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Health Concerns

Page: 12

Erectile Dysfunction

Ginkgo biloba. Ginkgo has also emerged as a possible treatment for ED, especially ED associated with the use of modern antidepressant medications. The newer selective serotonin reuptake inhibitor (SSRI) class of antidepressants, in particular, has been associated with a relatively high degree of sexual dysfunction. While depression itself is often associated with decreased libido, modern treatments for depression may add to the problem. For instance, a recent study conducted in Europe estimated that about one third of all patients taking SSRI antidepressants suffered from some degree of drug-induced sexual dysfunction (Williams VS et al 2006). It has been proposed that this effect is mediated in men by drug-induced increases in the amount of serotonin in the central nervous system, which in turn inhibits physiological mechanisms involved in penile erection (McKenna K 1999).

An open trial of ginkgo for the treatment of antidepressant-induced sexual dysfunction concluded that an impressive 76 percent of men experienced improved sexual function after taking 120 to 240 mg ginkgo extract daily for one month. “Ginkgo biloba generally had a positive effect on all four phases of the sexual response cycle: desire, excitement (erection and lubrication), orgasm, and resolution (afterglow),” wrote the authors. They speculated that this effect might be caused by ginkgo’s ability to improve dilation of peripheral blood vessels or to modulate central serotonin receptor factors (Cohen AJ et al 1998).

Icariin. This glycoside is found in horny goat weed. It has been studied for its ability to enhance erections and improve sexual performance by affecting nitric oxide synthesis. In one animal study, icariin administered to castrated rats improved a number of measures that are connected to erectile health, including nitric oxide levels and intracavernosal pressure (Liu WJ et al 2005). These results have been supported by additional studies that have found that icariin can improve intracavernosal pressure and thus enhance erectile quality (Tian L et al 2004).

Testofen. Testofen is a standardized extract of fenugreek. A number of animal studies conducted by Gencor Pacific have shown that Testofen can raise testosterone levels more than placebo can and to a degree comparable to the prescription drug Viagra®. In another animal study conducted by Gencor, Testofen produced activity almost equivalent to testosterone in castrated rats. The product is under investigation in human beings.

Tribulus terrestris and DHEA. ED has been associated with declining levels of dehydroepiandrosterone (DHEA), an important hormone that tends to be depleted steadily with age (Basar NM et al 2005; Feldman HA et al 1994). Studies have shown that supplemental DHEA may be helpful in relieving symptoms of ED in patients with initially low DHEA levels (Reiter WJ et al 1999, 2001).

An increase in bioavailable DHEA may underlie the efficacy of another herbal remedy for impotence, Tribulus terrestris. Also known as puncture vine, Tribulus contains the active ingredient protodioscin, which is reportedly converted to DHEA in the body (Adimoelja A 2000). This DHEA-boosting activity may account for puncture vine’s reputation as an aphrodisiac in its native Europe and Asia. While some animal studies appear to confirm the ability of Tribulus to improve sexual functioning, no reliable human trials have taken place (Gauthaman K et al 2002, 2003; Adaikan PG et al 2000).

Weight Loss: Restoring Function

Lifestyle changes may be sufficient to reverse ED, especially when ED is associated with obesity. Epidemiological studies indicate that physical activity and leanness are associated with a reduced risk for ED. A study published in the prestigious Journal of the American Medical Association found that about one-third of obese men with confirmed ED were able to improve their sexual function after losing weight and increasing physical activity over the course of two years (Esposito K et al 2004).

In a randomized trial involving 110 obese Italian men, test participants lost more than 10 percent of their initial body weight and roughly quadrupled the amount of time they spent exercising each week. Serum markers of inflammation, including C-reactive protein and interleukin-6, also decreased significantly. After two years, about one third of these initially obese participants reported significantly better sexual function than did control participants, whose weight and exercise levels remained roughly constant (Esposito K et al 2004).

Of course, this study also shows that lifestyle changes may not be feasible, or adequate, to reverse established ED in all cases. Fortunately, some safe, natural alternatives are available whose clinical data support their benefits for sex and health.

A Word of Caution

Some so-called aphrodisiacs may actually do more harm than good. “Spanish fly” is a case in point. Derived not from a fly but from the blister beetle, Spanish fly, or cantharidin, is far more likely to cause painful poisoning than pleasurable erection. It should be avoided (Sandroni P 2001; Karras DJ et al 1996).

Life Extension Foundation Recommendations

ED is a very serious condition that can gravely affect a man’s quality of life. In many cases, however, ED has physical causes that can be remedied through lifestyle changes and supplementation. Men who are overweight may find some relief through weight loss. For more information on male weight loss, please see the chapter titled Obesity.

In addition, a number of supplements may help:

It is also recommended that men test their hormone levels to see if an underlying hormonal deficiency may be contributing to their ED. If testing is conducted, it is important to note that so-called normal levels of testosterone for older men reflect simply averages in the current population. Life Extension believes that most aging men would not prefer to accept the loss of youthful vigor as “normal.” Instead, the Foundation suggests that a more valid “optimal” range for all men would be in the upper one-third of the range for men aged 21 to 49 and that any supplementation treatment should aim to restore hormone levels to that range. In addition, testing for estrogen levels is also recommended, with an effort to reduce estradiol to below 30 pg/mL. It is important, however, that men not begin testosterone therapy unless prostate cancer has been ruled out. For more information on male hormone therapy, please see the chapter titled Male Hormone Modulation.

Because of the close association between ED and heart disease, men with ED who have not been diagnosed with heart disease are encouraged to seek diagnostic testing to detect the possible presence of heart disease.

Product Availability

All the nutrients and supplements discussed in this section are available through the Life Extension Foundation Buyers Club, Inc. For ordering information, call anytime toll-free 1-800-544-4440, or visit us online at www.LifeExtension.com.

The blood tests discussed in this section are available through Life Extension National Diagnostics, Inc. For ordering information, call anytime toll-free 1-800-208-3444, or visit us online at www.LifeExtension.com.

Erectile Dysfunction Safety Caveats

An aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. These include:

Chrysin

  • Do not take chrysin if you have prostate cancer.
  • Chrysin can increase the effects of aromatase inhibitors such as aminoglutethimide, anastrozole and letrozole.

DHEA

  • Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or ovarian cancer.
  • DHEA can cause androgenic effects in woman such as acne, deepening of the voice, facial hair growth and hair loss.

Ginkgo biloba

  • Individuals with a known risk factor for intracranial hemorrhage, systematic arterial hypertension, diabetes, or seizures should avoid ginkgo.
  • Do not use prior to or after surgery.
  • Avoid concomitant use of ginkgo with NSAIDS, blood thinners, diuretics, or SSRI’s.
  • Gastrointestinal symptoms (nausea and diarrhea) may occur.
  • Allergic skin reactions may occur.
  • Elevations in blood pressure may occur.

Ginseng

  • Consult your doctor before taking ginseng if you have high blood pressure. Overuse of ginseng can increase blood pressure.
  • Consult your doctor before taking ginseng if you take nonsteroidal anti-inflammatory drugs (NSAIDs) and/or warfarin (Coumadin). Taking NSAIDs or warfarin with ginseng can increase the risk of bleeding.
  • Consult your doctor before taking ginseng if you have diabetes. Taking ginseng can cause an extreme drop in your blood glucose level.
  • Ginseng can cause breast pain, vaginal bleeding after menopause, insomnia, headaches, and nosebleeds.

L-Arginine

  • Do not take L-arginine if you have the rare genetic disorder argininemia.
  • Consult your doctor before taking L-arginine if you have cancer. L-arginine can stimulate growth hormone.
  • Consult your doctor before taking L-arginine if you have kidney failure or liver failure.
  • Consult your doctor before taking L-arginine if you have herpes simplex. L-arginine may increase the possibility of recurrence.

Saw Palmetto

  • Consult your doctor before taking saw palmetto if you have any form of cancer that is stimulated by hormones.

Zinc

  • High doses of zinc (above 30 milligrams daily) can cause adverse reactions.
  • Zinc can cause a metallic taste, headache, drowsiness, and gastrointestinal symptoms such as nausea and diarrhea.
  • High doses of zinc can lead to copper deficiency and hypochromic microcytic anemia secondary to zinc-induced copper deficiency.
  • High doses of zinc may suppress the immune system.

Yohimbe

  • Do not take yohimbe if you have heart disease, kidney or liver problems, or a history of ulcers.
  • Do not take yohimbe if you have panic disorder, posttraumatic stress disorder, or Parkinson's disease, since yohimbe tends to increase anxiety and trigger panic attacks.
  • Yohimbe can cause agitation, anxiety, sleeplessness, tremors, dizziness, headache, queasiness, vomiting, elevated blood pressure, and fast heartbeat.

For more information see the Safety Appendix

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