Translational Biomedicine

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A Review on Epidemiology, Risk Factors, Molecular Etiology and Management ofVarious Forms of Sexual Dysfunction - Special Focus on Erectile Dysfunction and Libido

Srividhya Sundararaman*, Harish Mohan and CN Ramchand

Sexual dysfunction in both men and women are caused by some common factors such as smoking, alcoholism, psychological stress, unhealthy lifestyle and other medical conditions like diabetes, organ failure etc. Similar to the shared causes for the condition, a subset of molecular pathways and etiology behind the condition are also overlapping between the sexes. Studies have demonstrated that ED is increasingly prevalent with age: approximately 40% of men are affected at age 40 and nearly 70% of men are affected at age 70. Pathways like NO/cGMP signalling, RhoA/ROK mediated calcium sensitizing pathways, testosterone and estrogen mediated gene regulation, neurotransmitter balance etc. have been shown to be the driving forces behind the smooth muscle tone, libido, penile erection and ejaculation. Currently, the only available treatment modality for ED is oral administration of PDE5 (Phosphodiesterase 5) inhibitors and hormone therapy. In spite of this, there is a constant need for a much simpler and cheaper method that can prevent or treat various types of sexual dysfunctions with none or lesser side effects. These reasons have altogether carved a niche for cheaper and safer alternatives to mainstream medication.

In this background, this review vividly elucidates the risk factors, molecular etiology, role of key players like hormones and signalling pathways, current treatment modalities and upcoming surge of Nutraceuticals in the management of sexual disorders; majorly focussing on erectile dysfunction (ED), molecular pathways and psychological drive behind libido. The review also touches upon the list of aphrodisiacs and their modes of action in the context of prevention and treatment of sexual dysfunction in both sexes.