Male sexual dysfunction: A review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention

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Male sexual dysfunction: A review of literature on its pathological mechanisms, potential risk factors, and herbal drug intervention

Lei Chena , Guang-rui Shib, Dan-dan Huangc , Yang Lid , Chen-chao Mae , Min Shia , Bin-xiao Suf, Guang-jiang Shig




ABSTRACT
Sexual dysfunction (SD) is a disorder of sexual behavior and sexual sensation that appears as an abnormality or absence of sexual psychology and physiological reaction. It is a general term for many different symptoms includes several aspects, erectile dysfunction (ED), failure of sexual intercourse and loss of libido/desire. According to statistics, 52% of 40-70 year old men suffer from varying degrees of SD. And these diseases caused by a variety of biological and psychological factors. In world about 15% of couples are affected by sexual disharmony among these 40 to 50% are because of male factors. Considering the sensitivity of male reproduction system, it is being easily affected by multiple risk factors, such as chronic diseases, environmental contaminants, drug toxicity and unhealthy lifestyle and so on. In the last few years, significant progress have been made toward understanding the various forms of male SD and the possible potential pathological mechanisms. However, for the time being, the exact cause of SD is not fully understood from the literature. What is also significant about there are quite limited treatments in reproductive medicine being directed against these lesions. The purpose of this review is to summarize the current findings of pathogenic factors of SD in clinical or animal studies, to elaborate the underlying mechanisms of these diseases from studies in vivo and in vitro, to analyses the risk factors, and to describe the management strategies traditionally recommended of male sexual dysfunction. The review findings elucidate a systematic strategies for effectively preventing these diseases.




5. Future directions

Issues in sexual desire and activity are widespread, regardless of economic status, gender, and age. The prevalence of ED and other SDs considerably increases because of the rapidly aging population. SD may cause serious distress for patients and requires attention and care. Our understanding of the pathophysiology of ED and SD has been driven by the effectiveness of therapies that affect one or more of the pathophysiological pathways. However, whether PDE-5 inhibitors benefit millions of men with ED remains unclear. As we further investigate the central and peripheral effects of hormones on the sexual response cycle, our understanding of hormonal and dopamine-oxytocin-nitric oxide pathways related to sexual function also improves [25] as seen in Fig. 4. Thus far, besides sildenafil and its related drugs, no other medicine exerts ideal therapeutic effects. Hence, the mechanisms discussed above are not the sole factor affecting SD. Thus, future works must focus on specific molecular targets of male SD that may affect spermatogenesis, testicular cell differentiation, sex maturation, and sperm production. Ongoing research on the alternative pathways of enhancing male sexual responses, including centrally acting agents, could contribute to achieve further breakthrough in treatment barriers.
 

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