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01

Gender Specific diseases of Ayurveda


W.S.R. to Male Erectile Dysfunction
(Klaibya)

Dr. K. Shiva Rama Prasad


M.D.(KC), C.O.P. (German) M.A, Ph.D (Jyo)
doctorksrprasad@sify.com

Ayurveda & Gender specificity

♦ Ayurveda with 8 branches did not give special priority to gender


♦ The term “Purusha” is used to human in general
♦ Women is identified with the special srotases viz. Artava vaha srotas
(Yoni) and Sthanya vaha srotas (Breast)
♦ The diseases of the female were discussed with reference to that of
Prasooti and Stree roga pertained to female genitalia but not given nay
importance of Sex or pleasure the function of the “Guhya” or “Upasta”
as given in case of male
♦ Sexual capacity is not an inherent, constant, general property. Capacity to have sexual
intercourse with woman differs from person to person and is not constant throughout the life
span of a person.

History & Gender specificity

♦ First time in the modern history Dr. William Masters, a gynecologist


with his wife and former assistant Mrs. Virginia Johnson, created
special packages of training for various sexual problems

♦ Medically speaking, Impotency is defined as the inability to sustain an


erection sufficient for intercourse on at least 25% of attempts

♦ 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
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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.

Disease development & Society


♦ The people who are living in the townships became lethargic
and diseased rapidly. This was the fault under went by them.
♦ They attained the symptoms such as mental confusion, loss of
potency, loss of luster, loss of voice, inconvenience, etc.,
♦ All these are conformed only because of “Gramyavasa” i.e.
living in the townships.
♦ It is clear and evidential that the “Klaibya” is also one such
disease condition developed only because of “Living City day
lights of Concrete Jungle”
♦ @ñ¹ÉªÉ: JɱÉÖ EònùÉÊSÉiÉ ¶ÉɱÉÒxÉɪÉɪÉÉ´É®úɶSÉ OÉɨÉÉè¹ÉvªÉɽþÉ®úÉ: ºÉÆiÉ: ºÉÉÆ{ÉÊzÉEòÉ
¨ÉÆnùSÉä¹]õɶSÉ xÉÉÊiÉEò±ÉɪÉÇ: |ɪÉähÉ ¤É¦ÉÚ´ÉÖ: . iÉä ºÉ´ÉÉǺÉÉʨÉÊiÉ EòiÉÇ´ªÉiÉÉxÉɨɺɨÉlÉÉÇ:
ºÉÆiÉÉä - ¨ÉxÉÉäM±ÉÉÊxÉ®ú|ɦÉÉ´Éi´ÉÆ ´É躴ɪÉÈ ´Éè´ÉhªÉÈ SÉ OÉɨªÉ´ÉɺÉEÞòiɨɺÉÖJɨɺÉÖJÉÉxÉÖ¤ÉxvÉÆ SÉ
OÉɨªÉÉäʽþ ´ÉɺÉÉä ¨ÉڱɨɶɺiÉÉxÉÉÆ - SÉ®úEò ÊSÉÊEòiºÉÉ 1/4/3-4
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03

Purusha – Sukra

♦ Pususha are of Srotomayam, Shaturvimshati tatwa yuktam,


Shatdhatu yuktam, Tridosha & Sapta dhatu yuktam, etc.
♦ Out of the very important factor of reproduction is semen i.e.
Sukram.
♦ The health of the individual can be estimated through the Ojas
and Sukra, which spread all over the body
♦ The Sukra formation, ejaculation till to the development of
progeny one reflects its genes and genetic reflections
♦ Klaibya is such a condition where physical, environmental.
Psychological, pathological, emotional and many more factors
are involved.

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)

♦ At opine of Charaka the semen is “Vishwaroopasya


Roopadravyam” with the qualities of thick (Bahalam),
sweet, soft, white and much (Bahu). Such semen is strong
to produce offspring.

♦ Vagbhata accepts both of the statements (A.H.Sh.1/18)


♦ º¡òÊ]õEòɦÉÆ pù´ÉÆ ÎºxÉMvÉÆ ¨ÉvÉÖ®Æú ¨ÉvÉÖMÉÎxvÉSÉ ¶ÉÖGòʨÉSUôÎxiÉ EäòÊSÉkÉÖ iÉè±ÉIÉÉèpùÊxɦÉÆ iÉlÉÉ - ºÉÖ¶ÉÞiÉ ¶ÉÉ®úÒ®ú 2/20
♦ ºÉÉ訪ÉÆ ¶ÉÖGÆò - (ºÉÉ訪ÉÆ ºÉÉä¨ÉMÉÖhɦÉÚʪɹ]õ¨É - b÷±½þhÉ) ºÉÖ¶ÉÞiÉ ¶ÉÉ®úÒ®ú 3/3
♦ SÉ®úiÉÉä Ê´É· É°ü{ɺªÉ °ü{Épù´ªÉÆ ªÉnÖùSªÉiÉä ¤É½þ±ÉÆ ¨ÉvÉÖ®Æú κxÉMvɨÉÊ´É»ÉÆ MÉÖ¯û Ê{ÉÎSUô±É¨É ¶ÉÖC±ÉÆ ¤É½Öþ SÉ ªÉSUÖôGÆò ¤É±É´ÉkÉnùºÉƶɪÉÆ
- SÉ®úEò ÊSÉÊEòiºÉ 2/4/49
♦ ¶ÉÖGÆò ¶ÉÖC±ÉÆ MÉÖ¯ûκxÉMvÉÆ ¤É½Öþ±ÉÆ ¤É½Öþ, PÉÞiɨÉÉÊIÉEòiÉè±ÉɦÉÆ ºÉnÂùMɦÉÉÇªÉ - +¹]õÉÆMÉ ¾þnùªÉ¨É ¶ÉÉ®úÒ®ú 1/18
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04

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

The saga of sex … LAPS with Astanga- Maidhuna


• Sex starts from the womb by fondling the genitalia
• Knowing the sexual anatomy at the adolescence,
interest generates to explore
• Generating the gender-maps (developmental
representation - gender identity) and Love-maps
(idealized Love & Lover - Affair - Program - Sexoerotic
activity projected either imaginary or actual)
• Leads to either harmonious matrimonial life or to get in
to a courtesan (sex worker)
• Sukra dhatu, which is, present all over the body with its
derangement either in quality or quantity not only leads to defective fertilization but also to
the mal formation of the foetus.
• Mutative age of Sex act – as a child Sukra is subtle like the flavor of a bud. Reproductive
capacity is expressed by the presence of the semen. At old age as natural degeneration
takes place the man loses his sexual urge. Thus the sex act for child under 16 years and old
aged of 70 years are prohibited.
• Astanga-Maidhuna - eight Sexes – acts
o Smarana - remembering Lover
o Keertana - singing for / with lover
o Kreeda - conjugal play with lover
o Prekshanam - dancing with lover
o Guhyabhashanam - secret seductive talk
o Sankalpa - psycho sex act initiation
o Adhyavasaya - developing enthusiasm in
o Kriya nivrutti - submissive withdrawal

• ªÉlÉɤÉÒVɨÉEòɱÉɨ¤ÉÖ EÞòʨÉEòÒ]õÉÎMxÉnÚùʹÉiɨÉÂ. xÉ Ê´É®úÉä½þÊiÉ ºÉÆnÖù¹]Æõ


iÉlÉÉ ¶ÉÖGÆò ¶É®úÒÊ®úhÉɨÉ - SÉ®úEò ÊSÉÊEòiºÉ 30/133
• ªÉlÉÉ ¨ÉÖEÖò±É{ÉÖ¹{ɺªÉ ºÉÖMÉÆvÉÉä xÉÉä{ɱɦªÉiÉä ±É¦ªÉiÉä. iÉÊuùEòɶÉÉkÉÖ
iÉlÉÉ ¶ÉÖGÆò ʽþ näùʽþxÉɨÉÂ.. xÉiÉæ´Éè ¹ÉÉäb÷¶ÉÉuù¹ÉÉÇiºÉ{iÉiªÉÉ: |ÉiÉÉä xÉSÉ. +ɪÉÖ¹EòÉ+Éä xÉ®ú: ºjÉÒʦÉ: ºÉƪÉÉäMÉÆ EòiÉÖǨɽÇþiÉä.. SÉ®ú Eò
ÊSÉÊEòiºÉ 2-4-39-40
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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.

♦ After ejaculation has been completed, blood begins to leave the


Erectile tissue, and the erection begins to subside. This subsidence,
called detumescence, (The loss of a penile erection) is mediated by
the sympathetic nervous system.

♦ Higher centers, including the cerebral cortex, can facilitate or inhibit


many of the important reflexes, thereby modifying the patterns of
sexual function.

♦ In summary, arousal, erection, emission, and ejaculation are controlled by a complex


interplay between the sympathetic and parasympathetic divisions of the ANS.

Eight ejaculatory factors


♦ The most important factor that produces ejaculation of the semen, which is spread all over
the body, is the sexual intercourse. There are eight factors, which initiates the semen
ejaculation other than that of intercourse. They are -
1. Pleasure with intention
2. Desire
3. Unsuitability of the semen
4. Sliminess of the semen
5. Heaviness of the semen
6. Capacity to pass through the srotas (Anutwa)
7. Inherent quality to move out of the body
8. Stimulation by Vata
♦ Any physical or psychological factor that affects a single
component of the system can result in male sexual dysfunction, also called impotence (The
inability to obtain or maintain an erection) i.e. Klaibya.

♦ ºÉ´ÉÇjÉÉxÉÖMÉiÉÆ näù½äþ ¶ÉÖGÆò ºÉƺ{ɶÉÇxÉä iÉlÉÉ. iÉiÉ ºjÉÒ{ÉÖ¯û¹ÉºÉƪÉÉäMÉä SÉä¹]õɺÉÆEò±{É


{ÉÒb÷xÉÉiÉÂ. ¶ÉÖGÆò |ÉSªÉ´ÉiÉä ºlÉÉxÉÉVVɱɨÉÉpùÉÇi{É]õÉÊnù´É.. ½þ¹ÉÉÇkɹÉÉÇiºÉ®úi´ÉÉSSÉ {ÉèÎSUô±ªÉÉnÂùMÉÉè®ú´ÉÉnùÊ{É. +hÉÖ|É´ÉhɦÉÉ´ÉÉSSÉ
pÖùiÉi´ÉÉx¨ÉɯûiɺªÉSÉ. +¹]õɦªÉÉä B¦ªÉÉä ½äþiÉÖ¦ªÉ: ¶ÉÖGÆò näù½þÉiÉ |ÉʺÉSªÉiÉä. SÉ®úEò ÊSÉÊEòiºÉ 2-4/46-48
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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.

Gender-map and Love-maps.


♦ Ones stimulus, arousal, erection, orgasm and ejaculation
depend upon gender-maps and love-maps. Prof. Dr. John
Money of Baltimore, USA, defines the Gender-map and Love-
maps.
♦ The Gender-map is defined as a developmental
representation or template synchronously in the mind and
brain depicting the details of one's gender/ identity role.
♦ Where as Love-map is depicting the idealized lover, the
idealized love affair and the idealized program of sexo-erotic
activity projected in imagery or actually doing sex with lover.
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Male Sexual Function


♦ Complex neural reflexes that we do not yet understand
completely coordinate sexual function in males. The
reflex pathways utilize the sympathetic and
parasympathetic divisions of the ANS.
♦ During arousal, erotic thoughts, the stimulation of
sensory nerves in the genital region, or both leads to an
increase in the parasympathetic outflow over the pelvic
nerves, which leads to erection of the penis.
♦ The integument covering the glans of the penis contains
numerous sensory receptors, and erection tenses the
skin and increases their sensitivity.
♦ Subsequent stimulation may initiate the secretion of the bulbourethral glands, lubricating the
penile urethra and the surface of the glans.
♦ During intercourse, the sensory receptors of the penis are rhythmically stimulated. This
stimulation eventually results in the coordinated processes of emission and ejaculation.
♦ Emission occurs under sympathetic stimulation. The process begins when the peristaltic
contractions of the ampulla push fluid and spermatozoa into the prostatic urethra.
♦ The seminal vesicles then begin contracting, and the contractions increase in force and
duration over the next few seconds.
♦ Peristaltic contractions also appear in the walls of the prostate gland. The combination
moves the seminal mixture into the membranous and penile portions of the urethra.
♦ While the contractions are proceeding, sympathetic commands also cause the contraction of
the urinary bladder and the internal urethral sphincter. The combination of elevated pressure
inside the bladder and the contraction of this sphincter effectively prevent the passage of
semen into the bladder.
♦ Ejaculation occurs as powerful, rhythmic contractions appear in the ischiocavernosus and
bulbospongiosus muscles, two superficial skeletal muscles of the pelvic floor. The
ischiocavernosus muscles insert along the sides of the penis; their contractions serve
primarily to stiffen that organ.
♦ The bulbospongiosus muscle wraps around the base of the penis, and its contraction
pushes semen toward the external urethral opening. These contractions are controlled by
somatic motor neurons in the lower lumbar and upper sacral segments of the spinal cord.
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09

Hormones of the Reproductive System


Hormone Source Regulation of Secretion Primary Effects
Males: inhibited by
testosterone and
Gonadotropin-
possibly by inhibin
releasing Stimulates FSH secretion, LH
Hypothalamus Females: GnRH pulse
hormone synthesis
frequency increased by
(GnRH)
estrogens, decreased
by progestins
Males: stimulates
Males: stimulated by spermatogenesis and
Follicle- GnRH, inhibited by spermiogenesis through effects
Anterior
stimulating inhibin Females: on sustentacular cells Females:
pituitary
hormone (FSH) stimulated by GnRH, stimulates follicle development,
inhibited by inhibin estrogen production, and oocyte
maturation
Males: stimulated by
GnRH Females:
Males: stimulates interstitial cells
production stimulated
to secrete testosterone Females:
Luteinizing Anterior by GnRH, secretion by
stimulates ovulation, formation of
hormone (LH) pituitary the combination of high
corpus luteum, and progestin
GnRH pulse
secretion
frequencies and high
estrogen levels
Androgens
Establish and maintain secondary
(primarily
sex characteristics and sexual
testosterone Interstitial cells
Stimulated by LH behavior; promote maturation of
and of testes
spermatozoa; inhibit GnRH
dihydrotestoster
secretion
one)
Stimulate LH secretion (at high
Granulosa and levels); establish and maintain
Estrogens thecal cells of secondary sex characteristics and
(primarily developing Stimulated by FSH sexual behavior; stimulate repair
estradiol) follicles; corpus and growth of endometrium;
luteum increase frequency of GnRH
pulses
Granulosa cells
Progestins from mid-cycle Stimulate endometrial growth and
(primarily through Stimulated by LH glandular secretion;
progesterone) functional life of reducefrequency of GnRH pulses
corpus luteum
Stimulated by factors
Sustentacular
released by developing
cells of testes Inhibits secretion of FSH (and
Inhibin sperm (male) and
and granulosa possibly of GnRH)
developing follicles
cells of ovaries
(female)
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10

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
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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

Etiological evaluation of impotency


♦ Napumsakata or impotence is going to be bestowed in a child through genetic defect as
qualitative or quantitative depletion of semen of father and irregularity in sex postures and
psyche attached to another male or any pyogenic conditions in vagina of mother.
♦ Apart from above said causes few dietetic, psychic, exorcists, excessive indulgence in sex
act, dhatukshaya, doshavaishamata, sephadosha, etc., causes are also mentioned as
etiology of impotency.
♦ We want sex badly enough but just can't be bothered. In this age lack of time and energy
made sex difficult, once a day or part night (Paksha Shanda). We began to compromise on
our sex life and on our relationships. Sex doesn’t come easy, it depends on health and it is
not just intercourse, it is all about pleasure.

Classification of Klaibya – (Charaka)


♦ Four fold Impotency (Charaka): Charaka classify Klaibya by origin as –
1. Beja dosha – due to the defective Pumbeeja (semen)
2. Dhwajopaghta – due to the injury to the genital organs
3. Jara – due to the old age
4. Sukra kshaya – due to the deficiency of semen
quantity (Stula Sukra)
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12

Classification of Klaibya – Susruta


♦ Six fold Impotency (Susruta) (Su.Chi.26/7-12)
1. Manasika or psychological – due to the bitter thoughts / recollection or a forced
intercourse with a disagreeable women who fails to sufficiently rouse up the sexual desire
2. Aharaja – due to the excessive intake of Katu, Amla, Lavana rasa and Ushna veerya
dravya, which leads to loss of semen
3. Ativyavayaja – due to addiction to excessive sexual pleasure with out using aphrodisiacs
4. Abhighataja – due to chronic disease of the genitalia (syphilis, gonorrhea, AIDS) or
destruction of a local marma by injury
5. Sahaja – (congenital) due to beeja dosha of either mother or father
6. Vegavarodhaja – due to voluntary suppression of natural urge – sex desire
♦ ¤ÉÒVÉv´ÉVÉÉä{ÉPÉÉiÉɦªÉÉÆ VÉ®úªÉÉ ¶ÉÖGò ºÉÆIɪÉÉiÉ C±É褪ÉÆ ºÉÆ{ÉtiÉä iɺªÉ ¶ÉÞhÉÖ ºÉɨÉÉxªÉ ±ÉIÉhɨÉ - SÉ ÊSÉ 30/154
Symptoms of Klaibya – Impotency
♦ A person is considered impotent in any one or all of the following symptoms are noted.
1) Inability to indulge in sexual act, ever if he desires to with a women who is capable of
rousing his desire
2) Dyspnoea and excessive perspiration and fatigue after the act
3) Ineffective stimulation of the genitals with complete lack of semen
♦ According to Vagbhata –
1. Premature ejaculation
2. Pelvic Pain (testis, penis, anus)
3. Swelling in the lower part of body (testis, penis, anus)
4. Fever
5. Chest pain
6. Obstructive urination
7. Testicular swellings
8. Urolithiasis (kidney, urethra)
9. Shandata – Klaibya

♦ ºÉÆEò±{É |É´ÉhÉÉä ÊxÉiªÉ¨É Ê|ɪÉÉÆ ´É¶ªÉɺÉÉÊ{É ÎºjɪɨÉ - xɪÉÉÊiÉ Ë±ÉMÉ


¶ÉèÊlɱªÉÉiEònùÉÊSÉtÉÊiÉ ´ÉɪÉÊnù - · ÉɺÉÉiÉÇκº´ÉzÉ MÉÉjɶSÉ ¨ÉÉäPÉ ºÉÆEò±{É SÉäι]õiÉ: - ¨±ÉÉxÉ Ê¶É¶xɶSÉ
ÊxɦÉÔVɺºªÉÉnäùiÉi±Eèò¤ªÉ ±ÉIÉhɨÉ - SÉ®úEò ÊSÉÊEòiºÉ 30/155-156
♦ ¶ÉÖGòÉkÉi»É´ÉhÉÆ MÉÖÁ´ÉänùxÉɺ´ÉªÉvÉÖV´ÉÇ®ú: ¾þnÂù´ªÉlÉɨÉÚjɺÉÆMÉÉÆMɦÉÆMÉ ´ÉÞnÂùvªÉ¶¨É¹ÉÆb÷iÉÉ: - +¹]õÉÆMÉ ¾þnùªÉ¨É ºÉÚjÉ 4/20
ED
13

Sukra & Sukra vaha srotas in Klaibya


♦ The Sukra or semen (the complete testicular secretions i.e., Semen + Androgens) has
synonyms of Retas, Beejam, Varam, Veeryam, Harshajam, Snehu, Powrusham, Suklam
and Pradhana dhatu.
♦ The Sukra flows in sukravaha srotas, which are spread all over the body. Shukra is the thing
belonging to man, product of 4 proto-elements (Ap, Agni, Pruthvi and Vayu), composed of
all six tastes, when deposited in the womb of a woman brings about conception (Cha.Sa2/3)
♦ Retas, the ejaculate (Rupadravya) comes out during intense coital pleasure. (Ca. Ci.
2/4/48-50, Su. Sa. 2/11). Praharsha (Excitement, Erotic), Dhairya (daring activeness), Priti
(Love), Cyavana (to come out), Bala (Energy) and Garbhotpatti (Fertilization) are the
functions of Sukra related to sexuality (A.H.Su. 1 1/4, Su. Su. 15/5, Ca. Ci. 15/6).
♦ Any defect in Shukra thus leads to infertility and sexual dysfunction (Ca. Ci. 30/153, Ca. Ci.
30/139-144, Su. Sa. 2/3). Therefore in man Sukra is responsible for all-reproductive
phenomena and relative psycho-sexo-neuro-endrocrinal dysfunction too (A.S.U. 50/7).
♦ When these are at failure two types of Impotency develops.
1) Sukra vaha sroto dusti with sukra dusti, where erection is possible but unable to
produce offspring.
2) Erection is not possible because of local lesion in penis or retovaha sira/srotas.
The causes of Sukra vaha srotas dusti are – (cha.chi.30/135-138)
1. Indulging in the several sex act at a time when the person is nor roused with desire
2. Indulging in sex act with animals
3. Withholding the sexual indulgence
4. Excessive sexual indulgence
5. Injury due to the instruments, Kshara and Agni kriya
6. Ahara – Asatmaya and non computable
7. Vihara – masturbation, excess sex acts
Eight defects of semen (cha.chi.30/139)
1. Phenila 5. Pooti
2. Tanu 6. Pichchila
3. Rooksha 7. Anya dhatu samslishtata
4. Vivarna 8. Avasadi
ED
14

Klaibya reemphasized as Napumsaka

SHANDA: - (Nara/nari Shanda) A child born of an act of fecundation foolishly or ignorantly


effected during the menaces of its mother by its progenitor by holding her on his bosom during
the act is called a Shanda and invariably exhibits effeminate traits in his character. A daughter
born of a woman riding on her husband during the act of sexual intercourse will develop
masculine traits in her character. Here Klinefelter's and Turner syndrome are applicable, which
are said to be the beeja dosha or chromosomal anomalies.
ASEKYA: - A child born of scanty paternal sperm becomes
an Asekya and feels no sex desire with out previously
drinking the semen of another man.
SOUGANDHIKA: - A child begotten in a sordid vagina is
called a Sougandhika, whose organ does not respond to
the sexual desire without smelling the genitals of others.
KUMBHIKA: - The man who first becomes a passive
member of an act of sodomy and able to act as man with
good erection is called as Kumbhika.
IRSHAYAKA: - The man who can not copulate with a
women without previously seeing the sexual intercourse of
another is called as Irshaka (Voyeurism).
KLEEBA: - Kleeba is defined as a person with ED under
various etiological factors.

Napumsaka (Klaibya) reclassified

Napumsaka are classified as under.


1. Asukra Napumsaka
i) Beeja dowrbalya or beeja dosha
a) sukra dosha - nara shanda ; Klinefelter's syndrome
b) artava dosha - nari shanda ; Turner syndrome
ii) Garbha dosha - pseudohermaphroditism
iii) sukra dhatu vaha sroto dosha
iv) Retovaha sira dosha or sosha
v) retovaha sroto dosha
ED
15

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

Classification of sexual disorders


The following people are said to be suffering from 'Sexual Disorders'
♦ Those individuals who are unable to participate in a sexual relationship and carry out the
sexual activity to their and their partners' satisfaction
♦ Those who lack interest in the heterosexual act and fail to have normal psycho-physiological
responses necessary for sexual interaction
♦ Fail to experience orgasm
♦ These disorders are:
1) Sexual dysfunction:
a) Lack or loss of sexual desire – In women it is known as 'Frigidity'.
b) Sexual aversion and lack of sexual enjoyment
c) Failure of genital response;
In men: Erectile dysfunction difficulty in developing and maintaining an erection
required for coitus
In female: Vaginal dryness.
d) Orgasmic Dysfunction
e) Premature ejaculation: Inability to
control ejaculation.
f) Vaginismus: Spasm of the muscles
surrounding the vagina leading to difficulty
in the coitus.
g) Dyspareunia: Pain during sexual
intercourse
h) Excessive Sexual desire
2) Gender identity disorders
a) Trans-sexualism: Desire to live and be
accepted as a member of opposite sex.
They ask for 'Sex change operation'.
b) Transvestism: Wearing of clothes of opposite sex and enjoy being the member of opposite
sex for short periods.
ED
17
3) Disorders of sexual preference:
a) Fetishism: Getting sexual arousal and satisfaction
with articles like clothes, shoes of the opposite sex.
b) Exhibitionism: Exposing genitalia to the members
of opposite sex and getting sexual satisfaction.
c) Voyeurism: Getting sexual satisfaction by looking
at people engaging in sexual act.
d) Paedophilia: Sexual preference for children
e) Sadomasochism: Sexual preference for infliction
of pain during sexual activity.
f) Homosexuality: Preference for member of the
same sex for sexual activity and gratification.
IV. Dhat Syndrome (Culture Bound Syndrome)
♦ Dhat Syndrome is specific to Indian subcontinent.
♦ As people wrongly believe that masturbation is bad and leads to sexual weakness, loss of
semen leads to sexual weakness as well as sterility;
♦ They start worrying about masturbation and semen loss.
♦ They develop multiple somatic complaints like general weakness, easy fatigability,
decreased concentration, memory, black rings around the eyes, loss of hairs or graying of
hairs, premature ejaculation, Erectile dysfunction, fear of being sterile and attribute these
symptoms to -
1. Masturbation
2. Nocturnal emission
3. Sexual fantasies
4. Passing semen in urine
5. Frequent sexual intercourse
They have to be reassured and educated to remove
these beliefs.
ED
18

INTERVENTION OF AGNI IN IMPOTENCY


♦ Dhatwagni influences two types of Dhatwagnipaka, prasada and kitta where transformation
of nourishing material and waste products takes place respectively.
♦ The specific functions of dhatwagni are synthesis of particular dhatu and continuous
replenishment by nutrients.
♦ The main dhatwagni vyapara of Sukra is stated by some Acharyas as production of Ojas
and Vagbhata considers it as mala of Sukra.
♦ Function of Sukra is said as reproduction. It not only means perpetuating the progeny but
also cell division in the body.
♦ The stula sukra (semen) and Sukradhatu are different entities. Sukra gata Kusta, where
Sukradhatu and sukragni are involved in pathogenesis influences the repair and healing
process or a loss of regeneration, and more over it carries to the offspring.
♦ A non-regenerative cell media leads to an individual depressed and physically week body
states, resulting into a temporary or permanent Impotency.

The Male Climacteric in Aging


♦ Changes in the male reproductive system occur more gradually than do those in the female
reproductive system. The period of change is known as the male climacteric (The age-
related cessation of gametogenesis in males due to reduced sex hormone production).
♦ Levels of circulating testosterone begin to decline between ages 50 and 60, and levels of
circulating FSH and LH increase.
♦ Although sperm production continues (men well in to their eighties can father children), there
is a gradual reduction in sexual activity in older men.
♦ This decrease may be linked to declining testosterone levels (Sukra
dhatu in the body). Some clinicians are now tentatively suggesting the
use of testosterone replacement therapy to enhance libido (sexual drive)
in elderly men.
♦ The inability to contract the ischiocavernosus and bulbospongiosus
muscles would interfere with a male's ability to ejaculate and to experience
orgasm.
♦ As the result of parasympathetic stimulation in females during sexual
arousal, there is engorgement of the Erectile tissues of the clitoris, increased
secretion of cervical and vaginal glands, increased blood flow to the walls of
the vagina, and engorgement of the blood vessels in the nipples.
ED
19

Physiology of erection -The penis and Erectile function


♦ The penis is composed of the corpus cavernosum, two parallel spongy columns of Erectile
tissue, and the corpus spongiosum
♦ Erectile tissue is rich in tiny pool-shaped blood vessels (cavernous sinuses), surrounded by
smooth muscles and supported by elastic fibrous tissue composed of collagen.
♦ In the flaccid, or un-erect, state of the normal penis, the small arteries leading to the
cavernous sinuses contract, reducing the in flow of blood.
♦ The smooth muscles of the many tiny blood vessels within the penis are also contracted,
and the blood they contain leaks out of the surrounding spongy tissue, when a man
becomes aroused, his central nervous system stimulates the release of a number of
chemicals, including acetylcholine and nitric oxide, that relax the smooth muscles in the
penis, allowing blood to flow into the tiny pool-like sinuses and flood the penis.
♦ The spongy chambers almost double in diameter due to the increase in blood flow.
♦ The veins surrounding the corpus cavernosum and corpus spongiosum are squeezed
almost completely shut by the pressure of the Erectile tissue
♦ They are unable to drain blood, causing the penis to become rigid.
♦ Oxygen-rich blood is critical for Erectile health.
♦ Oxygen itself affects two substances that are important in achieving erection; it suppresses
transforming growth factor beta I(TGF-BI) and enhances prostaglandin E1.
♦ The smooth muscles produce TGF-B1, a component of the immune system, its role is to
produce collagen.
♦ Collagen contributes not only to structural tissue in the
body but is also the material that comprises scar tissue.
♦ Prostagladin E1 is produced during erection by the muscle
cells in the penis; it activates and enzyme that results in
calcium release by the smooth muscle cells, which in turn,
relaxes them and allows blood flow.
♦ Prostaglandin E1 also suppresses collagen production.
Oxygen levels vary widely from reduced levels in the
flaccid state very high in the erect state.
♦ During sleep, for instance, oxygen levels are high and a
man can normally have three to five erections per night,
each one lasting from 20 to 40 minutes.
ED
20

Pathophysiology of Erectile dysfunction (impotence)


♦ Impotence or Erectile dysfunction is the inability to achieve or maintain
an erection sufficiently rigid for intercourse, ejaculation or both.
♦ It does not affect sexual drive or the ability to have an orgasm.
♦ Rarely does Erectile dysfunction signify a chronic problem.
♦ When a consistent pattern of sexual dysfunction extends over a
prolonged period of time.
♦ However, a physical or serious emotional disorder may be indicated.
Impotence is not new in the medical texts or in human experience.
♦ It is not easily or openly discussed, however.
♦ Our cultural expectations of male to sexuality have forced many men to
refrain from seeking help for a disorder that can, in most cases, benefit
from medical treatment.

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

How Is Impotence Diagnosed? Medical and personal history


♦ There are several tests available to assist physicians in diagnosing impotence and its
causes.
♦ The first step is, of course, talking openly the patient must be as frank as possible in order to
assist his physician in making a diagnosis.
♦ In addition to reporting any past and present medical problems, the patient should report
any medications or drugs he is taking and any history of psychological problems, including
stress, anxiety, or depression.
♦ The physician also requires a sexual history. This should include the nature of the onset
of the dysfunction, and the frequency, quality, and duration of- any erections, and whether
they occur at night or in the morning.
♦ The physician might also ask about the specific circumstances when Erectile dysfunction
occurred, details of technique, the man's motivation for and expectations of treatment, and
whether problems exist in the current relationship.
♦ The man should not interpret these questions as intrusive or too personal if he expects to
obtain help; they are very relevant and important for determining the proper
approach to the problem.
♦ If appropriate, the physician might also interview the sexual partner.
♦ Apart from this a Physician may use battery of tests, both
laboratory and invasive along with a detailed
examination to diagnose impotence.

Management of ED (Klaibya- IMPOPENCY)


♦ Impotency is of Neuro-vascular disorder, needs of counseling reassurance and correction.
♦ The counseling includes taking information of situation and careful & perfect analysis
♦ Second step is reassurance the patient and correcting the problem.
♦ Venous leak correction or penile prosthesis, etc. treated with surgical interventions.
♦ Erectile dysfunction due to metabolic disorders, emotional or attention deficit disorders
(ADD) are considered specifically or minimal brain dysfunction also leads one to develop
Impotency.
♦ Apanavata – Vyanavata – Sadhakapitta – Manas – axis leads to Sukra dusti & ED to be
regulated along with general health maintenance
ED
22

Medicinal classification used in ED


♦ Many medicines are told for the ED, apart from surgical, instrumental and exercises
♦ The non drug therapy are of psychological – out of the best is “A perfect Female”
♦ Drug therapy includes –
1. Sukra janaka – which increases the semen quantity to rouse the person – eg. Sukra janana
varga - Mudgaparni, Mashaparni, Shatavari, Jatamamsi, Karkata srungi, Dugdha, Masha,
Amalaki, Bhallataka majja, etc,
2. Sukrala or Sukra utpattikara – generates semen – Aswagandha, Sharkara, Musali, etc.
3. Sukra pravartaka or Sukra rechaka – surges the semen – Bruhati, Kantakari, Bhallataki, etc.
4. Sukra janaka pravartaka – increases the quality and quantity and surges semen well in time
– Ksheera, Masha, Amalaki, etc.
5. Sukra shodhaka – eliminates the seminal problems – Sukra shodhaka gana – Kusta,
Elavaluka, Katphala, Samudra phena, Kadamba niryasa, Ikshu, Kandekshu, Ikshurakam,
Vasuka, Usheera, Saireyaka, Gunja, etc.
6. Sukra stambhaka – retards the ejaculation and enhances the longevity of intercourse –
Jatiphala, Ahiphena, Udakeerya, Vatsanabhi, Koshamra, Poogeephala, Tinduka, Vakula,
Babboola, Akarakarabha, etc.
♦ Apart from these – we have many drugs which can act at their pharmacological properties
with specific alkaloids present in them as – Vajeekara, Sukrala, Vrushya, Dhatu pustikara,
Kamottejaka, etc. are – eg. Kapikacchu, Gokshura, Kakamachi (DM), Taalaphala,
Mocharasa, Kumari (for female), Palasha, Kharjura, Kushmanda, Eranda, Sariba,
Tamboola, Bakuchi, Latakasturi, Twaka, Shireesha, etc.
♦ Our of Rasa dhatu – Swarna, Abhraka, Parada, Swarna makshika, Vajra bhasma, etc.
♦ Vrushya varga – Madhura rasa, Snigdha Guru Guna, Brumhana, Jeevaneeya dravya and
Manollasakara vihara always useful to rectify ED
Some Vajikarana Yoagas are used at ED
Akarakarabhadi vati (Bh.Pr.Ut) Rativardhana Yoga (Bh.Pr.Ut)
Bruhatchagalyadighruta (Bh.Rt.74/312-336) Shatavari Ghruta (Ch.chi.2-3/18)
Brumhani Guti (Ch.chi.2-1/24-33) Vajikarana ghruta (Ch.chi.2-1/33-37)
Kameswara modaka (Bh.Pr.Ut) Vanariguti (Bh.Pr.Ut)
Mamsa Guti (Ch.chi.2-4/11-14) Vidaryadi churna (A.H. Ut.40/21-22)
Narasimha choorna (Chakradatta) Vrushya Ghruta (Ch.chi.2-2/21-23)
Poogapaaka (Bh.Pr.Ut) Vrushya Guti (Ch.chi.2-4/30-32)
ED
23

Uttravasti in ED and orgasmic problems - ultimate management


♦ Modern medicine has hardly any drugs or therapy to benefit patients with Inhibited
Sexual Desire (ISD)
♦ Uttaravasti with vatahara and sukradoshahara dravyas either in the form of taila or kashaya
to be introduced per urethra at the quantity of 10 to 15 ml according to the procedure. It
relieves the diseased state and normal equilibrated state is introduced in the body humors
and tissues.

ED – Other Managements (Select patient either for Drug Therapy or Drugless)


1. It is best to maintain general health to regulate under the stipulations of Dinacharya and
Rutucharya as a prophylactic measure.
2. Erection frequenter technique – repeatedly exciting erection withdrawal technique
3. Kegel Exercise – is simple used at urinary incontinence – inhibiting the urinary reflex and
tightening and releasing pelvic muscles at least 10 –15 times at each episode
4. Reducing causative medication - such as ACE inhibitors
5. Psychotherapy and Behavioral therapy - it is a part of counseling and reassurance
6. Injections – Alprostadil or Prostaglandin E1 urethral injections, Papvarine injections in to
spongy tissue
7. Oral Drug Therapy – Sildenafil – acts over PDE5, cGMP, effective with in 20 –30 minutes
8. Other experimental oral drugs - Phentolamine, Apomorphine, Pentoxifylline (for rich
Oxygen delivery), Naltrexone, etc.
9. Hormone Replacements – Testosterone therapy
10. Tropical medicine – Aerosol spray of Minoxidil, SS cream (Herbal), etc.
11. Vacuum devices – plastic cylinder emptiness at penis creates more blood rush
12. Penile implants – surgical procedures implants “Hydralic implant” or “Prosthesis” – a semi
rigid bendable rod resembles erect penis
13. Vascular surgery – bypass or revascularisation with venous legation
14. Folklore / Herbal medicines – Yohimbine, Ginkgo, Ginseng,
15. Ayurvedic Aphrodisiacs - Patient medicines for ED or ISD from Ayurveda (I tried)
Actiforte (Anuja) Himcolin (Himalaya) Spy (Yogi)
Afrol (Solumics) Mustong (TTK) Tentex Forte (Himalaya)
Amber Forte (Anuja) Neo (Charak) Vigorex (Zandu)
Confido (Himalaya) Rathi (Capro) Vimfix (Sandu)
Desirex (Anuja) Senzine (J&J)
ED
24

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)