . Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial. Eur Urol. 2011; 59(5):765-71. DOI: 10.1016/j.eururo.2011.01.019. View

Clarke T, Black L, Stussman B, Barnes P, Nahin R . Trends in the use of complementary health approaches among adults: United States, 2002-2012. Natl Health Stat Report. 2015; (79):1-16. PMC: 4573565. View

Sin V, Anand G, Koh H . Botanical Medicine and Natural Products Used for Erectile Dysfunction. Sex Med Rev. 2020; 9(4):568-592. DOI: 10.1016/j.sxmr.2020.10.005. View

Gray M, Zillioux J, Khourdaji I, Smith R . Contemporary management of ejaculatory dysfunction. Transl Androl Urol. 2018; 7(4):686-702. PMC: 6127532. DOI: 10.21037/tau.2018.06.20. View

Rodriguez J, Marzo J, Piqueras J . Efficacy of Sphincter Control Training (SCT) in the treatment of premature ejaculation, a new cognitive behavioral approach: A parallel-group randomized, controlled trial. PLoS One. 2019; 14(2):e0212274. PMC: 6391003. DOI: 10.1371/journal.pone.0212274. View

McMahon C, McMahon C, Leow L . New agents in the treatment of premature ejaculation. Neuropsychiatr Dis Treat. 2009; 2(4):489-503. PMC: 2671940. DOI: 10.2147/nedt.2006.2.4.489. View

Salonia A, Maga T, Colombo R, Scattoni V, Briganti A, Cestari A . A prospective study comparing paroxetine alone versus paroxetine plus sildenafil in patients with premature ejaculation. J Urol. 2002; 168(6):2486-9. DOI: 10.1016/S0022-5347(05)64174-2. View

Di Sante S, Mollaioli D, Gravina G, Ciocca G, Limoncin E, Carosa E . Epidemiology of delayed ejaculation. Transl Androl Urol. 2016; 5(4):541-8. PMC: 5002002. DOI: 10.21037/tau.2016.05.10. View

Arafa M, Shamloul R . Development and evaluation of the Arabic Index of Premature Ejaculation (AIPE). J Sex Med. 2007; 4(6):1750-6. DOI: 10.1111/j.1743-6109.2006.00213.x. View

10.

Jannini E, Lenzi A . Ejaculatory disorders: epidemiology and current approaches to definition, classification and subtyping. World J Urol. 2005; 23(2):68-75. DOI: 10.1007/s00345-004-0486-9. View

11.

Pastore A, Palleschi G, Leto A, Pacini L, Iori F, Leonardo C . A prospective randomized study to compare pelvic floor rehabilitation and dapoxetine for treatment of lifelong premature ejaculation. Int J Androl. 2012; 35(4):528-33. DOI: 10.1111/j.1365-2605.2011.01243.x. View

12.

Yin T, Yang J, Zhang B, Yan W, Xu W, Li W . Folic acid supplementation as adjunctive treatment premature ejaculation. Med Hypotheses. 2010; 76(3):414-6. DOI: 10.1016/j.mehy.2010.11.006. View

13.

Kim J, Kwak T, Jeon B, Cheon J, Moon D . Effects of glans penis augmentation using hyaluronic acid gel for premature ejaculation. Int J Impot Res. 2004; 16(6):547-51. DOI: 10.1038/sj.ijir.3901226. View

14.

Calderon-Ospina C, Nava-Mesa M . B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin. CNS Neurosci Ther. 2019; 26(1):5-13. PMC: 6930825. DOI: 10.1111/cns.13207. View

15.

Micoogullari U, Kisa E, Celik O, Erbay O, Koc E, Gok B . New behavior therapy in the treatment of acquired premature ejaculation: A comparative study of listening to music. Arch Esp Urol. 2021; 74(5):519-525. View

16.

Ng J, Dhawan T, Dogadova E, Taghi-Zada Z, Vacca A, Wieland L . Operational definition of complementary, alternative, and integrative medicine derived from a systematic search. BMC Complement Med Ther. 2022; 22(1):104. PMC: 9006507. DOI: 10.1186/s12906-022-03556-7. View

17.

Sansalone S, Leonardi R, Antonini G, Vitarelli A, Vespasiani G, Basic D . Alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide improve erectile function, sexual quality of life, and ejaculation function in patients with moderate mild-moderate erectile dysfunction: a prospective, randomized,.... Biomed Res Int. 2014; 2014:121396. PMC: 4127274. DOI: 10.1155/2014/121396. View

18.

Ng Q, Venkatanarayanan N, Ho C . Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis. J Affect Disord. 2017; 210:211-221. DOI: 10.1016/j.jad.2016.12.048. View

19.

Parnham A, Serefoglu E . Retrograde ejaculation, painful ejaculation and hematospermia. Transl Androl Urol. 2016; 5(4):592-601. PMC: 5002007. DOI: 10.21037/tau.2016.06.05. View

20.

Optale G, Burigat S, Chittaro L, Riva G . Smartphone-Based Therapeutic Exercises for Men Affected by Premature Ejaculation: A Pilot Study. Sex Med. 2020; 8(3):461-471. PMC: 7471091. DOI: 10.1016/j.esxm.2020.05.003. View