by Aftab J. Ahmed, Ph.D.
Despite the fact that erectile dysfunction
(ED) has been out of the
proverbial closet for several years, it
pretty much remains a taboo, especially for
those who suffer from it. Such attitudes
notwithstanding, ED is likely to become one
of the major healthcare concerns as the percentage
of men in their advanced years in the
society continually increases. In fact, issues
related to sexual function in both men and
women already figure prominently in professional
circles and public health policy
forums.
The emphasis on healthy sexuality is of
societal importance because, as detailed
later, numerous factors contribute to what is
now referred to as compromised libido or
“low mojo,” as the fictional Austin Powers
would have it. Ancillary variables contributing
to compromised sex drive are
exactly that, secondary to primary metabolic
and physiologic causes. Erectile dysfunction
illustrates the issues associated with sexual
function rather well.
It is established that in 70 to 75 percent of
the cases, ED is due to poor circulation in the
penile tissue, which may be caused by concomitant
conditions including high cholesterol
levels, diabetes and others. That is, if
blood flows smoothly and unhindered
throughout the body, the likelihood is that
ED would not present itself. Of course, ED is
a more complex condition and may also be
precipitated by both psychogenic (such as
fear of intimacy) and biogenic factors (for
example, congenital testosterone deficiency),
as is the case with the remainder of
the 25 to 30 percent of those afflicted with
ED. Whereas psychogenic and biogenic ED is
best managed under competent clinical
supervision, nutritive intervention in
enhancing circulation is potentially a preferable
regimen, if only to obviate the side
effects associated with pharmaceuticals.
To better appreciate this, it should be
noted that the erectile process is critically
dependent upon blood flow into the penile
tissue. As complex as it is, in essence it is how
quickly nitric oxide (NO) is broken down in
the erectile cascade. If NO is degraded more
rapidly than it is produced, erectile process is
likely to collapse. In contrast, if NO levels are
maintained at physiologically requisite
levels, it will come to successful culmination.
Viagra, the blockbuster drug, avails itself of
this basic mechanism, namely that it inhibits
the function of the enzyme that degrades
NO. While a market dynamo, Viagra not
only has rather unpleasant side effects associated
with it but also it is not uniformly effective
in ED patients. Consequently, many
clamor for safer, perhaps natural alternatives
to resolve ED.
Any nutritive that meaningfully induces
NO production is expected to help mitigate
ED over a period of time. The nutritive
Stimulin, comprised of the amino acid citrulline,
improves blood flow rather effectively
both in the penile area and
systemically.¹ Citrulline induces NO production
via arginine but has a distinct advantage
of serving literally as a “pacemaker” for
vasodilation. That is, at any given time, only
that amount of citrulline is used to produce
NO that the body requires to fulfill its metabolic
needs. As such, citrulline is stored, as
its naturally occurring form has a storage
depot in the liver and kidney for its expedient
mobilization. Importantly, citrulline
rather stimulates the body to generate an
increased amount of NO to offset its degradation
rather than inhibiting one step in a
cascade of reactions that can, and in fact
does, throw a spanner that results in side
effects. As such, citrulline is devoid of side
effects. As a nutritive, however, it exerts its
beneficial effects over time. Postponement of
“instant gratification” yields significant dividends.
It not only primes the body to utilize
its own machinations to offset ED with profound
implications but also it should help
avert side effects.
The Male Erectile Process |
| Step 1: |
Sexual stimulation causes a variety of nerves
originating in the brain to start firing. |
| Step 2: |
Once stimulated, these nerves release the neurotransmitter
acetylcholine in the penis. |
| Step 3: |
Acetylcholine, in turn, causes the endothelial
cells in the penile arteries to begin producing
NO by the action of a specific enzyme called
nitric oxide synthase. |
| Step 4: |
Once produced, NO triggers the release of
another chemical cyclic guanosine monophosphate
(cGMP). Cyclic GMP is one of the many
potent vasodilators found in the human body. |
| Step 5: |
As cGMP levels increase, the smooth muscles of
the penile arteries relax, the vessels dilate and
increase blood flow causes tumescence of
corpus cavernosa, producing an erection. |
| Step 6: |
Even as NO continues to generate cGMP,
another enzyme begins to break it down. This
enzyme, known as phosphodiesterase, functions
like a brake on the entire cascade of reactions
and prevents erections from becoming
excessive or permanent (priapism). Priapism
can cause permanent damage to erectile tissue. |
| Step 7: |
Following climax, or cessation of sexual stimulation,
the nerves stop firing and the nerve
endings stop releasing acetylcholine. In the
absence of acetylcholine, the endothelial cells
stop NO production, without which no cGMP
can be produced. The residual cGMP is
degraded by phosphodiesterase. The net result
is that smooth muscles once again contract as
the penile tissue goes back to its non-aroused,
flaccid state. |
| This flow sheet demonstrates how easily this balance of
steps in the erectile process can be affected at any step
and how erectile dysfunction could ensue. Importantly,
it also suggests that increased production of NO can
enhance libido. |
|
The term “libido” is used rather loosely
to characterize sexual dysfunction and is
ordinarily taken to mean low sex drive. Used
in its original Freudian sense, libido pertains
exclusively to sexuality, its functions and manifestations.ª While the term has undergone
many revisions over the years, in terms
of sexual dysfunction, its original, albeit
narrow, connotations still prevail, particularly
as applied to alleviation of underlying
problems as in ED. Strictly speaking, while
compromised libido and low sex drive could
be clinically put asunder, they are reciprocal
physiologically and hence cannot be clearly
demarcated. For instance, chronic fatigue,
stress or mild depression may lead to low sex
drive but their impact on libido cannot be
ignored.
Seen thus, libido is the psychic and physical
energy that drives sexuality. That is, the
physical energy that the challenges and
demands of daily life deplete. Also, all the
connivances of present day life contribute to
depletion of the energy necessary for healthy
libido, including the side effects of medications.³
Therefore, a nutritional energy source
should normalize libidinal response. The
Peruvian herb Maca (Lepidium Peruvianum)
is the nutritive in Maca-Stimulin to serve as
that energy source. Both by scientific evidence
and anecdotal accounts, Maca fosters vitality,
stamina and significantly helps restore hormonal
balance in women. Of course, the role
of proper circulation for healthy sexual function
can hardly be overemphasized. A combination
of citrulline and Maca, therefore, in
Maca-Stimulin should both promote circulation
and provide the body with robustness
necessary for healthy sexuality in both men
and women.
References:
- 1) Ahmed, A., Stimulin, Corporate Bulletin, Marlyn Nutraceuticals, Inc., (2002).
- 2) Hall, C., A Primer of Freudian Psychology,Harper and Row, New York, New York, (1982).
- 3) Hart, G. and Wellings, K., “Sexual Behavior and Its Medicalisation: In Sickness and Health,” Br. J. Med. (2002). Vol. 324, p. 896.
Aftab J. Ahmed, Ph.D. is vice president,
R&D and Business Development at Marlyn
Nutraceuticals, Inc. Phoenix, Arizona.
E-mail:
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