FORTEGE *, AN INDIGENOUS DRUG IN COMMON
SEXUAL DISORDERS IN MALES
By
Dr. N. C. BHARGAVA,
Venereologist-in-charge, S.T.D.
Centre,
Dr. O. P: SINGH
Psycho-Sexual Clinic, All
India Institute of Medical Sciences,
Paper presented at the Second
National Conference of the Indian Association for the Study of Sexually
Transmitted Diseases, Dec. Rd, 4th, 1977,
Vol. XXI, No. VI, September, 1978
MEDI5COPE
The Journal of Medicine &
Surgery NUNGAMBAKKAM :: MADRAS-600034.
INTRODUCTION:
Now-a days increased number of cases of male sexual disorders are
reported throughout the world: Stress, strain and Fatigue caused by modern
living conditions are largely responsible for this phenomenon. Fatigue was
mainly discussed at the III International Congress of Psycho-somatic Medicine
held in
Emotionally
Induced Illnesses (Ell) are becoming more common and these have an impact on
strength and vigor of the person and particularly in man it affects his sex
performance. Psychosomatic factors involved in this modern age causing fatigue
and stress lead to male impotency. Male impotence is mainly subjective and the
person brings his own diagnosis to the physician; He has no organic defects,
but his fatigue causes loss of potency. While counseling is good, it is not the
whole thing Unless fatigue is treated, there cannot be
worthwhile improvement in his condition. Lessening of the anxiety tensions are also helpful, but those will not disappear. because his main tension is his inadequate sex. Once fatigue
is corrected, sex stimulation which is mainly cortical returns, because the
gonads are normal and devoid of any defects.
Generally
sexual disorders are transient: Once they become chronic, they tend to become
permanent: While the male may be physiologically fertile, still he may be the
cause of infertility because of his inadequacy of sex performance. Or he may
ejaculate, but prematurely, causing dissatisfaction in both the partners.
As such the
man must be treated as a whole and not to isolate impotency as a defect by
itself. Counseling, to give him confidence and to lessen his tensions is useful:
Sex is a psychic and an emotional experience and not merely a physical act.
Fatigue, anxiety tensions, fear, affect proper erection. Constipation causes
congestion in the prostate region to trigger premature ejaculation. As such,
all these must be corrected, because coordination between healthy mind and
healthy body is necessary. Healthy body and healthy mind, without fatigue,
tensions, and fear complex are necessary not only for procreation but to
positively enjoy sex that nature has endowed.
FORTEGE:
We desired
to give a trial to a drug that treats the man as a whole and not the symptoms
only. In a sex act, the whole body, physically, mentally and the muscular,
nervous and endocrine systems are involved. As Ayurvedic system of Medicine
treats the disease on the concept of whole body, as evinced by the Tridosha Theory, an Ayurvedic drug Fortego
(Alarsin) was selected for this study.
Fortege
contains Ashwagandha (Withania
Somnifera), Kapikaahchu (Mucuna Prutiens), Vriddharak (Argyria Speciosa) Jeevanti (Leptadaenia Reticulata), Akalkara (Anocyclus Pyrethrum),
etc.
This
combination is described to have action on Neuroglandular
system. It is said to rel't,eve
fatigue and to reduce hyper-excitability at higher and lower sex centres. It is indicated in fatigue, psychic and functional
impotence, premature ejaculations, night emissions, spermatorrhoea,
weak orgasm, etc. It is said to be a safe drug without side effects and being
non-hormonal is devoid of the hazards of hormonal drugs. Fortege is said to
give a sense of relaxation and freshness that restores confidence in sex
performance.
MATERIALS AND METHODS:
Male cases
having fatigue, sex weakness and weak orgasm, that attended the S.T.D. Centre, Safdarjang Hoapital, and
Psycho-Sexual Clinic, AIIMS,
Out of 166
cases started with the Clinical Trial, ?3 case: could
not be followed for the full duration of 12 weeks of the trial period. Hence
the final assessment of 'results could be made only on 133 cases.
Routine
investigations of blood, urine, stools and VDRL were done in all the cases
before starting Fortege trial. Semen examination was done in those males where
the couple had history of Primary Sterility.
AGE GROUPS:
The largest
Age Group was of 21-30 years with 63.9%. The details are given in Table No. 1.
TABLE No.
1.-Age- Groups
Age Group No.
of cases %
18-20 Years 28 21.1%
21-30 85 63.9%
31-40 16 12.0%
41-46 4 3.0%
Total ... 133 100.0%
Nature of
male sex disorders :
Cases of
Premature Ejaculations were the largest in number, namely, 46 (34.6%). There
was one case of oligospermia. The details are given
in Table No. 2.
TABLE No.
2.
Showing
with Age Groups nature of Male Sexual Disorders
Sexual Disorder
18-20 21-30 31-40 41-46 Total %
Improper
erection 1 23 4 - 28 21.1%
Night emissions
12 12
-- -
24 18.0%
Premature
ejaculations 1 33 9 3 46 34.6%
Masturbation 5 3
- -
8 6.0%
Spermatorrhoea 8
6 - - 14 10.5%
Functional
impotence 1 7
3 1
12 9.0%
Oligospermia - 1
- -
1 0.8%
Total ... 28 85 16 4 133 100.0%
% ... 21.1% 63.9% 12.0% 3.0% 100.0%
FORTEGE : Dosage scheme and assessment of results
Fortege was
given in a dose of 2 tabs. three times a day, for a
minimum period of 4 weeks and to a maximum period of 12 weeks. Assessment was
made at the end of each 4 weeks. Those who had relief were put on a maintenance
dose of 2 tabs. two times a day for 2-6 months for a
general tone-up.
Criteria
for assessment was taken as good if the complaint was either fully relieved
within the trial period of 12 weeks or showed more than 70% improvement in fatigue,
anxiety tensions, fear complex and constipation. It was assessed as Moderate if
there was satisfactory relief in symptoms and the patient was fully devoid of
fatigue, anxiety and tension and regained confidence to have sex relation. It
was assessed as slight if there was improvement but not to the satisfaction,
both subjectively and objectively. When there was no improvement at all, it was
assessed as Nil.
RESULTS:
Improvement
was Good in 71.4% of improper erection, in 75% of
night emissions, in 71.7% of premature ejaculations, in 75.0% of masturbation,
in 71.5% of Spermatorrhoea, and in 66.7% of
-functional impotence. Over-all, out of 133 patients, 71.4% good, relief, 12.0% had moderate relief, 8.3% had Slight Relief and 8.3%
had no relief. The details are given in Table No. 3.
TABLE No. 3. /Response to Fortege
Treatment
Disorder No.
of cases Good % Moderate
% Slight % Nil %
Improper erection. .. 28 20 71.4% 4 14.3% 4 14.3% -
Night
emissions .. 24 18 75.0%
3 12.5% 2 ` 8.3% 1 4.2%
Premature ejaculations. .. 46 33 71.7% 5 10.9% 2 4.4% 6 13.0
Masturbation ... 8 6 75.0%
1 12.5%
1 12.5%
-
Spermatorrhoea ... 14 10 71.5% 2 14.3% 1 3.1% 1 7.71
Functional
impotence ... 12 8 66.7%
1 8.3%
1 8.3%
2 16.7
Oligospermia ... 1 -
._ 1 100%
Total ... 133 95 16 11 11
% ... 100.0% 71.4% 12.0% 8.3% 8.3%
DISCUSSION:
Fatigue is
the main contributory factor in these male sex disorders. With fortege treatment, on the whole, 71.4% showed good
response. Most of them could benefit in one' month of Fortege therapy. There
were 8 cases of masturbation and these were confined to the age of 18-21 years
and all these were unmarried. These were given counseling. Reassurance was also
given by telling them that masturbation was not an unnatural phenomena
and may be necessary to relieve sexual tension: They were, also advised not to.
have guilt complex or sin phobic regarding masturbation,
but to overcome their physical ` and mental fatigue, and to correct
constipation, if any. With Fortege therapy, their anxiety tension and fear
complex disappeared and there was complete relief in 6 out of 8 patients.
There was a
single case of oligospermia. This was a case of
primary sterility in the couple and this conditions came
to light because of semen examination. Though there was a slight improvement in
repeat semen examination, this was not considered for evaluation, as it required
longer therapy and longer follow-up, which was beyond the scope of the present
study.
Patients
attending psycho-sexual clinic lacked sex education and were having wrong
notions about sexuality and this leads to anxiety tension. Proper sex counseling
along with Fortege therapy helped to give relief to the majority of patients in
our series.
Constipation
was found to be common in prenoaturL ejaculation, spermatorrhoea and night, emissions. Constipation may cause
congestion in the region of the prostate, when even a slight stimulation, may
trigger forceful contraction of the seminal vesicles. . Fortege relieved
constipation and fatigue, as wall as anxiety and tension and their condition
improved. It also gave them freshness, vigor and a sense' of well being.
Improvement
was observed in the majority of cases in the first four weeks. The female
partner also expressed that the husband had better sea drive than before.
However, it was observed that if maximum benefit was not achieved in the first
month, later response became slow.
No sedation
or any other side effects were observed with Fortege, showing that this is a
safe drug.
CONCLUSIONS
The
majority of the patients 171.4%), had relief from the common sexual disorders.
Fortege relieved fatigue, reduced hyper-excitability and restored the lost
confidence in sexual performance. Constipation was corrected. ' Fortege was found to have no side effects and being
non=hormonal had no hazards of the hormonal treatment.
Fortege may
be considered as a useful drug in treating the common male sexual disorders as
it is cheap, effective and safe.
SUMMARY
133 male patients sexual disorders, attending the V.D. Training.
& Demonstration Centre,
ACKNOWLEDGEMENT:
We are
thankful to Dr. N.L, Pramanik, Superintendent,
We are
thankful to Alarsin Pharmaceuticals,
REFERENCES
1. Gupta,
L.N. & Saluja, J.S. (197 5) :
'Role of Fortege in Oligaspermia: Current Med: Pract. Vol., 19, No:.6, P:
272-273, 1975.
2. Joshi,
S.K. (1965) ~ Syndrome of Dhat in the male (use of an
Ayurvedic Compound) t Mah. Med. Jr. Dec:. 1965:
3. Shelat, R.K:, Majumdar,
Muktiben Banderia, Bhartiben C: & Basu, K.N.
(1977) : Usefulness of For= tege in Oligospermia and low motility Sperms : I Asian Congress of
Fer2ility &, Sterilit.y,.
5. Sukhtankar, V.R: (1960), A peculiar anxiety syndrome,
night` mare of millions : Indian Pract.,
Dec. 196U.