The problem of sexual weakness - Himalaya Drug Company

[Current Medical Practice (1968): 10, 749]
The Problem of Sexual Weakness
Vyas, J.N., M.B.,B.S., D.P.M., Tutor in Psychiatry and Saksena, H.C., M.D., Tutor in Medicine,
S.P. Medical College, Bikaner, India.
According to Freud (1926), the normal performance of the sexual function can only come about as
the result of a very complicated process and disturbances may appear at any point in it. In men, the
various stages at which inhibition occurs are shown by: a turning away of the libido a the very
beginning of the process (psychic unpleasure); an absence of the physical preparation for it (lack of
erection); an abridgement of the sexual act (ejaculation praecox), an occurrence which might
equally will be regarded as a symptom; an arrest of the act before it has reached its natural
conclusion (absence of ejaculation); or a non-appearance of the physical outcome (lack of a feeling
of pleasure in orgasm).
The commonest sex problems which we have come across are
1. Various degrees of impotency, extending from complete failure to obtain an erection with no
interest in coitus, a partial or inadequate erection with limited interest, periodic failure of
erection coupled with limited libido, ability to establish erection but lack of sexual gratification
with ejaculation in coitus.
2. Premature ejaculation and loss of semen in the urine.
For the successful completion of the sexual act there is needed a certain drive (libido), an attractive
partner, a situation that provides freedom from distraction and anxiety. These allow in turn erection,
penile insertion and the muscular activity that provides penile friction and stimulation to mount to
eventual ejaculation accompanied by a distinctive pleasure and climatic orgasm (Noyes, 1963).
Importance may follow when there is either lack of attraction to the partner, or when the coital
environment is threatening or distracting. Much more common however, are those often
unconscious and conflictual loves, due either to persisting infantile attachments to the mother, sister
or some other important succouring woman in early life or to instances of latent homosexual
attachments. Guilt, anxiety or shame may lead to impotency in which the sufferer fears disapproval
by parents or society, or impotence may result when he has unconscious wishes to damage the
partner or considers exposure of his body or his sexual performance as subject to ridicule (Benedek,
1959; Gutheil, 1959).
CLASSIFICATION OF IMPOTENCY IN MALES
The following classification is suggested by David (1967) for impotency in males:
1. Impotence associated with anxieties or conflicts in patient’s in which the character structure is
reasonably healthy.
2. Impotence when the character structure is not healthy, i.e. neurotic.
3. Impotence associated with neurosis.
4. Impotence associated with psychosis.
5. Impotence associated with infantile sexuality.
6. Impotence associated with physical disease.
MATERIAL AND METHDOS
We studied 100 cases of sexual neurosis in one and a half years’ time in the Psychiatry and
Medicine Departments of the S.P. Medical College, Bikaner (Rajasthan). All the cases were males

and their ages varied between 16 and 55 years. The maximum age incidence was found between 21
and 25 years (Table I).
Table 1: Age incidence
Sl.
No.
Age Group
(in years)
No. of Cases
1 16 to 20 24
2 21 to 25 38
3 26 to 30 19
4 31 to 35 8
5 36 to 40 5
6 41 to 45 3
7 46 to 50 2
8 51 to 55 1
Total cases 100
Majority of the cases (80%) belonged to the villages, and 20% came from urban areas. About 55%
cases complained of sexual impotence and the remaining 45% cases came with complaints of
premature ejaculation, night discharges and passing semen in the urine. In all the cases we used
mainly two drugs of ‘Himalaya Drug Co.’, i.e.
i) Tentex forte which contains Musk, Saffron, Yohimbine hydrochloride, purified Nox
vomica, Makardhwaj, Shilajeet, Orchis mascula, Anacyclus pyrethrum, Withania somnifera,
Sida cordifolia, Bombax malabaricum, Argyreia, speciosa, Mucuna pruriens and
Swarnamakshik chasma, and
ii) Speman forte which contains Orchis mascula, Lactuca scariola, Hygrophila spinosa,
Mucuna pruriens, extracts of Parmelia parlata, Argyreia speciosa, Tribulus terrestris and
Leptadenia reticulata, Suvarnavang, and Rauvolfia serpentina.
We studied the efficacy and usefulness of these two non-hormonal preparations. We have not done
any comparative study with placebos. We have given Tentex forte tablet in cases of sexual
impotence of various degrees. We prescribed 1 tablet morning and evening with milk or tea,
normally up to a total of 90 tablets. Sexual abstinence was strongly advised for the first 20 days. In
some cases we have given up to 120 tablets. After the resumption of sexual activity, we advised
intercourse twice a week.
In cases of premature ejaculation and passing semen in the urine, especially in the morning along
with defaecation, Speman forte (Himalaya Drug Co.) was prescribed in doses of 2 tablets twice a
day half an hour before meals for up to 6 weeks and abstinence was advised for 2 weeks.
OBSERVATIONS AND RESULTS
During these one and a half years we observed that the majority of patients came with physical
complaints. Their commonest complaints were pain in the abdomen, backache, palpitation, pain in
the limbs, feeling of dullness, weakness, lack of appetite, gas formation, constipation and mild
insomnia. Most of these patients had been taking medicines like B-complex, enzymes, analgesics
etc., from the medical out-door without much relief. The majority (80%) of cases were referred
from the medical out-patient department of P.B.M. Hospital, Bikaner to the psychiatry department
of this hospital with the diagnosis of neurosis. While interviewing these patients in detail, we found
that the root cause of their trouble was sexual weakness. A few patients (20%) came with a
secondary depression due to their sexual weakness.
The results were quite good and encouraging with these two drugs. Along with supportive
psychotherapy like persuasion and discussion to restore self-confidence, we noted that about 85%
of the patients got relief from their neurotic symptoms and became confident of their sexual power.

They also became free from the anxiety and secondary depression. In 15% of the cases, our results
were not very encouraging because of their basic neurotic personality.
DISCUSSION
Sexual weakness is one of the commonest problems among young persons now-a-days. But due to
their lack of knowledge and education, they will not consult a doctor in the beginning and they will
come with some physical illness or with secondary depression. In men, impotence and premature
ejaculation are the commonest psychosomatic symptoms. So, one must go into details to find out
the emotional problem in every case. One must take a careful history that will determine the
situations in which failure at intercourse has occurred. Particular attention should be paid to the
attitude towards the partner, the environment of the coital acts, the frequency of sexual relations,
attitudes toward and desires for various forms of precoital stimulation and study of the attitude of
the partner, which is most significant. Impotency due to such illnesses as multiple sclerosis,
syphilis, diabetes, or other disorders involving the sacral segments of the spinal cord, the lumbar
parasympathetic outflow, or the lumbar sympathetic chain should be excluded by general medical
and neurological examinations. A general check up must be followed by a minute inspection of the
penis, palpation of the tests and recital examination of the prostate with a view to remove doubts
about the condition of the genitalia and their adenexas (Heilig, 1968).
Sometimes, impotence may be the early sign of a serious mental illness such as general paresis or
other organic psychosis. They are regularly found in morphinism and severe alcoholism. In
endogenous depression, libido and potency are reduced or abolished and this may also occur in
Schizophrenia (Mayor Gross, 1962).
CONCLUSION
In conclusion it may be said that the problem of male sexual weakness has many facets. Most of the
patients get unduly frightened because of the lack of sex education and wrong advice given by their
friends and quacks, to whom they disclose their secrets in the beginning. In the present study we
found that while Tentex forte tablets are effective in increasing sexual desire and improving
performance, tablets of Speman forte relieve the symptoms of premature ejaculation and noctural
emissions. One should also find out the psychological factors for the disturbances of various sexual
problems. Along with these drugs, one must give some supportive psychotherapy to restore the self
confidence of the patient. Our results are based purely on the subjective response of the patients.
In the end it may be said that Tentex forte is strongly recommended for all cases of sexual
deficiency and Speman forte for over active sexual centres. which produce premature ejaculation,
nocturnal emissions and spermatorrhoea.
REFERENCES
1. Arthur, P. Noyes, Modern Clinical Psychiatry; P.403, 1963, W.B. Saunders Company,
Philadelphia, and London.
2. Benedek, T.F.; American Handbook of Psychiatry, Vol. 1, P. 727-748. New York Basic Book
Inc., 1959.
3. David Bland; The Practitioner, 198: 598; 1967.
4. Gutheil, E.; American Handbook of Psychiatry, Vol. 1, P. 708-726, New York Basic Books
Inc., 1959.
5. Heilig, R.; Probe, 7:49; 1968.
6. Mayer Gross; Clinical Psychiatry, P. 182, 1962.