We live in challenging times where chronic stress, environmental pollutants and a myriad of other burdens are eroding away health, wellness and sexuality. As the result of the accumulation of burdens that come with modern existence, an alarming 1 in 4 men at the age of 30 now have measurable low testosterone levels. This makes it difficult to survive, let alone thrive, when the very hormone that helps support inner health is fleeting.
Overt symptoms of low testosterone are believed to affect 50 percent of men with measurable low levels. Yet the slow erosion of wellness and zeal for life that occurs with low testosterone may be so gradual, that human perception is insufficient to note the change during the short term.
It is well known that testosterone levels decline with the passage of time, and the average man passively accepting the aging process may expect deterioration of performance. Without taking a proactive stance, men undergo such changes as a slow decrease in sex drive, diminished erectile strength, sleep disturbance, depressed mood, or lethargy.
In this article, I will discuss two mile markers of male wellness: libido and erectile performance.
Enhancing Male Performance
Erectile dysfunction affects 50 percent of men ages 40-70 in the United States and is considered an important public health problem by the National Institutes of Health. Clinically, I work with many men in their late twenties and early 30s that present to my office with decreased erectile performance or overt inability at times to perform. An even greater number of men report a “take it or leave it” approach when it comes to libido. These changes are symptoms of deeper health needs and serve as a barometer of ones wellness status.
Libido and pelvic responsiveness in both the male and female share many of the same biochemical pathways. Thus, much of what follows possesses relevance for both sexes.
Before I discuss the ways that both men and women can improve their libido and enhance intimacy performance, it’s important to acknowledge that maintaining healthy cardiovascular, neurological and mental wellness is also important for peak performance.
Natural Libido-Enhancing Strategies
A number of natural ingredients have been shown to affect the pathways involved in enhancing libido and improving sexual performance. Epimedium brevicornum, Tribulus terrestris, Panax ginseng, Ashwaghanda, grape seed extract, Eurycoma longifolia, pomegranate and green tea extracts (all found in the new Male Formula formula) have a synergistic role to play in helping men operate at peak performance.
Epimedium brevicornum has been widely used for impotence, infertility, osteoporosis, cardiovascular diseases, amnesia, and senile functional diseases.1 One of the mechanisms of action is that it supports nitric oxide levels, which are essential for arousal and erectile tissue engorgement. Nitric oxide (NO) is formed from the conversion of L-arginine by nitric oxide synthase (NOS), which exists in three isoforms: neuronal (nNOS), endothelial (eNOS), and inducible (iNOS). nNOS is expressed in penile neurons innervating the corpus cavernosum (CC), and eNOS has been identified primarily in both cavernosal smooth muscle of penileand clitoral tissue. Researchers have concluded that and extract of Epimedium relaxes the CC smooth muscle through multitargets in NO/cGMP/PDE 5 pathway and helps address erectile dysfunction.2 Epimedium can prove very helpful as part of a male wellness protocol, relative to enhanced sexual performance.
Tribulus terrestris is another botanical commonly used to enhance libido. After conducting a study of Tribulus terrestris in rodents, researchers concluded, “Tribulus terrestris extract appears to possess aphrodisiac activity probably due to androgen increasing property of Tribulus terrestris.”3 Similar findings were found in another study on primates, where researchers noted that Tribulus increased testosterone in the animals, and another later study on rodents, leading researchers to conclude, “The increase in intracavernous pressure which confirms the proerectile aphrodisiac property of Tribulus terrestris could possibly be the result of an increase in androgen and subsequent release of nitric oxide from the nerve endings innervating the corpus cavernosum.”4-5 Tribulus also is known to decrease levels of prolactin in women, which is important since increased prolactin is associated with reduced libido.6
Panax ginseng has long been known to help support the adrenal glands and thus help cope with stress, important because stress is known to affect sexual performance. In addition Panax ginseng also helps increase circulation as well as nitric oxide production.7 The ginsenosides contained in ginseng have been shown to cause a dose-dependent relaxation of the corpus cavernosal smooth muscle in rabbits by increasing nitric oxide release.8-9 In a human study, 90 patients were divided into three groups and given Panax ginseng, a placebo, or the antidepressant drug trazodone orally. In the Panax ginseng group a significant improvement in erectile parameters such as penile rigidity, girth, duration of erection, improved libido, and patient satisfaction were reported. The overall therapeutic efficacy for erectile dysfunction was 60 percent for the Panax ginseng group but only 30 percent for the trazodone and placebo groups.10
A more recent, double-blind, placebo-controlled, crossover study confirmed these results. Forty-five men diagnosed with ED received either 900 mg Panax ginseng or placebo three times per day for eight weeks. The first eight weeks of treatment were followed by a two-week washout period, after which the patients switched groups—those who had initially received the placebo received ginseng and those who initially received ginseng received the placebo for an additional eight weeks. Researchers measured the efficacy of treatment through changes observed in indexes of erectile function, including the International Index of Erectile Function (IIEF). Mean scores on the IIEF for Panax ginseng were significantly higher than for placebo after eight weeks of each treatment. In addition, penile tip rigidity was significantly better after eight weeks of Panax ginseng compared to placebo.11
Ashwagandha (Withania somnifera)
In clinical practice, Ashwagandha is an effective tool to support adrenal health. Stressed patients routinely report noticing an increased sense of well being with its use. An intriguing rat study evaluated the combined effects of Withania somnifera and Panax ginseng extracts. The two extracts were compared for their ability to attenuate some deleterious impact of chronic stress (CS). Both botanicals were able to decrease the number and severity of CS-induced ulcers, reverse CS-induced inhibition of male sexual behavior, and inhibit the adverse effects of CS on retention of learned tasks. Both botanicals also reversed CS-induced immunosuppression, but only the Withania extract increased peritoneal macrophage activity in the rats.12 This latter observation emphasizes the importance that can be gained by blending synergistic botanicals.
Grape Seed Extract
Maintaining the 60,000 miles of blood vessels and overall integrity of the circulatory system is essential. It is this long-term, broader thinking that helps preventively protect the body from needing to depend on what can be termed “reactionary” medicine. Several epidemiological studies suggest that the regular consumption of foods and beverages rich in flavonoids is associated with a reduction in the risk of several pathological conditions ranging from hypertension to coronary heart disease, stroke and dementia. Grape seed is one of the major polyphenols shown to have some of these effects in humans.13
Grape seed extract is emerging as a nutrient that has profound effects on nitric oxide production. Studies investigating grape seed’s ability to support healthy blood pressure levels have determined its mechanism of action is partly due to its ability to raise nitric oxide levels. As noted earlier, nitric oxide is essential for arousal and erectile tissue engorgement.14-15
Eurycoma longifolia, often called Long Jack, has a long history of use as a performance enhancing substance. In one study, extracts from E. longifolia Jack were orally administered to rats twice daily for 10 days. Testosterone was used as a positive control. Results showed that E. longifolia Jack produced a dose-dependent increase in sexual performance of the treated animals. The authors reported, “The present study therefore gives further evidence of the folk use of E. longifolia as an aphrodisiac.”16
A study using a rabbit model of arteriogenic erectile dysfunction (ED) measured the effect of pomegranate juice (PJ) concentrate on intracavernous blood flow and penile erection. The researchers found eight weeks administration of PJ concentrate daily significantly increased intracavernous blood flow and smooth muscle relaxation.17 These findings are preliminary, yet the results are promising.
As with many botanicals, there is not merely one potential clinical application. For instance, studies have shown that pomegranate can block the conversion of testosterone to estrogen, a process controlled by the aromatase enzyme. Pomegranate inhibited aromatase activity by 60–80 percent thus helping protect estrogen sensitive tissues including prostate and breast tissue.18
Green Tea Extract
Green tea extract is another nutrient important for male health. In vitro and animal studies have shown that green tea is a natural aromatase inhibitor that modulates estrogen synthesis.19-20 This effect can play a role in libido enhancement and overall male health.
One of the additional ways that ED begins to manifest is from the accumulation of unquenched oxidative products in erectile tissue.21 Antioxidant therapy is important for overall wellness and can prove useful prophylactic tool for preventing smooth muscle dysfunction and fibrosis in ED. Many of the ingredients mentioned above, including grape seed and pomegranate, also act as potent antioxidants.
New Male Formula
In addition to incorporating all the ingredients mentioned above, the new Male Formula formula also contains Bioperine® a proprietary black pepper extract. Bioperine was incorporated into Male Formula to augment the effectiveness of the individual constituent herbs and the overall synergy of the formula.
It is clear that ultimate sexual functioning depends on a strong and well-nourished body that provides the ability to attain or maintain an erection. Epimedium brevicornum, Tribulus terrestris, Panax ginseng,Ashwaghanda, grape seed extract, Eurycoma longifolia, and pomegranate extract along with Bioperine (all found in the new Male Formula) can provide synergistic support for optimal male performance.
Editor’s Note: Dr. Meletis is author of the book Better Sex Naturally, published by HarperCollins and co-author of His Change of Life, published by Greenwood Publishing.
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