Improve Your Chances

Viagra®
Is the Stampede Misdirected?
By Will Block

Just when you thought sex was taking second place to . . .

  • the comet on a collision course with the earth,
  • the indictment of the First Lady,
  • the millennium bug,
  • the Dow hitting 10,000, or
  • the next "big thing"

. . . the word is out on the street that it just isn't true. Sex is still #1. At least, among men willing to spend upward to $300 or more per month for a new drug aimed at the treatment of impotency by enhancing erection. The new blockbuster drug Viagra is selling so briskly that it could surpass the sales of Prozac.® An estimated 40,000 prescriptions were being written per day a mere two weeks after the introduction of Viagra. Doctors are writing prescriptions so fast that it strains the imagination. It's clear, however, that many men buying it don't just want to overcome dysfunction. They want enhancement - to keep it up and do it more frequently.

WOMEN CHASING BULLS
Even more interesting is the growing demand for Viagra by women; not for their lovers, but for themselves. Pfizer, the manufacturer of Viagra has taken note, and is already reported to be entering stage II of testing the potency pill for women's use. It is as if the famed Spanish Pamplona bull runs have been transformed; instead of the bulls chasing the macho men, the women are out-machoing the men and chasing the bulls.

Corrections


This article misstates Viagra's effect on reducing non-organic impotence. Viagra also reduces organic erectile dysfunction. Of eight double-blind placebo studies referred to in the Viagra package insert, only some cases of impotence could be described as non-organic (ie, psychogenic or mixed etiologies). In the largest study, quoting the insert, "erectile dysfunction was attributed to organic (58%; generally not characterized, but including diabetes and excluding spinal cord injury), psychogenic (17%), or mixed (24%) etiologies. Sixty-three percent, 74%, and 82% of the patients on 25 mg, 50 mg and 100 mg of Viagra, respectively, reported an improvement in their erections, compared to 24% on placebo." Some researchers believe that nitric oxide, produced entirely in the body from the amino acid, arginine, can help correct up to 90% of all penile dysfunction.
The article also describes the mechanism of yohimbe as acting to increase noradrenaline activity. Actually, yohimbine, the active ingredient of yohimbe, is an alpha adrenergic blocker. This means that it inhibits certain aspects of noradrenergic activity. A formula containing yohimbe is reported to help increase energy, particularly physical energy, and improve libido (men and women) and erections in men. Sometimes it causes erections even in the absence of any sexual stimulation.

The mechanism of action for Viagra (sildenafil) involves inhibition of an enzyme, phosphodiesterase type 5 (PDE5). This enzyme counters a man's ability to maintain an erection by allowing blood to escape from the penis. Therefore, inhibiting PDE5 prolongs erection. In a way, Viagra works by keeping the back door shut.

At the front door, however, there is another mechanism for enhancing erection. When the amino acid, arginine, is acted on by an enzyme, nitrous oxide synthase (NOS), as a result, a substance called nitric oxide (NO) is produced. NO enables two rods of sponge-like tissue (the corpus cavernosum and the corpus spongiosum) in the penis to relax thus allowing the inflow of blood to produce an erection. This is the front door approach. Further, as blood flows through the penile arteries into the penis, the increased pressure compresses the veins that drain blood from the penis preventing outflow during sexual stimulation. NO operates, similarly, on a woman's clitoris, helping to maintain sexual excitation. If sufficient NO is not produced, erection or sexual stimulation does not occur. Arginine is absolutely necessary for the production of NO.

Some scientists studying these phenomena have concluded that up to 90% of all impotency can be reversed by NO (and by implication, the use of arginine).1 However Viagra's figures (found on the package insert, but not yet available for scrutiny) are very good also, reducing non-organic impotence by 62% when using the lower 25 mg dose, and rising to 82% at 100 mg. However, if you want to use Viagra every day the cost can get out of hand. Realizing this, health insurers are already rebelling against payouts.2 None for those who do not present proof that they have been treated for impotency prior to Viagra's availability and as few as 6 pills per month for those who can prove it. HMOs and other health insurers are also dropping the standard 80% coverage for Viagra prescriptions down to 50%. You can be sure more restrictions are on the way.

THE PROSEXUAL ALTERNATIVES
You don't have to spend $10 or more per day on prescription drugs. Well designed arginine formulations have been available for some time now. A nutritional supplement, formulated by Dr. Ward Dean, contains arginine at levels that have shown to be beneficial for helping with penile dysfunction.3 It also contains additional ingredients such as ginkgo biloba which has proven to be of value for helping to activate the release of NO from both arteries and veins.4 Moreover, it enhances the natural "sex flush" with the addition of niacin.5 Sexual excitation normally releases histamine causing the natural sex flush, which niacin enhances even more so.6

Durk Pearson and Sandy Shaw designed another useful product. This well thought out formulation contains higher concentrations of arginine along with choline and vitamin B5. Arginine is well know for its growth hormone releasing function. Choline and B5, in addition to their impact on memory function, enhance production of the neurotransmitter acetylcholine which helps signal the release of the enzyme NOS that produces NO from arginine.


Arginine is absolutely necessary for the
production of NO which is
prerequisite for erection.

But NO is not the complete story. The importance of libido should not be minimized. Besides the sexual physiological aspect, where Viagra and arginine are focused, there is also the psychological aspect, the libido. This entails the mind, which is where the whole process begins in the first place. In that regard, adrenergics such as yohimbe can be helpful.7 Standardized yohimbe acts to increase noradrenaline activity, necessary for elevating libido. In addition, yohimbe is reported to give people an increase in mental energy, and improves libido (in men and women) and erections in men. Occasionally, it causes erections even in the absence of any sexual stimulation.

By all means, don't get trampled in the rush for sexual enhancement. It defeats the purpose of fulfillment. Besides, Viagra is still a drug with side effects, both known and unknown. Instead, consider redirecting your attention to more natural alternatives, products that can improve sexual functioning just as well as the drugs, if not better.

References

  1. San Jose Mercury News. Researchers find male sex trigger. 2F, July 17, 1992.
  2. Morrow D. The New York Times. Insurers limiting payments for use of impotence pill. A1, April 29, 1998.
  3. Zorgniotti AW, Lizza EF. Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction. Int J Impotence Res 1994;6:33-36.
  4. Auguet M et al. Ginkgo biloba extract (Egb 761) and the regulation of vascular tone. In Cardiovascular Effects of Ginkgo biloba Extract. (Clostre F, DeFeudis FV, Eds) Elsevier, Amsterdam, 1994:19-26.
  5. Kunin RA. The action of aspirin in preventing the niacin flush and its relevance to the antischizophrenic action of megadose niacin. J Orthomolec Psychiat 1976;5(2):89-100.
  6. Langmyhr GJ. Physical signs of sexual response and orgasm in women. Med Aspects Hum Sex 1976;10(10):163-164.
  7. Adaikan PG, Ratnam SS. Pharmacology of penile erection in humans. Cardiovasc Intervent Radiol. 11(4): p191-4, 1988.

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