IRANIAN MEDICINAL PLANTS EFFECTIVE ON SEXUAL DISORDERS: A SYSTEMATIC REVIEW

IRANIAN MEDICINAL PLANTS EFFECTIVE ON SEXUAL DISORDERS: A SYSTEMATIC REVIEW

Kamal Solati ¹, Saeid Heidari-Soureshjani ², Tahra Luther ³ and Majid Asadi-Samani^{* 4}

Medical Plants Research Center ¹, Cellular and Molecular Research Center ², Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Department of General Surgery ³, University of Michigan, Ann Arbor, MI, USA.

Students Research Committee ⁴, Shahrekord University of Medical Sciences, Shahrekord, Iran.

ABSTRACT: Medicinal plants used in traditional medicine and various cultures can be valuable resources for discovering new drugs. This review was conducted to report Iranian medicinal plants effective on sexual dysfunction (sexual desire disorders, erectile dysfunction, and premature ejaculation). To conduct this systematic review, the search terms Sexual*, Aphrodisiacs, Erectile, and Libido* combined with Medicinal plants, Herb*, and Phyto* were used to retrieve relevant publications from the databases International Scientific Institute, PubMed, Scopus, and EBSCO. Tribulus terrestris, Rosa damascena, Crocus sativus L., rosmarinic acid, and crocin are a number of medicinal plants and their derivatives that have libido-boosting properties. C. sativus, Zingiber officinale, and Peganum harmala are some of the plants that exert therapeutic effects on erectile dysfunction. Boswellia serrata and Lavandula angustifolia are two plants used to treat premature ejaculation. Medicinal plants that are used to treat sexual dysfunctions in Iran can help to improve sexual desire disorders, erectile dysfunction, and premature ejaculation through certain mechanisms such as affecting the cerebral neurotransmitters and sex cells, increasing physical strength, causing hormonal changes, and affecting neurons and certain parts of the brain. They can be used to discover and produce new effective drugs for sexual dysfunction.

Medicinal Plant, Sexual desire disorders, Erectile dysfunction, Premature ejaculation, Sexual dysfunction

INTRODUCTION: Satisfying sexual experiences are addressed as an aspect of sexual health and well-being in the health care arena ¹, and being satisfied with fruitful sex is considered an integral part of people's quality of life ². Satisfying sex has positive effects on and strengthens couple's relationships and has pleasant effects on many of the aspects of marital life ^3-6.

Several factors are effective on sexual behavior and sexual desire including sexual desire, the aspects of social and emotional relationships (intimacy and strong relationships among family members), sexual attitudes and values, physical health, mental health and depression, environmental barriers, the frequency of sexual intercourse, difference in sexual behaviors, orgasm, and age ^{1, 7-11}.

However, sexual dysfunctions remain undetected despites their high prevalence and need appropriate therapeutic strategies ^{12, 13}. In addition to psychotherapies and pharmacotherapies, several treatments are used for sexual dysfunctions among which plant-based therapies and use of sex drive-boosting foods contribute importantly to treating these disorders ¹⁴, and have attracted people's attention due to their effective role in treating impotence ^{15, 16}. It can be argued that the phytochemicals present in such plants can be effective in increasing sexual potency via affecting gonads, endocrine system, and the brain ¹⁷. However, the use of nature-based treatments to treat sexual dysfunctions such as hypoactive sexual desire disorder (HSDD) remains controversial ¹⁸. Besides that, certain plant-based products and foods can be effective in decreasing sexual desire and treating sexual dysfunctions yet cause certain side effects such as decline in fertility ^{19, 20} that should be taken into consideration in treating these disorders. Because of being lower cost and causing fewer side effects compared to chemical drugs, medicinal plants are being increasingly welcome and used to treat different diseases in Iran ^21-30. Therefore, regarding the significance of this issue, the current systematic review was conducted to report Iranian medicinal plants effective on changes in libido, erectile dysfunction, and premature ejaculation.

To conduct this systematic review, the search terms Sexual, Aphrodisiacs, and Erectile combined with Medicinal plants, Herb, and Phyto were used to retrieve relevant publications from the databases International Scientific Institute, PubMed, and EBSCO. Besides that, the relevant publications indexed in Scopus were independently searched. Overall, 192 articles were retrieved of which 63 were indexed in more than one database. The abstracts of 129 articles were carefully studied by two of the researchers and only those articles that reported studies mainly investigating Iranian medicinal plants effective on sex disorders were included in this study. The full texts of eligible articles were analyzed and the data needed to conduct this study drawn from them.

Several studies were conducted to investigate the potential effects of medicinal plants to boost libido and treat erectile dysfunction and premature ejaculation using laboratory methods or clinical trials.

Libido-enhancing medicinal plants:

Tribulus terrestris: T. terrestris is a tropical plant that occurs in some regions of Iran. A clinical trial on women with HSDD demonstrated that the use of T. terrestris extract for four weeks boosted the women's sexual desire ³¹.

Rosa damascene: R. damascena has many uses in Iranian traditional medicine, and its extract is widely uses in cosmetics industry. Patients with depression are likely to develop certain complications such as decreased sexual desire due to taking selective serotonin-reuptake inhibitors (SSRIs). A study investigated the effect of adjuvant R. damascena on this complication, and demonstrated that after 4-week treatment, sexual desire, orgasm, and sexual satisfaction improved in women ³².

Crocus sativus Linn.: The sexual desire-boosting effects of C. sativus have been confirmed in human and animal studies. Study of this plant's effect on fluoxetine-induced sexual impairment in depressed men demonstrated that C. sativus was significantly effective on different sexual parameters including sexual desire ³³.

Libido-boosting plant-based compounds:

Rosmarinic acid: Rosmarinic acid is one of the derivatives of rosemary whose effects on the sexual behaviors of male and female diabetic rats were investigated. Rosmarinic acid, as a libido-boosting agent, was found to improve sexual desire and behavior in these animals ³⁴.

Crocin: Farzadi et al., isolated safranal and crocin, two derivatives of C. sativus, from this plant and investigated their effects on laboratory mice's sexual behaviors. They found that safranal did not have any effects on studied sexual behavior items, but crocin boosted libido in the studied mice ³⁵.

Medicinal plants effective on erectile dysfunction:

C. sativus: C. sativus extract effect was investigated on fluoxetine-induced sexual impairment in depressed men under treatment with fluoxetine. That study demonstrated that use of 15 mg C. sativus twice a day caused improvement of erectile dysfunction in these men ³³. In patients with diabetes, the local application of C. sativus gel leads to treatment of erectile dysfunction ³⁶. A study reported that treatment with 200 mg of C. sativus a day improved tip rigidity and tip tumescence as well as base rigidity and base tumescence in studied people ³⁷.

Zingiber officinalis: Z. officialis is a plant that was initially imported to Iran yet has certain uses in Iranian traditional medicine and food industries. The extract of Z. officialis root can improve erectile dysfunction in studied samples through specifying human platelet cAMP and cyclic guanosine monophosphate phosphodiesterase (cGMP) inhibitory activity ³⁸.

Peganum harmala: P. harmala is a plant that mostly occurs in tropical regions. A study demonstrated that P. harmala extract displayed a more potent cGNIP-PDEI activity than sildenafil and therefore treated erectile dysfunction ³⁸.

Medicinal plants effective on premature ejaculation: A study examined the effect of a combination of Boswellia serrata and Lavandula angustifolia on apomorphine-induced ejaculation in male mice. After treatment with 50 and 100 mg/kg of this combination, the sperm rate decreased. This combination, therefore, can be used to treat premature ejaculation ³⁹.

Implications and mechanisms: Sex disorders are inextricably intertwined with various environmental, psychological, and biological factors. Therefore, there are controversies about the use of medicinal plants and nature-based compounds to treat some types of these disorders ¹⁸. For example, sexual arousal is dependent on several factors including endocrine (androgen), genetic, neurological (such as cerebral neurotransmitters), and psychological; therefore, plants can help to improve HSDD in both men and women by affecting some of these factors ^{17, 32, 40}. Medicinal plants with antioxidant compounds neutralize oxidants in the brain and genital tract and protect the cells of these organs against the adverse effects of the antioxidants ^{41, 42}. As a result, with promotion of health of these organs and other cells of the body, general health is maintained and subsequently sexual health is promoted.

In addition, compounds present in medicinal plants help to treat erectile dysfunction in men via affecting nitric oxide levels and opioid system ^{43, 44}. The axons of the parasympathetic nerves release nitric oxide in sexual arousal. This gas is released in the smooth muscle cells of corpus carvenosum, which leads ultimately to the formation of cGMP in this area. Then, cGMP causes dilation and blood flow in the penis ^{37, 45, 46}. However, many questions about how drugs, especially herbal drugs, affect premature ejaculation remain unanswered. Meanwhile, studies indicated that the relief of mental problems and the prevention of serotonin reuptake such as the SSRIs with sedative properties can help to treat this disorder ^{39, 47-50}. Overall, medicinal plants are effective on sexual dysfunction via several mechanisms of action (Fig. 1).

FIG. 1: THE MECHANISMS OF THE ACTIONS OF MEDICINAL PLANTS ON SEX DISORDERS

According to biochemical investigations, the active ingredients of plants and nature-based compounds can modulate the levels of androgens, gonadotropins, and prolactin to a small extent ⁵¹. Besides that, there is a common false belief that the use of most medicinal plants is useful to further boost sexual desire or treat sex disorders, and causes no side effects because such products are nature-based. Such misconceptions increase the likelihood of developing side effects and overdose due to taking certain plant-based compounds. These side effects are life-threatening in some cases and can even cause psychologically adverse effects ⁵². In addition to the above mentioned plants, some other plants such as Pistacia species ⁵³ and Nigella sativa ⁵⁴ are used to treat sex disorders in Iranian traditional medicine. However, C. sativus and its derivatives are attracting much attention because of their refreshing property, in addition to being useful to treat sex disorders ^{41, 55-58}.

However, some studies have reported inconsistent findings about the effects of medicinal plants on sex disorders. For example, Safarnejad et al., reported that the use of 30 mg of C. sativus twice a day for four weeks could not improve erectile dysfunction in studied men ⁵⁹. A study indicated that there was no significant difference in premature ejaculation between case group treated with a combination herbal drug vigRX and control group ⁶⁰.

It can be argued that in some cases, organs' dysfunction or psychiatric disorders are the main causes of sex disorders and medicinal plants cannot treat them. In such cases, therefore, certain therapies such as surgery, chemical pharmacotherapy, and psychiatric treatments can be useful ^{61, 62}. It is obvious that medicinal herbs and their products via antioxidant activities and anti inflammatory properties can be benefit for improvement a lot of diseases ^63-75.

CONCLUSION: In Iranian traditional medicine, several medicinal plants are used to treat some sex disorders such as HSDD, erectile dysfunction, and premature ejaculation. Although information about how it is that medicinal plants do affect these disorders is inadequate and ambiguous aspects of their effects have not yet been satisfactorily investigated, the medicinal plants and their derivatives can help to improve these disorders in human through several mechanisms such as affecting the cerebral neurotransmitters and sex cells, increasing physical strength, causing hormonal changes, and affecting neurons and certain parts of the brain.

However, it should be constantly taken into account that associated and underlying factors for sex disorders play important role in developing such disorders, and therefore therapeutic strategies should incorporate physical, psychological, and social aspects.

ACKNOWLEDGMENTS: The authors would like to acknowledge Research and Technology Deputy of Shahrekord University of Medical Sciences for supporting this study.

CONFLICT OF INTEREST: The authors declared no competing interests.

REFERENCES:

1. Higgins JA, Mullinax M, Trussell J, Davidson JK, Moore NB. Sexual Satisfaction and Sexual Health among University Students in the United States. Am J Public Health 2011; 101(9):1643-54.
2. Chan JL, Letourneau J, Salem W, Cil AP, Chan SW, Chen LM, et al. Sexual satisfaction and quality of life in survivors of localized cervical and ovarian cancers following fertility-sparing surgery. Gynecol Oncol 2015; 139(1):141-7.
3. Neto F. The satisfaction with sex life scale. Meas Eval Couns Dev 2012; 45(1):18-31.
4. Hatfield E. The Handbook of Sexuality in Close Relationships. Arch Sex Behav 2006; 35(6):759-60.
5. Davison SL, Bell RJ, La China M, Holden SL, Davis SR. Original Research-Psychology: The Relationship between Self‐Reported Sexual Satisfaction and General Well‐Being in Women. J Sex Med 2009; 6(10):2690-7.
6. Solati K, Ja’Farzadeh L, Hasanpour-Dehkordi A. The effect of stress management based on group cognitive-behavioural therapy on marital satisfaction in infertile women. J Clin Diagn Res 2016; 10(7).:VC01-VC03. doi:10.7860/JCDR/2016/17836.8077.
7. Carpenter LM, Nathanson CA, Kim YJ. Physical women, emotional men: Gender and sexual satisfaction in midlife. Arch Sex Behav 2009; 38(1):87-107.
8. Dundon CM, Rellini AH. More than sexual function: Predictors of sexual satisfaction in a sample of women age 40–70. J Sex Med 2010; 7(2pt2):896-904.
9. Henderson AW, Lehavot K, Simoni JM. Ecological models of sexual satisfaction among lesbian/bisexual and heterosexual women. Arch Sex Behav 2009; 38(1):50-65.
10. Warehime MN, Bass LE. Breaking singles up: Sexual satisfaction among men and women. Int J Sex Health 2008; 20(4):247-61.
11. Harvey JH, Wenzel A, Sprecher S. The handbook of sexuality in close relationships: Psychology Press; 2004.
12. Montgomery KA. Sexual Desire Disorders. Psychiatry (Edgmont). 2008; 5(6):50-5.
13. Rosen RC. Prevalence and risk factors of sexual dysfunction in men and women. Curr Psychiatry Rep 2000;2(3):189-95.
14. Kotta S, Ansari SH, Ali J. Exploring scientifically proven herbal aphrodisiacs. Pharmacogn Rev. 2013; 7(13):1-10.
15. Kamatenesi-Mugisha M, Oryem-Origa H. Traditional herbal remedies used in the management of sexual impotence and erectile dysfunction in western Uganda. Afr Health Sci 2005; 5(1):40-9.
16. Shin YS, Zhao C, Zhang LT, Park JK. Current Status and Clinical Studies of Oriental Herbs in Sexual Medicine in Korea. World J Men Health 2015; 33(2):62-72.
17. Chauhan NS, Sharma V, Dixit VK, Thakur M. A Review on Plants Used for Improvement of Sexual Performance and Virility. BioMed Res Int 2014; 2014:868062.
18. Shamloul R. Natural aphrodisiacs. J Sex Med. 2010; 7(1 Pt 1): 39-49.
19. Lohiya NK, Goyal RB, Jayaprakash D, Ansari AS, Sharma S. Antifertility effects of aqueous extract of Carica papaya seeds in male rats. Planta med. 1994; 60(5):400-4.
20. Siepmann T, Roofeh J, Kiefer FW, Edelson DG. Hypogonadism and erectile dysfunction associated with soy product consumption. Nutrition. 2011; 27(7-8):859-62.
21. Nikfarjam M, Bahmani M, Heidari-Soureshjani S. Phytotherapy for depression: A review of the most important medicinal plants of flora of Iran effective on depression. J Chem Pharm Sci 9(3): 1242-1247.
22. Karimi A, Moradi MT, Alidadi S, Hashemi L. Anti-adenovirus activity, antioxidant potential, and phenolic content of black tea (Camellia sinensis Kuntze) extract. J Complement Integr Med 2016; 13(4):357-63.
23. Shirani-Boroujeni M, Heidari-Soureshjani S, Hafshejani ZK. Impact of oral capsule of Peganum harmala on alleviating urinary symptoms in men with benign prostatic hyperplasia; a randomized clinical trial. J Renal Inj Prev 2017; 6(2): 127-131.
24. Asadi-Samani M, Moradi MT, Bahmani M, Shahrani M. Antiviral medicinal plants of Iran. A review of ethnobotanical evidence. Int J Pharm Tech Res 2016; 9(5):427-34.
25. Asadi-Samani M, Kooti W, Aslani E, Shirzad H. A systematic review of Iran's medicinal plants with anticancer effects. J Evid Based Complementary Altern Med 2016; 21(2): 143-153.
26. Gholamian-Dehkordi N, Luther T, Asadi-Samani M, Mahmoudian-Sani MR. An overview on natural antioxidants for oxidative stress reduction in cancers; a systematic review. Immunopathol Persa 2017; 3(2): e: 12.
27. Shabanian S, Bahmani M, Asadi-Samani M. The medicinal plants effective on female hormones: A review of the native medicinal plants of Iran effective on estrogen, progesterone, and prolactin. J Chem Pharm Sci 2016; 9(3): 1270-1276.
28. Kooti W, Hasanzadeh-Noohi Z, Sharafi-Ahvazi N, Asadi-Samani M, Ashtary-Larky D. Phytochemistry, pharmacology, and therapeutic uses of black seed (Nigella sativa). Chin J Nat Med 2016; 14(10): 732-745.
29. Sani MRM, Asadi-Samani M, Saeedi-Boroujeni A, Banitalebi-Dehkordi M and Bahmani M: Suppressive effects of medicinal plants and their derivatives on inflammasome complex: A systematic review. Int J PharmTech Res 2016; 9(6): 325-335.
30. Baharvand-Ahmadi B, Asadi-Samani M. A mini-review on the most important effective medicinal plants to treat hypertension in ethnobotanical evidence of Iran. J Nephropharmacol 2017; 6(1): 3-8.
31. Akhtari E, Raisi F, Keshavarz M, Hosseini H, Sohrabvand F, Bioos S, et al. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo - controlled study. Daru 2014; 22.
32. Farnia V, Hojatitabar S, Shakeri J, Rezaei M, Yazdchi K, Bajoghli H, et al. Adjuvant Rosa damascena has a small effect on ssri-induced sexual dysfunction in female patients suffering from MDD. Pharmacopsychiatry. 2015; 48(4-5):156-63.
33. Modabbernia A, Sohrabi H, Nasehi AA, Raisi F, Saroukhani S, Jamshidi A, et al. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology 2012; 223(4):381-8.
34. Farzadi L, Khaki A, Ghasemzadeh A, Ouladsahebmadarek E, Ghadamkheir E, Shadfar S, et al. Effect of rosmarinic acid on sexual behavior in diabetic male rats. Afr J Pharm Pharmacol 2011; 5(16):1906-10.
35. Hosseinzadeh H, Ziaee T, Sadeghi A. The effect of saffron, Crocus sativus stigma, extract and its constituents, safranal and crocin on sexual behaviors in normal male rats. Phytomedicine:. 2008; 15(6-7):491-5.
36. Mohammadzadeh-Moghadam H, Nazari SM, Shamsa A, Kamalinejad M, Esmaeeli H, Asadpour AA, et al. Effects of a topical Saffron (Crocus sativus L) gel on erectile dysfunction in diabetics: a randomized, parallel-group, double-blind, placebo-controlled trial. J Evid Based Complementary Altern Med. 2015; 20(4):283-6.
37. Shamsa A, Hosseinzadeh H, Molaei M, Shakeri MT, Rajabi O. Evaluation of Crocus sativus (saffron) on male erectile dysfunction: a pilot study. Phytomedicine 2009; 16(8):690-3.
38. Khanavi M, Azimi H, Ghiasi S, Hassani S, Rahimi R, Nikfar S, et al. Specifying human platelet camp and cgmp phosphodiesterase inhibitory activity of the plants used in traditional Iranian medicine for the purpose of erectile dysfunction. Int J Pharmacol. 2012; 8(3):161-8.
39. Zaringhalam J, Shams J, Rezazadeh S, Manaheji H, Akhondzadeh S, Asefifar F. Role of the methanolic extracts of Boswellia serrata and Lavandula angustifolia on apomorphine induced ejaculation in male Wistar rats. J Med Plants Res. 2010; 4(11):1073-80.
40. Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry 2001; 62 Suppl 3:10-21.
41. Hosseinzadeh H, Sadeghnia HR, Ghaeni FA, Motamedshariaty VS, Mohajeri SA. Effects of saffron (Crocus sativus L.) and its active constituent, crocin, on recognition and spatial memory after chronic cerebral hypoperfusion in rats. Phytother Res. 2012; 26(3):381-6.
42. Akomolafe SF, Oboh G, Akindahunsi AA, Afolayan AJ. Antiperoxidative Activity of Tetracarpidium conophorum Leaf Extract in Reproductive Organs of Male Rats. Evid Based Complement Alternat Med. 2015; 2015:798491.
43. Andersson KE. Mechanisms of penile erection and basis for pharmacological treatment of erectile dysfunction. Pharmacol Rev 2011; 63(4):811-59.
44. Khori V, Alizadeh AM, Yazdi H, Rakhshan E, Mirabbasi A, Changizi S, et al. Frequency-dependent electrophysiological remodeling of the AV node by hydroalcohol extract of Crocus sativus L. (saffron) during experimental atrial fibrillation: the role of endogenous nitric oxide. Phytother Res. 2012; 26(6):826-32.
45. Chew KK, Stuckey BG, Thompson PL. Erectile dysfunction, sildenafil and cardiovascular risk. Med J Aust. 2000; 172(6):279-83.
46. Singh R, Singh S, Jeyabalan G, Ali A, Semwal A. Medicinal plants used to treat sexual dysfunction: A review. Int J Rec Adv Pharm Res. 2013; 3: 29-35.
47. Zavatti M, Zanoli P, Benelli A, Rivasi M, Baraldi C, Baraldi M. Experimental study on Satureja montana as a treatment for premature ejaculation. J Ethnopharmacol. 2011; 133(2):629-33.
48. McMahon CG. Premature ejaculation. Indian Journal of Urology: India J Urol. 2007; 23(2):97-108.
49. Simões Paço J, Jorge Pereira B. New Therapeutic Perspectives in Premature Ejaculation. Urology. 2016; 88:87-92.
50. Saadat SH, Ahmadi K, Panahi Y. The effect of on-demand caffeine consumption on treating patients with premature ejaculation: a double-blind randomized clinical trial. Curr Pharm Biotechnol. 2015; 16(3):281-7.
51. Grant P, Ramasamy S. An Update on Plant Derived Anti-Androgens. Int J Endocrinol Metabol. 2012; 10(2):497-502.
52. Corazza O, Martinotti G, Santacroce R, Chillemi E, Di Giannantonio M, Schifano F, et al. Sexual Enhancement Products for Sale Online: Raising Awareness of the Psychoactive Effects of Yohimbine, Maca, Horny Goat Weed, and Ginkgo biloba. BioMed Res Int. 2014; 2014:841798.
53. Bozorgi M, Memariani Z, Mobli M, Surmaghi MHS, Shams-Ardekani MR, Rahimi R. Five Pistacia species (P-vera, P-atlantica, P-terebinthus, P-khinjuk, and P-lentiscus): A Review of Their Traditional Uses, Phytochemistry, and Pharmacology. Sci World J. 2013.
54. Mandavi R, Heshmati J, Namazi N. Effects of black seeds (Nigella sativa) on male infertility: A systematic review. J Herb Med. 2015; 5(3):133-9.
55. Alavizadeh SH, Hosseinzadeh H. Bioactivity assessment and toxicity of crocin: A comprehensive review. Food Chem Toxicol. 2014; 64:65-80.
56. Hosseinzadeh H, Nassiri-Asl M. Avicenna's (Ibn Sina) the Canon of Medicine and Saffron (Crocus sativus): A Review. Phytother Res. 2013; 27(4):475-83.
57. Javadi B, Sahebkar A, Emami SA. A survey on saffron in major Islamic traditional medicine books. Iran J Basic Med Sci. 2013; 16(1):1-11.
58. Moghaddasi MS. Saffron chemicals and medicine usage. J Med Plants Res. 2010; 4(6):427-30.
59. Safarinejad MR, Shafiei N, Safarinejad S. An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus ) for treating erectile dysfunction in men naive to treatment. Int J Impot Res. 2010; 22(4):240-50.
60. Raisi F, Farnia V, Ghanbarian N, Ghafuri Z. Effects of Herbal vigRX on Premature Ejaculation: A randomized, double-blind study. Iran J Psychiatry. 2010; 5(1):4-6.
61. Allahdadi KJ, Tostes RCA, Webb RC. Female Sexual Dysfunction: Therapeutic Options and Experimental Challenges. Cardiovasc Hematol Agents Med Chem. 2009; 7(4):260-9.
62. Clark VL, Kruse JA. Clinical methods: the history, physical, and laboratory examinations. JAMA. 1990; 264(21):2808-9.
63. Moradi B, Heidari-Soureshjani S, Asadi-Samani M, Yang Q, Saeedi–Boroujeni A. Efficacy and mechanisms of medicinal plants as immunotherapy in treatment of allergic rhinitis: A systematic review. Int J Pharm Sci Res 2017; 8(5): 1892-99.doi: 10.13040/IJPSR.0975- 8232.8(5).1892-99.
64. Samarghandian S, Azimi-Nezhad M, Samini F, Farkhondeh T. Chrysin treatment improves diabetes and its complications in liver, brain, and pancreas in streptozotocin-induced diabetic rats. Can J Physiol Pharmacol. 2016; 94(4):388-93. doi: 10.1139/cjpp-2014-0412.
65. Karimi A, Mohammadi-Kamalabadi M, Rafieian-Kopaei M, Amjad L, Salimzadeh L. Determination of antioxidant activity, phenolic contents and antiviral potential of methanol extract of Euphorbia spinidens Bornm (Euphorbiaceae). Trop J Pharm Res 2016; 15(4):759-64.
66. Raeisi R, Heidari-Soureshjani S, Asadi-Samani M, Luther T. A systematic review of phytotherapies for newborn jaundice in Iran. Int J Pharm Sci Res 2017; 8(5): 1953-58.doi: 10.13040/IJPSR.0975-8232.8(5).1953-58.
67. Akhlaghi M, Shabanian G, Rafieian-Kopaei M, Parvin N, Saadat M, Akhlaghi M. Citrus aurantium Blossom and preoperative anxiety. Rev Bras Anestesiol 2011; 61(6):702-12.
68. Moradi MT, Karimi A, Alidadi S, Ghasemi-Dehkordi P, Ghaffari-Goosheh MS. Cytotoxicity and in vitro antioxidant potential of Quercus Brantii acorn extract and the corresponding fractions. Int J Pharm Phytochem Res 2016; 8(4):558-62.
69. Samarghandian S, Azimi-Nezhad M, Borji A, Farkhondeh T. Effect of crocin on aged rat kidney through inhibition of oxidative stress and proinflammatory state. Phytother Res. 2016. doi: 10.1002/ptr.5638.
70. Samarghandian S, Farkhondeh T, Samini F, Borji A. Protective Effects of Carvacrol against Oxidative Stress Induced by Chronic Stress in Rat's Brain, Liver, and Kidney. Biochem Res Int. 2016; 2645237. doi: 10.1155/2016/2645237.
71. Moghaddam HS, Samarghandian S, Farkhondeh T. Effect of bisphenol a on blood glucose, lipid profile and oxidative stress indices in adult male mice. Toxicol Mech Methods. 2015; 25(7): 507-13. doi: 10.3109/15376516. 2015. 1056395.
72. Bahmani M, Sarrafchi A, Shirzad H, Rafieian-Kopaei M. Autism: Pathophysiology and promising herbal remedies. Curr Pharm Des 2016; 22(3):277–285. doi: 10.2174/13816 12822666151112151529.
73. Rafieian-Kopaei M, Shahinfard N, Rouhi-Boroujeni H, Gharipour M, Darvishzadeh-Boroujeni P. Effects of Ferulago angulata extract on serum lipids and lipid peroxidation. Evid Based Complement Alternat Med 2014; 2014: 680856. doi: 10.1155/2014/680856.
74. Sarrafchi A, Bahmani M, Shirzad H, Rafieian-Kopaei M. Oxidative stress and Parkinson's disease: New hopes in treatment with herbal antioxidants. Curr Pharm Des 2016; 22(2): 238 – 246. doi: 10.2174/1381612822666 151 112 151653
75. Rouhi-Boroujeni H, Heidarian E, Rouhi-Boroujeni H, Deris F, Rafieian-Kopaei M. Medicinal plants with multiple effects on cardiovascular diseases: a systematic review. Curr Pharm Des 2017; 23(7): 999–1015. doi: 10.2174/1381612822666161021160524.
    

    ---

    How to cite this article:

    Solati K, Heidari-Soureshjani S, Luther T and Asadi-Samani M: Iranian medicinal plants effective on sexual disorders: a systematic review: Int J Pharm Sci Res 2017; 8(6): 2415-20.doi: 10.13040/IJPSR.0975-8232.8(6).2415-20.

    ---

    All © 2013 are reserved by International Journal of Pharmaceutical Sciences and Research. This Journal licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.

    ---