(Probe (1978): (XVII), 4, 309-312)

Tentex forte and Himcolin in Sex Disorders

Mrinal Kanti Sarkar, M.B.,B.S. Medical Officer In-charge, Burn-Standard Company (Government of India), Durgapur, India. Sexual function in the human male is a dynamic interaction of psychic and somatic factors. Sexuality is a highly emotional experience which, in practice, varies in frequency from person to person. It is influenced by complex psychic factors, as well as physiological factors such as neurological and endocrine status and age. Even socio-cultural factors as income and education and the prevailing sexual norms and attitudes about women could influence sexual activity. Sexual disorders of different types affecting both the sexes present a vast psychosomatic problem difficult to assess and still more elusive to treat. These are the patients who do not seek medical advice primarily for their sexual weakness but mention it only in the course of searching history of some other ailment. It is one of the glaring defects of modern medical education that very little instruction is imparted on medical aspects of sex ailments. Sex education or diagnosis of sex-based disorders or sex disorders is completely neglected. The family physician who is fully conversant with the health, social and psychosomatic background of these ailments finds himself quite helpless to deal with these problems. This personal contact can be helpful for the role of a confidant to establish the underlying sexual basis which most patients feel shy or awkward to talk about. Sexual weakness is not a clinical diagnosis but a relatively vague term. It is a gap between an individuals sexual expectation and performance, between wishful dreaming and plain reality. What is sexual weakness in one might well be sexual prowess in another. While most couples mutually adjust their sexual needs, others panic and create problems for themselves, both real and imaginary. The average doctor finds himself at a loss to counsel when consulted in sex problems. There is every need for a careful examination (so as not to overlook any somatic or toxic cause of sexual deficiency), counselling, reassurance and education in the techniques of love making. Dr. Heilig, feels that besides persuasion, patients need something to restore their self confidence. Effective treatment must be given to the patients. A person who feels incompetent in his sexual activity is apt to get so disturbed that his lack of confidence may indirectly influence his other day-to-day activities. Failure to consummate the sexual act properly may disturb mental peace and bring marital disharmony in his social life and even lead to a broken home. The most frequently committed mistake in the choice of treatment is to prescribe male hormones. Every increase of male hormone in the circulation inhibits the secretion of pituitary gonadotrophin. The less gonadotrophins produced, the less stimulation of leydig cells takes place and the less male hormone is produced. Administration of testosterone therefore inhibits the hormone production by reducing the secretion of leydig cell stimulating gonadotrophin. Impotence is not improved by testosterone therapy. Prof. Dr. R.D. Kulkarni mentions that as the clinical assessment of the effectiveness of sex remedies depends on the subjective reports by the patients, animal experiments are more valuable. In his study, Tentex forte administered to male monkeys had a two-fold action on sexual behaviour. Tentex forte had an immediate stimulant effect and on prolonged administration, a more radical change in sexual behaviour occurred due to increased sexual desire leading to improved performance. Remedies used
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for restoring sex powers have to be effective on lines expected by the patients and the effect has to be apparent, fairly quickly. After studying the published papers and the clinical study reports by many clinicians and clinical pharmacologists, the present study of Tentex forte tablets with Himcolin cream (applied locally to the penis and suprapubic region) was undertaken. I started these long-term clinical trials on 4 patients with various types of sexual disorders most confidently since the last few years. I am fully satisfied as regards therapeutic values of these indigenous non-hormonal products, Tentex forte and Himcolin of The Himalaya Drug Co. The therapy was advised only when psychotherapy, reassurance and hormonal therapy failed to show any favourable results. All these patients were well-educated, had good dietary habits and were sexually alert. MATERIAL AND METHODS During the present study, complete history was taken with special reference to past illness, any stress or strain, relations with wife, sexual desire, penile erection, premature ejaculation, frequency and degree of success in the sexual act, cooperation and understanding between the partners, physical and other environment, history of drug or alcohol addition, any organic disease and complete assessment of physical and mental status. After full assessment, Tentex forte 2 tablets b.i.d. and Himcolin cream b.i.d. applied locally to penile and pubic region were given for 20 days. Mild hypertension was not considered as a contra-indication. But the drug was not administered to patients with very high blood pressure, heart disease or chronic renal disease. In these 4 patients, earlier psychotherapy and hormone, therapy had failed to give any results. OBSERVATIONS The personal data in respect of the four patients is given in Table 1.
Table 1: Age and Status Age (years) Married for (years) 55 25 48 20 40 15 40 8

Patient F.O. C. P.K.B. C.C.

Socio-economic status Educated-High Income Gr. ----

The common complaints reported by the above patients were depressed libido, poor erection, short duration of the sexual act which totally contributed to an unsatisfactory sex life. In addition, one patient (F.O.) complained of premature ejaculation. While the general health was more or less good in all cases, their psychological status showed anxiety, depression, feeling of inferiority and mild hypertension. Personal enquiries revealed 2 cases with alcohol addiction and two others who found their jobs demanding and strenuous. All stated that they had tried sex hormones and nervine tonics without any success. Following treatment for 20 days with Tentex forte tablets taken orally and application of Himcolin cream in the penile and pubic region, all the 4 patients reported a remarkable change in physical and mental outlook. They regained sexual confidence and experienced vigorous sexual urge. With this improvement in libido and penile erection, all the four patients could derive sexual satisfaction of longer duration. The other benefits included good sleep and weight gain but they may well be the indirect result of sexual satisfaction and freedom from worry over sexual weakness. There were no adverse or toxic side-effects. The patients were followed up from 1-3 years and each one of them

expressed complete sexual satisfaction. Although this study comprised of a small group of patients, the findings are highly promising for further investigation. DISCUSSION The combination therapy, Tentex forte tablets with Himcolin cream gave excellent results on both young and elderly patients suffering from functional impotence, sexual weakness in the elderly and for improvement of sex desire, when given in carefully adjusted doses as per individual requirements, in the last few years in my practice. The patients were selected with great care, excluding those who had any genital disease or other hormone or endocrine disorders of long standing nature. An immediate stimulant effect was observed, while more radical changes in sexual behaviour followed due to increased sexual desire. Sexual performances improved probably due to the action of the drug on the hypothalamus. The mechanism of the action remains to be elucidated. (I found rich high protein diet and use of garlic helpful). Restriction of sex activities to twice a week would be advisable initially. The choice of the drug should be quick acting with minimum side-effects at the same time, if possible, economic to the patients. Tentex forte and Himcolin cream combination are non-hormonal and non-toxic and gave excellent results in all cases. The age group ranged from 40 to 55 years, all educated and higher income group. Sex and married life of all these became very satisfactory. There were no toxic reactions or intolerance to the drug or any side-effects. Erection and performance were satisfactory and they slept well. Some gained in weight, felt physically better and confident. Their outlook in life changed. The results were gratifying in this series on all counts when earlier psychotherapy, hormone and other modes of treatment failed to give any results. I advised repetition of the course for twenty days in the following years. The patients were followed up for three years and their sex life is reported to be very satisfactory. Other coincident illnesses were treated with appropriate therapy. SUMMARY 1. Four cases were treated with oral Tentex forte tablets 2 t.i.d. and local Himcolin cream application twice a day where psychotherapy and hormone therapy failed. 2. 3. There was gradual improvement within 20 days and the libido, erection and sex performance were normal in all cases. There were no toxic reactions or intolerance of any nature.