Nutraceuticals in treating Erectile Dysfunction
Nutraceuticals means Healthy and Nutritional Supplement/Food items.
About 50% of men experience some form sexual dysfunction at some point of their lifetime. But, those seeking medical help for it are very few as discussing sexual health matters such as libido and erectile dysfunction are associated with embarrassment and stigma of being diagnosed with sexual dysfunction.
Are you taking supplements to boost sexual health? Here are few things you should know:
Natural /Herbal sexual health supplements – a misnomer?
Many products advertised as herbal supplements for male sexual health are adulterated with prescription pharmaceuticals in undisclosed amounts. The dietary supplements are categorised as ‘nutraceuticals’ which do not fall under the regulatory jurisdiction of the FDA. So the consumers have few resources to verify the efficacy and safety of such supplements. Commonly used drugs for adulteration are:
- Sildenafil which is commonly known by the trade name “Viagra”
- Non FDA approved analogs of the above drug have also been found
Herbal / Natural / Ayurvedic Supplements for Sexual Health:
Red ginseng(panax ginseng /korean ginseng)
It is the most common ingredient among supplements for sexual health. It acts by increasing production of nitric oxide which causes dilatation of blood vessels which in turn helps in erection due to increased blood flow to the penis. Studies show significant improvement in erectile dysfunction but not yet approved as first line therapy. Side effects observed were:
- Hypoglycaemia(hence to be used with caution in diabetics)
- Headaches/insomnia
- Gastric upset/constipation
- Rash
Tribulis Terrestris / Gokshura
It is a low growing vine. Advertisers claim that it improves sexual and sports performance by increasing testosterone production. Studies show no improvement in erectile function or testosterone levels with use. Severe liver and kidney toxicity has been reported with use .
Horny goat weed
It is an extract of the epimedium plant which is a flowering perennial plant found throughout Asia and parts of the mediteranean. It contains ‘icariin’ which has action similar to sildenafil. Icariin also has neuroprotective and anti-inflammatory effects. No human trials have been conducted for its efficacy in human beings with regards to improvement in sexual health.
Fenugreek (trigonella foenum-graecum/ “methi”)
It contains diosgenin which is an important precursor of numerous sex hormones. It also contains numerous other compounds such as amino acids(arginine), essential oils, vitamins (vitamin D), Lipids and alkaloids. It is thought to assist hormonal regulation with potential implications for male sexual health, lactation, circadian rhythms and control of serum glucose and cholesterol levels. A study noted significant increase in sexual arousal and orgasm accompanied by increased quality of life related to muscle strength, energy and well being. No adverse effects have been noted.
Maca(Lepidium meyenii)
It is a root vegetable native to the Andes mountains primarily in Peru. Mechanism of its action in improving male sexual health are unknown and studies regarding its physiologic effects are limited.
Gingko biloba tree extracts
have been advertised to treat erectile dysfunction(ED) as well as numerous other conditions such as hypertension,peripheral vascular disease which have physiologic similarities. The mechanism of action has been proposed as dilatation of blood vessels.
Toxicities reported with it are:
- Major bleeding(particularly if taken with warfarin)
- Seizures with reported fatality
- Headaches
With the above detailed profile gingko biloba is not recommended for routine use in men with ED.
Yohimbine
is derived from the bark of African yohimbe tree.It works by increasing penile nerve stimulation and decresing inhibition of arousal by the brain.Side effects observed are:
- Headache, insomnia
- Anxiety, panic attacks, agitation
- Sweating
- Hypertension
Yohimbine is contraindicated in persons taking:
- Antidepressants
- Antihypertensives
- Stimulant drugs
It is one of the more promising natural products for treatment of ED but yet to be approved as first line therapy.
Trace minerals found in sexual health supplements:
Trace minerals are found in most supplements in quantities beyond their recommended daily intake values. Following are the minerals commonly found in supplements:
- Zinc – studies show that zinc deficiency leads to decreased testosterone production but there is no evidence that zinc supplementation in normal individuals causes increased testosterone production /improved sexual performance.
- Magnesium – No studies show association of magnesium supplementation with improved sexual function.
- Selenium – No studies show improvement in sexual health with selenium supplementation.
Vitamin supplementation :
B vitamins are essential for healthy metabolism. Deficiency in one or more of these can result in hyperlipidemia, hyperhomocystenemia and degenerative neuropathy which may be associated with sexual dysfunction. Hence replenishing B vitamins may be helpful in sexual dysfunction symptoms.
- Vitamin B6 regulates homocysteine levels in the body. High levels of homocysteine have been associated with decreased levels of nitric oxide and poor erectile function.Hence vitamin B6 supplements may be useful.
- Vitamin B12 supplementation in deficient individuals may improve sexual function by improving psychological aspects such as mood ,arousal,libido and energy.
Steroid in supplements:
- Dehydroepiandrosterone(DHEA)
It is a steroid which gets converted to sex hormones testosterone and estrogen in the body. When used for improving sexual health it is not known to cause drastic alterations in hormone levels. Its efficacy in treating ED is yet to be proven.
Other ingredients:
L-arginine
It is a precursor for nitric oxide which helps in increasing blood flow to the penis . Studies have shown promising results for its use in erectile dysfunction.Low oral absorption limits its use.L-citrulline has been tried in its place owing to better oral absorption.
L-incarnadine
It is an amino acid derivative which causes blood vessels of the penis to dilate by augmenting prostaglandin synthesis. Few studies suggest its efficacy in treating erectile dysfunction when combined with other drugs.
Antioxidants
Oxidation stress plays a role in ED. Hence antioxidants like lycopene, vitamin E are known to be helpful in erectile dysfunction.
Caution:
Supplements said to boost sexual health contain one or more of the several ingredients mentioned above which have varied safety and efficacy profiles. Some of the ingredients cause serious and sometimes life threatening interactions with drugs prescribed for other medical conditions. Many of these supplements are known to contain contaminants or they do not contain the contents listed on the nutritional label. The amount of ingredients may be sufficiently large so as to cause ill effects or may not match the nutritional label.
