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426 Elaheh Zibaee et al.
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Avicenna’s Canon of Medicine for treating low
sexual desire. However, only around 30 out of
more than 75 mentioned plants have been studied for this purpose. Table 14.2 presents the
aphrodisiac herbs cited in the Canon of Medicine.
Acorus calamus (Acoraceae)
Ethanol extracts obtained from roots of
Acorus calamus are enriched with α- and
β-asarone, acorenone, calamenone, acora-
din, and shyobunone. The extract demonstrated a PDE5-inhibiting effect in in vitro
research studies (Ganapathy et al., 2021).
Allium cepa (Amaryllidaceae)
It was found that extracts obtained from the
bulb of Allium cepa raise the blood total testosterone level in rats when fed fresh onion
juice (Nimrouzi et al., 2020).
Apium graveolens (Apiaceae)
Eighty women participated in a clinical trial
where they consumed 500 mg of celery (Api-
um graveolens) seeds and a placebo. The Female Sexual Function Index (FSFI) questionnaire was used to evaluate the women’s
sexual function. The study results showed
an increase in total FSFI score and improvement in sexual desire, arousal, lubrication,
and pain (Hessami et al., 2021).
changes, sperm parameters, and testis morphology. The studies showed ameliorated sperm
damage and improved sperm morphology besides improving histological damage in the testis in diabetic rats. Testosterone levels were
significantly elevated (Heidari et al., 2021).
Brassica rapa (Brassicaceae)
In studies performed with male mice, the
application of Brassica rapa and Prunus
amygdalus (explained below) presented various benefits such as increases in weight of
seminal vesicles, testosterone and dihydrotesterone (DHT) levels, sperm count, and
sperm motility (Qureshi et al., 1989).
Cicer arietinum (Fabaceae)
Seventy-two male albino mice were divided
equally into four groups that were daily fed a
diet containing 0, 20, 30, and 50% w/w of Cicer
arietinum seeds, respectively. At day 7, 14, and
21 from the start of the experiment, the mice
were anesthetized and euthanized to collect
blood, testes, epididymis, and seminal vesicles.
Enhancement of testicular function and elevation of serum testosterone and luteinizing
hormone (LH) levels, sperm concentration,
sperm motility as well as testicular levels of
antioxidants including glutathione (GSH),
glutathione peroxidase (GPx), and catalase
(CAT) were reported (Sayed et al., 2018).
Cinnamomum zeylanicum (Lauraceae)
Alpinia officinarum (Zingiberaceae)
Twenty-four male rats were randomly assigned into separate groups (control, diabetic),
a single dose (60 mg/kg) of streptozotocin was
injected intraperitoneally to induce diabetes in
the experimental group, and the diabetic rats
were treated orally with a hydroalcoholic extract of Alpinia officinarum (200 and 500 mg/
kg, respectively). After 8 weeks of treatment,
blood samples, testis, and cauda epididymis
were excised to evaluate specific hormonal
Cinnamomum zeylanicum contains comparatively high amounts of cinnamaldehyde,
which is mainly found in the bark of the tree.
This active component enhances testosterone
secretion from Leydig cells and improves
sperm parameters (Alahmadi, 2020).
Crocus sativus (Iridaceae)
The most important valuable secondary
substances occurring in the stigma of Crocus
Table 14.2. Plants with aphrodisiac properties cited in Avicenna’s Canon of Medicine.
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Scientific name Common name No. Scientific name
No.
1 Acorus calamus L. Sweet flag
2 Allium cepa L. Onion
3 Allium hirtifolium Boiss. Persian shallot
4 Allium porrum L. Leek
5 Alpinia officinarum Hance Lesser galanal
6 Althaea cannabina L. Egyptian hemp
7 Androsace lactea L. Milkwhite rock jasmine
8 Apium graveolens L. Celery
9 Aristolochia fontanesii Boiss. & Reut. Long aristolochia
10 Arum maculatum L. Snakeshead
11 Asarum europaeum L. Asarabacca
12 Asparagus officinalis L. Garden asparagus
13 Astragalus tragacantha L. Gum tragacanth plant
14 Brassica nigra (L.) W.D.J. Koch Black mustard
15 Brassica oleracea L. Cabbage
16 Brassica rapa L. subsp. rapa Common turnip, field
mustard
17 Capparis spinosa L. Caper bush
18 Centaurea behen L. White behen
19 Cheilocostus speciosus (J. Koenig)
C.D. Specht
Basionym: Banksia speciosa J. Koenig
20 Cicer arietinum L. Chickpea
21 Cinnamomum verum J. Presl Common cinnamon tree
22 Cocos nucifera L. Coconut
23 Colchicum autumnale L. Colchicum, meadow
24 Corylus avellana L. Common hazel
25 Crocus sativus L. Saffron crocus
Crepe-ginger
saffron, autumn crocus
36 Moringa pterygosperma Gaertn.
Synonym: Moringa aptera Gaertn.
37 Musa × paradisiaca L. Banana
38 Myristica fragrans Houtt. Nutmeg tree
39 Gundelia tournefortii L. Tumble thistle
40 Himantoglossum hircinum (L.) Spreng. Lizard orchid
41 Lagoecia cuminoides L. Common wild cumin
42 Lepidium coronopus (L.) Al-Shehbaz
Basionym: Cochlearia coronopus L.
43 Limonium vulgare Mill. Sea lavender
44 Linum usitatissimum L. Common flax
45 Lupinus termis Forssk.
Lupinus albus L.
46 Medicago sativa L. Alfalfa
47 Papaver somniferum L. Opium poppy
48 Pastinaca sativa L. Parsnip
49 Peucedanum oreoselinum (L.) Moench.
Basionym: Athamanta oreoselinum L.
50 Phaseolus vulgaris L. Common bean
51 Phyllanthus emblica L. Emblic myrobalan
52 Pimpinella anisum L. Anise
53 Pinus gerardiana Wall. ex D. Don Chilgoza pine
54 Piper cubeba L. Tailed pepper
55 Piper longum L. Long pepper
56 Piper nigrum L. Black pepper
57 Pistacia terebinthus L. Turpentine tree, terebinth
58 Pistacia vera L. Pistachio
59 Prunus persica (L.) Batsch Peach
60 Raphanus sativus L. Common cultivated radish
Common name
Ben oil tree
Swine’s cress
Sexual Dysfunction Management 427
Egyptian lupine
Mountain parsley
Continued
Scientific name Common name No. Scientific name
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No.
26 Cucumis melo L. Muskmelon
27 Cyperus esculentus L. Tiger nut
28 Daucus carota L. Carrot
29 Elettaria cardamomum (L.) Maton
Basionym: Amomum cardamomum L.
30 Eruca vesicaria (L.) Cav.
Basionym: Brassica vesicaria L.
Synonym: Eruca sativa Mill.
31 Ferula assa-foetida L. Asafoetida
32 Ferula szowitziana DC. Persian giant fennel
33 Fraxinus excelsior L. Ash
34 Glossostemon bruguieri Desf. Moghat
35 Mentha spp. Mint
Small cardamom
Arugula
61 Roccella tinctoria DC. Orchil
62 Sesamum indicum L. Sesame
63 Sisymbrium officinale (L.) Scop. Hedge mustard
64 Taxus baccata L. Common yew
65 Tribulus terrestris L. Caltrop
66 Trigonella foenum-graecum L. Fenugreek
67 Urtica pilulifera L. Roman nettle
68 Vicia faba L. Broad bean
69 Withania somnifera (L.) Dunal Ashwagandha
70 Zingiber officinale Roscoe Ginger
428 Elaheh Zibaee et al.
Common name
Sexual Dysfunction Management 429
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sativus are crocin, picocrocin, and safranol.
Studies performed with aqueous and ethanol extracts of saffron stigma in rats showed
improved erectile dysfunction and sperm
parameters. In a clinical trial, male patients
underwent the nocturnal penile tumescence
(NPT) test. Use of the International Erectile
Function Index Questionnaire (IIEF-15) revealed an increase in the number and duration of erectile events from the beginning
to the end of the 10-day study (Shamsa
et al., 2009). In another research, the effect of saffron stigma, its valuable ingredients, and aqueous extracts obtained from them on sexual behavior was investigated. In that study, the
aqueous extract, crocin, safranal, and sildenafil
were administered intraperitoneally to male rats
and their sexual behavior was investigated. It was
reported that the frequency of copulation and
erection increased (Hosseinzadeh et al., 2008).
Cyperus esculentus (Cyperaceae)
Cyperus esculentus tubers with the common
name of “tiger nut” contain high levels of
quercetin, vitamin C, vitamin E, and the
mineral zinc. Two sets of sexually active
male rats including intensely and moderately active were treated with raw tiger nut
powder. Copulatory behavior and serum
hormonal levels were measured. The powder
could stimulate sexual motivation and performance in active rats, reducing mount and
intromission latencies, intromission frequency, and ratio. It also increased serum
testosterone levels (Allouh et al., 2015).
rats with acrylamide-induced hypogonadism showed an antiapoptotic effect indicated by elevation of both B-cell lymphoma
2 (Bcl-2) and Bcl2-associated-X protein (Bax)
expression and protected testis against
acrylamide-induced testicular toxicity by
normalizing testicular steroidogenesis, keeping Leydig cells, and improving oxidative
stress status (Abd-Elsalam et al., 2021).
Ferula assa-foetida (Apiaceae)
Application of ethanol extracts from Ferula
assa-foetida seeds in combination with root
hydroethanolic extracts from the same plant
caused improvement of sperm count, libido,
and erectile function after 2 months of
treatment (Nimrouzi et al., 2020).
Linum usitatissimum (Linaceae)
Hydroalcoholic extracts of Linum usitatissimum seeds were used in an experiment per-
formed on mice. Two sets of mice containing
32 aged and 32 young ones were divided into
four groups. The control group remained untreated, while the experimental groups were
fed with seed extract. After 3 weeks, the
brain was removed, and blood samples were
collected to measure the individual sex hormone levels by ELISA. Generally, an increase
in sex hormone levels was observed (Bahmanpour and Kamali, 2016).
Daucus carota (Apiaceae)
In a randomized clinical trial conducted on
women with sexual dysfunction, carrot
(Daucus carota) improved desire, arousal, lubrication, orgasm, satisfaction, and pain
(Molkara et al., 2018).
Eruca sativa (Brassicaceae)
The efficacy of ethanol extracts obtained
from arugula (Eruca sativa) seeds in male
Myristica fragrans (Myristicaceae)
According to studies performed with ethanol
extracts from nutmeg (Myristica fragrans),
mating efficiency and mounting behavior of
mice and rats could be improved (Nimrouzi
etal., 2020). It is known that sterols of this
plant have nerve-stimulating properties
(Kotta et al., 2013). When the general mating
behavior, libido, and potency of albino rats
(male and female) were evaluated and compared to sildenafil, an increase in sexual activity was noted. Thus, in addition to its use as a
430 Elaheh Zibaee et al.
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spice, nutmeg has been found to have aphrodisiac, nerve-stimulant, hyperlipidemic, antithrombotic, antifungal, antidysenteric, and
anti-inflammatory effects, thus making a
valuable contribution in the treatment of SD
in men (Nimrouzi et al., 2020).
Mentha species (Lamiaceae)
Biochemical and physical evaluation was conducted on Wistar albino rats treated with
Mentha piperita and Mentha spicata tea, showing an increase in LH and follicle-stimulating
hormone (FSH) levels, as well as in the diameter of the testicular tubules (Sharma and Jocob, 2001; Akdogan et al., 2004).
Musa × paradisiaca (Musaceae)
Dessert banana (Musa × paradisiaca) had andro-
genic and anabolic effects in sexually mature
male albino rats receiving root extract and was
able to increase testicular/body weight ratio and
decrease LH and FSH levels (Yakubu et al., 2013).
Pastinaca sativa (Apiaceae)
According to literature, the roots, leaves,
and seeds of parsnip (Pastinaca sativa) contain 5α-androstenone, which enhances libido and has a remarkable impact on sexual
activity (Kenari et al., 2021).
with herbal medicines in a clinical trial. All male
patients received one tablet daily of a combination of tryptophan, Satureja montana, Tribulus
terrestris, and P. emblica extracts for 3 months,
after which all patients underwent follow-up
visits with the same investigations. Improvement of premature ejaculation was completely
remarkable (Sansalone et al., 2016).
Piper longum (Piperaceae)
Ethanol extracts of long pepper (Piper longum)
fruits were administered to mice in acute (24 h)
and chronic (90 days) oral toxicity studies. All
external morphologic, hematologic, and spermatogenic changes, in addition to body weight
and vital organ weights, were recorded. In the
study, a significant increase in reproductive
organ weights, sperm motility, and sperm
count, and failure to illicit any spermatotoxic
effect were reported (Khushbu et al., 2011).
Piper nigrum (Piperaceae)
Ethanol and aqueous extracts of black pepper
(Piper nigrum) offered to male mice as pellets
once daily for 90 days were found to be potentially effective to improve sexual drive (Sutyarso et al., 2015). In another study, black
pepper fruits showed the compensation of
normal estrogen level and antioxidant activity (Zodape and Gaikwad, 2020).
Papaver somniferum (Papaveraceae)
The findings of a clinical trial involving 100 impotent male patients showed that papaverine
combined with prostaglandin E1 (PGE1) was
more effective than PGE1 alone and therefore
can be a useful supplement in the treatment of
male impotence (Drewes et al., 2003).
Phyllanthus emblica (Phyllanthaceae)
Fruits of the amla tree (Phyllanthus emblica)
were used as a part of a combination therapy
Pistacia terebinthus (Anacardiaceae)
The fruits of the so-called “turpentine tree”
(Pistacia terebinthus) are known for their
aphrodisiac effect, which has not yet been
proven by objective scientific studies. However, the tree resin and the fruits of this
plant are associated with an aphrodisiac effect (Bozorgi et al., 2013).
Prunus amygdalus (Rosaceae)
Seeds of almond (Prunus amygdalus) were
applied to male mice and effects of the seeds
Sexual Dysfunction Management 431
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on the epidydimal spermatozoa, quantity
and motility of sperm, and weight of testis
and vesicles were investigated. An increase
in weight of seminal vesicles, testosterone,
DHT, sperm count, and motility were found
to be the particular benefits of this plant
(Qureshi et al., 1989).
Sesamum indicum (Pedaliaceae)
Ethanol extracts of sesame seeds (Sesamum
indicum) in male Wistar rats showed a
significant improvement in sperm count,
life/death ratio of sperm cells, and sperm
motility when compared to a placebo group
(Tahvilzadeh et al., 2016).
Syzygium aromaticum (Myrtaceae)
Ethanol and hexane extracts of clove buds
(Syzygium aromaticum) contain various active
ingredients that increased libido and erection,
mounting frequency, intromission frequency,
and latency in studies performed with rats and
mice. Δ5-3β- and 17β-Hydroxysteroid dehydrogenase and testosterone levels, mating
behavior, and mating performance were also increased (Nimrouzi et al., 2020).
Tribulus terrestris (Zygophyllaceae)
Caltrop (Tribulus terrestris) is a famous plant
species known for its aphrodisiac properties
and many types of research have been conducted to investigate the individual effects
of this plant. Fruits, seeds, and flowers of
T. terrestris were used in various research studies (Ștefănescu et al., 2020). Increase in testosterone level, influencing spermatogenesis and
improving sexual behavior in male Swiss albino mice, reducing the level of nuclear factor-κB (NF-κB), and increasing the levels of
nuclear factor erythroid 2-related factor 2
(Nrf2) and heme oxygenase-1 (HO-1) were reported in male rats by comparing treated male
rats’ sexual behavior and biochemical properties with a sildenafil-treated group as control
(Qureshi et al., 2014; Sahin et al., 2016). Improvement in total FSFI score, increase in
DHEA level, and decrease in serum testosterone and free testosterone levels were reported
in a clinical trial on female patients of reproductive age and presenting sexual dysfunction.
In rabbits, weight of the prostate, mount and
intromission frequencies, and penile erection
index were increased; but in chronic use,
mount, intromission, ejaculatory latency, and
serum levels of testosterone were decreased
(Gama et al., 2014).
Trigonellafoenum-graecum (Fabaceae)
Fenugreek seeds (Trigonella foenum-graecum)
were used in a short-term, double-blind,
randomized, placebo-controlled study of 80
women aged 20 to 49 years. In this context
biochemical and behavioral properties were
evaluated. Generally, an increasing sexual
arousal and desire in women treated with
seeds of this plant was mentioned (Rao
et al., 2015). In another trial, 60 healthy
males aged between 25 and 52 years, without
erectile dysfunction, were randomly treated
with an oral dose of the active treatment or
placebo for 6 weeks. The primary outcome
measure was the Derogatis Interview for Sexual Functioning (DISF-SR) self-administered
quality of life (QOL) total score, with the
specific QOL metrics being the secondary
outcomes. The study outcomes were improvements in the subdomains of sexual
arousal and orgasm, an increase in the
physiological element of libido and QOL in
self-reported satisfaction, and maintenance
of normal, healthy testosterone levels (Steels
et al., 2011).
Urtica pilulifera (Urticaceae)
Different doses of Urtica pilulifera extracts
were examined for PDE inhibitory (PDEI)
activity in a clinical experiment versus
control groups that received sildenafil and a
placebo. The results revealed a notable dosedependent cGMP-PDEI impact (Khanavi
etal., 2012).
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Withania somnifera (Solanaceae)
testicular weight, blood testosterone, and
testicular cholesterol levels (Kamtchouing
Withania somnifera is another herbal plant that is
known for its aphrodisiac activity. Aqueous extract of the root used in rats caused an increment
in spermatogenesis and testosterone level (Bhattacharya and Muruganandam, 2003; Ambiye et
al., 2013). Methanol extracts of the root applied
to male rats improved their libido, penile erection, and semen quality (Ilayperuma et al., 2002).
et al., 2002). Furthermore, Z. officinale
showed numerous beneficial effects and was
also able to protect against the negative effects of various toxic chemicals on the sperm
properties of the epididymis in male diabetic
rats treated with ginger root extract. Phenols
present in this plant also act as potent antioxidants (Mohammad and Hamed, 2012;
Alahmadi, 2020; Nimrouzi etal., 2020).
Table 14.2 shows all aphrodisiac herbs
Zingiber officinale (Zingiberaceae)
mentioned in Avicenna’s Canon for making
some recommendations for future research,
Administration of an aqueous extract of
ginger (Zingiber officinale) to rats increased
given that only a few plants have been
studied so far.
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15 The Current Situation of Medicinal
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and Aromatic Plants’ Industry, Research,
Education, and Standardization in Iran.
How Can Traditional Persian Medicine
Products be Successfully Adapted to the
Needs of the European Market?
1
Shahid Beheshti University, Medicinal Plants and Drugs Research Institute Tehran,
Iran; 2MateriaMed GmbH, Vienna, Austria; 3Consulting and Project Management for
Abstract
e use of medicinal plants and natural products in the treatment of human and animal diseases has a
long history in Iran. is may be due to the vast geographical area of this country and its climatic diver
sity, rich plant diversity, cultural diversity, and also its history as one of the rst cradles of human civilization. e existence of the Silk Road and the extensive commercial connections of this country with
other civilizations have played a role in the richness of this knowledge and its development. As in other
parts of the world, this rich knowledge was neglected in Iran for many years after modernization, and the
use of medicinal plants was limited to traditional herbal healers in rural areas. In recent years, Iran has
followed the global trend and traditional and alternative medicine, cultivation of herbs, related industries
as well as research and education in this eld have been greatly developed. In this chapter we show briey
the situation of medicinal and aromatic plants in Iran from dierent aspects as well as the potentials and
also the requirements to introduce this rich knowledge to international markets like Europe.
Current Situation of Medicinal and
Aromatic Plants in Iran
Cultivation and wild collection
Iran, with an area of 1,648,195 million km
is the 18th largest country in the world and
Farsad Nadjafi
Medicinal and Aromatic Plants, Stahnsdorf, Germany
1,2
* and Hartwig Schulz
situated in three areas of Asia (West, Central, and South) in the Middle East. It has
about 33% of its area under cultivation, 14
million km
steppes, and 16 million km2 of deserts.
2
Because of the particular climatic importance
,
(with 11 climate zones out of 13 climate
2
of meadows, 60 million km2 of
3
-
*Email: md@materiamed.at
© CAB International 2023. Medicinal Plants Used in Traditional Persian Medicine
(eds. H. Schulz, Seyed Ahmad Emami and Farsad Nadjafi)
DOI: 10.1079/9781800621671.0015
435
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