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01
♦ Anxiety, stress and depression are among the most frequently cited
contributors to psychological impotency.
♦ For many reasons, cultural as well as situational anxiety over sexual
performance may provoke an intense fear of failure and self-doubt on
the part of the individual
ED
02
Erectile dysfunction
♦ Sex has got ups and downs in lifetime. A person looking strong in physical growth may be
weak in sexual activities and one who looks weak in physique may be sexually strong,
potent and possess many offspring.
♦ Erectile dysfunction (ED) is both increasingly recognized
and increasing in prevalence with the aging of our
population
♦ Erectile dysfunction is a potentially devastating ailment that
affects not only men, but also their sexual partners. The
Massachusetts Male Aging Study revealed that age is the
single most important variable associated with Erectile
difficulty.
♦ Currently, more than 30 million American men suffer some
degree of Erectile dysfunction (ED), with projections that up
to 47 million individuals will have treatable Erectile
dysfunction by the year 2020.
Purusha – Sukra
Qualities of Sukra
♦ Susruta defines the semen as – crystalline whitish luster’s,
liquid, soft, sweet taste and equal to that of honey smelled.
In further it resembles the Oil or Honey consistency
(Su.Sh.2/20).
♦ The semen is dominant of “Udaka” with its soft (Sowmya)
nature but all the bhutas are interrelated and associated
(Su.Sh.3/1)
Sukra as a Vega
♦ Sukra in one of the 13 non suppressible natural urges
♦ If Sukra vega is controlled or suppressed following are
witnessed.
1. Pain and oedema in the genital organs
2. Uncontrolled excretion of semen
3. Distress in the chest
4. Fever
5. Fatigue and pain all over the body
6. Retention of the urine (Sukrashmari)
♦ According to Charaka – the man may gradually become impotent apart from the condition
generated from the excessive sexual indulgence produced Dhatu kshaya, which eventually
lead to “Yakshma”.
♦ ¨ÉäfÅäø ´ÉÞ¹ÉhɪÉÉ䶶ÉÚ±ÉÆ +ÆMɨÉnùÉæ ¾þÊnù´ªÉvÉÉ ¦É´Éäi|ÉÊiɽþiÉä ¶ÉÖGäò Ê´É´ÉqÆù ¨ÉÚjɨÉä´ÉSÉ - - SÉ.ºÉÚ. 7/10
♦ ¶ÉÖGòÉkÉi»É´ÉhÉÆ MÉÖÁ´ÉänùxÉÉ º´ÉªÉvÉÖV´ÉÇ®ú: ¾þnÂù´ªÉlÉɨÉÚjÉ ºÉÆMÉÉÆMɦÉÆMÉ ´ÉÞnÂùt¶¨É¹ÉÆb÷iÉÉ: - +.¾þ.ºÉÚ. 4/20
♦ ¶ÉÖGòºªÉ nùÉä¹ÉÉiÉ C±É褪ɨɽþ¹ÉÇhɨÉ - SÉ.ºÉÚ. 28/27
♦ ®úÉäÊMÉhÉÉÆ C±ÉҤɨɱ{ÉɪÉÖÆ Ê´É°ü{ÉÆ ´ÉÉ |ÉVÉɪÉiÉä xÉ´ÉÉ ºÉÆVÉɪÉiÉä MɦÉÇ: {ÉiÉÊiÉ, |ɻɴÉiªÉÊ{É ¶ÉÖGÆòʽþ nÖù¹]Æõ ºÉÉ{ÉiªÉÆ ºÉnùÉ®úÉÆ ¤ÉÉvÉiÉä
xÉ®ú¨É - SÉ.ºÉÚ. 28/27
The physiology of sexual intercourse
• Sexual intercourse, also known as coitus or copulation, introduces semen into the female
reproductive tract. We shall now consider the process as it affects the reproductive systems
of males and females.
• Sex is a harmonious act of two genders with a proper understanding and desire
• Sex melts the Male and Female to get in to the action of generating the best of the best
natures miraculous act of generating the new generations - offspring
• Sex doesn’t come easy, it depends upon health and it is not just intercourse, it
is all about pleasure.
• Sex is achieved by keeping fit, eating well, having a good relationship,
proper communication, fine stimulus, proper arousal, perfect erection,
good orgasm and timely ejaculation.
• The sex act friction generates the flame of Orgasm & the ego burns in inferno
ED
• Apart from all other reasons erection plays an important role. 05
Ejaculation
♦ Ejaculation is associated with intensely pleasurable sensations, an
experience known as male orgasm.
♦ Several other noteworthy physiological changes occur at this time,
including pronounced but temporary increases in heart rate and
blood pressure.
Premature ejaculation
♦ Ejaculation is commonly called premature if a man
climaxes and releases his semen before or within a
few minutes after entering his partner's vagina and
before his partner has an orgasm.
♦ Premature ejaculation is a problem only if it prevents a
couple from having sexual experiences that are
satisfying for both partners.
♦ The human experience of orgasm is a complex
interplay of psychological, physical, and physiological
factors.
♦ To control the timing of ejaculation a man must learn
to exercise some control over these factors.
Premature ejaculation is rarely caused by a medical
condition.
♦ Premature ejaculation can occur when a man has not
had sexual intercourse for a long period of time. Other situations in which there is unusually
heightened sexual arousal and excitement may also promote early ejaculation.
♦ Premature ejaculation may happen in a new relationship because the partners have not yet
learned each other's stimulation needs for arousal and orgasm.
Importance of Women
♦ Women are the “Kshetra” for the progeny. (Ch.Chi.2-1-4)
♦ Woman is the platform and media for sex and considered always
potent in sexual activity but she plays passive role in sex, hence
Vajikarana is not mandatory for woman.
♦ Women with female physique where they are stationed collectively (the
multitude sense objects is only in the female body not anywhere else),
beautiful, youthful, endowed with auspicious features, submissive and
trained is regarded as the bets aphrodisiac.
♦ The women who is being excellent in terms of age, beauty, voice similar
psyche, similar mind, submissive, pleases with partners liking and amorous
movements enters in to heart quickly to fortune and by look it self exhilarates
the man and arouses the impulse of sexual urge, such women is the best
aphrodisiac. . (Ch.Chi.2-1/8-10)
♦ Due to the diversity in liking of the people and fortune of women, the qualities like good
appearance etc. get enhanced on finding a suitable man.
♦ ´ÉÉVÉÒEò®úhɨÉOªÉÆ SÉ IÉäjÉÆ ºjÉÒ ªÉÉ |ɽþ̹ÉhÉÒ - <¹]õÉÁäEèòEò¶ÉÉä%{ªÉlÉÉÇ {É®Æú |ÉÒÊiÉEò®úÉ: º¨ÉÞiÉÉ: -ºÉÆPÉÉiÉÉä½þÓÊpùªÉÉlÉÉÇxÉÉÆ
ºjÉÒ¹ÉÖxÉÉxªÉjÉ Ê´ÉtiÉä - ºiªÉɸɪÉÉä ¿ÓÊpùªÉÉlÉÉæ ªÉ: ºÉ |ÉÒÊiÉVÉxÉxÉÉä%ÊvÉEò¨É - SÉ®úEò ÊSÉÊEòiºÉ 2/1/4-7
♦ ºÉÖ°ü{ÉÉ ªÉÉè´ÉxɺlÉÉ ªÉÉ ±ÉIÉhÉèªÉÉÇ Ê´É¦ÉÚʹÉiÉÉ - ªÉÉ ´É¶ªÉÉ Ê¶ÉÊIÉiÉÉ ªÉÉ ºÉÉ ºjÉÒ ´ÉÞ¹ªÉiɨÉÉ ¨ÉiÉÉ - xÉÉxÉÉ ¦ÉCiªÉÉiÉÖ ±ÉÉäEòºªÉ
nèù´ÉªÉÉäMÉSSÉ ªÉÉäʹÉiÉɨÉ - iÉÆ iÉÆ |ÉÉ{ªÉ ÊxÉ´ÉiÉÈiÉä xÉ®Æú °ü{ÉÉnùªÉÉä MÉÖhÉÉ: - ´ÉªÉÉä°ü{ɨÉÞVÉÉ ½þÉ´ÉèªÉÉÇ ªÉºªÉ {É®ú¨ÉÉÆMÉxÉÉ - |ÉÊ´ÉiªÉɶÉÖ
¾þnùªÉÆ nèù´ÉÉuùÉ Eò¨ÉÇhÉÉä%Ê{É ´ÉÉ - ¾þnùªÉÉäiºÉ´É°ü{ÉÉ ªÉÉ ºÉ¨ÉÉxɨÉxÉ: ¶ÉªÉÉ - ºÉ¨ÉÉxɺÉi´ÉÉ ªÉÉ ´É¶ªÉÉ ªÉÉ ªÉºªÉ |ÉÒiɪÉä Ê|ɪÉè: -
SÉ®úEò ÊSÉÊEòiºÉÉ 2/1/8-10
Reduced Factors of sexual capacity
1) Emaciating diseases that is, Dhatu kshaya including Sukra kshaya
2) Fear complex
3) Worry, Grief, etc
4) Due to Ungrateful and unbelievable natured women
5) Due to unhygienic, diseased, faithless women
6) Due to lack of capacity of sexually rouse the mate by women
7) Abhichara – Black magic etc stated to modify mental faculties
8) Total abstinence from the sexual act
♦ VÉ®úªÉÉ ËSÉiɪÉÉ ¶ÉÖGÆò ´ªÉÉÊvÉʦÉ: Eò¨ÉÇ Eò¹ÉÇhÉÉiÉ IɪÉÆ MÉSUôiªÉxɶÉxÉÉiÉ ºjÉÒhÉÉÆSÉÉÊiÉ ÊxɹÉä´ÉhÉÉiÉ -
IɪÉÉiÉ ¦ÉªÉÉnùÊ´É»ÉƺÉÉiÉ ¶ÉÉäEòÉiÉ ºjÉÒnùÉä¹Énù¶ÉÇxÉÉiÉ xÉÉ®úÒhÉɨɮúºÉYÉi´ÉÉiÉ +Ê´ÉSÉÉ®úÉnù ºÉä´ÉxÉÉiÉ -
iÉÞ{iɺªÉÉÊ{É ÎºjɪÉÉä MÉÆiÉÖÆ xɶÉÊHò ¯û{ÉVÉɪÉiÉä näù½þºÉi´É ¤É±ÉÉ{ÉäIÉÒ ½þ¹ÉÇ: ¶ÉÊHò¶SÉ ½þ¹ÉÇVÉÉ - SÉ.ÊSÉ.2-
4/43-45
ED
11
Synonyms of impotency
♦ Ayurveda has clearly explained the situation of inactivity of the male in sex act. It has given
different words as synonyms to Impotency are -
1. Napumsaka - neither female or male
2. Kleeba - unable do the sex act and produce offspring
Ê´ÉOɽþ{ÉÖι]õ xÉè´ÉätxÉι]õ
3. Shanda (both sex) - Hermaphrodite
4. Vandhya (both sex) - non-conceived male or female
5. Triteeya prakriti - third gender
6. Stapatya - who doesn't have "staman" (strength)
7. Stapathi - who can not achieve Orgasm (Staputa = ups and downs)
8. Kanchuka - male desires to wear ladies garments
9. Varshavara - who develops over-hydrosis by thinking sex act (over sweating)
10. Sama - equal; neither male or female character dominance
2. Sasukra Napumsaka
A) Sukra and Sukravaha sroto dusti
i) Impotency - unable to produce offspring
Azospermia
Oligospermia
Defective morphology of semen
ii) 8 varieties
Vata, pitta, kapha,
Kunapa gandhi, Grandhi, Ksheena
Pootipooya, Mutrapureesha gandhi
B) Retovaha (Seminal duct) sroto and sira dusti
i) temporary ED or emotional ED
ii) Semi permanent ED or kleeba
Beejopaghata - non production of semen leading to ED
Organic - Heart problems
Metabolic - Diabetis
Jara - geriatric ED
Loss of vigour
loss of strength
Sukra kshaya - loss of semen leading to ED
Dwaja bhanga - ED
Krimija - infective ED
Pootigandha - Fungal Infections leading to ED
Viseerya mani - wound at glans
Viseerya medhra - injury to shaft
Viseerya mushka - wound at testis
iii) Paraphilic ED or napumsaka
Asekya - Mukha yoni - Erection after Swallow of semen
Sougandhika - Nasa yoni - Erection after smelling
others genetelia
Kumbheeka - catamite; Erection after anal penetration
Ershayaka - Drig yoni - Erection after Voyerism
ED
16
Mechanism of impotency
♦ It is being observed the erection is under the Neurovascular control as emotional control,
where chemicals are released and physically filling the vessels of penis and making hard
with proper erection.
♦ So the neuro-vascular control in normal man stress when sexually aroused. The brain
activates and releases Nitric oxide in the spongy tissues. It activates the enzyme Guanylate
cyclase that produces cyclic guanosina mono phosphase (cGMP).
♦ The cGMP relaxes the spongy tissues and increases the blood flow to the penis.
♦ The penis stiffens as the auteries and the spongy tissues dilate and squeeze the vein shunt.
♦ It withstands till the venous drain leakage takes place. Otherwise erection flags when
another enzyme called phospho diesterase type 5 (PDE5) neutralises the cGMP. The
spongy tissues compress and blood drains out through vein.
♦ Usually anxiety or fear leads to the situational impotency. A temporary impotency mostly
achieved by verious leakage or any metabolic disorders such as stoulya (obesity). Out of the
various groups of impotency beejadosha janya or sukra dhatu gata mapumsakata can not
be treated. We can make a prophylactic treatment for father and mother before conception
there by they want give birth to child of impotency. The other group, temporary impotency
are situational impotency can be treated best out of Ayurveda.
ED
21
Conclusions
1. Sex act is equal responsibility, sharing and inter personal
communication of partners. Both of sex partners are equally
responsible for the ED development
2. Sex disturbances are common and need not be always a psycho
pathology
3. Mother is responsible for genesis of impotency in child by her psyche,
dietetics, behavioral or genetically intervention
4. Growth (proper cell division) is directly proportional to Libido / sex
arousal
5. Apart from many symptoms nervousness, over sweating and pseudo
anasarca are predominate symptoms of Erectile dysfunction
6. The situational or temporary ED can be treated effectively with Vata
hara, Sukra shodhaka modalities of management and any structural
imparities are well managed with surgical procedures
7. Uttara vasti is a best shodhaka and also shamaka management in ED
8. Vajikarana is a management told in samhita much times misinterpreted as Sexology, which
can not be accepted
9. Vajikarana is intended to facilitate potent offspring is a Male dominate and meant for Males
either to relieve penile problems or to initiate sex even to get abundant semen for enerating
the healthy successive generation other wise it is “Eugenics” I.e. improvement of the
qualities of a race by control of inherited characteristics
10. Vajikarana (Aphrodisiacs) is that which potentates a man to traffic in to women like a horse
and also sustenance in the same mainly the animal relationship example are –
♦ Chataka - (Sparrow) multiple short span conjugation with small amount of semen
♦ Gaja - (Elephant) once in a while long time conjugation with abundant semen discharge
♦ Vrusha - (Buffalo) regular stable seasonal conjugation with more quantity sperm (Semen)
♦ Ashwa - (Horse) regular forceful dynamic conjugation with less qualitative semen
♦ Vajikarana is Long lasting since the descend of Ayurveda it needs initial purification of the
body cleansing through “Panchakarma Shodhana” “Temptations” towards female and there
by a chemical reaction occurs in the body through the buffered “Vajikarana Dravya” the
probable action is a - psycho-neuro-motor activity enhances the blood flow to the Male
genitalia, so it erects and ejaculates well to produce a child
ED
25
♦ Sexology is ... A science which is based on mutual consent, gratification, seduction and
conjugal satisfaction of either gender where birth of child is not essential
♦ Sex is other wise a materialistic pleasure of either gender, some times it is of the same
gender initiated by PDE5, cGMP & NO and lacks of it gives rise to ED
♦ A patient of ED or Perfect Sex of an individual is assessed by –
1. MSP - my sexual persona,
2. GRISS - Golombok-Rust Inventory of sexual satisfaction
3. GRIMS - Golombok-Rust Inventory of Marital state
4. HARDS (HAR) - Hospital A&D score & Stress score
5. Libido score
6. Frequency of NPT
7. Penile Erection score
8. Penile Rigidity score
9. Semen Ejaculation score
10. Orgasm score
11. Androgen deficiency score
♦ Woman is the platform and media for sex and considered always potent in sexual activity
but she plays passive role in sex, hence Vajikarana is not mandatory for woman is a
statement of ancient.
♦ Not only Vaginismus, Dyspareunia, Sexual fantasies, masturbation and Premature
ejaculation and/or orgasm problems are becoming common in female.
♦ At present many occasions it is found and researches are going on with the “Female sexual
dysfunction” and Female ED. Next topic of interest is “Female sexual dysfunction”
From the Desk of Dr. K. Shiva Rama Prasad, M.D.(KC), C.O.P. (German) M.A, Ph.D (Jyo)