A Randomized Double-blind Placebo-controlled Trial to Assess the Effect of Tamarind seed in Premature Ejaculation

Homayuonfar, Abdulla; Aminsharifi, Alireza; Salehi, Alireza; Sahraian, Ali; Dehshari, Shadab; Bahrami, Mohsen

A Randomized Double-blind Placebo-controlled Trial to Assess the Effect of Tamarind seed in Premature Ejaculation

Document Type : Original Article

Authors

¹ School of Traditional Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

² Department of Urology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

³ Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

⁴ Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

⁵ Department of Traditional Medicine, Zanjan University of Medical Sciences, Zanjan, Iran

Abstract

Background: This randomized clinical trial was aimed to evaluate the effect of oral use of tamarind seed powder as an herbal product in patients affected by premature ejaculation (PE). Materials and Methods: In this study, 75 patients randomized in tamarind group (25 patients received daily 130 mg tamarind seed powder), paroxetine group (25 patients received daily 20 mg paroxetine), and placebo group (25 patients). Patients received the treatment regimen for 4 weeks. The primary outcome was intravaginal ejaculatory latency time (IELT). The secondary outcomes were PE diagnostic tool score, sexual function using International Index of Erectile Function (IIEF), and complications. Studied sexual functions include erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Results: The mean of IELT in tamarind, paroxetine, and placebo groups at baseline was 35.2 ± 26.5, 38 ± 27.6, and 44 ± 34.9 s and at the end of study was 49.5 ± 48.2, 147.4 ± 209.6, and 46.9 ± 37.6 s, respectively, which in paroxetine group significantly increased compared to other groups. IIEF scores for orgasmic function and intercourse satisfaction for paroxetine after treatment significantly increased than that of other groups. The differences between tamarind and placebo groups for studied variables were not statistically significant. The mean of increases in IELT for tamarind, paroxetine, and placebo groups was 14.35 ± 34.3, 109.4 ± 213.4, and 2.9 ± 9.3 s, respectively, which in paroxetine group was significantly higher than other groups and in tamarind group was significantly higher than placebo. Conclusions: Paroxetine was significantly better than tamarind seed powder and placebo although side effect in paroxetine was more frequent. IELT significantly more increased in tamarind group compared to placebo.

Keywords

References

1.	Rosen RC. Prevalence and risk factors of sexual dysfunction in men and women. Curr Psychiatry Rep 2000;2:189-95. [PUBMED]
2.	Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, et al. Guidelines on male sexual dysfunction: Erectile dysfunction and premature ejaculation. Eur Urol 2010;57:804-14. [PUBMED]
3.	American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4^th ed. Text Revision. (DSM-IVTR). Washington, DC: American Psychiatric Association; 2000. p. 554.
4.	Sharifi AR, Homayounfar A, Mosavat SH, Heydari M, Naseri M. Premature ejaculation and its remedies in Medieval Persia. Urology 2016;90:225-8. [PUBMED]
5.	Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J. The Premature Ejaculation Prevalence and Attitudes (PEPA) Survey: Prevalence, comorbidities, and professional help-seeking. Eur Urol 2007;51:816-24. [PUBMED]
6.	Giuliano F, Patrick DL, Porst H, La Pera G, Kokoszka A, Merchant S, et al. Premature ejaculation: Results from a five-country European observational study. Eur Urol 2008;53:1048-57. [PUBMED]
7.	Patrick DL, Althof SE, Pryor JL, Rosen R, Rowland DL, Ho KF, et al. Premature ejaculation: An observational study of men and their partners. J Sex Med 2005;2:358-67. [PUBMED]
8.	McMahon CG, Althof S, Waldinger MD, Porst H, Dean J, Sharlip I, et al. An evidence-based definition of lifelong premature ejaculation: Report of the international Society for Sexual Medicine ad Hoc Committee for the Definition of Premature Ejaculation. BJU Int 2008;102:338-50. [PUBMED]
9.	Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J, et al. The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: Prevalence, comorbidities, and professional help-seeking. Eur Urol 2007;51:816-23.
10.	McMahon CG, Abdo C, Incrocci L, Perelman M, Rowland D, Waldinger M, et al. Disorders of orgasm and ejaculation in men. J Sex Med 2004;1:58-65. [PUBMED]
11.	Hyun JS, Kam SC, Kwon OY. Changes of cerebral current source by audiovisual erotic stimuli in premature ejaculation patients. J Sex Med 2008;5:1474-81. [PUBMED]
12.	Cooper K, Martyn-St James M, Kaltenthaler E, Dickinson K, Cantrell A. Interventions to treat premature ejaculation: A systematic review short report. Health Technol Assess 2015;19:1-180, v-vi.
13.	Xin ZC, Zhu YC, Yuan YM, Cui WS, Jin Z, Li WR, et al. Current therapeutic strategies for premature ejaculation and future perspectives. Asian J Androl 2011;13:550-7. [PUBMED]
14.	Mohee A, Eardley I. Medical therapy for premature ejaculation. Ther Adv Urol 2011;3:211-22. [PUBMED]
15.	Rowland D, Tai W. A review of plant-derived and herbal approaches to the treatment of sexual dysfunctions. J Sex Marital Ther 2003;29:185-205. [PUBMED]
16.	Thomas CA, Tyagi S, Yoshimura N, Chancellor MB, Tyagi P. Effect of hyperforin-enriched extract on pro-ejaculatory effect of 8-hydroxy-2-(di-N-propylamino) tetralin in anesthetized rats. Urology 2007;70:813-6. [PUBMED]
17.	Ratnasooriya WD, Fernando TS. Effect of black tea brew of camellia sinensis on sexual competence of male rats. J Ethnopharmacol 2008;118:373-7. [PUBMED]
18.	Zavatti M, Zanoli P, Benelli A, Rivasi M, Baraldi C, Baraldi M, et al. Experimental study on Satureja montana as a treatment for premature ejaculation. J Ethnopharmacol 2011;133:629-33.
19.	Kenjale R, Shah R, Sathaye S. Effects of Chlorophytum borivilianum on sexual behaviour and sperm count in male rats. Phytother Res 2008;22:796-801. [PUBMED]
20.	Song GH, Halmurat U, Geng JC, Feng LC, Yilihamujiang S, Ma C, et al. Clinical study on the treatment of premature ejaculation by Uighur medicine gu-jing-mai-si-ha tablet. Chin J Integr Med 2007;13:185-9.
21.	Choi YD, Park CW, Jang J, Kim SH, Jeon HY, Kim WG, et al. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: A multicenter, placebo-controlled, double-blind clinical study. Int J Impot Res 2013;25:45-50. [PUBMED]
22.	De Caluwé E, Halamová K, Van Damme P. Tamarindus indica L.: A review of traditional uses, phytochemistry and pharmacology. Afr Focus 2010;23:53-83.
23.	Vargas-Olvera CY, Sánchez-González DJ, Solano JD, Aguilar-Alonso FA, Montalvo-Muñoz F, Martínez-Martínez CM, et al. Characterization of N-diethylnitrosamine-initiated and ferric nitrilotriacetate-promoted renal cell carcinoma experimental model and effect of a tamarind seed extract against acute nephrotoxicity and carcinogenesis. Mol Cell Biochem 2012;369:105-17.
24.	Aravind SR, Joseph MM, Varghese S, Balaram P, Sreelekha TT. Antitumor and immunopotentiating activity of polysaccharide PST001 isolated from the seed kernel of Tamarindus indica: An in vivo study in mice. ScientificWorldJournal 2012;2012:361382. [PUBMED]
25.	Sole SS, Srinivasan BP, Akarte AS. Anti-inflammatory action of tamarind seeds reduces hyperglycemic excursion by repressing pancreatic β-cell damage and normalizing SREBP-1c concentration. Pharm Biol 2013;51:350-60. [PUBMED]
26.	Shahraki MR, Harati M, Shahraki AR. Prevention of high fructose-induced metabolic syndrome in male Wistar rats by aqueous extract of Tamarindus indica seed. Acta Med Iran 2011;49:277-83. [PUBMED]
27.	Maiti R, Das UK, Ghosh D. Attenuation of hyperglycemia and hyperlipidemia in streptozotocin-induced diabetic rats by aqueous extract of seed of Tamarindus indica. Biol Pharm Bull 2005;28:1172-6. [PUBMED]
28.	Althof SE, Abdo CH, Dean J, Hackett G, McCabe M, McMahon CG, et al. International society for sexual medicine's guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med 2010;7:2947-69. [PUBMED]
29.	Pakpour AH, Yekaninejad MS, Nikoobakht MR, Burri A, Fridlund B. Psychometric properties of the Iranian version of the premature ejaculation diagnostic tool. Sex Med 2014;2:31-40. [PUBMED]
30.	Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A, et al. The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology 1997;49:822-30.
31.	Pakpour AH, Zeidi IM, Yekaninejad MS, Burri A. Validation of a translated and culturally adapted Iranian version of the international index of erectile function. J Sex Marital Ther 2014;40:541-51. [PUBMED]
32.	Falahatkar S, Asgari A, Hosseini Sharifi SH, Joafshani MA, Emadi SA, Khaledi F. Efficacy and safety of herbal drug, Hypericum perforatum in the treatment of premature ejaculation. J Guilan Univ Med Sci 2009;18:53-8.
33.	Waldinger MD, Hengeveld MW, Zwinderman AH. Paroxetine treatment of premature ejaculation: A double-blind, randomized, placebo-controlled study. Am J Psychiatry 1994;151:1377-9. [PUBMED]
34.	Salonia A, Rocchini L, Sacca' A, Pellucchi F, Ferrari M, Carro UD, et al. Acceptance of and discontinuation rate from paroxetine treatment in patients with lifelong premature ejaculation. J Sex Med 2009;6:2868-77.
35.	Alghobary M, El-Bayoumy Y, Mostafa Y, Mahmoud el-HM, Amr M. Evaluation of tramadol on demand vs. Daily paroxetine as a long-term treatment of lifelong premature ejaculation. J Sex Med 2010;7:2860-7. [PUBMED]
36.	Sunay D, Sunay M, Aydoǧmuş Y, Baǧbancı S, Arslan H, Karabulut A, et al. Acupuncture versus paroxetine for the treatment of premature ejaculation: A randomized, placebo-controlled clinical trial. Eur Urol 2011;59:765-71.
37.	Sunay D, Sunay M, Aydoǧmuş Y, Baǧbancı S, Arslan H, Karabulut A, et al. Acupuncture versus paroxetine for the treatment of premature ejaculation: A randomized, placebo-controlled clinical trial. Eur urol 2011;59:765-71.
38.	Mamidi P, Gupta K. Efficacy of certain yogic and naturopathic procedures in premature ejaculation: A pilot study. Int J Yoga 2013;6:118-22. [PUBMED] [Full text]

Advanced Biomedical Research