1) Definition and importance of erectile dysfunction:
"Erectile dysfunction" (ED), sometimes called "male / impotence" (or "impotence" only), is the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse (coitus / copulation). Erectile dysfunction is different from other conditions affect the normal sexual intercourse such as lack of sexual desire (libido) and ejaculation / orgasm disorders. However, most associatedSexual dysfunction can occur, leading to a significant suffering (morbidity) of patients.
DE, the closely linked to cultural notions of potency, success and masculinity, can have devastating psychological consequences including feelings of shame, loss or inadequacy. ED can be a serious damage to relationships and self-esteem. It affects millions of people around the world with implications that go far beyond sexual activity alone. At the age of 45 years, most men have ED and at least once inLife. Many men are not willing to discuss erectile dysfunction with their wives and doctors, and then the condition is underestimated.
Although erectile dysfunction can occur at any age, in general, the older the person is, the greater the risk.
- Core idea: ED is a frequent and important harmful condition in people's lives.
2) anatomy and physiology of penile erection:
The penis contains two chambers, the so-called "cavernous" fly the length of the upper side of the penis. TheUrethra, which is the channel for urine and semen runs along the underside of the penis. Fill the erectile tissue is a spongy tissue consisting of smooth muscles, connective tissues, spaces, veins and arteries. A membrane, called the "tunica albuginea", surrounds the erectile tissue. Veins drain blood away from the tunica albuginea of the penis.
The erection of the penis can be induced by two different mechanisms. The first is the reflex erection, which is obtainedto touch gently, directly and continuously, and rub the penis.
The second is the psychogenic erection, which is achieved by erotic fantasies, dreams and ideas.
Giving you sexual stimulation, the tactile (reflex) or psychogenic / psychological electrical impulses along the nerves of the penis and causes the nerves to nitric oxide (NO), which in turn increases the production of cyclic GMP release (cGMP) in cells smooth muscle of the corporacavernosum. The cGMP causes the smooth muscle relaxation of the cavernous bodies, the blood flow into the penis rapidly (the blood fills the corpora cavernosa, making the penis bigger, harder and thicker). The resulting pressure squeezes the veins in the tunica albuginea, helping to trap the blood in the corpora cavernosa, therefore maintaining erection. The building is falling inversely with the levels of cGMP in the corpus cavernosum, allowing the smooth muscles of the corpora cavernosa toContract, the failure of blood flow in the veins that drain open and the blood from the penis. The levels of cGMP in the cavernous fall, because it is inactivated by an enzyme called "phosphodiesterase type 5" (PDE5).
- The basic ideas: the erection of the penis during sexual stimulation / arousal (physical and / or psychological), resulting in swelling and enlargement of the penis due to local accumulation of blood, caused by the dilation of the arteries. Nitric oxide resulting in increased(NO) is in turn increase cyclic GMP (cGMP) - this is the most important molecular cascade promoting erection of vasodilator.
3) Causes (Etiopathogenesis) and Pathophsiology of ED:
There are many possible causes of erectile dysfunction, which can generally be divided into 3 broad categories: Organic / Somatic; Psychogenic / Psychological Mixed / Other. Each of these classes can be subclasses, as an effective way to organize, classify and study each individual case.
Organic / Somatic are those thatOrigin is located somewhere in the body, an organ or tissue, not in the sense nor thoughts / emotions. Consequently, there are a lot of diseases that can cause ED - Endocrine (related to hormones and glands, for example: hypogonadism, hyperprolactinemia), vascular (related to arteries and / or veins, such as: atherosclerosis, hypertension , dyslipidemia, diabetes, metabolic syndrome), neurological (related to the nervous system, central nervous system (CNS) and / or peripheral nervous system (PNS), such as: SpineSpinal cord injury, neuropathy, Parkinson's, Alzheimer's disease, multiple sclerosis, stroke), drug-induced (many drugs can cause a side effect of ED - some antihypertensives and antidepressants are often associated with erectile dysfunction, but there are many other drugs with a potential cause of ED).
Usually, biological / somatic associated with a worse prognosis, atherosclerosis, now, as a "sentinel event" is detected in cardiovascular disease, metabolic syndrome and diabetesmellitus.
Psychogenic causes / psychological ED are collectively the most common, and young people may be affected - the sexually inexperienced young man, without disease, ED is the first sexual activity with his partners, because they "can not be afraid / to disappoint her partners. "The belief that the erection will not develop, if necessary, then, is a self-fulfilling prophecy.
On the other hand, for every age, men who live in conditions of psychological stress(Too much work, little sleep, personal conflicts) can be depressed, anxious, helpless and feel the lack of libido (sexual desire). ED can be caused and aggravated fears exist and thus a "vicious circle" can be set and very difficult to treat.
Increased sympathetic vasoconstrictor tone, with an increase in circulating norepinephrine / epinephrine levels, seems to play a key role in psychogenic ED. The sympathetic branch of the autonomic nervous system is usuallyactivated in stress situations, preparing the body to react "fight or flight ', releasing two major catecholamines (norepinephrine, epinephrine = norepinephrine released from sympathetic nerves and released from the adrenal adrenaline = = supra-adrenal glands, after stimulation of the sympathetic nerves). This catecholamines induce vasoconstriction (narrowing of the arteries), making it more difficult to kick the erection.
Although it is not often associated with ED may be moreserious psychiatric illness such as depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders.
There are several other possible causes of erectile dysfunction (Mixed / Other), but are relatively rare - disorders of the penis with erectile dysfunction (other primary diseases of the penis, such as: Peyronie, epispadias, post-priapism), blood diseases linked (blood diseases, for example, sickle cell anemia, leukemia), liverLiver cirrhosis, hemochromatosis, scleroderma, ...
All causes of ED will converge to a common effect - the expansion of the penile arteries and therefore can not capture the local blood.
The diagnosis of erectile dysfunction usually starts reported by the patient, and the next thing is the study of nocturnal penile tumescence (NPT) following the request of the diagnostic test to confirm the diagnosis suspected. NPT is the spontaneous erections during sleep. All men without ED go through this phenomenon,usually many times during sleep. Therefore, the NPT is crucial tests for the diagnosis of ED is to ask, since it can have a psychological cause (most common), or point out an organic cause - patients with psychogenic ED have nocturnal erections, which means that no organic / somatic basis for their erectile dysfunction.
- Core ideas: Although ED can be caused by many serious diseases / disorders can, and often occurs in men who were in good health and are temporarily under heavy psychological stress,what a bad lifestyle, characterized by anxiety, poor sleep and poor nutrition, and where the ED and a general bad feeling and weakness.
The causes of erectile dysfunction find a sequence of overlap - there will be no extension of the arteries of the penis, so no local storage of blood.
The diagnosis of erectile dysfunction is confirmed by the test of the NPT.
Do 4) natural alternatives for the treatment of erectile dysfunction is worth it!
Everyone knows the name "Viagra", "Levitra" and"Cialis".
Viagra (sildenafil), Levitra (vardenafil) and Cialis (Tadalafil) are drugs known as PDE5 inhibitors, and are often prescribed for the treatment of erectile dysfunction. Few drugs have received so many attentions and approvals as Viagra / Cialis / Levitra, thanks in part to heavy and expensive marketing efforts by pharmaceutical companies.
Everyone recognizes that the work, yes, Viagra / Levitra / Cialis ... But at what cost to health? As with all chemical drugs, there are risks and side effectsEffects Viagra / Levitra / Cialis. These drugs have potential side effects, and so all men should be informed, considering this medication. Viagra / Levitra / Cialis side effects, usually in the low to moderate (although not very frequently, sometimes side effects can be serious or even life threatening). They usually last a few minutes to several hours after administration. The most common side effects include: nasal congestion (stuffy nose), headache, flushing (facialWarmth or redness), dyspepsia (upset stomach). The most serious possible side effects: sudden vision or hearing impaired, angina pectoris (chest pain or heavy feeling), cardiac arrhythmia (irregular heartbeat), dyspnea (shortness of breath), edema (swelling), priapism (painful condition in which the erect penis does not return to its flaccid state, despite the absence of physical and psychological stimuli of at least 4 hours). On the other hand there is the possibilitythat users may be psychologically dependent on him, unable to achieve erections without Viagra / Levitra / Cialis. It is not surprising that many natural products are less harmful alternatives, good work and have no side effects. These Viagra / Levitra / Cialis alternatives are not chemical drugs, and provide a natural and gentle approach towards better sexual health and general well-being. Unlike Viagra / Levitra / Cialis are natural alternatives availablewithout a prescription, so they are immediately usable - men need not waste time and money just to get the prescription sheet, and avoid shame and embarrassing interviews. Furthermore, natural Viagra / Levitra / Cialis alternatives cheaper and have more beneficial effects. Increase blood circulation, not only on the genitals, but to all the organs of the body including the brain. In addition, provide the body with various nutrients such as amino acids compounds, vitamins and mineralsimportant for a healthy life. Thus, natural alternatives are worthwhile because they work well, are safe and inexpensive.
5) the best natural products for the treatment of ED:
Many natural products can help men with erectile dysfunction, especially when organized:
=> Food (food) supplements:
- L-arginine (amino acid)
- Minerals: zinc, selenium, magnesium
- DHEA (De-Hydro-Epi-Androsterone)
=> Herbs / Plants / herbal and natural products (Phytotherapy):
-Yohimbine;
- Panax (Asian) Ginseng;
- Tribulus terrestris;
- Ginkgo biloba;
- Muira Puama (Ptychopetalum unicatum / Ptychopetalum olacoides);
- Maca (Lepidium meyenii);
- Damiana (Turnera diffusa / Turnera aphrodisiaca);
- Forskolin (Coleus forskohlii);
- Pycnogenol
=> Other Natural Products:
- Deer Antler Velvet
L-Arginine is an amino acid.
L-arginine is the precursor for the synthesis of nitric oxide (NO)(The production of cGMP is subsequently increased), and it is also necessary for the synthesis of creatine, that his oral intake is useful not only for men with erectile dysfunction, has many important health benefits in general:
#] Increases blood flow throughout the arteries throughout the body (not only but also in reproductive organs);
#] The male subfertility / infertility, improving sperm production and motility;
#] Reduces blood pressure (excellent forhypertensives);
#] Reduces body fat (excellent for overweight / obese);
#] Improves insulin sensitivity (great for diabetics);
#] Decreases risk of serious heart disease (eg, stroke);
#] Increases muscle mass (athletes like it!)
#] Stimulates the release of important anti-aging hormone in the body (GH = growth hormone);
#] Improves the immune system;
#] Decreases healing time of injuries.
Zinc, asSelenium and magnesium, is an indispensable element (mineral), necessary for the preservation of life. Numerous proteins in the human body contain zinc prosthetic groups, a type of which is the so-called "zinc fingers". It 'a cofactor in many biological processes such as DNA, RNA and protein synthesis. About 30% of zinc is located inside the cell nucleus. A large number of proteins that play a role in the regulation of gene expression is believed to contain zinc.
InThe men, the testicles and prostate particularly high concentrations of zinc. The sites, which bind to the cells of male hormones (androgens) require zinc to function properly.
Zinc deficiency significantly reduced levels of testosterone, sperm production, and can shorten the life of ejaculation, as well. Male fertility seems to be influenced by zinc. Infertile men have lower seminal plasma zinc, zinc-normal blood or decreased. A short-term depletion of zinc in the diet leads to aDecrease in serum testosterone levels, seminal volume and total loss of zinc semen to ejaculate. Zinc supplementation alleviates the parameters of sperm motility in men with low. The levels of zinc in prostate tissue and appear in the prostatic fluid in men with prostate cancer fall.
Zinc plays a role in immune function, wound healing, behavior and learning, taste and smell of blood coagulation, the function of thyroid hormones and the effect of insulin. In addition, zincneed to occur, the hepatic synthesis of "retinol-binding protein" (RBP), the transport protein for vitamin A. Without enough zinc, symptoms of vitamin A deficiency can, in spite of a large vitamin supplementation.
Magnesium, such as zinc and selenium is a mineral of the highest importance as an enzyme cofactor in many biochemical reactions inside the human body. It plays a key role in the production and transfer of biological energy (ATP = adenosine tri-phosphate) inMuscle contraction and relaxation, nerve conduction, in protein synthesis ...
How is closer to erectile dysfunction, it is appropriate to point out that magnesium promotes the synthesis of nitric oxide (NO), which will promptly lead to the strengthening of cGMP cell signaling pathways, which is in the arterial dilation - as already mentioned, this is the physiologic basis of penile erection.
In addition, ED, magnesium is very important, other medical / health, therefore, magnesium intakeshould always be encouraged. The same ideas apply to Se ...
Selenium is an essential component of glutathione peroxidase system, as an antioxidant. It works in combination with vitamins A, C, E, prevent oxidative damage to cells ("oxidative stress"). Reactive oxygen species (ROS) are free radicals that come from oxygen metabolism. The production of ROS such as superoxide (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH), is done quietly in the cells.ROS play an important role in many physiological cellular processes. "Oxidative stress" is a state where there are high concentrations of ROS winning success on the antioxidant defense against oxidative damage. This is the pathophysiological basis of most serious diseases. All organs of the body must be strong enough to have antioxidant defenses. Selenium supplementation is beneficial not only for the sex organs, healthy organs with it all!
Pycnogenol also acts as an antioxidant. This is aExtracted from the bark of French maritime pine. Pycnogenol contains several active flavonoids including monomers such as catechin, epicatechin and taxifolin. It also contains condensed procyanidins (also known as flavonoids and proanthocyanidins) such as procyanidin B1, B3, B6, B7 and dimers, oligomers and polymers of catechin and epicatechin are. Pycnogenol also contains phenolic acids such as gallic acid, ferulic acid, caffeic acid, vanillin, p-coumaric, and protocatechuicp-hydroxybenzoic acids and their glucosides and glucose esters.
Ginkgo biloba is a unique tree with no Chinese cousins who live nearby. The useful parts of ginkgo are the leaves and seeds. Leaves of the ginkgo is the most commonly used form of ginkgo, usually as an extract. Ginkgo leaves and its extracts contain several active ingredients, including flavonoids, terpenoids and organic acids. Many of the ginkgo leaf extracts are standardized to contain 24% to 25% flavonoid glycosides and 6%Terpenoids. The main flavonoids mainly consist of the flavonol rutin and quercetin derivatives isorhamnetin, kaempferol, and proanthocyanidins. The primary terpenoids are ginkgolides A, B, C, M and J and bilobalide. Although many of the pharmacological effects of ginkgo constituents have intrinsic individual, there is evidence that the ingredients work synergistically to produce more potent pharmacological effects of individual ingredients. Leaves of ginkgo products have a strongantioxidant activity, inhibit platelet aggregation (blockade of blood clotting, blood thinning effect), but also relax the smooth muscles in the arterial wall, thus promoting blood circulation. These are the reasons why the ginkgo leaf products are so important for people with erectile dysfunction and / or many other conditions.
Forskolin is a labdane diterpene produced by the plant Coleus India (Coleus forskohlii). Forskolin stimulates and activates the enzyme adenylate cyclase in cardiac muscle and smooth. ThisGuide blown production of cyclic AMP (cAMP) to open calcium channels and increase intracellular calcium, causing an increase in contractility of the heart muscle and smooth muscle relaxation (and thus acts as a vasodilator).
Panax ginseng is used as an "adaptogen" for increasing resistance to environmental stress and as a general tonic to improve well-being. The useful part of Panax ginseng root. It contains several active ingredients. TheMost important components are triterpene saponins called ginsenosides or collectively panaxosides. Other ingredients include pectin, various B vitamins and flavonoids.
Panax ginseng has antioxidant and vasodilator and also increases libido.
Maca (Lepidium meyenii) is a robust and long plant cultivated in the Andes. The relevant part of Maca is the root. Dried maca root is 59% carbohydrate, 10.2% protein, 8.5% fiber and 2.2% lipidsincluding linolenic, palmitic and oleic acids. It also contains sterols such as campesterol, stigmasterol and beta-sitosterol, and a considerable amount of minerals such as iron, calcium and copper. Two polyunsaturated fatty acids, Maca and macamides compounds are used as a marker for maca. Lipid extracts of maca macamides and increase sexual activity and improve erectile dysfunction. This plant stimulant is also known as Peruvian ginseng (although maca does not belong to the same family as ginseng) citations;because, as ginseng, maca increases strength, energy, stamina, libido and sexual function.
Yohimbe is an evergreen tree from West Africa known as Pausinystalia Yohimbe Corynanthe Yohimbe or. The relevant part of Yohimbe is the bark. Available for the constituent is the alkaloid yohimbine Yohimbe effects. Yohimbe bark has about 6% yohimbine. Actions are an aphrodisiac yohimbe genital blood vessel dilation, nerve impulse transmission inGenital tissues and reflected an increase in the sacral spinal cord. The constituent yohimbine immediately enters the central nervous system (CNS) and acts primarily by blocking alpha 2-adrenergic receptor. He also monoamine oxidase (MOA) inhibiting, calcium channel blockers and peripheral serotonin receptor blocker. Yohimbine's consequences on impotence are both by increased penile blood flow and provides increased central sympathetic excitatoryImpetus to the genital tissues.
Muira Puama (Ptychopetalum unicatum / Ptychopetalum olacoides) is a small tree that grows 5 feet tall and indigenous to the Amazon region of Brazil and other regions of the Amazon rainforest. The genus is Ptychopetalum short - only two species of small trees grow in tropical South America and five in tropical Africa. The two South American varieties, P. olacoides (seen in Brazil, Guyana, Guyana, Suriname and) and P. uncinatum met (onlyin Brazil) are used interchangeably in South American herbal medicine systems. The type is selected olacoides usually because it has a higher content of lupeol (one of the secondary plant metabolites active) has. A completely different kind of Brazilian tree, Liriosma ovate, with the common name Muira puama (and is widely distributed in commerce as such), but it's a completely different structure with a different phytochemical constitution.
Historically, whole componentsMuira Puama has been used medically, but the bark and roots are used as parts of the plant. The root and bark is rich in fatty acids and fatty acid esters (the primary essence of behenic acid), known as essential oils (including beta-caryophyllene and alpha-humulene), plant sterols, triterpenes (including lupeol) and muirapuamina an alkaloid. The active components also included long-chain fatty acids, sesquiterpenes, monoterpenes, and novel alkaloids.
Revision,The main plant chemicals in Muira puama are: alpha-copa, Elemeno-alpha, alpha-guaiene, alpha-humulene, alpha-muurolene, alpha-pinene, alpha-resin acid, alpha-terpinene, arachidic acid, the aromadendrene, behenic acid, beta-bisabolene, beta-caryophyllene, beta-pinene, beta-resin acid, beta-sitosterol, beta-transfarnesene, borneol, campesterols, camphene, camphor, car-3-ene, caryophyllene, cerotinic, chromium, coumarin, cubebene, delta-cadinene, dotriacontanoic acid, Elixergosterol, eugenol, essential oils, gamma-muurolene, hentriacontanoic heptacosanoic acid, lignoceric acid, limonene, linalool, lupeol, melissic, montan acid muirapuamina, myrcene, nonacosanoic acid, para-cymene, phlobaphenes pentacosanoic acid, stigmasterol, acid and acid trichosanic uncosanic.
Through the mouth, Muira puama is often used for the prevention of sexual disorders, and as an aphrodisiac. This raises the libido and improves the ability to maintain an erection, andIt also acts as, adaptogen anti-fatigue, anti-stress remedy. Can be used with other herbs alone or in combination. It 'also used (oral) as a nerve tonic for dyspepsia, menstrual disorders, rheumatism, paralysis caused by polio, as a general tonic and appetizer.
Damiana (Turnera diffusa / Turnera aphrodisiaca) is a shrub comes from Central America, Mexico, South America and the Caribbean. The medicinal part of the plant is its leaves, whichcollected during the flowering season. Damiana is found throughout Mexico, Central America and the Caribbean and parts of South America. Turnera diffusa and T. aphrodisiaca known to be generally the same plant in herbal commerce. A closely related species, T. ulmifolia, is similar to the visual aspect, but has other applications of conventional medicine. The plant's botanical name, Turnera aphrodisiaca reported on its former use as an aphrodisiac. With a history as oldTraditional use around the world, it is not surprising that the plant will be released worldwide in many books on herbal remedies. Damiana is also widely sold on a healthy diet and natural food stores in a variety of forms - from tea blends, capsules and tablets, tinctures and liquid extracts. Most herb doctors choose, Damiana applied in combination with additional herbs, so it can in a few herbal combination formulas for sexual potency, weight loss occursDepression, hormonal balance and general tonic.
Components of damiana include up to 35 compounds, including flavonoids, terpenes, cyanogenic glycosides and saccharides. Some of them include triacontane, beta-sitosterol, hexacosanol, 5-hydroxy-7 ,3,4-trimethoxyflavone, arbutin, tannins, resins, hydroquinone glycosides, luteolin 8-CE-propenoic acid and others.
DHEA (De-Hydro-Epi-Androsterone/dehydroepiandrosterone) is a natural steroid hormone produced from cholesterol-Proadrenal glands, gonads, adipose tissue, brain and skin (from autocrine mechanism). DHEA is the precursor of androstenedione, which can pass through the further implementation, in order to produce testosterone, androgens and estrogens estrone and estradiol. DHEA is a potent agonist at sigma-1 as well. Oral DHEA is used to delay or reverse aging, weight loss, metabolic syndrome and increased immune function and cognitive. It 'also used to increase strength, energy and muscleUnder Mass DHEA orally for 24 weeks improves ED, orgasm, libido and overall sexual satisfaction in men with erectile dysfunction.
The active parts of Tribulus terrestris, are the leaves, fruits and roots. Tribulus terrestris contains saponins such as diosgenin and protodioscin, flavonoids, and alkaloids.Tribulus terrestris increases the levels of testosterone, luteinizing hormone (LH), DHEA, and hydro-testosterone. LH is the pituitary hormone that signals natural testosterone production.Libido sun, and sperm production and mobility are improved. Tribulus terrestris lowers blood pressure by inhibiting angiotensin converting enzyme (ACE) and stimulating the release of NO. This also explains why the increased blood flow into the corpora cavernosa, favoring the erection of the penis. Extracts from the fruit and leaves have a diuretic effect, the traditional use of Tribulus terrestris may explain kidney stones and other urological problems. Tribulus terrestrishas anti-inflammatory effect, because as cyclooxygenase (COX) -2 inhibitor acts. Tribulus terrestris helps diabetic patients because it lowers blood sugar levels. Some constituents of Tribulus terrestris and anti-helminthic activity.
Deer Velvet Antler is a pillar of traditional Chinese medicine, ginseng is probably only of importance. Velvet Velvet Horn is not the "skin" refers to the growing antlers, but the entire horn of cartilage in a pre-calcified.Typically, the horns near the base is cut off after about two-thirds of their potential in full size, and before any substantial calcification takes place.
The horn is dehydrated and is used in the form of powder or tea for a series of treatments. Velvet Horn is effective as an anti-inflammatory, anti-cancer, immune-stimulating, and growth promoters.
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