OnLine Journal of Biological Sciences, 2012, 12 (4), 149-155

ISSN: 1608-4217© 2012 P. Wannanon et al., This open access article is distributed under a Creative Commons Attribution(CC-BY) 3.0 license
doi:10.3844/ojbssp.2012.149.155 Published Online 12 (4) 2012 (http://www.thescipub.com/ojbs.toc)

Efficacy Assessment of Kaempferia parviflora for the Management ofErectile Dysfunction
1,2

Panakaporn Wannanon,
Jintanaporn Wattanathorn, 1,2Terdthai Tong-Un, 1,2Prasert Pangphukiew,
1,2
Supaporn Muchimapura, 3Bungorn Sripanidkulchai and 2,4Wathita Phachonpai
1,2

2

1
Department of Physiology, Faculty of Medicine,
Integrative Complimentary Alternative Medicine Research and Development Group,
3
Center for Research and Development of Herbal Health Product,
4
Division of Physiology, School of Medical Science,
University of Phayao, Phayao, 56000, Thailand

ABSTRACT
Age-related decline in erectile function is a noted phenomenon worldwide. A variety of medicinal plants
have been identified as having strong aphrodisiac properties along with the ability to improve erectile
functioning. Kaempferia Parviflora (KP) has famous as a Thai Viagra and use it to increase male
impotency. However, there is limited scientific evidence regarding the efficacy of this herb on this issue inaging healthy men. This study therefore investigated the effect of KP extract administration on erectile
response of male elderly volunteers. Total 45 male healthy elderly volunteers will be divided into 3 separated
groups including placebo and the different doses of ethanolic extracts of KP (25 and 90 mg) once daily at aperiod of 2 months. The erectile function tests including the response latency time to visual erotic stimuli, sizeand length of penis both in flaccid and erection states were assessed after single administration, 1 and 2 monthsof treatment. In order to investigate the possible underlying mechanism, we also determined the alteration of
testosterone, FSH and LH concentrations. KP at a dose of 90 mg day−1 treated group exhibited a significant
enhanced all parameters after 1 and 2 months of treatment. Moreover, the penile length at erection states andthe response latency to sexual erotic stimuli appeared to be the parameters that showed significant changes
during the delay period. Unfortunately, our study failed to show the significant changes on hormones
concentration. Our study clearly demonstrates that KP is a potential resource for the development of
nutraceutical compound against aged related male erectile dysfunction.
Keywords: Kaempferia Parviflora (KP), Erectile Dysfunction (ED), Nitric Oxide (NO), Follicle
Stimulating Hormone (FSH), Luteinizing Hormone (LH)
(Monga, 1999). Several type of treatment is claimed in
the modern medicine but due to serious side effects andhigher cost, search of natural supplement frommedicinal plants as an aphrodisiac substance issignificantly increased (Yakubu et al., 2007).
Kaempferia Parviflora Wall. Ex. Baker (KP), which
commonly referred to Thai name, Kra-Chai-Dum,belongs to Family Zingiberaceae. Thai folk use therhizome of this plant as a traditional medicine to increase
male libido, alleviate male impotency, induce an

1. INTRODUCTION
Sexual relationships are some of the most importantsocial and biological relationship in human life. Male
impotence also called Erectile Dysfunction (ED) is acommon medical condition that affects the sexual lifeof millions of aging men worldwide (Montorsi et al.,2003). ED is a sexual dysfunction characterized by theinability to develop or maintain penile erection
sufficiently while engaging in sexual intercourse

Corresponding Authors: Wathita Phachonpai, Division of Physiology, School of Medical Science, University of Phayao, Phayao,
56000, Thailand Tel: 66-54-466666 Fax: 66-54-466690
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energizer, balance blood pressure and also reducestomach pain by boiling or soaking KP with alcohol(Yenjai et al., 2004). Previously, we provided evidence
that oral administration of KP extract, a Thai medicinal
plant reputed for aphrodisiac activity and enhanced theexpression of male sexual behaviors in aging rats
(Wattanathorn et al., 2012). Recently, KP products arewidely available in market as aphrodisiac booster.
However, supported document with valid biological datais still very limited. Therefore, the present study is carriedout to determine the effect of KP extract on the erectile
function in the male elderly volunteers.

Pharmaceutical Sciences, Khon Kaen University.
Standardization and conformity of the extract is assured bystrict in-process controls during manufacture and complete
analytical control of the resulting dry extract. A-day capsulecontained total flavonoids content approximate 40.37 mg
g−1 dried powder consisting 2 main constituents 5, 7dimethoxyflavone (8.789 mg g−1) and 3,5,7,3’,4’pentamethoxy flavone (9.858 mg g−1).

2.3. Procedures and Treatments
This study was a pilot study conducted as 8-week,
double-blind, placebo-controlled, randomized trial. A
random list of numbers was generated by computer. Afterbeing randomly assigned to various treatment groups, eachparticipant received one capsule of placebo or KP extract atdose of 25 and 90 mg once daily. Placebo and KP capsules
had the same color, texture, size and smell.
All participants were assessed baseline data about the
response latency time to visual erotic stimuli, size andlength of penis both in flaccid and erection state and thenthey were assessed all parameter as mention previously,
after the single administration, 1 and 2 months oftreatment and 1 month after the cessation of KP
administration (the delay period).
The code for study allocation was only broken
when the last participant completed the entire follow
up. Staff involved in the collection of the study’s
endpoints was instructed to follow a rigorous protocol
and not to discuss any issues related to the use of
medication.

2. MATERIALS AND METHODS
2.1. Subjects
Forty-five male healthy elderly volunteers (mean age
65.05±3.56 years) were recruited to participate in thisstudy. Prior to participation, each volunteer signed an
informed consent form and completed a medical healthquestionnaire. All subjects were also undergone
extensive medical evaluation in order to ascertain subject
suitability for entering the double-blind phase of trial.
Individuals on medication, abusing drugs/alcohol, or
exhibiting endocrinological, psychological, or sexual
dysfunction/disorders, were excluded from the study. All
participants reported that they had an exclusively
heterosexual orientation and a relaxed attitude towardpornography. The protocol for this study was approvedby the Ethics Committee of Faculty of Medicine, Khon
Kaen University, Thailand. Additionally, most of thesubjects did not use dietary supplements that interferedon the sexual function for at least 6 months before study.
All volunteers were randomly placed in one of threegroups. No significant difference about mean age, heightand body mass index among groups were observed. Twogroups received active treatment whereas the other group
received placebo. For 8 weeks, one group (n =15)
received one capsule of KP extract at a dose of 25 mg
day−1. The second group (n = 15) received one daily
capsule of KP extract at a dose of 90 mg day−1. The thirdgroup received capsule of placebo daily for the 8-weekspan in the same schedule. During the study, all men
maintained their usual eating regimen.

2.4. Penile
Circumference
Measurements

LengthAll subjects were fitted with the Rigiscan device(UroHealth Systems, Laguna Niguel, California) and seatedin a room on their own with a video screen in front of them.
After 15 min of adaptation, the Rigiscan was as turn on torecord the erectile response to visual erotic stimuli.
In addition, the flaccid and fully stretched penile
lengths were measured after watching erotic films
involved heterosexual activity for 12 min.
A measuring tape was used to measure the length andthe midshaft circumference of the penis. The starting point
was on the dorsal aspect of the penis at its base at the pubicpenile skin junction, pushing the prepubic fat pad against
the pubic bone as described by Wessells et al. (1996) while
the tip of the penis was the other reference point.

2.2. Kaempferia Parviflora Preparation
A standardized extract of KP rhizomes was prepared by
the Center for Research and Development of Herbal Health
Product, Faculty of Pharmaceutical Sciences, Khon Kaen
University. All KP used in this study was obtained from
Amphoe Na Hear, Loei Province, Thailand. The plant wasauthenticated and kept as voucher specimen at Faculty of
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and2.5. Erectile Response to Visual Erotic Stimuli
Measurement
The duration of erectile response to visual erotic
stimuli was measured with real-time Rigiscan
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monitoring. Subjects recorded the duration of erectile
events (resting state until fully erect state).

showed no significant difference. After 1 and 2 monthsof treatment with KP at a dose of 90 mg day−1
experienced a statistically significant increase in thelength and width of their penis both in flaccid anderection states when compared with the placebo treatedgroup (p<0.05). Interestingly, the length of penis at
erection states appeared to be the parameter that showedsignificant change during the delay period (p<0.05).
However, no significant difference was seen in theseparameters in either the KP at a dose of 25 mg day−1 orthe placebo treated groups.

2.6. Hormones Measurement
Venous blood samples were drawn for thedetermination of the levels of the following hormones:
LH, FSH and testosterone after a single administration, 1
and 2 months of treatment. Analyses for hormone
concentrations were conducted at the laboratory of
Srinagarind Hospital, Faculty of Medicine, Khon Kaen
University, Thailand.

2.7. Statistical Analysis

3.3. Latency of Erectile Response to Visual
Erotic Stimuli

All data are expressed as mean ± S.E.M.
Comparisons between placebo and various doses of
KP at different time points were made using analysis
of variance (ANOVA). The differences between
frequencies before and during treatment were assessedby the chi-squared test. A p<0.05 was considered
statistically significant.

Again, KP at a dose of 90 mg day-1 significantly
decreased the response latency to sexual erotic stimuli
and still showed the significant changes during the delay
period (p<0.05) as shown in the Fig. 5. No major
adverse events were reported during the clinical trial.

3.4. Hormonal Status

3. RESULTS

Prior to the determination of KP effect on
testosterone, FSH and LH concentrations, baseline
data for all treated groups were subjected to a oneway ANOVA. There were no significant differenceson any measure. Unfortunately, no statisticaldifferences in testosterone, FSH and LH levels after
treatment in any of the subject groups (Table 2).

3.1. Characteristics of subjects
The baseline data about characteristic of subjects inall groups were shown in Table 1. No significant
differences of all parameters among various groups
were observed.

3.2. Penile Circumference and Length

Table 1. Characteristics of subjects
Baseline data Placebo
KP 25
Age (y)65.88±5.1167.25±1.39
BMI (kg/m2)
22.29±3.32
21.25±2.61
Height (cm)170.25±6.39
171.50±5.47

The effects of KP extract on penile circumference
and length both in flaccid and erection states were shownin Fig. 1-4 respectively. The baseline data of penile
circumference and length both in flaccid and erection
states of placebo, KP 25 and KP 90 day−1 treated groups

KP 90
64.75±2.71
22.75±1.13
169.25±5.09

Fig. 1. Effect of KP (25 and 90 mg day-1) on penile circumference in resting state. Values given are the mean ± S.D (n =15).
*p<0.05 as compared to placebo treated group
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Fig. 2. Effect of KP (25 and 90 mg day−1) on penile circumference in erection state. Values given are the mean ± S.D (n = 15).
*p<0.05 as compared to placebo treated group, **p<0.01 as compared to placebo treated group

Fig. 3. Effect of KP (25 and 90 mg day−1) on penile length in resting state. Values given are the mean ± S.D (n=15). *p<0.05 ascompared to placebo treated group

Fig. 4. Effect of KP (25 and 90 mg day−1) on penile length in erection state. Values given are the mean ± S.D (n=15). *p<0.05 ascompared to placebo treated group
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Fig. 5. Effect of KP (25 and 90 mg day-1) on response latency to sexual erotic stimuli. Values given are the mean ± S.D (n = 15).
*p<0.05 as compared to placebo treated group
Table 2. Effect of KP extract administration on serum hormones concentrations
Pre-dose (baseline)
Pre-dose---------------------------------------------------------------Blood testGroup(baseline)
Single dose
1 month
2 monthTestosterone
Placebo
4.14+0.92
5.28+2.76
5.92+5.49
5.65+1.23
KP 25
4.11+1.56
4.79+4.63
5.11+3.13
4.64+1.22
KP 90
4.11+1.30
4.89+2.63
4.26+0.83
5.74+2.60
FSH
Placebo
7.88+4.34
6.73+2.54
6.52+5.51
5.95+2.34
KP 25
8.80+4.29
7.35+4.23
7.23+5.37
7.96+3.32
KP 90
7.53+2.92
6.14+2.26
6.29+2.25
6.01+2.79
LH
Placebo
7.14+5.62
7.59+3.21
7.30+4.24
7.82+2.34
KP 25
7.25+5.90
8.12+2.72
7.04+5.34
8.48+4.64
KP 90
6.99+4.37
7.65+1.88
8.55+3.64
7.41+4.67

Moreover, the penile length at erection states and the
response latency to sexual erotic stimuli appeared to be
the parameters that showed significant changes during
the delay period. This indicates that the KP extract also
increases erectile activity. These data confirm ourresults obtained in aging rats (Wattanathorn et al.,2012). Recent findings showed that effect of KP at adose of 90 mg day-1 in aging healthy men is noticeable
since 1 week of treatment. Certainly, data at single
administration of treatment did not show differences
between KP treated men and placebo treated men.
Unfortunately, low dose of KP extract do not affecterectile function in aging healthy men. One possible
explanation for this phenomenon might be related to theinsufficient concentrations of active ingredients of KP toreach the therapeutic level.
It has been reported that hormonal control system isrecognized as one key factor to regulate sexual behavior
and ED including Follicle Stimulating Hormone (FSH),

4. DISCUSSION
There is a growing worldwide trend in use ofalternative medicine especially herbal medicine. For
centuries among the herbal experts, Kaempferia
Parviflora (KP) has been known to have aphrodisiac like
properties.
However, the validity and efficacy of such a claim hadremained uninvestigated. In this study we evaluated andconfirmed its effect on ED of male elderly volunteers.
The penile erection index is important for evaluating
the effect of drug or substance administration on erectile
function (Thakur and Dixit, 2007). The results of thepresent study demonstrate that the ethanolic extract of
KP at a dose of 90 mg day−1 administered orally in a
capsule during 8 weeks significantly increased the penile
circumference, length and rigidity compared with theplacebo treated group. In addition, the plant extract also
decreased the response latency to sexual erotic stimuli.
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Delay
5.14+0.92
5.71+2.38
6.06+3.19
5.88+3.34
8.81+5.12
7.03+2.35
8.14+3.23
8.72+4.67
8.82+4.44

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activity including the dopamine, the serotonin and the
GABA systems (Hull et al., 2004; Michelson et al., 2001).
From the study of chemical components by gas
chromatographic technique, the contents of KP rhizome
were kinds of flavonoid substances, including 5hydroxy-3,
7-dimethoxyflavone,5-hydroxy-7methoxyflavone, 5-hydroxy-3, 7, 4’-trimethoxyflavone,5-hydroxy-7, 4’-dimethoxyflavone, 5-hydroxy-3, 7, 3’4’
tetramethoxyflavone, 3, 5, 7-trimethoxyflavone, 3, 5, 7,
4’-tetramethoxyflavone, 5, 7, 4’-trimethoxyflavone and5, 7, 3’4’-tetramethoxyflavone (Sutthanut et al., 2007;
Yenjai et al., 2004). Therefore, the effects of KP extract
on modulation the several neurotransmitter systems still
could not be omitted. Further studies are required to
identify the active constituent(s) responsible for the male
impotence improvement activities and the mechanisms
whereby these activities are implemented.
The results of the current study suggest that ethanolic
extract of KP rhizomes may be a promising novel
nutraceutical compound for the clinical treatment of ED.

Luteinizing
Hormone(LH)
andtestosterone
concentrations (Finkelstein et al., 1991; Luboshitzky etal., 1996). However, the current study has demonstrated
that the improvement in ED by KP administration did
not correlated with the change of serum hormones asmention earlier. This finding is in accordance with theprevious report of serum testosterone levels were notassociated to the improvement in sexual desire or ED bytreatment with KP (Trisomboon et al., 2007; Sudwan etal., 2006). Since there was no any change in testosteroneor gonadotropin concentrations after KP administration,
it is clearly indicate that KP does not have testosteronelike effect and then does not disrupt the hypothalamicpituitary-testicular axis in aging healthy men.
A normal erection occurs as a resulted of acoordinated vascular event in the penis. This is usuallytriggered neutrally and consists of vasodilation andsmooth muscle relaxation in the penis and its supplying
arterials vessels (Shabsigh and Anastasiadis, 2003).
Arterial inflow causes enlargement of the substance ofthe corpora cavernosa. Venous outflow is trapped by thisenlargement, permitting sustained high blood pressuresin the penis sufficient to cause rigidity.
Previous studies have been found that the rats
treated with the alcohol extract of KP could induce asignificant increase in testicular blood flow without
affecting heart rate and mean arterial blood pressure(Chaturapanich et al., 2008).
Accumulating lines of evidence reported that theincreasing of penile size, length and rigidity indicatedthe involvement of Nitric Oxide (NO) (Du and Hull,1999). Experimental studies have demonstrated that KP
extracted with alcohol could also induce an increasingof endothelial Nitric Oxide Synthase (eNOS) andprotein expression in human umbilical vein endothelial
cells (Hu et al., 2009). eNOS, abundantly presented in
the endothelium of penile vasculature and sinusoidal
endothelium within the corpora carvernosa, is amediator of penile erection. eNOS inhibitor can block
penile erection. Then, the penile erection is depended
on the nitric oxide via eNOS action (Yakubu andAfolayan, 2009; Tajuddin et al., 2004). Hence, we
assume that KP may affect the increasing penile
circumference, length and rigidity of the aging healthy
volunteers via the increasing blood flow.
Many studies have reported that many bioactive
components of plant extracts especially the flavonoids
also exhibit aphrodisiac activities by acting directly on thecentral nervous system to modulate the action ofneurotransmitters are involved in the regulation of erectile
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5. CONCLUSION
Male impotence was studied in aging healthy men tofurther understand the role of KP extract as an
aphrodisiac. There was an overall increase in the erectile
function in the KP extract at a dose of 90 mg treatedgroups of volunteers as reflected in penile size andlength both in flaccid and erection states and the
response latency time to visual erotic stimuli. These
results were statistically significant. It is concluded thatthe ethanolic of KP rhizomes appears to possess
aphrodisiac activity.

6. ACKNOWLEDGMENT
This study was supported by the National ResearchCouncil of Thailand and Integrative Complimentary
Alternative Medicine Research and Development Group,
Khon Kaen University, Thailand. The authors have noconflict of interest to report.

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