Effects of saffron (Crocus sativus) on sexual dysfunction among men and women: A systematic review and meta-analysis

Document Type: Review Article

Authors

1 Department of nursing, school of nursing and midwifery,Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

2 Department of midwifery, school of nursing and midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

Abstract

Objective: This systematic review and meta-analysis study evaluated the effect of saffron (Crocus sativus) on sexual dysfunction and its subscales (dimensions) among men and women.
Material and Methods: PubMed/Medline, ScienceDirect, Google Scholar, as well as Scientific Information Database (www.SID.ir) and Magiran (as Persian databases) were searched without any time and language restrictions. Statistical pooling was done using the random effects model.
Results: A total of 5 studies comprising 173 participants were included in this systematic review and meta-analysis. The analysis showed a statistically significant positive effect of saffron on sexual dysfunction (Std diff in means=0.811; 95% CI, 0.356–1.265) and its subscales (Std diff in means=0.493; 95% CI, 0.261–0.724). Heterogeneity indexes such as Cochran Q index and  indicated a heterogeneity among the included studies (Q=9:981, df:4, (p=0.041),I2=59.92%). There was no evidence of publication bias in these studies.
Conclusion: In general, saffron was proven effective in improving sexual dysfunction and its subscales among participants; this effect was different on different dimensions of sexual dysfunction. Further studies are required to extend these initial findings.

Keywords

Main Subjects


Abedimanesh N, Ostadrahimi A, Bathaie SZ, Abedimanesh S, Motlagh B, Jafarabadi MA, Sadeghi MT. 2017. Effects of saffron aqueous extract and its main constituent, crocin, on health-related quality of life, depression, and sexual desire in coronary artery disease patients: a double-blind, placebo-controlled, randomized clinical trial. Iran Red Crescent Med J, 19: e13676

Aslan E, Fynes M. 2008. Female sexual dysfunction. Int Urogynecol J, 19: 293-305.

Bebb R, Millar A, Brock G, Committee DCCPGE. 2018. Sexual dysfunction and hypogonadism in men with diabetes. Can J Diabetes, 42: S228-S233.

Bolhassani A, Khavari A, Bathaie SZ. 2014. Saffron and natural carotenoids: biochemical activities and anti-tumor effects. Biochim Biophys Acta, 1845: 20-30.

CONSORT. 2010. Checklist of information to include when reporting a randomised trial Retrieved 26/6/218, from http://www.consort-statement.org/consort-2010.

Costantini E, Villari D, Filocamo MT. 2017. Female sexual function and dysfunction, pp.138-146, Springer.

Duval S, Tweedie R. 2000. A nonparametric “trim and fill” method of accounting for publication bias in meta-analysis. J Am Stat Assoc, 95: 89-98.

Egger M, Smith GD, Schneider M, Minder C. 1997. Bias in meta-analysis detected by a simple, graphical test. BMJ, 315: 629-634.

Fanta T, Haile K, Abebaw D, Assefa D, Hibdye G. 2018. Assessment of sexual dysfunction and associated factors among patients with schizophrenia in Ethiopia, 2017. BMC psychiatry, 18: 158.

Hausenblas HA, Heekin K, Mutchie H L, Anton S. 2015. A systematic review of randomized controlled trials examining the effectiveness of saffron (Crocus sativus L.) on psychological and behavioral outcomes. J Integr Med, 13: 231-240.

Hosseinzadeh H, Ziaee T, Sadeghi A. 2008. The effect of saffron, Crocus sativus stigma, extract and its constituents, safranal and crocin on sexual behaviors in normal male rats. Phytomedicine, 15: 491-495.

Kashani L,  Raisi F,  Saroukhani S,  Sohrabi H,  Modabbernia A,  Nasehi AA, Ghaeli P. 2013. Saffron for treatment of fluoxetine‐induced sexual dysfunction in women: randomized double‐blind placebo‐controlled study. Hum Psychopharmacol, 28: 54-60.

Khajehei M, Doherty M, Tilley PJM, Sauer K. 2015. Prevalence and risk factors of sexual dysfunction in postpartum Australian women. J Sex Med, 12: 1415-1426.

Kotta S, Shahid H, Ansari A, Javed A. 2013. Exploring scientifically proven herbal aphrodisiacs. Pharmacogn Rev, 7: 1-10.

Laumann EO, Paik A, Rosen RC. 1999. Sexual dysfunction in the United States: prevalence and predictors. JAMA, 281: 537-544.

Lewis RW,  FuglMeyer KS,  Bosch R,  FuglMeyer AR,  Laumann EO,  Lizza E,  Martin‐Morales A. 2004. Epidemiology/risk factors of sexual dysfunction. J Sex Med, 1: 35-39.

Lewis RW, Fugl‐Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira Jr, Rellini AH, Alessandra H, Segraves T. 2010. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med, 7: 1598-1607.

Lipshultz LI, Pastuszak AW, Goldstein AT, Giraldi A, Perelman MA. 2016. Management of sexual dysfunction in men and women: an interdisciplinary approach, pp.362-366, New York, Springer.

Mahmoudzadeh L, Najafi H, Ashtiyani SC, Yarijani ZM. 2017. Anti‐inflammatory and protective effects of saffron extract in ischaemia/reperfusion‐induced acute kidney injury. Nephrology (Carlton), 22: 748-754.

Maleki-saghooni N, Mirzaeii K, Hosseinzadeh H, Sadeghi R, Irani M. 2018. A systematic review and meta-analysis of clinical trials on saffron (Crocus sativus) effectiveness and safety on erectile dysfunction and semen parameters. Avicenna J Phytomed, 8: 198-209.

Mazidi M, Shemshian M, Mousavi SH, Norouzy A, Kermani T, Moghiman T, Ferns GA. 2016. A double-blind, randomized and placebo-controlled trial of Saffron (Crocus sativus L.) in the treatment of anxiety and depression. J Complement Integr Med, 13: 195-199.

Minhas S, Mulhall J. 2017. Male sexual dysfunction: a clinical guide, pp 311-320, John Wiley & Sons.

Modabbernia A, Sohrabi H, Nasehi AA, Raisi F, Saroukhani S, Jamshidi A, Akhondzadeh S. 2012. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology (Berl), 223: 381-388.

Mohammadzadeh-Moghadam H, Nazari SM, Shamsa A, Kamalinejad M, Esmaeeli H, Asadpour A A, Khajavi A. 2015. Effects of a topical saffron (Crocus sativus L) gel on erectile dysfunction in diabetics: A randomized, parallel-group, double-blind, placebo-controlled trial. J Evid Based Complement Altern Med, 20: 283-286.

Moreau C, Kågesten AE, Blum RW. 2016. Sexual dysfunction among youth: an overlooked sexual health concern. BMC public health, 16: 1170.

Safarinejad M, Shafiei N, Safarinejad S. 2010. An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatment. Int J Impot Res, 22: 240-250.

Safarinejad MR, Shafiei N, Safarinejad S. 2011. A prospective double‐blind randomized placebo‐controlled study of the effect of saffron (Crocus sativus Linn.) on semen parameters and seminal plasma antioxidant capacity in infertile men with idiopathic oligoasthenoteratozoospermia. Phytother Res, 25: 508-516.

Scheepe JR, Alamyar M, Pastoor H, Hintzen RQ, Blok BF. 2017. Female sexual dysfunction in multiple sclerosis: Results of a survey among Dutch urologists and patients. Neurourol Urodyn, 36: 116-120.

Shamsa A, Hosseinzadeh H, Molaei M, Shakeri MT, Rajabi O. 2009. Evaluation of Crocus sativus L. (saffron) on male erectile dysfunction: a pilot study. Phytomedicine, 16: 690-693.

Sumalatha K, Kumar S, Lakshmi SM. 2010. Review on natural aphrodisiac potentials to treat sexual dysfunction. Int J Pharm Ther, 1: 6-14.

Tsai TF, Yeh CH, Hwang TI. 2011. Female sexual dysfunction: physiology, epidemiology, classification, evaluation and treatment. Urol Sci, 22: 7-13.

Vestergaard N, Søgaard, P, Torp-Pedersen C, Aasbjerg K. 2017. Relationship between treatment of erectile dysfunction and future risk of cardiovascular disease: A nationwide cohort study. Eur J Prev Cardiol, 24: 1498-1505.

Walsh KE, Berman JR. 2004. Sexual dysfunction in the older woman. Drugs Aging, 21: 655-675.