Natural Supplements for Male Sexual Performance
Byron J. Richards, Board Certified Clinical Nutritionist
It doesn’t seem like you can watch TV without seeing an ad for Cialis, Viagra, Levitra, or some type of dietary supplement that will help a man perform better. Then there are the low T commercials, guaranteed to make any tired man feel he needs testosterone. Sorting out this nonstop and bewildering advertising blitz is not easy, especially when it comes to understanding the risks and claims in the typically over-hyped commercials. This article gives you a better understanding of the subject so you can formulate a healthy plan that works for you.
Cialis, Viagra & Levitra
Cialis, Viagra, and Levitra are drugs known as phosphodiesterase type 5 inhibitors (PDE5 inhibitor). These drugs are widely used and therefore serve as excellent examples to understand how they work, what that implies about your health, what their actual risks are, and what steps you can take to naturally improve your health.
Upon sexual stimulation, blood vessels within the penis release friendly nitric oxide (eNOS), helping blood flow into the penis. In turn, eNOS stimulates the production of another compound called cGMP (cyclic guanosine monophosphate), further enhancing blood flow into the penis and supporting the relaxed muscle function needed for an erection. These two compounds interact synergistically to significantly increase nitric oxide, to dilate the arteries entering the penis, and to supply enough blood to produce an erection.
The arteries supplying the penis are small, yet they must accommodate a rapid 80 percent dilation in order for enough blood to flow into the penis to enable an erection. No other part of the body requires such an extreme dilation for normal function (10 percent to 20 percent is common in other areas). This is why the penis is so sensitive to general circulatory issues.
While eNOS is the “on” switch for cGMP there is also a natural “off” switch, an enzyme called phosphodiesterase type 5, which takes cGMP apart. Cialis, Viagra, and Levitra all work by deactivating the enzyme that takes cGMP apart, helping in many cases to produce and sustain an erection by prolonging the existence of cGMP and thus eNOS. This biochemistry activity occurs in men who “need it” or not, which is why the recreational or performance-enhancing use of these drugs is rampant.
When a man “needs” one of these drugs in order to have a satisfactory sexual experience, it is a symptom of a larger cardiovascular problem; i.e., risk factors for cardiovascular disease are already established and typically progressing in the wrong direction. Erectile dysfunction (ED) existing alongside extra body weight and low testosterone is especially predictive of cardio risk. You might say that sexual problems are a red flag for cardiovascular problems, as the penis is very sensitive to the progression of general circulatory issues.
Ironically, blood pressure medication often starts ED or makes it worse. Such drugs force less circulation, and since the penis is a rather sensitive endpoint of the circulatory system, its blood supply is reduced and existing struggles are then magnified, not improved. On the other hand, circulatory problems that increase blood pressure also cause ED. These chicken and egg issues are hotly debated in the medical literature, which is why you need to understand the actual nature of the problem to truly fix it. Quite frankly, the medical profession’s treatment paradigm is lacking, if not dangerous.
The side effects of Cialis, Viagra, and Levitra are worth understanding, since they are relatively easy to manage. And heaven forbid that a man should get an erection lasting more than four hours.
While the goal of these drugs is to inhibit the phosphodiesterase type 5 enzyme, they also inhibit other phosphodiesterase enzymes. This may adversely affect eyesight or hearing, especially in people with structural issues in these body parts. The risk of this type of side effect is considered minimal for most people.
The more common side effects are headache and backache, which researchers think is mostly caused by excessive inappropriate dilation of your general circulatory system. This means that the blood-brain barrier becomes leakier, potentially allowing compounds in your circulation to enter your head that should not necessarily get in.
What the researchers do not seem to understand or report on are the rather unpredictable results of significantly increasing the pool of nitric oxide with these drugs. This is because nitric oxide can be both anti-inflammatory (friendly eNOS) and pro-inflammatory (unfriendly iNOS).
In practical terms, what happens after you take the drug will likely determine what kind of nitric oxide you get. For example, if sexual stimulation and pleasure occurs, it is likely that eNOS will be made at high levels. But, what happens if you unfortunately have an argument with your partner after taking the drug? You will then get a lot of iNOS. When that is combined with increased brain permeability, you expose your head to an excitotoxic buzzsaw.
The moral of the story is, don’t ever take these drugs unless you are planning on being pleasant and having a good time. Also, it is important to avoid stress and excess alcohol while the drug is in your system.
Cialis has been approved at a lower dose for daily use. Some researchers suggest that this can have general anti-inflammatory effects on the circulation and even be used to manage blood pressure. Unfortunately, the issue is not so simple. As I have previously explained, these drugs can readily turn pro-inflammatory. Why on earth would anyone want that drug in his system when dealing with the day-to-day pressures of work?
It is possible to guard against issues of excess vascular permeability in your brain and the unwanted production of unfriendly iNOS. I would suggest that any man who uses these drugs also take nutrients that promote eNOS production, while protecting the vascular system from excess dilation. Top choices include grape seed extract, resveratrol, hawthorn berry, and horse chestnut.
There is no arguing that these drugs can be helpful for many men, as a temporary remedy for a system that is in distress. Indeed, the stress of a sexless relationship can be traumatic for both men and women, having a significant negative overall health impact. My interest in explaining all of this is to hopefully encourage men to actually fix their health. After all, wouldn’t you like to live longer with a high quality of health so you have more opportunities for pleasure?
Boosting Friendly eNOS and Lowering Inflammation
As can be understood from the previous section, activating and sustaining cGMP and eNOS levels are major keys to erectile function. It makes sense that correcting the factors reducing cGMP and eNOS levels will improve or return normal erectile function.
Two critical issues to improve and achieve this result:
The availability of eNOS in the penis is subject to the overall availability and status of eNOS in your circulatory system. The most important form of exercise to develop better eNOS function is aerobics. If you don’t do aerobics two to three times per week, you simply won’t turn on genes that activate eNOS production. Supplements can still help eNOS in the absence of exercise, but their result is much better when combined with aerobics.
Many supplements can help you boost friendly eNOS production. Top choices include grape seed extract, resveratrol, Q10, L arginine, panex ginseng, quercetin, and magnesium. These may help to some extent if taken before sexual activity, but they do not work like the drugs that force chemistry reactions. Rather, nutrients along with exercise help build the pool of available friendly nitric oxide. As you improve your fitness and eNOS status, you will eventually reach a point where your eNOS supply is adequate for normal erectile function. Thus, these supplements should be used regularly, including before exercise, while also working to improve factors that deplete friendly eNOS.
Friendly nitric oxide levels are depleted by stress of any type and especially by weight gain. If you are overweight you must engage in the process of weight loss for any truly long lasting improvement in friendly nitric oxide status, sexual function, and reduction in cardio risk.
Excess body weight, high stress, and toxins are all inflammatory in nature. It is interesting that research on the sex drugs has actually demonstrated that high levels of inflammatory TNFa increase the activity of the enzyme phosphodiesterase type 5, which deteriorates cGMP status and makes erections more difficult.
For example, many men experience an occasional erectile issue following a period of high stress or a traumatic stressful event. As the stress dissipates, erectile issues improve. This is a common example of high stress temporarily taking its toll on cGMP.
Excess body weight is a huge issue in this regard, since white adipose tissue constantly releases excess TNFa into the bloodstream, eventually taking its toll on cGMP. While it may take a while for excess weight to interfere with sexual function, once it does the problem is fairly stubborn to solve. To see real improvement, a man must commit to a healthier lifestyle.
Every supplement mentioned above not only enhances friendly eNOS production, but also improves multiple aspects of inflammation. Many other nutrients, especially DHA, are vital for proper ongoing reduction of inflammation. How many you need to take depends on your health status, lifestyle, exercise, diet quality, how much sleep you get, and how you manage any other factors that affect your health. The goal is to establish a comprehensive program that involves improved aerobic fitness, stress and inflammation management, proper diet, weight loss (if overweight), and rejuvenation of your overall cardiovascular system. The side effect of this approach is eventually a male sexual system in good working condition.
Testosterone as a Foundation
Testosterone is the foundation of male sexual function. Everything I discussed regarding eNOS, inflammation, and cGMP will be improved when testosterone status is good. Conversely, it will deteriorate or be hard to correct when testosterone status is bad. Unfortunately, testosterone levels decline with age, and many factors speed up their decline.
One factor is weight. When a man has inappropriately high blood levels of leptin due to excess body weight, he automatically forces his testosterone levels down. Leptin and testosterone are synergistic opposites. Thus, losing weight is the first thing a man should do to correct low T.
On the flip side, weakened states of health are associated with low leptin levels, as well as low testosterone. While this issue is mostly associated with frail health conditions, it can also be produced by trying to lose weight too fast via starvation. To lose weight in a healthy way, follow the Leptin Diet®. I should point out that extra zinc may be needed during weight loss to prevent a slide into worsening testosterone status (meaning your sex drive leaves you whenever you try to lose weight). It is vital to lose weight the right way to optimize your potential testosterone levels.
Just as aerobics turn on genes that condition better eNOS function, so it is that strength training or demanding sports turn on genes to enhance testosterone production. If you don’t use your muscles intensely several times a week, you are failing to take one of the most basic actions that can drastically improve your testosterone status.
Dietary supplements can also help normalize testosterone levels, improve drive, and help improve performance. Three of the better studied nutrients in this category include panex ginseng (up to 2,000 mgs per day), acetyl-l-carnitine (2,000 mg per day) and saw palmetto (320 mg per day).
Yohimbine is one nutrient in this category that I do not recommend because it is also a stimulant that can drive up blood pressure. Since many men seeking improved sexual function also have cardio issues, this is not a safe combination.
Many of the testosterone-supporting aphrodisiac herbs have a long history of folk use in traditional medicine of various cultures. None of these raise testosterone abnormally high. Rather, they may have a rejuvenating effect on a tired out testosterone system. Two of my favorite herbs in this category are muira puama and tribulus terristrus.
Muira puama, also called “potency wood,” is a small tree native to the Brazilian Amazon. It has been used traditionally as a tonic for muscles, an aide for weak digestion, and a sexual stimulant. Early explorers, noting the aphrodisiac properties of muira puama, brought it back to Europe, where it became a staple of herbal medicine. Tribulus is an herb that has been used for centuries in India as a male system tonic and aphrodisiac.
From my viewpoint, using a drug to boost testosterone levels can be done, but it would be my last choice after working on all of the above. As you age, testosterone metabolism becomes more unpredictable, especially if you have other health problems that frequently occur with erectile dysfunction. For example, testosterone can fuel prostate cancer even though levels are lower in older men. This is because of all the other hormonal confusion going on in a man who is not fit and is overweight. It is far safer to correct health issues that impede testosterone production than to take testosterone with multiple health issues. If all of your health issues are moving in the right direction and your testosterone levels are still low, trying a drug at the lowest dose is workable (if it seems to help), while you make every effort to get your body into better shape.
A Comment on Cardiovascular Disease Progression
Unfortunately, the longer health problems remain in place, the more difficult they are to solve. In the context of this article, this means there can be a progressive accumulation of damage in the walls of the arteries leading into the penis. Plaque formation in penile arteries, which is common during aging, makes the issues more difficult to resolve.
Such problems can and should be fixed, but they take some time. Some men may need more comprehensive cardio support than I have outlined in this article. Simply taking some nutrients or improving your diet does not automatically fix accumulated plaque. Importantly, you must first create a personalized program that enables you to quit forming plaque. Once on track, you create an environment wherein your body can begin to undo plaque from your arteries, including your penile arteries. This is a slow and steady process that requires months of consistent effort in making healthy lifestyle choices. There are no quick fixes. Drugs for cardiovascular health are Band-Aids that often make your health worse. You aren’t trying to manage numbers, you are actually trying to be healthy. Your sexual performance is a direct predictor of your cardio health.
On the positive side, your body considers sex to be one of the most important functions in terms of survival of the human race. This means that your body will make every effort to help you restore natural and healthy sexual function – if you give it the chance to do so.
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