Abstract

Introduction

Materials & Methods

Results

Discussion & Conclusion

References

Discussion
Board

It has been reported in the literature that dietary supplementation with certain botanical extracts, vitamins, or amino acids have led to modest improvements in male sexual function. No studies, however, have examined a systematically designed combination of natural products for the enhancement of male sexual function. Based on the proposed and elicited mechanisms of various natural products in the literature, we postulated that a combination regimen (ArginMax) could provide a major impact in support of male sexual function. First, a review of the supporting literature.

It is well established that nitric oxide (NO) is the key mediator for the up-regulation of cGMP which in turn mediates erectile function.(1) L-arginine is the precursor of nitric oxide. The conversion of L-arginine to nitric oxide is mediated by nitric oxide synthase (NOS). Increasing tissue L-arginine levels results in the increase of NO and cGMP.(2,3) Supplementation with L-arginine has been shown to be sufficient to restore endothelial-d erived nitric oxide production in many disorders in which endothelial-derived nitric oxide is reduced or impaired including impairment resulting from diabetes and hypercholesterolemia.(4,5,6,7,8) Studies also point to the role of L-arginine as not only a substrate for NOS in the up-regulation of cGMP, but also acts to reduce cell-mediated breakdown of nitric oxide.(9)

The efficacy of Korean ginseng (Panax Ginseng) in treating erectile dysfunction was recently demonstrated in a randomized controlled clinical trial involving a total of 90 patients studied over 3 months, 30 each receiving placebo, trazadone, or ginseng.(10) Ginseng was the most efficacious treatment with improvements measured in erectile parameters such as girth, libido, and patient satisfaction. Frequency of intercourse, ejaculations, and erections did not differ among groups. In a controlled study with 66 patients, Panax ginseng was demonstrated to increase spermatozoa count and motility, testosterone, DHT, FSH, and LH levels in 66 patie nts with fertility problems.(11) Ginsenosides (the primary active component of ginseng) have been shown to increase NO production in endothelial cells.(12,13,14) One observed mechanism for increase in NO production is up-regulation of NOS activity by ginsenosides.(14) The effects of ginsenosides on NO production has implications for improved sexual function, and may partly account for the aphrodisiac effect of Panax ginseng used in traditional Chinese medicine.

Ginkgo biloba is well established to facilitate microvascular circulation(15) which may physiologically lead to improvement of erections. In addition to ginkgo biloba's ability to facilitate microvascular circulation, potentially benefiting erectile function through enhanced vascular blood flow, there is evidence that ginkgo biloba extract may also directly elucidate smooth muscle relaxation in the corpus cavernosum, likely via effects on the nitric oxide pathway.(16,17)

B-complex vitamins are important to the activity of hundreds of enzymes and in energy metabolism. Low levels of circulating folate and vitamin B6 confer an increased risk of peripheral vascular disease,(18) leading to potential reduction of erectile function.

Zinc is a fundamental mineral in the maintenance of human reproductive function. Low levels of serum zinc has been shown to cause sexual dysfunction and associated with infertility in males.(19,20) Zinc deficiency during growth periods result in lack of gonadal development in males.(21,22) Zinc deficiency leads to depletion of testosterone and inhibition of spermatogenesis.(23) Zinc is also thought to help extend the functional life span of ejaculated spermatozoa.(23)

Selenium has a key influence on spermatozoa numbers and motility. It is an essential element in normal spermatozoa development. Selenium is incorporated in the sperm mitochondria capsule and may thus affect the behavior and function of the spermazoon.(24) It has been shown that dietary supplementation with selenium-vitamin E statistically significantly in creases sperm motility, percent live, and percent normal spermatozoa.(25)

It is well established that one of the key roles of seminal plasma is the protection of spermatozoa against reactive oxygen species.(26) In a study of 101 patients seeking consultation for infertility and 15 fertile donors, a strong inverse relationship was found between total reactive antioxidant potential in seminal plasma and infertility.(26)

ArginMax (The Daily Wellness Company, Mt. View, CA) is a natural dietary supplement which incorporates a highly standardized combination of ginkgo biloba (24% flavone glycosides, 6% terpene lactones), Korean ginseng (Panax Ginseng-30% ginsenosides), American ginseng (Panax Quinquefolius- 5% ginsenosides), L-arginine, along with B-vitamins 6 and 12, folate, antioxidant vitamins A, C, E, thiamin, riboflavin, niacin, biotin, pantothenic acid, zinc, and selenium. ArginMax was developed as a dietary supplement to support male sexual fitness. This paper reports our findings of a clinical p ilot study of male sexual function using ArginMax as a daily dietary supplement in a group of men with mild to moderate erectile dysfunction.

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