African traditional medicines for erectile dysfunction: elusive dream or imminent reality?

the body, inhibition of PDE-5 increases cGMP levels, reduces intracellular calcium (Ca 2+) and induces vasodilation. The drugs possess identical mechanisms of action, but differ essentially in their duration of action and in some aspects of their pharmacokinetic profiles. Recent clinical studies have shown that the three PDE-5 inhibitors are effective and relatively safe, and that they do not increase cardiovascular risk in patients with CAD. The availability of these PDE-5 inhibitors has provided effective and well-tolerated oral treatments for ED. Moreover, these drugs have been reported to improve endothelial function , 10,14 and are speculated to have vascular and myocardial protective properties. 10,17 As a class, the three drugs are indicated for the treatment of erectile dysfunction only. They are contra-indicated in patients undergoing therapy with any form of nitrate, either regularly or intermittently. The common side effects of the three PDE-5 inhibitors include headache and dyspepsia, back pain, myalgia and non-arteritic anterior ischae-mic optic neuropathy. Sildenafil citrate (Viagra TM) and related sexual stimulant 'love' drugs have been widely studied for their tolerability, safety and efficacy in the treatment of erectile dysfunction in a variety of patient populations. In men, oral sildenafil citrate, tadalafil and vardenafil hydrochloride are generally known to be effective in erectile dysfunctions of organic, psychogenic or mixed origins. However, the aetiology of erectile dysfunction has been shown to have a significant impact on treatment success and satisfaction rates, with neurogenic causes of erectile dysfunction (eg, diabetes mellitus and prostate surgery) having significantly lower treatment success rates than psychogenic or vasculogenic erectile dysfunction. 15 The pharmacokinetic characteristics of tadalafil differ significantly from those of sildenafil citrate and vardenafil hydro-chloride. The mean half-life for both sildenafil and vardenafil is about four hours, whereas the mean half-life of tadalafil is 17½ hours, and tadalafil has also been shown to improve erectile dysfunction for up to 36 hours post dosing. In Africa, from ancient times, plants have served as a dependable and ever-ready source of medicines for the treatment of a plethora of chronic and acute diseases of mankind. The various communities and societies on the continent, in addition to Erectile dysfunction (ED) is a common medical condition that affects about 200 million men worldwide, 1,2 and as many as 30 million American men. 3 Although ED also afflicts many African men, authentic figures on the incidence and/or prevalence of the disease are not available in most African countries. …