Herbal medicine used to treat andrological problems: Europe

Abstract

Abstract Pycnogenol, produced from Pinus pinaster (French maritime pine) extractions, is a significant source of medicinal procyanidins with OS and immune-modulating properties. Limited studies suggest a role in protection against induced spermatotoxicity through improved OS markers, and may improve fertility outcomes of subfertile males. However, the most significant clinical indication of this combination has been demonstrated for erectile dysfunction. Urtica dioica (stinging nettle) contains numerous molecules relevant to human health, including various polyphenols, triterpenoids, sterols, flavonoids, lectins, and fatty acids. Mechanisms of action relevant to the clinical indications include antioxidant and anti-inflammatory activity, alongside 5α-reductase and aromatase inhibition, and antiproliferative and cell cycle arrest in cancers. Preclinical studies have shown benefit in both BPH and prostate cancer cell lines, and the prevention of diabetes-induced reproductive dysfunction. Clinical studies predominantly combine U. dioica with Sabel serrulata (saw palmetto) in BPH-induced LUTS. This combination has shown benefit in numerous clinical trials particularly in IPSS scores, improved residual volume, peak, and maximal urinary flow rates. This chapter reviews the current preclinical and clinical evidence for these herbal medicines in andrology.