The Rise and Fall of Viagra
Safer, more effective ways to extend and enhance your sex life.
In my entire career, I can think of few pharmaceutical drugs that ignited public imagination the way Viagra has. In the days and weeks following the introduction of the new impotence drug, the phones in my office rang off the hook. Everyone wanted to know more about Viagra. Actually, it seemed that all anyone really wanted to know was how to get hold of a bottle of it.
Even now that the limitations and the risks of Viagra have become better known, (according to reports filed with the Food and Drug Administration, at least 130 men have died), men are still clamoring for the drug. Apparently, many men are willing to risk death in order to revive their sex lives—a risk I consider completely unnecessary, as you’ll see in a moment.
A Cure at Any Cost?
In talking with my patients, it’s become clear that very few are actually candidates for Pfizer’s new wonderdrug. First of all, if you have any kind of cardiac disorder or risk factor or are taking cardiac medications, you should be very cautious about taking Viagra. The drug affects the body’s circulatory function and has been linked with fatal heart attacks. It also can be deadly if combined with common heart medication like nitrates (used for angina pain.)
Viagra can also damage your vision, reducing retinal function by up to 50% for several hours after use. It can cause extreme light sensitivity and cause a pronounced blue tint in your field of vision. The American Academy of Ophthalmology has issued warnings about the serious risks of Viagra and the Federal Aviation Adminstration has instructed airline pilots not to use the drug before flights.
Secondly, Viagra is only effective in about 50 percent of cases. That’s because Viagra does one thing and one thing only—it helps blood to flow, and stay, in the penis by acting on a single biochemical pathway. But optimal sexual function depends on many complex hormonal and biochemical systems—most of which are unaffected by Viagra.
Unlike the natural nutrients I recommend to my patients, Viagra does NOT:
· Enhance your desire or libido
· Heighten your enjoyment or sensation
· Give you the mental energy and alertness to perform optimally
· Supply the physical vigor and stamina that fuels good sex
Impotence Comes Out of the Closet
Many of those now clamoring for a Viagra prescription are men who have never before consulted their physicians about their “problem.” A disappointing sex life is a topic they’d rather not discuss—not with their doctors, and often not even with their partners. Even when responding to completely anonymous surveys, many men are likely to deny or understate the problem.
According to the National Institutes of Health, 20 to 30 million American men suffer from some form of erectile dysfunction. Among married men 60 and older, impotence affects 1 in 3. And yet, it is estimated that fewer than one in 5 of those affected seek treatment. I think that’s what made the reaction to Viagra so surprising and unexpected: many health professionals had vastly underestimated the number of men suffering from sexual dysfunction. Perhaps you, too, were surprised to find that you are not alone.
Although I don’t think Viagra is worth the risks and side effects, it has served to reveal a “secret” crisis in men’s healthcare. The good news is that there are safe and natural ways to restore what is apparently missing from the lives of far too many men. Not only are there ways to increase blood flow to the penis without risking death from heart attack, but there are ways to do what Viagra can’t do: increase desire and sexual energy, enhance performance and stamina, and intensify pleasure.
In Search of the Real Thing
There are scores of natural substances that have been heralded as so-called aphrodisiacs for centuries—everything from powdered rhinoceros horns to bull testicles. Although the lore surrounding many of these traditional sex potions is colorful, few have been shown to have any measurable physiological effect. (Because sexual response has a distinct psychological component, the placebo effect, which usually accounts for 10 to 20 percent of the reported ‘effects’ of a drug or other substance, can play a much greater role in substances purported to enhance sexual performance.)
For years, “serious” scientists have cautioned hopeful consumers that herbal sexual enhancers are a waste of money. In 1989, the Food and Drug Administration declared that it could find no proof that any over-the-counter “aphrodisiac” was effective in treating sexual dysfunction. However, a blanket dismissal of natural sex-enhancing supplements appears to have been premature.
A handful of these traditional sex tonics have withstood scientific scrutiny and show great promise. Researchers have identified natural substances that variously enhance blood flow, naturally increase testosterone levels, raise levels of key brain chemicals, and even increase nerve sensitivity—all of which play a role in restoring and enhancing sexual function.
Although medical reporters continue to insist that these natural substances are “unsubstantiated,” “unproven,” or “without evidence,” there is, in fact, a wealth of clinical, empirical evidence substantiating the actions of several substances. Many have been shown to increase sexual activity in laboratory animals (which presumably removes the possibility of a placebo reaction).
I think this stubbornly conservative stance regarding natural sex enhancers reflects a conventional medical community lagging behind the mainstream American consumer in the acceptance of natural alternatives to drugs, but also betrays a certain puritanical reluctance to address sexual function as a legitimate medical concern.
Long before Viagra splashed across the front pages of newspapers world wide, I have taken seriously the concerns of my patients who are experiencing declining sexual function and satisfaction. I’ve searched for the multiple causes of such problems, and found them—in our polluted environment, in our depleted, modern diets, and in our frantically-paced lives. The protocol that I have developed through years of clinical experience reflects nature’s multi-faceted approach to sexual function, focusing on three basic principles:
1) optimizing local and general blood flow and circulation
2) balancing hormone levels to increase libido
3) enhancing physical sensation and vitality
Improving Circulation Naturally
The inability to achieve or sustain an erection is quite frequently the result of insufficient blood flow to the penis. Fortunately, there are several safe, natural substances that can enhance circulation in general and blood flow to the penis, in particular.
Muira Puama (or Amazon potency wood) has a long history of use in South American folk medicine as a treatment for impotence and reduced sex drive. It also has an impressive body of modern, scientific evidence supporting it. In one sizeable study (nearly 300 patients), French researchers found that muira puama was over 50% effective in restoring sexual function in impotent men.
An even higher number of subjects (60 percent) reported a marked increase in libido. (By comparison, Viagra is about 50 percent effective in treating impotence, and virtually useless in treating loss of libido.)
Although not yet evaluated in clinical trials, muira puama is also reputed to be helpful for women, stimulating libido and also relieving menstrual cramps and premenstrual syndrome (both of which can be potent anti-aphrodisiacs). This, along with the reported benefits for men’s libido, suggest that muira puama works through multiple pathways, not only increasing blood flow but probably helping to balance sex hormones as well.
Forskohlin, an herb that briefly caught the attention of leading impotence researchers, is an alkaloid isolated from the Coleus forskohlii tuber, a plant native to India. Forskohlin directly activates enzymes that relax the smooth muscles in the penis, stimulating an erection. In 1996, it was studied in head-to-head tests with pharmaceutical impotence drugs. Amazingly, in over two-thirds of the cases, forskohlin produced successful results in subjects who were not helped by drug therapy alone.
However, research on forskohlin has been largely abandoned by the pharmaceutical companies, who are unwilling to invest money in the study of a natural, and therefore unpatentable, solution to impotence.
Many people aren’t aware that niacin, a nutrient in the B-family of vitamins (B3), is also a powerful prosexual nutrient. It has been shown to increase circulation by dilating the blood vessels. It is useful in increasing blood flow to the lower extremities when blood vessels have been partially blocked by plaques. For the same reason, it can also increase blood flow to the penis, aiding erectile function. Niacin also has a favorable effect on high cholesterol.
Niacin can cause a pronounced “flush,” resulting from the dilation of blood vessels close to the skin. The flush is harmless and temporary and can actually be put to good use as a sexual stimulant. Many people—both men and women—find that the niacin “flush” increases skin sensitivity and enhances the tactile sensations during sex. Some even find the sensation similar to the rush of blood to the face, neck and chest that frequently follows orgasm.
The government’s recommended daily amount (RDA) for niacin is 15 to 20 milligrams a day, but it is safe at ten times that amount. Extremely high doses (2,000 to 3000 milligrams a day) can cause unpleasant and even dangerous side effects, including upset stomach, fatigue, and impaired liver function.
Rebalancing Hormones to Restore
Lost Libido
In my work with hundreds of male patients, I’ve learned something that the advocates of Viagra are now finding out the hard way. While vascular problems are a factor in many cases, increasing blood flow doesn’t always solve the problem. In fact, once the circulatory insufficiencies are addressed, a much different problem often comes to light—reduced libido.
Many men experience gradual changes in energy or libido as they go through their forties or fifties and assume that they are experiencing an “inevitable” age-related decline. As men age, there is some natural decrease in hormonal output, roughly analogous to the decrease in estrogen production that signals a women’s menopause. In fact, the term “andropause” refers to a decline in androgens, or male sex hormones.
Men of any age who have had vasectomies can also experience reduced libido. Vasectomies can change circulation patterns of blood and hormones and as a result, lower testosterone levels. Even extreme stress—which seems to be the rule rather than the exception these days—can affect the pituitary gland and cause lowered testosterone production.
Estrogen—an Environmental Hazard
I’m also concerned that environmental factors may be affecting sex hormone production in men. It’s well documented that the average sperm count of the American male has been dropping consistently over recent years. And there’s evidence that our environment is increasingly estrogenic, with environmental toxins tending to induce estrogen production in men as well as women. This feminizing environment may be blunting the effects of testosterone in men, making them more prone to the changes of andropause.
Healthy testosterone levels are related to a general vitality, the kind of energy that makes you want to bound out of bed in the morning and charge through your day. They are also directly related to a healthy sex drive. Low testosterone can not only dampen your ardor, it can also result in flaccid musculature and a tendency to put on weight.
When testosterone levels are extremely low, as verified by medical tests, I sometimes prescribe supplemental testosterone to bring hormones back into healthy ranges. But like any steroid hormone, testosterone therapy must be carefully monitored for side effects and overdosage. I’m opposed to using testosterone to promote sex drive when levels are in healthy ranges. This is a harmful abuse and not the correction of a deficiency.
But there’s no doubt that testosterone levels at the low end of the “healthy” range can result in reduced libido. For men who are experiencing a decrease in vitality and sex drive due to the natural process of andropause, I prefer natural, non-prescription supplements that encourage the body to produce more testosterone and—even more importantly—bring the body’s many interdependent hormones into optimal balance.
The following substances can be safely used without fear of side effects because they work in harmony with the body’s own natural functions.
Tribulus terrestris, like the forskohlin discussed above, is a product of the ancient system of Indian medicine called Ayurveda. Traditionally used in the treatment of prostate and urinary difficulties, it was more recently “discovered” by Eastern European athletes, who found it to be effective as a performance enhancer, increasing endurance and strength during workouts. It has also been reported to increase libido in both men and women.
The Chemical Pharmaceutical Instititute in Sofia, Bulgaria, has been investigating Tribulus Terrestris as a natural treatment for male impotence and infertility in both men and women. Although it contains no hormones, it is rich in phytochemicals, called steroidal saponins, that stimulate the endocrine system.
In men, it stimulates the secretion of leutinizing hormone (LH), which in turn stimulates the gonads to produce more testosterone. In one study of men age 28 – 45, it increased testosterone levels by as much as 30 percent over a five-day period. Other studies using Tribulus terrestris have shown an increase in sperm production and motility, as well as increased sexual activity.
In women, it has been found to relieve symptoms of menopause, such as hot flashes and insomnia, even more effectively than estrogen replacement therapy and without side effects. In premenopausal women, it appears to enhance fertility and relieve symptoms of PMS. Study subjects also reported that the preparation led to an increase in sex drive.
Toxicology studies found no adverse effects, either at high doses or with long-term administration. Tribulus terrestris appears to be an exceptionally safe and a very promising remedy for sexual dysfunction in both men and women.
Epimedium grandiflorum is used in Chinese medicine to promote sexual activity and treat impotence. The Chinese name (Yin Yang Huo) has been translated as “Horny Goat Wort.” According to the Chinese system of medicine, it fortifies the Yan (male) energy and tonifies the kidney, which is regarded as the seat of sexuality. It is traditionally used to treat impotence, infertility, and urinary problems in men, and irregular menstruation in women.
Modern pharmacological and clinical research has found that epimedium has a “moderate androgen-like effect” on the testes, and prostate gland.(Androgens are male sex hormones.) This would explain its ability to increase sperm production and sexual desire. It also stimulates the sensory nerves—indirectly increasing sexual desire by enhancing pleasurable sensation.
Ginseng is a well-known virility enhancer, with origins in Chinese and Korean medicine and a wealth of scientific data to support its reputation. Animal studies have demonstrated its ability to increase sperm production, increase testosterone levels, and stimulate increased sexual activity. Agricultural research shows that ginseng added to the feed of hens can even increase egg production. And several centuries of clinical observation indicate that its benefits in humans are just as impressive!
Ginseng is considered a tonic herb, with beneficial effects on the whole body. In addition to its ability to enhance sexual prowess, it has the power to increase vitality, stamina, endurance, and mental well-being—even lifting depression.
Traditionally, ginseng is ingested by chewing the root, but it can also be consumed as a tea or as a standardized extract. I find ginseng extremely helpful for those middle aged and older, who often find that flagging energy and “sharpness” cuts into their enjoyment of life and its many pleasures.
Compared to the exotic herbs and roots described above, zinc may seem somewhat unglamorous, but if I had to pick one nutrient that is essential to optimum male sexual function, it would have to be zinc. Zinc is absolutely essential to the production of male sex hormones and sperm formation. Zinc deficiencies can lead to infertility, impotence, and reduced libido. The prostate gland itself contains an extremely high concentration of zinc and adequate zinc intake is crucial to prostate health and function. (One of the reasons that oysters and other shellfish have a reputation as aphrodisiac foods may be their high zinc content.)
Unfortunately, zinc deficiency is common. In fact, nutritionists at the National Institute of Health recently released a statement that many people in the U.S., particularly young children, female teenagers, and those over 70, do not get enough zinc in their diets and are at risk of deficiency. In my experience, almost everyone benefits from zinc supplementation. For men suffering sexual dysfunction, it’s my first recommendation.
Putting the Pieces Together
The nutrients outlined in this article form the foundation of a holistic and synergistic approach to optimal sexual function and health. As a daily regimen, this program addresses all aspects of male sexual function, including circulation, biochemistry, hormone balance, physical stamina, nerve sensitivity, and overall health and well-being.
