Your NE could be caused by chronic prostatitis as Pulsatilla was found beneficial in its management.
Pulsatilla is among the top 10 most often used TCM herbs.
Table 3 Summary of top ten most frequently used Chinese medicinal substances (single herbs)
https://cmjournal.biomedcentral.com/articles/10.1186/s13020-022-00591-x/tables/3Eviprostat sounds an interesting product to try if someone manages to get it.
Eviprostat is a phytotherapeutic agent widely used in the treatment of prostatic hypertrophy and has been used in Japan and Germany for more than 40 years. Eviprostat consists of five components: four are extracted from the umbellate wintergreen Chimaphila umbellata, the aspen Populus tremula, the small pasque flower Pulsatilla pratensis, and the field horsetail Equisetum arvense, and the fifth is germ oil from wheat (Tritium aestivum).
Oka et al previously reported that by using a model of non-bacterial prostatitis (NBP) induced in castrated aging rats by the injection of 17b-estradiol, they showed that the increased production of oxidative stress marker malondialdehyde (MDA) and the proinflammatory cytokines TNF-a, IL-6, and IL-8 in prostate tissue homogenates from NBP rats. Eviprostat treatment significantly suppressed oxidative stress and proinflammatory cytokines in the NBP rats.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672535/In a clinical study Eviprostat significantly improved the International Prostate Symptom Score (IPSS), quality of life (QOL) score, and average and maximum urinary flow rate (Qmax), and decreased the prostate volume (PV) without serious side effects. Eviprostat is known to suppress the production of free radicals in cell-free systems and human neutrophils.https://sci-hub.se/https://onlinelibrary.wiley.com/doi/abs/10.1002/ptr.2909The benefits of Pulsatilla are most likely due to saponins, especially anemoside.
Saponins are found in a variety of higher plants and display a wide range of pharmacological activities, including expectorant, anti-inflammatory, vasoprotective and antimicrobial properties. Pulsatilla chinensis (P. chinensis, Bai Tou Weng) has been used medically in China for thousands of years for the treatment of diseases caused by bacteria, and it is rich in triterpenoid saponins. Many saponins shown great potential anti-cancer activity, and some of them have been found against neurodegenerative diseases, cardiovascular disease and kidney disease. Saponins are thought to be the major active components of Pulsatilla, such as pulchinenoside A (PSA or anemoside A3, AA3), pulchinenoside C (PSC or anemoside B4, AB4), pulsatilla saponin D (PSD or SB365) and pulsatilloside E (PSE). Besides, PSA and 23-hydroxybetulinic acid are two possible metabolites of PSC, and among triterpenoid saponins, PSC is the most abundant component in Pulsatilla and has been used as a quality control marker for P. chinensis. PSC is believed to be the principal active ingredient of P. chinensis.https://cmjournal.biomedcentral.com/articles/10.1186/s13020-022-00613-8Unfortunately the toxic effects are also related to saponins.
Further investigations revealed that P. chinensis saponins caused lipid metabolism dysregulation and apoptosis through bile acid-mediated sphingolipid pathway which ultimately induced liver injury. The traditional pharmacological activities of P. chinensis focused on the treatment of cool blood and stop dysentery. Modern investigation proved that triterpenoids with the prominent antitumor and anti-inflammatory activities were the main contributors to the traditional pharmacological activities.https://www.sciencedirect.com/science/article/pii/S1878535221004184This article mentions several uncommon herbs in the management of prostatitis and I found it most enlightening. Prostatic irritation and burning urine are common indications for prostatitis. Surprisingly alfalfa and damiana, which work really well for me, are also mentioned. Also who would have thought that corn silk or a weed like couchgrass rhizome could be also used for the same purpose. Pulsatilla and some other herbs are only recommended as homeopathic dilutions due to their toxicity. It may be also worth investigating a combination Pulsatilla and Thuja as they are both available as homeopathic products.
Upon searching the Eclectic literature one finds a substantial repertoire of medicines used to treat a broad range of male reproductive issues such as BPH, acute prostatitis, orchitis, impotence, sexual neurasthenia, along with recommendation for treating the perceived threat of "self-abuse" (masturbation).
Pulsatilla herb (Anemone spp.)
Indications: Acute inflammation of the prostate gland. Alternate every 2 hours with Thuja.
Dose: Fresh Tincture (1:2): 2-3 gtt every 4 hours
Thuja leaf (Thuja occidentalis)
Acute inflammation of the prostate gland. Alternate every 2 hours with Pulsatilla.
Fresh Tincture (1:2): 2-5 gtt every 4 hourshttps://www.americanherbalistsguild.com/sites/americanherbalistsguild.com/files/sample-articles-pdfs/eclectic_therapeutics_for_the_male_reproductive_system.pdf