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Complementary & Alternative Medicine for Prostate and Urologic Health pp 107–143Cite as

Complementary and Alternative Medicine for Erectile Dysfunction, Testosterone Replacement Therapy, and Female Sexual Dysfunction

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Abstract

Sexual health state-of-the-art guidelines provide a thorough overview of conventional prescription options. Yet over the past 10–15 years numerous clinical trials have shown that complementary and alternative (CAM) interventions or dietary supplements may be an option to prevent and treat some forms of erectile dysfunction (ED) and possibly female sexual dysfunction (FSD). One of the barriers to adequately educating health care professionals and patients on effective dietary supplements for ED and FSD may be the unctuous history of this category in terms of over-the-counter products laced with contaminants, adulterants, or drug mimics (e.g., PDE-5 inhibitors). The FDA has removed more products for sexual health from the dietary supplement marketplace compared to any other health condition. Still, despite the questionable efficacy of so many products that will also be reviewed in this chapter, several agents are promising and have ample data to be utilized with patients. These dietary supplements have the potential to be used with and without conventional treatments. And it should be kept in mind that prescription medications for ED and TRT, for example, are not without their controversial issues, including consistently high past and current costs with expectations that create a serious barrier to adequate long-term compliance. Research shows that 50–66 % of the patients starting on PDE-5 inhibitors are no longer continuing to use these agents within 6–12 months of the initial prescription. Dietary supplements such as l-arginine in combination with other agents (e.g., pycnogenol), l-citrulline, Panax ginseng with concentrated ginsenosides, and several others should receive more attention. Perhaps the three biggest issues with many effective dietary supplements for ED are the higher dosages needed (number of pills), cost, in some cases, a complete safety or quality-control profile, and average time needed for efficacy. In the area of TRT, there are also some promising agents, but the vast majority of products have serious issues that make them substandard to prescription TRT at this time. However, this could potentially change in the near future if an ingredient is found to directly or indirectly enhance Leydig cell function, for example. Indeed, contrary to popular belief, there are some CAM options for patients concerned about ED and FSD, but there are very limited to no options currently in the area of TRT.

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  1. Department of Urology, University of Michigan Medical Center, Ann Arbor, MI, USA

    Mark A. Moyad M.D., M.P.H.

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Moyad, M.A. (2014). Complementary and Alternative Medicine for Erectile Dysfunction, Testosterone Replacement Therapy, and Female Sexual Dysfunction. In: Complementary & Alternative Medicine for Prostate and Urologic Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8492-9_6

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