Comparison of the Effects of Tamarind Seed Extract (Tamarindus Indica L.) with Sertraline in Treating Premature Ejaculation: A Randomized Double-blind Trial

Authors

  • Ali Sahraian Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran
  • Iman Shamohammadi Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
  • Somayeh Daneshvar Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran
  • Payam Sadeghi Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran

DOI:

https://doi.org/10.31661/gmj.v14i.4015

Keywords:

Premature Ejaculation; Tamarind; Sertraline; Treatment; Trial

Abstract

Background: Premature ejaculation (PE) is a prevalent male sexual disorder often untreated due to embarrassment. This study compares the efficacy of tamarind seed extract (Tamarindus indica L.) with sertraline in treating PE. Materials and Methods: In this randomized, double-blind, parallel-group trial, 41 men diagnosed with PE at urology and psychiatric clinics in Shiraz, Iran (2023) were enrolled. Participants were randomly assigned to receive either 80 mg tamarind seed extract capsules (Group A, n=20) or 50 mg sertraline tablets (Group B, n=21) daily for 4 weeks. The primary outcome was the Premature Ejaculation Diagnostic Tool (PEDT) score, with secondary outcomes including International Index of Erectile Function (IIEF) scores (erectile function, orgasmic function, sexual desire, intercourse satisfaction, overall satisfaction) and side effects. Data were analyzed using SPSS version 22 with t-tests and ANOVA (P<0.05). Results: Both treatments significantly improved PEDT scores (P=0.001, η_p^2=0.76, 95% CI for mean difference: [-6.95, -4.95]) and IIEF subscales (P<0.01). No significant differences were observed between groups (P=0.69, η_p^2=0.10) or in the time-group interaction (P=0.42, η_p^2=0.15). Side effects were minimal in both groups.Conclusion: The findings indicate a potential relationship between tamarind seed extract and improvements in premature ejaculation and related factors, comparable to sertraline; however, these results should be interpreted with caution and require further validation through additional research.Trial registration number: IRCT20140926019295N4.

Author Biography

Iman Shamohammadi, Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran

 

 

References

ElHamd MA, Saleh R, Majzoub A. Premature ejaculation: an update on definition and pathophysiology. Asian journal of andrology. 2019;21(5):42532.

https://doi.org/10.4103/aja.aja_122_18

PMid:30860082 PMCid:PMC6732885

Raveendran AV, Agarwal A. Premature ejaculationcurrent concepts in the management: A narrative review. International journal of reproductive biomedicine. 2021;19(1):5.

https://doi.org/10.18502/ijrm.v19i1.8176

PMid:33553999 PMCid:PMC7851481

Bhambhvani HP, Kasman AM, Zhang CA, Hu SS, Eisenberg ML. Delayed ejaculation after lumbar spine surgery: a claims database analysis. Global Spine Journal. 2022;12(4):6637.

https://doi.org/10.1177/2192568220962435

PMid:33047620 PMCid:PMC9109564

Gillman N, Gillman M. Premature ejaculation: aetiology and treatment strategies. Medical sciences. 2019;7(11):102.

https://doi.org/10.3390/medsci7110102

PMid:31731516 PMCid:PMC6915345

Kulkarni PV, Chandola H. Evaluation of Stambhanakaraka Yoga and counseling in the management of Shukragata Vata (premature ejaculation). AYU (An International Quarterly Journal of Research in Ayurveda). 2013;34(1):428.

https://doi.org/10.4103/0974-8520.115445

PMid:24049404 PMCid:PMC3764879

Oguzhanoglu NK, Ozdel O, Aybek Z. The efficacy of fluoxetine and a stopstart technique in the treatment of premature ejaculation and anxiety. Journal of clinical psychopharmacology. 2005;25(2):1924.

https://doi.org/10.1097/01.jcp.0000161449.50969.28

PMid:15738757

McMahon CG, Althof S, Waldinger MD, Porst H, Dean J, Sharlip I et al. An evidence‐based definition of lifelong premature ejaculation: Report of the International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. BJU international. 2008;102(3):33850.

https://doi.org/10.1111/j.1464-410X.2008.07755.x

PMid:18498422

AbdelHamid I, El Naggar E, El Gilany A. Assessment of as needed use of pharmacotherapy and the pausesqueeze technique in premature ejaculation. International journal of impotence research. 2001;13(1):415.

https://doi.org/10.1038/sj.ijir.3900630

PMid:11313839

Boeri L, Pozzi E, Fallara G, Montorsi F, Salonia A. Reallife use of the eutectic mixture lidocaine/prilocaine spray in men with premature ejaculation. International journal of impotence research. 2022;34(3):28994.

https://doi.org/10.1038/s41443-021-00424-9

PMid:33828264

Xin ZC, Zhu YC, Yuan YM, Cui WS, Jin Z, Li WR et al. Current therapeutic strategies for premature ejaculation and future perspectives. Asian Journal of Andrology. 2011;13(4):550.

https://doi.org/10.1038/aja.2010.130

PMid:21532601 PMCid:PMC3739616

Yi ZM, Chen SD, Tang QY, Tang HL, Zhai SD. Efficacy and safety of sertraline for the treatment of premature ejaculation: systematic review and metaanalysis. Medicine. 2019;98(23):e15989.

https://doi.org/10.1097/MD.0000000000015989

PMid:31169738 PMCid:PMC6571276

Thomas CA, Tyagi S, Yoshimura N, Chancellor MB, Tyagi P. Effect of hyperforinenriched extract on proejaculatory effect of 8hydroxy2(diNpropylamino) tetralin in anesthetized rats. Urology. 2007;70(4):8136.

https://doi.org/10.1016/j.urology.2007.05.016

PMid:17991578

Ratnasooriya W, Fernando T. Effect of black tea brew of Camellia sinensis on sexual competence of male rats. Journal of ethnopharmacology. 2008;118(3):3737.

https://doi.org/10.1016/j.jep.2008.04.023

PMid:18565706

Zavatti M, Zanoli P, Benelli A, Rivasi M, Baraldi C, Baraldi M. Experimental study on Satureja montana as a treatment for premature ejaculation. Journal of ethnopharmacology. 2011;133(2):62933.

https://doi.org/10.1016/j.jep.2010.10.058

PMid:21040774

Malviya N, Malviya S, Jain S, Vyas S. A review of the potential of medicinal plants in the management and treatment of male sexual dysfunction. Andrologia. 2016;48(8):88093.

https://doi.org/10.1111/and.12677

PMid:27681645

Homayuonfar A, Aminsharifi A, Salehi A, Sahraian A, Dehshari S, Bahrami M. A randomized doubleblind placebocontrolled trial to assess the effect of tamarind seed in premature ejaculation. Advanced biomedical research. 2018;7(1):59.

https://doi.org/10.4103/abr.abr_16_17

PMid:29862208 PMCid:PMC5952527

Suralkar AA, Rodge KN, Kamble RD, Maske KS. Evaluation of antiinflammatory and analgesic activities of Tamarindus indica seeds. International Journal of Pharmaceutical Sciences and Drug Research. 2012;4(3):2137.

https://doi.org/10.25004/IJPSDR.2012.040309

VargasOlvera CY, SánchezGonzález DJ, Solano JD, AguilarAlonso FA, MontalvoMunoz F, MartínezMartínez CM et al. Characterization of Ndiethylnitrosamineinitiated and ferric nitrilotriacetatepromoted renal cell carcinoma experimental model and effect of a tamarind seed extract against acute nephrotoxicity and carcinogenesis. Molecular and cellular biochemistry. 2012;369(1):10517.

https://doi.org/10.1007/s11010-012-1373-0

PMid:22761015

Le Phuong Ha NVN, Huyen NTT, Le Thi Thu Hang NT, Oanh K, Tuyet TT, Phuong NTM et al. Total phenolic, flavonoid contents and antioxidant activity of tamarind seed and pulp extracts. Vietnam Journal of Biotechnology. 2022;20(2):30516.

https://doi.org/10.15625/1811-4989/15930

De Caluwé E, Halamouá K, Van Damme P. Tamarindus indica L.-A review of traditional uses, phytochemistry and pharmacology. Afrika focus. 2010;23(1):5383.

https://doi.org/10.21825/af.v23i1.5039

Aravind S, Joseph MM, Varghese S, Balaram P, Sreelekha T. Antitumor and immunopotentiating activity of polysaccharide PST001 isolated from the seed kernel of Tamarindus indica: an in vivo study in mice. The Scientific World Journal. 2012;2012(1):361382.

https://doi.org/10.1100/2012/361382

PMid:22593679 PMCid:PMC3349139

Sole SS, Srinivasan B, Akarte AS. Antiinflammatory action of tamarind seeds reduces hyperglycemic excursion by repressing pancreatic βcell damage and normalizing SREBP1c concentration. Pharmaceutical Biology. 2013;51(3):35060.

https://doi.org/10.3109/13880209.2012.729067

PMid:23151094

Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49(6):82230.

https://doi.org/10.1016/S0090-4295(97)00238-0

PMid:9187685

Pakpour AH, Zeidi IM, Yekaninejad MS, Burri A. Validation of a translated and culturally adapted Iranian version of the International Index of Erectile Function. Journal of sex & marital therapy. 2014;40(6):54151.

https://doi.org/10.1080/0092623X.2013.788110

PMid:24308814

Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K et al. Development and validation of a premature ejaculation diagnostic tool. European urology. 2007;52(2):56573.

https://doi.org/10.1016/j.eururo.2007.01.028

PMid:17275165

Mahran A, Morsy H. Comparison between ondemand use of sertraline and dapoxetine for treating patients with premature ejaculation. Human Andrology. 2016;6(4):1069.

https://doi.org/10.1097/01.XHA.0000510703.23703.89

Sahan A, Cubuk A, Ozkaptan O, Toprak T, Ozcan T, Ertas K et al. Comparison of the safety and efficacy of the on‐demand use of sertraline, dapoxetine, and daily use of sertraline in the treatment of patients with lifelong premature ejaculation: a prospective randomised study. Andrologia. 2020;52(11):e13854.

https://doi.org/10.1111/and.13854

Elder DP, Kuentz M, Holm R. Pharmaceutical excipients-quality, regulatory and biopharmaceutical considerations. European journal of pharmaceutical sciences. 2016;87:8899.

https://doi.org/10.1016/j.ejps.2015.12.018

PMid:26699228

Bharate SS, Bharate SB, Bajaj AN. Interactions and incompatibilities of pharmaceutical excipients with active pharmaceutical ingredients: a comprehensive review. International Journal of Pharmaceutical Excipients. 2016;1(3):2010.

https://doi.org/10.1002/chin.201147271

Raja MM, Poonguzhali S, Rao BV, Choudhury A, Devarajan A. A scientific evidencebased review of tamarind usage in Indian folklore medicine. J NATURAL REMEDIES. 2022; 22(3):30123.

Himori N, Inoue Yanagimachi M, Omodaka K, Shiga Y, Tsuda S, Kunikata H et al. The effect of dietary antioxidant supplementation in patients with glaucoma. Clinical Ophthalmology. 2021:2293300.

https://doi.org/10.21203/rs.3.rs-56426/v1

Mustapha A, Yakasai I, Abdu Aguye I. Effect of Tamarindus indica L on the bioavailability of aspirin in healthy human volunteers. European journal of drug metabolism and pharmacokinetics. 1996;21(3):2236.

https://doi.org/10.1007/BF03189717

PMid:8980919

Benson BB, Békro YA, MamyrbékovaBékro JA, Coulibaly WK, Ehilé EE. Assessment of sexual stimulant potential of total flavonoids extracted from leaves of Palisota hirsuta Thunb K Schum (Commelinaceae). Eur J Sci Res. 2008;22(4):5338.

Atmaca M, Karadag F, Tezcan E. Serum antioxidant enzymes and malondialdehyde levels in patients with premature ejaculation before and after pharmacotherapy. The Journal of Sexual Medicine. 2005;2(2):2548.

https://doi.org/10.1111/j.1743-6109.2005.20236.x

PMid:16422894

McMahon CG, Jannini EA, Serefoglu EC, Hellstrom WJ. The pathophysiology of acquired premature ejaculation. Translational andrology and urology. 2016;5(4):434.

https://doi.org/10.21037/tau.2016.07.06

PMid:27652216 PMCid:PMC5001985

De Vera JS, De Castro MEG, Dulay RM. Phytochemical screening and teratogenic effect of lyophilized water extracts from Ocimum sanctum L.(Holy Basil) and Tamarindus indica L.(Tamarind) leaves in Danio rerio embryos. Der Pharma Chemica. 2016;8(8):86.

Downloads

Published

2025-08-27

How to Cite

Sahraian, A., Shamohammadi, I., Daneshvar, S., & Sadeghi, P. (2025). Comparison of the Effects of Tamarind Seed Extract (Tamarindus Indica L.) with Sertraline in Treating Premature Ejaculation: A Randomized Double-blind Trial. Galen Medical Journal, 14, e4015. https://doi.org/10.31661/gmj.v14i.4015

Issue

Section

Original Article