Men's Health

Erectile Dysfunction

I would like to share some information on a fairly sensitive topic. It seems that ads about erectile dysfunction (aka impotence) are everywhere in the media these days. The latest ad features a racecar bursting through barriers and the slogan "Tune Up For Life," which goes by so fast it's almost subliminal. Although erectile dysfunction is a common experience of men in over 50, it was the unmentionable topic until a pharmaceutical became available to "treat" the condition. Once Viagra(tm) was approved for use by the FDA, the unmentionable became table conversation.

However, before you or someone you loves begins taking Viagra(tm), I think you should be aware of the warnings and dangers associated with its use and the fact that there are natural alternatives. The first is, yohimbine, the first substance approved by the FDA for erectile dysfunction. And the second alternative is muira puama (or potency wood, sometimes termed "herbal Viagra"). I hope to delineate the pros and cons of each.

First, Viagra(tm): A careful reading of the Physicians' Desk Reference (PDR) is enlightening. Although Pfizer (the manufacturer) has tried to couch their warnings in the most positive terms, there is much about Viagra(tm) to cause concern. The post-marketing experience has been sobering; to quote: "Serious cardiovascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack and hypertension, have been reported post-marketing in temporal association with the use of Viagra(tm). Most, but not all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Viagra(tm) without sexual activity...." (emphasis added) PDR, 55th Edition, 2001, pg. 2537.

In the PDR, the side effects are listed in decreasing order of frequency. So, the most common adverse effect is a heart attack, followed by sudden death, life-threatening arrythmias and strokes. Furthermore, the effects are unpredictable, as noted in the phrases I've emphasized. In addition, the PDR points out that men with impaired liver or kidney function are at risk from Viagra(tm). Yet, who are the very men who might be the target consumers? Older men, or men with diabetes, two groups at high risk for liver and/or kidney insufficiency. I certainly wouldn't want anyone I loved taking such risks with his health. Maybe the slogan should be "Play Russian Roulette With Your Life." It certainly would be more accurate.

Yohimbine (aka yohimbe or Rauwolfia serpentina) was actually the first substance approved by the FDA for the treatment of impotence. It has fallen out of favor due to its serious adverse effects, which can be life threatening. One of my sources states that the FDA now lists Yohimbe bark as an "unsafe herb." Traditionally, yohimbine bark has been used as an aphrodisiac, used to treat angina and hypertension, and smoked as an hallucinogen.

While the proposed physiologic mechanism of yohimbine would lead one to expect an anti-hypertensive action, clinical use has proven otherwise. An oral dose of 5 mg (which is far less than the recommended dose, 6 mg three times a day, for aphrodisiac effects) causes a significant increase in blood pressure in men with orthostatic hypotension (adrenal insufficiency). The response is associated with an increased heart rate and increased plasma noradrenaline levels (thereby stressing the heart).

Other reported side effects include anxiety, panic attacks, hallucinations, dizziness and headache. In susceptible individuals, it may result in psychosis. It can also cause severe hypotension, abdominal distress and weakness. Since it readily crosses the blood brain barrier, it may result in CNS overstimulation and paralysis. Again, men with kidney problems should not take this substance; nor should those taking anti-depressants. There have been no large scale studies on this product due to lack of funding, but what information is available is troubling. (Sources: PDR, 55th Ed, 2001 pg. 3164; The Review of Natural Products, 1st Ed, 2001 by Facts and Comparisons, a Wolters Kluwer Company, pp. 647 & 648; and Botanical Influences on Illness, by Melvyn R. Werbach, M.D. and Michael T. Murray, N.D. pp. 200 & 201)

Lastly, I would like to bring you up to speed on muira puama (potency wood, scientific name Ptychopetalum guyanna). Muira puama is a bush or small tree and is native to the Brazilian Amazon. Traditionally, it has been used internally as a tea for treating sexual debility and impotence, neuromuscular problems, rheumatism, grippe, cardiac weakness, gastrointestinal weakness and to prevent baldness. It is also used externally in baths and massages for treating paralysis and beri-beri. In 1925, a pharmacological study was published which indicated its effectiveness in treating disorders of the nervous system and sexual impotence which indicated that "permanent effect is produced in locomotor ataxia, neuralgias of long standing, chronic rheumatism and partial paralysis." (Dias Da Silva, Rodolpho, 1925. "Medicinal plants of Brazil. Botanical and pharmacognostic studies. Muira puama," Rev. Bras. Med. Pharm. 1(1):37-41, 1925) In 1930, a French study confirmed the efficacy of the plant for gastrointestinal and circulatory weakness and sexual impotence. It has been listed in the British Herbal Pharmacopoeia, where it is recommended for the treatment of dysentery and impotence. It has been in the Brazilian Pharmacopeia since the 1950s. Interestingly, in Europe, muira puama is also used for menstrual disturbances; and American herbalists and health care practitioners are using it for menstrual cramps and PMS, as well.

Recently, a study was conducted in Paris, France, with 262 men experiencing lack of sexual desire and the inability to attain or maintain an erection. The results indicated that muira puama is effective in improving libido and treating erectile dysfunction. 62% of the men with loss of libido reported that the extract of muira puama "had a dynamic effect." 51% of the men with erectile dysfunction felt that muira puama was beneficial. (Waynberg, J., "Aphrodisiacs: Contribuiton to the clinical validation of the traditional use of Ptychopetalum guyanna." Presented at The First International Congress on Ethnopharmacology, Strasbourg, France, June 5-9, 1990) The second study conducted by Waynberg in France evaluated the positive psychological benefits of Muira puama in 100 men with male sexual asthenia. (Waynberg, J., 1995, "Male Sexual Asthenia - Interest in Traditional Plant-Derived Medication. Ethnopharmacology, Mar 1995)

There are no reports of adverse side effects from muira puama in any of the sources I researched. There are, however, one or two cautions when utilizing potency wood. If you are arthritic and are taking nitric oxide quenchers (niacinamide, n-aceytlcysteine found in our product Arthrogen(R), you may not have a satisfactory effect from potency wood. Also, I wouldn't recommend taking muira puama in the presence of prostate cancer -- primarily because there is no data on how it may or may not affect tumor growth.

I found this information compelling enough, that at the RFHC, we now have begun to carry a product (Androplex(tm) which contains muira puama, gingko biloba leaf extract and panax ginseng (Korean red ginseng). The herbal extracts are standardized; and 2 capsules daily provide the amount of each substance demonstrated in clinical studies to have a positive effect on male sexual dysfunction. Korean red ginseng has a mild effect on erectile dysfunction and has been demonstrated to increase circulating testosterone in rats. Ginkgo biloba has only been studied in the test tube, using tissue samples. It is included in the formula because of its proven effect on peripheral blood flow and the assumption is made that it will, therefore, aid penile blood flow.

For women who have had a total hysterectomy (including removal of the ovaries) and who suffer from loss of libido, Androplex(tm) may prove beneficial (private communication Dr. Frank Strehl). However, if a woman wants to use Androplex(tm), I would have to assess adrenal function, as well, since women's sexual response is more complex than men's.

If you, or someone you love, would like a safe, natural alternative therapy for erectile dysfunction or loss of libido, call us and order a bottle. A month's supply is $28. Within the month, you should be able to determine whether it is working well for you.

Does this apply to you? If so, see our information on Consultations.