Friday, April 1, 2011

Traditional herbal remedies used in the management of sexual impotence and erectile dysfunction

Background
The utilisation of ethnobotanical indigenous knowledge is vital in male sexual reproductive health care delivery in western Uganda. Reproductive health care is the second most prevalent health care problem in Africa. However, this concept of reproductive health care has been focusing mainly on women disregarding men. Thus, some diseases such as sexual impotence and erectile dysfunction that deserve mention are regarded as petty though important in economic productivity, family stability and sexually transmitted diseases control including HIV/AIDS.
Objective
This study was carried out mainly to document medicinal plants used in the treatment of sexual impotence and erectile dysfunction disorders in western Uganda.
Methods
The medical ethnobotanical indigenous knowledge were collected by visiting traditional healers and documenting the medicinal plants used and other socio-cultural aspects allied with sexual impotence and erectile dysfunction. The methods used to collect the relevant information regarding the medicinal plants used included informal and formal discussions, field visits and focused semi-structured interviews.
Results
Thirty-three medicinal plants used in the management of sexual impotence and erectile dysfunction were documented and Citropsis articulata and Cola acuminata were among the highly utilized medicinal plants.
Conclusion
From the researchers' point of view, the usage of herbal remedies in managing male sexual disorders is useful because of long cultural history of utilisation and the current renewed interest in natural products to sustain health globally. As a way recognising the values and roles of traditional medical knowledge in health care provision, further research into the efficacy and safety of herbal remedies in male sexual disorders is precious in Uganda and beyond. More so, the establishment of rapport between relevant government department in Ministry of Health, modern health workers through collaborative and networking ventures with traditional healers under close supervision and monitoring of herbal treatments is noble.
Keywords: Medicinal Plants, Erectile Dysfunction, Sexual Impotence, Ethnobotanical Indigenous Knowledge, Western Uganda
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Introduction
About 70 – 80% of the Ugandan population still rely on traditional healers for day-to-day health care. In some rural areas the percentage is around ninety compared to 80% reported world-wide10,13,14. WHO32 had earlier estimates that the usage of traditional medicine in developing countries is 80 %. This is an indication that herbal medicine is important in primary health care provision in Uganda. There are several reproductive ailments that local communities have been handling and treating for ages such as sexual impotence and erectile dysfunction (ED). The concept of reproductive health care has been focusing mainly on women disregarding men and yet men are part.

Erectile dysfunction, sometimes, which also may imply to refer to “impotence,” is the repeated inability to get or keep an erection firm enough for sexual intercourse23,34. The word “impotence” may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm23. Roper29 defines erectile dysfunction as the total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections (premature ejaculation). Pamplona-Roger27 defines impotence as the inability to finish sexual intercourse due to lack of penile erection. These variations make defining ED and estimating its incidence difficult. For purposes of this publication, since ethnobotanical indigenous knowledge (IK) cannot clearly distinguish between these two terms, then erectile dysfunction and sexual impotence are both used. The local people who are providers of this information are not in position to classify these two conditions.
The estimated range of men worldwide suffering from ED is from 15 million to 30 million23. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. This is in USA, where statistics are clearly compiled, the level of awareness and education is high as compared to sub Saharan countries like Uganda. This is a clear indication that there are many silent men, particularly couples affected by ED.
Reproductive Health care is the second most prevalent health care problem on African continent4. Reproductive health care did not appear on the health agenda until recent after the Cairo conference on population and the Peking conference on women that it indeed became a live issue4. In some instances RH certainly includes the RH needs of the youth or adolescents.
According to Uganda's health policy priorities8,25, men's reproductive health is not given any mention. The national health policy focuses on services like family planning, diseases control like STI/HIV/AIDS, malaria, perinatal and maternal conditions, tuberculosis, diarrhoeal diseases and acute lower respiratory tract infections that are given priority8,25. The sexual and reproductive health rights in Uganda focus on maternal and child mortality, family planning and the like exclusive of men's sexual needs and rights8.
The causes of ED are varies from one individual to another. For whatever cause, since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. This sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa23. Thus, ED causes reported include, damage to nerves, arteries, smooth muscles, and fibrous tissues. These are often as a result of diseases, such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic diseases that account for about 70 percent of ED cases23. NIH23 reported that between 35 and 50 percent of men with diabetes experience ED. NIH23 further reported that the usage of many common medicines such as blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug) can produce ED as a side effect. Nevertheless, psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. In addition, men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression)23. Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone23.
In modern medication of erectile dysfunction, the oral prescription medication of popular Viagra (Sildenafil) is effective, but in some men it is not compatible and Sildenafil works in less than 70% of men with various etiologies and has certain side effects23. The availability of Viagra has brought millions of couples to ED treatment. Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage34. Other drugs such as Yohimbine, papaverine hydrochloride [used under careful medical supervision]5, phentolamine, and alprostadil (marketed as Caverject) widen blood vessels. However, this available modern medication for the ED in men is very expensive for most of the rural people in Ugandan and other developing countries. Yet, in traditional medicine, there are several medicinal plants that have been relied on for use in the treatment of ED. This ethnobotanical indigenous knowledge has not been earlier documented and scientifically validated for efficacy and safety, future drug discovery and development.
Therefore, this particular study was carried out purposely to document medicinal plants used by traditional medical practitioners to treat ED and sexual impotence and other male erectile related conditions in western Uganda. This manuscript only covers the ethnobotanical documentation of medicinal plants used in the management of erectile dysfunction excluding the socio-cultural aspects. The socio-cultural aspects in details will be presented in the next manuscript covering the broad range of reproductive health ailments management using the indigenous knowledge in western Uganda.
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Study area and Methods
This study was carried out in areas in and around Queen Elizabeth Biosphere Reserve (QEBR) and some other sub counties such as Katerera, Kichwamba and Kitagata in Bushenyi and Munkunyu, Kayonza and Kitsinga in Kasese districts in Western Uganda. The sampling sites were located in the parishes around the biosphere reserve, and in the selected fishing villages within the biosphere reserve. These included, Katwe, Mweya, Katunguru, Hamukungu, Kahendero and Kayanja Fishing Villages and many other villages.
The study was conducted between April 2000 and March 2003 in western Uganda. To collect this data indirect asking of questions and investigations that do not refer or offend anyone were used since nobody especially men can say openly that they have this problem. These methods are explained in the textbook of ethnobotany and others have been used in the field for this kind of studies in Uganda and elsewhere in the world10,12,13,14,21. These methods included visiting the traditional healers to document the indigenous knowledge (IK), regarding medicinal plants used, gender and socio-cultural aspects and where the plants are harvested. Informal and formal conversations, discussions and interviews, market surveys and field visits were conducted.
The informal conversations were held with the specialist resource users and other knowledgeable people on particular ailments. The meeting places were the gardens, women group meetings, at their homes, and any other places convenient to them. Through conversations, the sources of knowledge of the healers on medicinal plants, the medicinal plants used and changes in the availability of medicinal plants were established. Those who were more knowledgeable were later followed and interviewed further especially the TBAs, and some knowledgeable men healers. Focused discussions were held with them later for formal recording. In some instances, young mothers were visited too. This was done to verify the information gathered and the spread of the indigenous knowledge (IK) in reproductive health care among the different reproductive groups particularly on ED management.
The semi-structured interviews and discussions were held with the specialist resource users and other knowledgeable people on particular ailments by use of interview schedules for each respondent. Interviewed people were mainly the herbalists (both men and women) and TBAs. In this selection to some extent, ethnic groups were recorded where possible because different people use the same plants differently. The time and place of interviews were arranged according to the schedules of the respondent. Depending on where the interviews and discussions were held, recording was done immediately or afterwards or appointments were made for more details in a more convenient place arranged with the respondent. Key informants were identified and later interviewed separately and even followed for further details. Some of the key questions asked included, name of the respondents, the village or parish or sub-county he or she was coming from, diseases treated, plant local names used, parts harvested, methods of preparation and administration. In addition, ingredients and incantations with which the plants are used for preparation and where the herbal medicines were harvested were documented.
The field visits and excursions were arranged with the healers for places far from their homesteads or took place concurrently with the interviews and discussions. When going to the forests, game reserves or other areas where herbalists collect plant specimens, prior arrangements were made with the community leaders and park staff. This was done with individuals or groups depending on where the herbs are collected. In the shared areas such as the fishing villages, or the multiple use areas, group and individual excursions were conducted. Some of the medicinal plants that are harvested from distant places such as the Democratic Republic of Congo, other districts and unsafe areas within the reserve were not collected but their local names were recorded. The data collected were to supplement the information on plant names, plant parts used, collection of the herbarium voucher specimens and conservation status of these medicinal plants. The medicinal plants collected were given the voucher numbers and then later identified in Botany Department herbarium of Makerere University.
The key respondents were mainly old men, male traditional healers, traditional birth attendants and young women and all in total about 160 traditional healers were interviewed. To document male related ailments men are particularly more knowledgeable and most men share their problems with men. In addition, the old men and healers are the ones in charge of administering these herbal remedies. Young women through the informal discussions, interviews and market surveys are particularly more dynamic in the use of herbs for themselves, husbands and children besides being the most active reproductive age group. The medical ethnobotanical data collected has been analysed, medicinal plants from the study areas have been listed and methods of administering the herbal drugs were also documented. In checking for the proper updated naming, spellings and authors of the medicinal plants, besides using voucher specimens in Makerere University Herbarium, several reference books were used1,3,9,15,16,20,22,27.
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Results
Thirty-three medicinal plants both cultivated (Table 1) and wild harvested (Table 2) were documented and identified in the area of study. In the description below these results of these two table are combined as presented below. All the identified medicinal plants in both tables belong to 25 families and 30 genera. The family Rubiaceae (4) is the most represented followed by Alliaceae, Euphorbiaceae, Mimosaceae, Papilionaceae and Caesalpinaceae families which have two species each and the rest with one species. The composition is that 42.4% are shrubs, 39.4% herbs and herb climbers and 18.2% trees. Leaves (57.6%) are the commonest plant parts followed by roots (42.1%), barks (27.3%) and the rest of the plant parts harvested have less than 10% of the parts harvested. From Allium cepa, Allium sativum, Rhus vulgaris, Warburgia ugandensis, Cleome gynandra and Tarenna graveolens, three different plant parts, are harvested for use in sexual impotence and erectile dysfunction. In the case of Impetiens species and Urtica massaica, the whole plants are harvested while the rest of the species one or two different plant parts are used. The conservation status of these documented plants is that 27.3% are cultivated while 72.7% are collected from wild places. The common methods of plant medicine preparation included boiling, chewing, pounding, cooking, roasting and smoking. The commonest method of herbal administration was by oral means as food, herbal teas or by mixing in several drinks including locally made beer.
Table 1
Table 1
Cultivated Medicinal Plants used in treatment of Sexual Impotence and Erectile Dysfunction in Western Uganda
Table 2
Table 2
Wild-harvested Medicinal Plants used in treatment of Sexual Impotence and Erectile Dysfunction in Western Uganda
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Discussion
A list of 33 medicinal plants both cultivated and wild-harvested generated show that herbal remedies are greatly utilized by men for managing sexual impotence and erectile dysfunction in western Uganda. Erectile dysfunction and sexual impotence are old problem and traditionally the indigenous knowledge had ways of treating or managing these conditions associated with male reproductive system. These plants in the tables we are discussing have been in use for centuries in treating or managing conditions in male reproductive organs.
The medicinal plants used such as Citropsis articulata, Cannabis sativa, Cleome gynandra and Cola acuminata are frequently utilized. Some of these plants (Citropsis articulata, Cola acuminate) are already under sale for treating these conditions. Their propagation is on-going in western Uganda in places like Rukararwe Partnership Workshop for Rural Development Centre in Bushenyi District36 and researchers personal experience at Rukararwe. Rukararwe is a non-governmental organisation that is processing herbs, running a famous herbal clinic and with a medicinal plants arboretum and medicinal plants agro-forestry.
A plant like Cleome gynandra is a popular vegetable used all over Uganda and is on sale in most markets. Other medicinal plants that are food stuff include Allium cepa (onions), Allium sativum (garlic), Rhus vulgaris, Capsicum frutescens(red pepper) and Zingiber officinale (Ginger) are also on sale in most markets of Uganda and internationally. In addition, the roots of Mondia whiteii are used as an aphrodisiac for males and for improving female sexuality (women's Viagra) in most areas of Uganda11 particularly in urban centres and the Kampala City. To date, Mondia whiteii has been an old traded medicinal plant in most in Kampala. Recently the patented ‘Mulondo Wine’ a drink flavoured by the roots of Mondia whiteii has hit the national and international markets35. The Mulondo Wine is also believed to be an aphrodisiac for both men and women.
The herbal medicines used in the management of sexual impotence and erectile dysfunction are mainly prepared by pounding, chewing and boiling and are mainly orally administered. The traditional healers treat sexual impotence and ED by prescribing some of these herbs in tea or using local beers, fermented milk and porridge. Some herbs are herbs are roasted or smoked such as coffee before administration. The dispensing of herbal medicines used in sexual impotence and ED using local beers, fermented milk and porridge possibly the alcoholic content improves on the kind of active chemicals extracted than water alone12.
Some studies carried in and outside Uganda show that some of these plants listed in the management of sexual impotence and ED may be potent. Some of these medicinal plants are regarded as traditionally aphrodisiacs, implying that they have ability to increase sexual desires. For instance, Cola acuminata fruits are widely used herbal remedies in ED and are harvested from the forests of Democratic Republic of Congo. The Cola acuminata fruits contain about 2% catechine-coffeine (Colanine)7. The roasted seeds in Europe are used as strong stimulant, in addition to the treatment of migraine, neuralgia, diarrhoea and stimulant or cardiotonic, loss of appetite, antidepressant and melancholy (severe form of depression)7. Coffee is drunk for certain migraine, nausea, resuscitation and diuretic7. Coffee is a famous stimulant used world over as a beverage. However, the wild coffee species are more popular in treating ED and are believed to contain more alkaloids (caffeine). Coffee is further reported to be a nervous system stimulant (Pampalona-Roger, 2000). Cannabis sativa (Marijuana) is smoked by mentally sick and impoverished men7. C. sativa is like morphine, it is an opioid analgesics. Allium sativum (garlic) is used in treatment of diabetes, high blood pressure, prevention of arteriosclerosis (hardening of the arteries and is one of the causes of ED)7. Garlic reduces blood sugar levels and blood cholesterol levels which are the direct causes of ED if not checked. The Zingiber officinalis (ginger) volatile oils from the rhizome are used for stimulating the nerves and making then sensitive7. Capsicum frutescens in many African cultures is a known powerful stimulant and carminative24. Capsicum frutescens (chilli) contains enzyme capsaicine that helps in blood clotting (fibrinolytic) and people who consume C. frutescens seldom suffer from heart attack. In addition, the pharmacological tests showed that the capsaicin chemical compound from Capsicum frutescens acted like powerful stimulant of the receptors participating in circulatory and respiratory reflexes24.
Phytolacca dodecandra leaves and roots are pounded and smeared on ripe banana and then the ripe banana roasted before being eaten for treating erectile dysfunction. However, care has to be taken Phytolacca dodecandra is poisonous. Cola acuminata fruits are mixed with other plants in Benin to treat primary and secondary sterility24. Cola acuminata is also said to be diuretic and laxative when administered orally24. Some Acacia species are regarded as aphrodisiacs in Niger2. Cassia species have high repute as drugs and poisons. For instance, Cassia sieberiana is used urinary problems, impotence and kidney diseases in Mali24. In Burkina Faso, Cassia occidentalis is used as a stimulant24. Flueggea virosa is famous medicine in African cultures. Flueggea virosa used in sterility, aphrodisiacs, stimulant, rheumatism, arthritis, spermatorrhoea, kidney and liver problems among many other diseases treated17,24.
In Uganda gender specific malfunctions or complications or diseases and conditions in reproductive health care are not given the due regard and the suffering persons tend to shy away. Sexual impotence and ED in men is considered a secret affair and the suffering persons keep quite or seek medical help in privacy. The psychologically affected men will try other women to test the viability of their manhood. The same is true, women with spouses with such erectile problems may be tempted to go outside their marriage vows to satisfy their sexual needs. This can also lead to HIV/AIDS exposure and result in broken homes and marriages12. The consequential outcomes of promiscuity, low self-esteem, polygamy, sexually transmitted diseases including HIV/AIDS are more detrimental to the individuals and society.
Only the few elite (educated) and with money seek modern medical care privately and secretly. The description of impotent men in western Uganda among the Banyankore ethnic grouping is literally translated as the persons having no legs (Kifabigyere, Runyankore Dialect) to imply that the penis is dead (cannot bear children). There are other various terms used to describe such men with sexual impotence and ED like the one trampled by a goat, [Akaribatwa embuzi (empene), Kinyankore dialect]. In other places they called, such men who were unable reproduce as “Ekifera in Kinyankore meaning worthless). The men who were unable to have children were not supposed to be given the positions of responsibility or leadership because they were regarded as abnormal. Socially these men were excluded from society, even on drinking joints for the local brew or beer, they are not expected to talk and if they talked, they are hushed. Even women and children always taunted the suffering individuals. Socio-economically, sexual impotence and ED is demeaning and tortures the sufferers by reducing their self-esteem and worthiness in the society. Culturally, in olden days, the impotent men married wives and entrust their wives to very close friends and or relatives to bear them children. In central Uganda, the men with erectile problems are equalled to car engines that cannot start on their own [non-starters] or cars whose batteries have no or low charge (‘Takuba self’, Luganda dialect).
Although there are few men who are born absolutely impotent, the number of men with erectile problems are many especially those tending to 50 years and above. Pfizer28 reported that about 40% of men above years, 50% of men above 50 years, 60% of men above 60 years and in any population are affected by ED. ED has profound effect on psychological well being, it can be devastating, it can lead to low self-esteem, depression, negative effect on relationships and reduced life satisfaction28. Among several other causes, aging is one of the factors leading to ED. There are some other social causes of ED such as high unemployment rates, and diseases like diabetes, hypertension, HIV/AIDS, high cholesterol levels, stress, smoking and obesity28. ED is slowly creating adverse problems in homes in Uganda and particularly, among the mid-aged and old men. The men with sexual impotence and erectile dysfunction deserve proper diagnosis of the conditions and treatment. Thus, the plant remedies described may be healthy if administered
Erectile dysfunction is a common problem in men of all ages than publicly perceived. Since, I started the research in reproductive health care; the commonest question asked by men is related with medicinal plants that empower male sexuality. So far, several males have been consulting on the treatment of ED using herbal remedies, either by themselves or through friends12.
The proved herbal remedies with therapeutic values such as Prunus africana used in the treatment of hypertrophy in male genitalia is indicative that some herbals may be potent though not yet studied comprehensively5,13. However, most of the herbal remedies used in male ailments are not well documented and researched. The dangers of loosing valuable indigenous knowledge (IK) on sexual impotence and ED are likely to occur because westernization in the present generation. This indigenous knowledge in medicine ought to be documented for future use and sustainable utilisation19. According to the convention on biological diversity (CBD)6, specific reference is made to the need to protect the world's indigenous cultures and traditions (Art. 8 of CBD). This article points out that national legislation need to respect, preserve and maintain knowledge, innovations and practices of indigenous and local communities encompassing traditional life styles relevant for the conservation and sustainable use of biodiversity. UNEP argues nations to have an urgent action to safeguard indigenous cultures and their knowledge.
From the conservation point of view, medicinal plants usage will continue to grow in popularity as people seek ways to support health naturally and gently31. So far, over 72% of these medicinal plants used in ED conditions were harvested from the wild. Yet, there is increasing trend in usage of traditional medicine in developed countries30. The dramatic increase in herbal remedies usage will continue to rise since WHO has taken on monitoring of all unconventional medicine according to the traditional medicine strategic plan of 2002 to 200533. Most medicinal plants have proved successful sources or have acted as leads of effective ingredients that today's drug companies often look first to traditional places such as the rain forests, forest animals and traditional healers for clues to guide their drug development efforts. Furthermore, the harvesting of medicinal plants from the wild places such as the forest reserves, national parks in QEBR is a point of concern whereby no viable mechanisms have been put in place to propagate them. The plant parts harvested especially those of wild medicines such as roots and stem, pose threat to the future survival of natural reservoirs if domestication strategies are not adopted in the near future.
This calls for serious conservation strategies of plant targets in drug development borrowing from the indigenous knowledge of the local people. For instance, medicinal plants documented in this study like Warburgia ugandensis and Cirtopsis articulata used in erectile dysfunction and sexual impotence and ED need to be conserved based on their demand and medicinal value to the people. In the event of increased biotechnology and the use of modified living organisms in agriculture, health and environment, most people will go for natural products18,26. Furthermore, research in natural products is on the increase in both developed and developing nations to show that there is renewed interest in medicines of natural origin.
The medicinal plants used in male-related conditions will be very significant in the present and future generations. From the researchers point of view, the usage of herbal remedies in managing sexual impotence and erectile dysfunction is useful because of long history of utilisation of some herbs that are perceived as effective. Thus, the establishment of rapport between modern health workers through collaborative ventures with traditional healers, relevant NGOs like Rukararwe in Bushenyi by having close supervision and monitoring of herbal treatments in such conditions is noble. Ministry of Health through its research wing in traditional medicine the Natural Chemotherapeutics Research Laboratory in Wandegeya has role to play in advocacy of traditional medicine. In addition, Public-Private Partnership in Health Care Delivery Desk Office in Ministry of Health and distinguished researchers in herbal medicine need to network, collaborate and have policy in place for herbal medicine as an alternative form of health care in Uganda. The traditional herbal medicines, relevant to the needs of ailing Ugandans can be tried out after being licensed by the National Drug Authority. In our view, sexual impotence and erectile dysfunction are real silent conditions affecting Ugandan men. Additionally, further investigations into the safety and efficacy of these traditional herbal remedies used in the treatment of erectile dysfunction and other male-related conditions are recommended in Uganda.
Acknowledgments
Most sincere gratitude to the sponsors, Third World Organisation for Women in Sciences (TWOWS), NUFU Medicinal plants Project through Botany Department, Faculty of Science, Makerere University, UNESCO-MAB Young Scientist Research Award, 2000, Gender studies, Makerere University and WHO-Uganda. The Staff of Queen Elizabeth National Park, Field assistants, local leaders, the resource users and all respondents, particularly the TBAs and traditional healers in Bushenyi, Mbarara and Kasese Districts who provided the information.
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References
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69 comments:

sexual health care said...

Great article! Now i can say that there are still natural ways of remedying sexual health issues. We can always account herbs to these issues. Thanks!

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NITA said...

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johnpeter said...


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James Nelson said...

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WhatsApp: +2348100368288
Email: Priestazibasolutioncenter@gmail.com
Good-luck.

Alex Williams said...

Hello everyone I was heartbroken because i had very small penis, not nice to satisfy a woman, i had so many relationship called off because of my situation, i have used so many product which i found online but none could offer me the help i searched for. i saw some few comments about this specialist called Dr Okougbe and decided to email him on so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal pills for Penis t, Enlargement Within 1 week of it, i began to feel the enlargement of my penis, and now it just 1 weeks of using his products my penis is about 9 inches longer and am so happy feel free to contact Dr Okougbe on email address Drokougbespecialhome@gmail.com or whatsapp him this number +2348119278442 for more info you can call him

Terry Kirkman said...

I was despondent because i had a very small penis, about 2.5 inches soft and 4 inches hard not nice enough to satisfy a woman, i have been in so many relationship, but cut off because of my situation, i have used so many product which doctors prescribe for me, but none could offer me the help i searched for. i saw some few comments on the INTERNET about this specialist called Dr movo and decided to contact him on his email: {drmovo.supernaturalherbalmedic@gmail.com} so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal pills for Penis Enlargement, Within 3 week of it, i began to feel the enlargement of my penis, " and now it just 4 weeks of using his products my penis is about 9 inches longer, and i had to settle out with my Ex girlfriend JOY, i was surprised when she said that she is satisfied with my sex and i have got a large penis. Am so happy, thanks to Dr movo I also learn that Dr movo also help with Breast Enlargement Hips and Bums Enlargement etc.. If you are in any situation with a little Penis, weak ejaculation, small breast_hips_bums do get to Dr movo now for help on his email:{drmovo.supernaturalherbalmedic@gmail.com} or whatsapp +2347061865209).

denail said...

I want to share a testimony of how Dr.Omohan herbal mixture cream saves me from shame and disgrace, my penis was a big problem to me as the size was really so embarrassing,and i was also having weak erection problem. I can't make love to my wife and my penis was just too small a full grown man like me having 4 inches penis and to worsen it i don't last in sex i cant even last two minutes it was really a thing of shame to me. My wife was really tired of me because my sex life was very poor,she never enjoyed sex,i was always thinking and searching for solutions everywhere until when i saw a testimony of how Dr.omohan herbal mixture cream have been helping people regarding their sex life, so i decided to give him a try and to my greatest surprise in less than one week of taking the herbs my penis grow to 8 inches i couldn't believe my eyes and as i speak now my penis is now 8 inches and i do not have week erection again. I can make love to my wife longer in bed. And my marriage is now stable,my wife now enjoy me very well in bed. can contact him dromohanherbalmedicine@gmail.com or call or what-apps him through +2348164816038. . .he also specialize on the following things

BREAST ENLARGEMENT
BREAST LIFT & REDUCTION
PENILE/PENIS ENLARGEMENT
GENERAL BODY SLIMMING
HIPS & THIGH REDUCTION
REGAIN VIRGINITY BACK
Thanks for the Enlarging my penis sir, you indeed save my marriage...I am really grateful sir,

Joseph said...





How can i ever stop saying thank you to Dr yemi, After taking his product today my sexual life is health and balance am living up to my wife expectation. For the past 13 years i have been struggling with weak erection and premature ejaculation. I have spend money on it but no cure until i took this product from Dr yemi just within few days i got cured. for his products contact him email:dryemi156@gmail.com
or WhatsApp/Call +2349050456053,You can contact Dr yemi He can also cure so many sickness


Anonymous said...

TESTMONY! TESTMONY!! TESTMONY!!!. I decided to join facebook to share my testimony with you guys about a spell caster called DR Maxwell, I have been humiliated many times in relationships due to the fact of not being able to satisfy my girlfriend because I had a very small penis. i had so many relationship called off because of my situation, i have used so many product which i found online to enlarge it but none could offer me the kind of help i searched for. I was going through some comments on Facebook when I saw a testimony about this specialist called DR Maxwell and how he helped solve the testifies relationship issues regarding to their sex life, so i decided to seek his help too following the email I saw. so I decided to give his herbal product a try. i emailed him and he got back to me, and I told him my story, DR Maxwell sent me some herbal pills for Penis Enlargement after doing what he ask me, Within 3 week of it, i began to feel the enlargement of my penis, and now it just 4 weeks of using his products my penis is about 9 inches longer, a very big thanks to him, I believe their so many people going through the same thing which I went through that why I decided to tell the world how I got help from this great man, ladies i think He can help you enlarge your breast too if you need it because some guys love big breast. email him on dr maxwellomi@gmail.com or whatsapp him on + 218924677903 or call him on +2347016600744 thank you Dr Maxwell may God bless you.,,,,,,

Anneke Sergio said...

HOW I GOT CURED OF HERPES VIRUS.

Hello everyone out there, i am here to give my testimony about a herbalist called dr imoloa. i was infected with herpes simplex virus 2 in 2013, i went to many hospitals for cure but there was no solution, so i was thinking on how i can get a solution out so that my body can be okay. one day i was in the pool side browsing and thinking of where i can get a solution. i go through many website were i saw so many testimonies about dr imoloa on how he cured them. i did not believe but i decided to give him a try, i contacted him and he prepared the herpes for me which i recieved through DHL courier service. i took it for two weeks after then he instructed me to go for check up, after the test i was confirmed herpes negative. am so free and happy. so, if you have problem or you are infected with any disease kindly contact him on email--- drimolaherbalmademedicine@gmail.com. or / whatssapp --+2347081986098.
This testimony serve as an expression of my gratitude. he also have herbal cure for COLD SORE, SHINGLES, CANCER, HEPATITICS A, B. DIABETES 1/2, HIV/AIDS, CHRONIC PANCERATIC, CHLAMYDIA, ZIKA VIRUS, EMPHYSEMA, LOW SPERM COUNT, ENZYMA, COUGH, ULCER, ARTHRITIS, LEUKEMIA, LYME DISEASE, ASTHMA, IMPOTENCE, BARENESS/INFERTILITY, WEAK ERECTION, PENIS ENLARGEMENT. AND SO ON.

Unknown said...

droisemudiamenherbalhome@yahoo.com my dear readers around the globe, it is a great privilege to tell you about this great man who helped me over come the tragedy in my relationship, and how his herbal medicine help me too. My relationship became so complicated to a stage that I was scared of losing my wife to another, lasting long in bed was a problem and I knew deep down in my that my wife was not happy about it. Sometimes when I asked for sex the way she would act before the sex I noticed it was because I was not satisfying her, when she needed it more I hard already come and it was not the best. So I needed to find solution that was how I came in contact with DR OISE he really changed my sex life and ever since then life has been fun because my wife now love me more than she used to, all thanks to DR OISE for this great thing he did for me.. If you ever need help of any kind sickness like DIABETES.. HERPES.. you can visit DR OISE for solution droisemudiamenherbalhome@yahoo.com or what's app +2348121847014

Unknown said...

droisemudiamenherbalhome@yahoo.com my dear readers around the globe, it is a great privilege to tell you about this great man who helped me over come the tragedy in my relationship, and how his herbal medicine help me too. My relationship became so complicated to a stage that I was scared of losing my wife to another, lasting long in bed was a problem and I knew deep down in my that my wife was not happy about it. Sometimes when I asked for sex the way she would act before the sex I noticed it was because I was not satisfying her, when she needed it more I hard already come and it was not the best. So I needed to find solution that was how I came in contact with DR OISE he really changed my sex life and ever since then life has been fun because my wife now love me more than she used to, all thanks to DR OISE for this great thing he did for me.. If you ever need help of any kind sickness like DIABETES.. HERPES.. you can visit DR OISE for solution droisemudiamenherbalhome@yahoo.com or what's app +2348121847014

Asare Bismark said...

hello every one am very happy to share this awesome testimony about Dr OLIHA a great herbal doctor who helped me enlarge my penis size from 4.2 cm to 9.4 cm longer with his herbal cream mixture and i can also last in bed as long as i want to am so amazed with the autonomous size of my penis,if you are also in need of help on how to enlarge your penis size to become bigger and stronger i advice to contact Dr OLIHA today on his email[ oliha.miraclemedicine@gmail.com ] contact on his whatsapp number +2349038382931. he his one of the best herbal doctor

Ozil Amos said...

There is someone so so reliable and trusted when it comes to penis enlargement, premature ejaculation and erectile dysfunction. His name is Dr Korofo, A powerful and trusted Dr with high range of intelligence. I worked with him by requesting for his enlargement product and after usage, my penis increase from 3 inches to 13.5 inches. I never believe that this was gonna happen, Dr Korofo is indeed a man full of wonder's.

You can as well contact him on email: greatkorofosolutionhome@yahoo.com

Facebook page: https://web.facebook.com/A-place-where-you-can-get-your-problems-solved-no-matter-the-situation-659772167547824
Call him on: +2348159354512


This is for those that are interested and need his product for penis enlargement and solution to premature or delay ejaculation.

Unknown said...

Hello viewers around the Globe, I was despondent because i had a very small penis, about 2.5 inches soft and 4 inches hard not nice enough to satisfy a woman, i have been in so many relationship, but cut off because of my situation, i have used so many product which doctors prescribe for me, but none could offer me the help i searched for. i saw some few comments on the INTERNET about this specialist called Dr,MOSES Buba and decided to contact him on his email: buba.herbalmiraclemedicine@gmail.com) so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal pills for Penis Enlargement, Within 3 week of it, i began to feel the enlargement of my penis, " and now it just 4 weeks of using his products my penis is about 9 inches longer, and i had to settle out with my Ex girlfriend JOY, i was surprised when she said that she is satisfied with my sex and i have got a large penis. Am so happy, thanks to Dr MOSES Buba  I also learn that Dr MOSES Buba also help with Breast Enlargement Hips and Bums Enlargement etc.. If you are in any situation with a little Penis, weak ejaculation, small breast_hips_bums do get to Dr MOSES Buba  now for help on his email ( buba.herbalmiraclemedicine@gmail.com ). for any further question you can call me or message me on my cell phone number +1(845)4742852 i really want to share your good work Dr Moses Buba cause you are kind and your herbal product help me bring back  my wife and she now enjoys me .i never believe in you till i got my result to be honest after Dr A  make me lost my money he stole from me and i never receive any product from him after i paid him $2000 he block me  but yours was different  ,once again thanks so much i will forever be Grateful 

Rohan said...

Herbal remedies for low sperm count is helpful post for those men which are suffering from this problem. If we use Medicine To Increase Sperm Count we get best result.

Herbal Remedy is 100% guarantee for Penis Enlargement said...

I want to share this wonderful testimony to the Good people all over the world on how I was able to Enlarge my Penis by Dr. Aziba. I was living a shameful life from my young age, just last month as I was browsing on the internet about Penis size and Enlargement Products, I saw a testimony of a Man called George , testifying of how he was able to get his penis Enlarged by Dr. Aziba and I decided to also Email Dr. Aziba for my small penis size and he quickly respond to me and gave me the normal instructions which i did and then he shipped the product to me here in the united state which i received in just 3 working days and today i am very happy because i started seeing positive changes in my penis size in just 7 days of use. Dr Aziba herbal product is the best recommended for you and to whom ever suffering from this shame or having any other diseases as well should Contact this great herbal doctor via his Email : Priestazibasolutioncenter@gmail.com and WhatsApp Him on +2348100368288

Anonymous said...

THANKS TO DR HARY WHO HELP   ME OF PREMATURE EJACULATION AND ENLARGE MY PENIS. MY MARRIAGE WAS ALREADY GOING DOWN THE DRAWN, MY WIFE WAS CONTEMPLATING KITING. BECAUSE AM UNABLE TO SANCTIFY HER SEXUALLY, UNTIL I CAME IN CONTACT WITH DR HARY RECOMMENDATION ONLINE, ON HOW HE HAS HELPED SO MANY PEOPLE TO ENLARGE THERE PENIS AND I CONTACTED HIM, AND HE ADMINISTERED HIS HERB PRODUCT FOR ME. IN CASE YOU WANT TO CONTACT HIM YOU CAN CALL EMAIL DR VIA :   drchaudharydr469@gmail.com AND ALSO WHATSAPP DR ON : +13022311696

marvin fred said...

I would like to let all know that the size of your Penis really matters in your relationship or marriage. I got married to my wife about 1 month after we met on a photo studio, we lived happily for the first 3 months of our marriage until i and my wife started having quarrels at home because i couldn't satisfy her on bed with my little penis. Actually my penis was very small, it measured about 4.5 inch long on erection and i am 51 years old. My wife said it was forbidden by the women of this world. My wife started sleeping with other men outside. Sometimes i will return from work without finding my wife at home and whenever i call or ask her where she was, she will always snub at me and sometimes just tell me to go get a larger dick. All this continued for a long time and it hurt me so much that i was at the edge of breaking up on the marriage till when i read about a doctor called DR.Moses Buba. online. I never thought i could smile and be in a happy marriage again if not for the help of DR.Moses Buba. I got the doctors Emails:(buba.herbalmiraclemedicine@gmail.com ) on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs cream which i use for just 8 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 10 days and to my surprise my wife keeps screaming that she love my big dick now. Now my wife no longer cheat on me, and my penis is now about 10.5 inches long on erection and off course very large round. And now my wife uses breasts, hips and bums enlargement. I and my wife are very happy for the help rendered to me by DR.Moses Buba, and i want to say a big thanks to Doctor for the help. You can contact the Doctor now on his Email:( buba.herbalmiraclemedicine@gmail.com ) OR WHATSAPP +2349060529305 

Helen Wesley said...

Herbal Penis Enlargement product is 100% guarantee to Enlarge and get a better ERECTION , the reason why most people are finding it difficult to enlarge Penis is because they believe on medical report, drugs and medical treatment which is not helpful for Penis Enlargement . Natural roots/herbs are the best remedy which can easily Enlarge your Penis permanently. Feel free to contact him via WhatsApp: +2347031846539, email: drpaulherbals@outlook.com for Natural root and herbal remedies put together to help you get Enlarge and Erect healthy.
He also specializes on curing:
{1}HIV/AIDS
{2}DIABETES
{3}EPILEPSY
{4} BLOOD CANCER
{5} HPV
{6} ALS
{7} HEPATITIS
{8}LOVE SPELL
{9} SICKLE AND ANAEMIA
{10}Chronic pancreatic
{11} Emphysema
{12} COPD (chronic obstructive pulmonary disease)
{13} Herpes

WhatsApp: +2347031846539, email: drpaulherbals@outlook.com

Thank you.

Dr Sebi Jr said...

I want to share this wonderful testimony to the Good people all over the world on how I was able to Enlarge my Penis by Dr. Aziba. I was living a shameful life from my young age, just last month as I was browsing on the internet about Penis size and Enlargement Products, I saw a testimony of a Man called George , testifying of how he was able to get his penis Enlarged by Dr. Aziba and I decided to also Email Dr. Aziba for my small penis size and he quickly respond to me and gave me the normal instructions which i did and then he shipped the product to me here in the united state which i received in just 3 working days and today i am very happy because i started seeing positive changes in my penis size in just 7 days of use. Dr Aziba herbal product is the best recommended for you and to whom ever suffering from this shame or having any other diseases as well should Contact this great herbal doctor via his Email : Priestazibasolutioncenter@gmail.com and WhatsApp Him on +2348100368288


marvin fred said...

Hello everyone , i am here to give my testimony about a herbal doctor called sabo, I was heartbroken because i had very penis, not nice to satisfy a woman, i have been in so many relationship, but cut off because of my situation, i have used so many product which doctors prescribe for me, but none could offer me the help i searched for. i saw some few comments on the internet about this specialist called Dr, sabo and decided to email him on his email i saw on the internet,(saboherbalmedicine@gmail.com) so I decided to give his herbal product a try. i emailed him and he got back to me, he gave me some comforting words with his herbal product for Penis Enlargement, Within 3 week of it, i began to feel the enlargement of my penis, " and now it just 4 weeks of using his products my penis is about 9 inches longer, and i had to settle out with my Ex girlfriend Jane, i was surprised when she said that she is satisfied with my sex and i have got a large penis.
Am so happy, thanks to Dr sabo I also learn that Dr sabo also help with Breast Enlargement Hips and Bums Enlargement etc.. If you are in any situation with a little Penis, weak ejaculation, small breast_hips_bums do get to Dr.sabo now for help on his email via (saboherbalmedicine@gmail.com) or call his mobile line +2348074412569 Thanks and may God bless You.

Eric brunt said...

i am ERIC BRUNT by name. Greetings to every one that is reading this testimony. I have been rejected by my wife after three(3) years of marriage just because another Man had a spell on her and she left me and the kid to suffer. one day when i was reading through the web, i saw a post on how this spell caster on this address AKHERETEMPLE@gmail.com have help a woman to get back her husband and i gave him a reply to his address and he told me that a man had a spell on my wife and he told me that he will help me and after 3 days that i will have my wife back. i believed him and today i am glad to let you all know that this spell caster have the power to bring lovers back. because i am now happy with my wife. Thanks for helping me Dr Akhere contact him on email: AKHERETEMPLE@gmail.com
or
call/whatsapp:+2349057261346










i am ERIC BRUNT by name. Greetings to every one that is reading this testimony. I have been rejected by my wife after three(3) years of marriage just because another Man had a spell on her and she left me and the kid to suffer. one day when i was reading through the web, i saw a post on how this spell caster on this address AKHERETEMPLE@gmail.com have help a woman to get back her husband and i gave him a reply to his address and he told me that a man had a spell on my wife and he told me that he will help me and after 3 days that i will have my wife back. i believed him and today i am glad to let you all know that this spell caster have the power to bring lovers back. because i am now happy with my wife. Thanks for helping me Dr Akhere contact him on email: AKHERETEMPLE@gmail.com
or
call/whatsapp:+2349057261346










Rohan said...

Best diet plan and Low Sperm Count Supplements Online are really work on this problem. And you are shared traditional herbal remedies for this treatment.

Dr Sebi Jr said...

I thought the physicians said there is no pills or another way for PENIS ENLARGEMENT !!! I am telling you today that Dr Aziba has the product for PENIS ENLARGEMENT and it worked perfectly for me from 3:0 to 8:95 and still counting. Contact Dr Aziba for help to Enlarge your penis via Email Address: priestazibasolutioncenter@gmail.com and also reach him on WhatsApp with mobile number: +2348100368288
and please lets keep sharing this solution to other fellow men around the world with living with such mess.

Dr Sebi Jr said...

I thought the physicians said there is no pills or another way for PENIS ENLARGEMENT !!! I am telling you today that Dr Aziba has the product for PENIS ENLARGEMENT and it worked perfectly for me from 3:0 to 8:95 and still counting. Contact Dr Aziba for help to Enlarge your penis via Email Address: priestazibasolutioncenter@gmail.com and also reach him on WhatsApp with mobile number: +2348100368288
and please lets keep sharing this solution to other fellow men around the world with living with such mess.

cambell spivey said...

Hello I'm cambell by name, I'm giving a testimony about Dr.Emmanuel the great Herbalist, he has the cure to all manner of diseases, he cured my herpes disease, though I went through different website I saw different testimonies about different spell casters and herbalist, I was like: 'Many people have the herpes cure why are people still suffering from it?' I though of it, then I contact Dr. Emmanuel via email, I didn't believe him that much, I just wanted to give him a try, he replied my mail and Needed some Information about me, then I sent them to him, he prepared it (CURE) and sent it to Airfreight Online Courier Service for delivery, he gave my details to the Courier Office, they told me that 3-5 days I will receive the package and i took the medicine as prescribed by him and I went for check-up 2 weeks after finishing the medicine, I was tested herpes negative, if you are herpes positive do me a favor for you to contact him and I will try my possible best to make sure you get cured, when you contact him, make sure you tell him that I referenced you.. contact him via: nativehealthclinic@gmail.com or WhatsApp +2348140073965 or IG:@dremmanuel2