Premature Ejaculation – What Ayurveda & Yoga Can Offer?

Home , Basti (hatha yoga), Bindu (symbol), Nauli, Shatkarma

Internationa Journal of Complementary & Alternative Medicine

Premature Ejaculation – What Ayurveda & Yoga can Offer?

Abstract Review Article

Shukragatavata’ PrematureAyurveda Ejaculation (PE) is defined as ejaculation before the completion of Volume 9 Issue 6 - 2017 satisfactory sexual activity for both partners. ‘ is a pathological entity Faculty of Ayurveda, Parul University, India Ayurvedaof and similar in Yoga to. Ayurvedic premature ejaculation. The present article is aimed to find out various formulations or practices available in ancient Indian erotic literature, *Corresponding author: management of premature ejaculation consists of, various herbal and herbo-mineral formulations, external applications over lower Kshama Gupta, Associate abdomen or all over the body, wearing different amulets made by herbs, psychotropic Email:professor, Faculty of Ayurveda, Parul University, Vadodara, Gujarat, 391760, India, Tel: 7567222309; herbalshukra drugs stambhaka for reducing performance anxiety, various techniquesVasti is elaboratedan important in Received: | Published: panchakarmaancient Indian erotic literature to fasten the orgasm in female partner and also use of yoga drugs to improve control over ejaculation. August 11, 2017 December 09, 2017 procedurevajroli mudra’ and an is an ideal important choice one. in the management of premature ejaculation. Various practices are also described to get control over ejaculation Keywords:and among them ‘ Ayurveda; Yoga; Vajroli mudra; Panchakarma; Vasti Premature ejaculation;

Introduction like, Charaka samhita, Sushruta samhita, Ashtanga sangraha, Ashtanga hridaya, Bhaishajya ratnavali and Yogaratnakara. Yoga Hatha yoga pradipika’ Asana, Pranayama, Mudra & Bandha’. Electronic Premature Ejaculation (PE) is defined as ejaculation before Materials pertaining to were collected from ‘ the completion of satisfactory sexual activity for both partners. & ‘ In severe cases, it is characterized by ejaculation either before databases ‘Google scholar search’ and ‘Google search’ were penetration or soon after that. The causes can be biological [1]. searched for relevant studies andAyurveda reviews published/appeared (relatively uncommon) or psychological (performance anxiety) from 2010 to December 2016. The key words used for search PE is generally regarded as one of the most common male sexual were, ‘Premature ejaculation & ’. Abstracts and full text dysfunctions. It is affecting on average 40% of men worldwide. articles which are freely downloadable and in English language PE is a psychosomatic disturbance due to a psychologically Conceptwere only included.of PE in Ayurvedic Classics overanxious personality and it is classified in to primary (lifelong) or secondary (acquired) [2]. The essential feature of PE is the kama’ persistent or recurrent onset of orgasm and ejaculation with purusharthas minimal sexual stimulation before, on or shortly after penetration The rich heritagekama’ of reveals Indian that culture the recreational considered aspects ‘ and before the person wishes it. Various other factors such as age, (desire/sex) as one among the , the objectives of life. The concept of ‘ [3].novelty Vajikarana of the sexual partner or situation and recent frequency like enjoyment and it is also equally important for procreation. of sexual activity etc should be consideredAyurveda while diagnosing PE kama’ (sexual medicine/sexology/aphrodisiac therapy) medicinalAs an art asimportance. well as science the ancient Indian erotic literature is one of the eight branches of which deals with the deals various aspects of ‘ along with its social, cultural and Anangaranga’ Kalyana malla’ preservation and amplificationVajikarana of the sexual potency of a man, conception of healthy progeny as well as management of infertility ‘ is a sexual treatise written by ‘ & sexual dysfunctions. improves sexual capacity and which deals with various aspects of achieving optimum sexual also physical, psychological and socialAyurvedic health of an individual [4]. pleasure in intercourse and also provides sexual education [6]. The diagnosis and management of infertility and variousKlaibya’ sexual Various concepts like, class of women who should be avoided for indysfunctions Ayurvedic are dealt inShukragata detail in vata’ classics. The male sexual relation, prohibited places for sex [7] and also description sexual dysfunctions have been elaborately described as ‘ Ayurveda of various body parts of womenAnangaranga to be stimulated during foreplay classics [5]. ‘ is a pathological entity Ayurveda for better gratification according to theseeghrasambhava lunar cycle of progression) moderate described in which is similar to PE [2]. The present and Yoga. timedand regression (madhyama is available sambhava In . Threechirasambhava types of sexual). article deals with the concepts and management of PE in unions are described- short timed, ( Review Methodology to the stimulation (kriya ) and long timed ( Ayurvedic Shukragata vata Vajikarana’ –Degree laghu of arousal which variesmadhyama from person to person according Ayurvedic chirodaya ) is described (which is of three types material related to ‘ ’/ ‘ (easily aroused), (moderately aroused), and was collected from major texts with their commentaries (late aroused) [8]. A number of recipes for hastening

Submit Manuscript | http://medcraveonline.com

dravana yogas and Ashwagandha Kalyanamalla Brahmi (Bacopa monnieri), ejaculationthe orgasm (ofsukrastambana the female partner ( ) are describedKama Mandukaparni (Withania somnifera Linn) has improved deva[9]. prescribed a number of recipes to delay the duration of sexual act [2]. Putranjeevaka smarana ) in men. The residing place of “ (Centella asciatica) are having anti-anxiety, ” (lord of desire) is human mind and its manifestation occurs time.adaptogenic Kapikacchu and (Mucuna stress prurience) relieving properties.is an aphrodisiac and also by (fantasy). It signifies the importance of mind in sexual (Drypetes roxburghii) is beneficial in increasing theAshwagandha ejaculation function. [8] Various measures were used to distract the mind is a vajikarana duringAyurveda sexual act [10]. effective in improving the performance in men [16]. harsha tarsha Shukra stambhana drug yapana and also vasti it is having properties like, anxiolytic, enumerates eight factors responsible for ejaculation. (sliminess saratwat paicchilya anti-depressant, anti-stress adaptogen and uplifts (an mood [17]. They are (excitement, sexual fantasy), (strong Shukrastambhakara yoga Ayurvedic gaurava anutva (medicated enema) is also found desire for sex), (fluidity of semen), semen), pravanabhava drutatvat beneficial in PE [18]. of semen), (heaviness of semen) and (atomicity of (due to vata formulation) proved as psychotropic, improves the duration of (tendency to flow out), marutasya drutatvat the sexual act, reduces performance anxiety and found effective ). Dysfunction of either one or all of these eight factors in PEIn [4].‘Bhaishjya ratnavali’ (an Ayurvedic leadsvata to ejaculatorydosha impairmentvata out of which ‘ apana vata marutasya’) leads veerya stambhana adhikara’ is most important. The physiology of ejaculation is underAyurvedic control text), a chapter named of . Vitiation ofshukragata (especially vata’ Shukragata vata ‘ (chapter which contains various to PE [11]. Previous scholars compared PE with an formulations which are useful to control ejaculation) is mentioned. pathological entity called, “ [12]. Various single drugs (herbal), herbo-mineral formulations, is a distinct pathological entity characterized Kshipramby a group munchati’ of clinical, various external applications (a paste containing various herbs) presentationsshukrasya either sheeghram related withutsargam’ the impairment, [13] ‘pravritti/Atiseeghra of ejaculation or otherover feet practices and lower are mentioned abdomen into Bhaishajyawith hold ejaculation,ratnavali different pravritti’with the impairment of seminal properties.shukragata ‘ vata’ amulets (wearing amulets prepared by various herbs) and various [12] ‘ One more Ayurvedic ‘Yoga ratnakara’ [19]. [14] are the classical features of ‘ which various Ayurvedic text called, has described Ayurvedicdenotes early Management / fast ejaculation of /PE PE. Vanari gutika’ formulationsAtmagupta which (Mucuna are prurience) useful in lossas one of Ayurveda shukra (semen / reproductive erections and early ejaculation. A formulation called, ‘ which contains Chandanadi Vajikarana has given importance to Ayurveda tailamof the and main Maha ingredients sugandhi is tailam indicated in early ejaculation and system) as the supreme body tissue because of its generative also in loss of erection. Various medicatedAbdhishoshadi oils like, yoga (an property. is the branch of , which deals with Ayurvedic are mentioned for application various types of physical, psychological, sexual problemsvajikarana like Veeryastambhakaall over the body vati in early(an Ayurvedic ejaculation. impotence, libido, poor erection, and early ejaculation in the Ahiphena formulation) is useful to get control over ejaculation. males as well as sterility and frigidity in females. The formulation) which contains drugs are helpful in providing strengthAyurvedic and vigor to the person (Papaver somniferum) as one of the main ingredient is along with improvementPraharsha of reproductive anna potentiality [15]. Scanty alsoAyurvedic indicated in PE [20]. sukragatavata balyaresearch (tonics), has been shukrakara done on role of drugs/proceduresvajikarana in vrishya (aphrodisiacs), balya (tonics), vasti’sthe management of PE. (exhilarating food items), vatahara line of treatment for early ejaculation/vata dosha), medhya drugsshukragata (aphrodisiacs) vata. and should consists of sukrastambhaka (various enemas with medicated oils & decoctions) are ejaculation)(drugs/procedures properties. Vasti which pacifies useful in the managementErandamoola of (Ricinus communis Linn.), (psychotropic drugs)vata vikara’s and or shukragata vata(drugs, as helpful it controls to delay vata Brahmi (Bacopa monnieri Linn), Mandukaparni (Centella asciatica is the best available treatment / an Linn),Individual Amlaki herbs like, Jatiphala ideal choice for Akarakarabhadi at its own site [21]. yoga, Rasayana (Emblica vati, Manasamitra officinalis Garten),vataka, Katphaladi (Myristica kwatha mineralfragrans compounds Houtt); compound like, Swarna formulations bhasma like, Rasa sindhura By considering the above facts it seems that PE is managed ; by, different herbal drugs/herbo-mineral formulations (which (gold), are useful to delay ejaculation, to vataimprove dosha performance or works panchakarma(mercury based procedures formulations) (Ayurvedic etc; proved effective in the as tonics), various external applicationsAyurveda) over lower abdomen/ procedures)management like of PE. vasti Few (various studies havemedicated evaluated oil theor efficacydecoction of all over the body (to regulate which is the main enemas) and shirodhara five major body cleansing pathological factor in PE according to , wearing different herbs as amulets (whichmedhya may divert the mind during sexual act (continuous oil drip on forehead) were mood),or may dravana increase vidhi confidence and decrease performance anxiety alsoAkarakarabhadi proved effective yogain PE [2]. during sexual act), drugs (may reduce anxiety or uplifts Narasimha or shukraother techniques stambhaka elaborated in ancient choorna, Bhallataka phala hasmajjadi improved avaleha, the Musalyadi time taken choorna for Indian erotic literature (different techniques to accelerate orgasm ejaculation and satisfaction to female partner. in female partner) and drugs/formulations Atmagupta (may improve control over ejaculation). Further clinical trials are have provided better results in improving the duration of sexual required to substantiate these claims. act and frequency of coitus. (Mucuna prurita Hook)

Citation: Ayurveda & Yoga

Gupta K, Mamidi P (2017) Premature Ejaculation – What can Offer?. Int J Complement Alt Med 9(6): 00319. DOI: 10.15406/ijcam.2017.09.00319 Copyright: Premature Ejaculation – What Ayurveda & Yoga can Offer? ©2017 Gupta et al. 3/4

Role of Yoga in PE ‘Hatha yoga’ ushtrasana, vyaghrasana, kati-chakrasana, tadasana, meruprishtasana, utthanasana, trikonasana, yogamudrasana, gives utmost importance related to conservation matsyasana and all backward bending asana’s; pranayama’s like of semen and controllingyogi ejaculation. Identification with the nadi shodhana pranayama, bhastrika and ujjayi; mudra’s like, thebody bindu ceases and consciousness becomes free from physical ashwini mudra, vajroli mudra, vipareetakarani mudra, maha identification,maithuna if a (the one who practices yoga)‘Hatha controls yoga mudra and maha bheda mudra; bandha’s like moola bandha and pradipika (semen) and preventsyoga its release from the body even maha bandha; shatkarma procedures like, nauli, agnisara kriya; theduring bindu (sexual intercourse),bindu according to other practices like, yoga nidra and meditation are useful for ’. The knower of conquers death by preserving general toning of male and female reproductive organs and also to in hatha yoga (semen). Release of the is equal to death and calm the mind [23]. In a pilot study, yoga protocol which consists conservation of semen is life. Therebindu are some practices explained of various yoga practices has provided encouraging results in texts to preserve the semen (to stop / to control/ Conclusionimproving IELT in PE patients [24]. to withhold ejaculation). The which is about to fall in to the woman’s vagina should be made to move upwards with Shukragatavata’ Ayurveda similar to continuous practice. The ejaculated bindu semen along with the Ayurvedic secretions of women’s vagina should be drawn up through urethra ‘ is a pathological entity of by muscular contractions. The flow of can be reversed by premature ejaculation. For management of PE, various continuous practices of various mudra’s like, vipareeta karani herbal or herbo-mineral formulations, external applications mudra,Vajroli khechari mudra mudra, vajroli mudra etc [22]; over lower abdomen or all over the body, wearing different amulets made by herbs, psychotropic herbal drugs for reducing Vajra’ Vajra nadi’ performanceshukra anxiety,stambhaka various techniques elaborated in ancient Vajra nadi Indian erotic literature to fasten the orgasm in female partner and The word ‘ refers to ‘ , which governs the uro- yoga practices are also use of drugs/formulations to improve control genital system. is the energy flow within the spine vajroli Vajroli over ejaculation are mentioned. Various which governs the sexual functions of the body. There are seven mudra’ described to get control over ejaculation and among them ‘ practices of and these practices takes years of preparation is an important one. Further clinical trials are required to which starts with the simple contraction of uro-genital muscles Yogic Acknowledgmentsubstantiate these claims. and later sucking up of liquids through urethra. The seventh practice is ‘ intercourse’ (doing intercourse by withholding None ejaculation or sucking up of ejaculated semen after ejaculation in women’s vagina through urethra by muscularvajroli contractions). Conflict of interest vajroliBy practicing gradual upward contractions during ejaculation in intercourse, man can achieve perfection in . Perfection of means, being able to withdraw the seminal fluid during the The authors declare that there is no conflict of interest height of climax and this involves the practice of contracting and Referencesregarding the publication of this article. controlling the muscles of the uro-genital complex [22]. Vajroli 1. th TheShiva semen samhita’ is not supposed to be ejaculated and it must be drawn up through the generative organ by . According Ahuja N (2005) A short textbook of psychiatry. Chapter 10- Sexual disorders- Premature ejaculation. (5 edn), Jaypee brother’s medical to ‘ , ‘the wise should first absorb the vaginal publishers (P) Ltd, New Delhi, India, pp. 135-138. secretions through penis by muscular contractionsyoni mudra of the or urethravajroli. and there after performvajroli coitus, uddiyana without bandha, ejaculating nauli theand seminal moola 2. Kulkarni PV, Chandola HM (2012) Systemic. review and critical analysis of research work on premature ejaculation. Indian Journal bandhafluid’. Ejaculation should be restrainedvajroli by 3. Before practicing of Ancient Medicine and Yoga 5(4): 195-200 has to be perfected. Later should be practiced by American Psychiatric Association (2000) Diagnostic andth Statistical muscular contractions of the urethra and then by using a tube or Manual of Mental Disorders – Text Revision (DSM-IV-TR). Sexual and Rolecatheter of [22].Mind in Ejaculation According to Yoga gender identity disorders – Premature ejaculation. (4 edn), Jaypee Publications, New Delhi, India, pp. 552-554. 4. Kulkarni PV, Chandola HM (2013) Evaluation of stambhanakara yoga and counselling in the management of shukragata vata (premature controlledA man’s and semen conserved. can be Yogiscontrolled by the mind and control of 5. semen is life giving. Therefore, the semen and mind should be ejaculation). AYU 34(1): 42-48. (people who practices yoga) have Chandra N, Nagaraj S. Clinical understanding of Klaibya. International always claimed that autonomic body functions can be consciously Ayurvedic Medical Journal 1(3): 1-4. yoga practices st controlled with time and effort. Functions of thevajroli reproductive, one can 6. Tripathi R (2004) Kalyanamalla. Anangaranga. Prathama sthala organs can also be influenced and controlled by – 1/1-6. First edition. (1 en), Chaukhamba Sanskrit pratishthan, over a sustained period of time. By practicing Delhi, India, p. 1-13. learn to control the physical mechanism, but along with the st mental control also can be developed [22]. 7. Tripathi R (2004) Kalyanamalla. Anangaranga. Ashtama sthala – Yoga Practices Useful in P 8/15-26. (1 edn), Chaukhamba Sanskrit pratishthan, Delhi, India, 8. pp. 213-224. 13. (1st Tripathi R (2004) Kalyanamalla. Anangaranga. Tritiya sthala – 3/10- Various asana’s like, pawanamuktasana, surya namaskara, edn), Chaukhamba Sanskrit pratishthan, Delhi, India, p. 62- sarvangasana, halasana, shashankasana, marjari asana, 63.

Citation: Ayurveda & Yoga

Ashwagandha (Withania st somnifera Dunal. Linn. 9. Tripathi R (2004) Kalyanamalla. Anangaranga. Shashtham sthala – 17. Mamidi P, Thakar AB (2011) Efficacy of 6/1-10. (1 edn), Chaukhamba Sanskrit pratishthan, Delhi, India, p. ) in the management of psychogenic erectile 148-151. 18. dysfunction. AYU 32(3): 322-328. st 10. Tripathi R (2004) Kalyanamalla. Anangaranga. Shashtham sthala – Manjunath D, Lohith BA, Kumar AM, Chaturvedi A (2013) Basti 6/11-19. (1 edn), Chaukhamba Sanskrit pratishthan, Delhi, India, Ardha chikitsa – A critical review. International Ayurvedic Medical 11. p. 152-154. Journal 1(4): 1-7. st Khader A, Singh G (2014) Concept of sexuality in Ayurveda. Journal 19. Govind das Sen (2005) Bhaishajya ratnavali. In: Siddhinandan of Ayurveda and Holistic Medicine 2(4): 35-43. Mishra (Ed.), Veeryastambhana adhikara – chapter 75 / 1 & 4. (1 edn), Chaukhamba surbharati prakashan, Varanasi, India, pp. 1158- 12. Agnivesha (2008) Elaborated by Charaka and Dridhabala 1160. commentary by Chakrapani. Charaka samhita, Chikitsa sthana, Vata vyadhi chikitsitam adhyaya, 28 / 34. In: vaidya Jadavji & Trikamji 20. Anonymous (2013) Yogaratnakara.th Commentary by Indradev Acharya (Eds.), Chaukhamba surbharati prakashan, Varanasi, India, tripathi and Dayashankar tripathi. Uttarakhanda – Vajeeakarana 13. pp. 617. prakarana / 27-155. (4 edn), Chowkhamba krishnadas academy, Varanasi, India, pp. 875-887. Vagbhata, Ashtanga Hridaya (2005) Commentary by Arunadatta and Hemadri, Nidana sthana, Vata vyadhi nidaanam adhyaya, 15 / 13, In: 21. Agnivesha (2008) elaborated by Charaka and Dridhabala Bhishagacharya Harishastri & Paradkara Vaidya (Eds.), Chowkhamba commentary by Chakrapani. Charaka samhita, Chikitsa sthana, Yoni Sanskrit series office pp. 531. vyapat chikitsitam adhyaya, 30/145-152. In: vaidya Jadavji Trikamji Acharya (Ed.), Chaukhamba surbharati prakashan, Varanasi, India, 14. Sushruta, Sushruta samhita (2009) Commentary by Dalhana. Nidana pp. 640-641. sthana, Vata vyadhi nidaanam adhyaya, 1/29. In: vaidya Jadavji nd Trikamji Acharya & Narayana Ram Acharya (Eds.), Chaukhamba 22. Swami Muktibodhananda (2005) Hatha yoga pradipika by 15. orientalia, Varanasi, India, pp. 261. Swatmarama. Chapter 3/verse 83-90. (2 edn), Yoga publications trust, Munger, India, pp. 370 - 390. Bhikaji PK, Moshram DS, Jadhao MN, Dhimdhime RS, Borse VP Bandha. (3rd (2015) Shukra - the essence of all other dhatu: A review. Int. J Ayur 23. Swami Satyananda Saraswati (2006) Asana Pranayama Mudra Pharma Research 3(8): 101-105. edn), Yoga publications trust, Munger, India, pp. 534- 540. 16. Gandhi AJ, Tavhare S, Bedarkar P, Patgiri BJ (2016) Herbs indicated in the management of infertility with special reference to vandhyatva 24. Mamidi P, Gupta K (2013) Efficacy of certain yogic and naturopathic and klaibya: A review. World Journal of Pharmacy and Pharmaceutical procedures in premature ejaculation: A pilot study. Int J Yoga 6:118- Sciences 5(6): 599-608. 122.

Citation: Ayurveda & Yoga

Gupta K, Mamidi P (2017) Premature Ejaculation – What can Offer?. Int J Complement Alt Med 9(6): 00319. DOI: 10.15406/ijcam.2017.09.00319