Sexual Enhancement Available to Women Too

Viagra® Duality:
Better to NO?

By Will Block

ccording to urologist Dr. Myron Murdoch, national medical director for the Impotence Institute of America, "A lot of women are interested [in Viagra]."1 And why shouldn't they be? High sexuality is associated with youthfulness and, indeed, sexual-function decline typically goes along with aging. Now hear this: The world-wide proclamation of Viagra for men is about to be overshadowed by a growing clamor for Viagra by women! And why not? "If you think there's a big demand for male sexual dysfunction medicine, wait until women find out they can have some sort of sexual dysfunction medicine," warns Dr. Murdoch. To fully understand the significance of this statement substitute the phrase "arousal restoration and enhancement" for "sexual dysfunction." As the dam of female enthusiasm bursts, you can hear a new rendition of an old song wafting from the deck of an observation boat, "How you gonna keep 'em down on the farm after they've seen Viagra Falls?"

VIAGRA NOT AS GOOD AS "NORMAL"
Once women start to use Viagra, you can imagine the personal want ads: Virile woman desires to meet arousable man. Must be willing to enter into a Co-Viagra relationship. Yet there is still no real evidence of what Viagra can do for non-dysfunctional (normal) men, let alone normal women; i.e., can it make a man or woman supernormal? As the first major study found,2 861 men taking Viagra orally in amounts of 25, 50 or 100 mg before anticipated sexual activity, but not more than once per day, reported significantly increased arousability with the best improvements occurring at the highest dose. These men had been diagnosed principally with organic erectile dysfunction. However, the results still did not bring them to the responsiveness level of non-dysfunctional (normal) men. While Viagra's achievements cannot be knocked - the mean number of successful attempts at intercourse per month was 5.9 for Viagra vs. 1.5 for placebo - being able to determine one's own sexual pinnacle at will is obviously preferable. And six times per month is not exactly the Mt Everest of an active sex life for many men, not to mention women. Moreover, Viagra is only part of the story, if you look at the chemistry involved.

NO SEX - YES!
There is no question that nitric oxide (NO) is absolutely necessary for erectile function, meaning that without adequate supplies of NO erection cannot occur.3 Recently, researchers at Johns Hopkins Hospital and School of Medicine in Baltimore have identified the presence of nitric oxide in the human clitoris, thus supporting the hypothesis that NO promotes erectile function in this organ as well as in the penis.4 Actually, the clitoris is the embryonic equivalent of the male penis, or as Dr Murdoch has said, "Physiologically ... the clitoris is nothing more than a penis without a urethra [the conduit for urine and sperm in men]." NO has been found to be concentrated in the corpora cavernosa of the clitoris, just as is the case in men. The researchers concluded that NO is probably involved in the erectile physiology of the clitoris as a modulator of clitoral smooth muscle activity. There is even data supporting the role of NO in the vagina, for increasing sexual stimulation.5,6 While functional studies are required to support this hypothesis, anecdotal reports of women arginine users - NO is produced entirely from the amino acid arginine - which seems better, by far, than reports to date of women who are experimenting with Viagra.

Our knowledge of the physiology of penile and vaginal/clitoral arousal has been assembled during the past thirty years and is now considered a multifactorial process.7 Simply stated, physiological sexual arousal starts in the brain with erotogenic stimuli such as may be provided by sight, sound, smell, touch, or imagination. This leads to the stimulation of the parasympathetic nervous system resulting in the production and release of vasodilating substances (such as nitric oxide). Then the sinusoids of the corpus cavernosum in the clitoris or penis are filled with blood; this is the tumescence stage. Finally, the veno-occlusive mechanism starts to work as a result of NO's effect on the corpus cavernosum, thus complete arousal occurs.

TECHNICAL EXPLANATION
Technically stated: sexual arousal involves a number of mutually-coordinated processes. In the central nervous system, they include autonomous and motor pathway activation. Control function is exerted by spinal as well as cerebral centers and mediation involves the neurotransmitters acetylcholine, NO, noradrenaline, VIP (vasoactive intestinal polypeptide), CGRP (calcitonin gene-related peptide) and prostaglandins.

Yet the most important roles of arousal are played by nitric oxide and VIP. Usually there are six stages: at rest, latent, the tumescence (hardening) stage, complete arousal (erection of penis and clitoris), rigid arousal, and finally detumescence (softening). An essential prerequisite for arousal is the increase in blood flow to the genital areas and the so-called veno-occlusive mechanism. This is the blocking of blood egress by the impingement of the veins by the contractions of the perineum muscle thereby compressing the portions of the corpora cavernosa and leading to clitoral or penile rigidity.

FOR THE LONG-TERM - NO!


The honeymoon keeps going on and on and on when Viagra hits the falls. Or does it? Some marriages are reported to be breaking up over complications resulting from the sexual reawakening caused by the use of Viagra. ("Viagra Blamed For Breakup" read the headline of The New York Post on Friday, May 29.)
Significant studies have found certain nutrients - in particular arginine, choline, vitamin B5 - and specific herbs (ginkgo biloba and yohimbe) can help achieve increased production of NO, and increase adrenergic inhibition, both critical to proper sexual function. Nutrients and herbs can also accomplish improved cardiovascular and central nervous system functioning as they improve sexual health, thus assisting in the prevention of further sexual and overall health decline with age. So, why would someone or anyone or everyone (as the headlines have it) opt for a drug [albeit with few side effects exhibited so far, but without long term studies] if nutrients could achieve the same result and perhaps even better [Viagra: Is the Stampede Misdirected? - June 1998]? Answer: a major investment of advertising dollars, sensational media coverage, and the stamp of institutional and political approval - from the White House to the Vatican (I kid you not).8 But let me suggest that these are not the vestibules of science. Therefore, it might be a better idea to hear it objectively from the journals of science.

On that count, a recent study with rats found that oral administration of high doses of L-arginine improves the erectile response in the aging rat by acting as the substrate-limiting factor for NO production and activity.9 Indeed, in rat studies, arginine blood levels have been found to increase significantly with age.10 These data support the possible long-term use of dietary supplements for the treatment of erectile dysfunction.

HEALTH NOT OVERLOOKED WITH NO
In the long run, the right nutrients, herbs and amino acids are caregivers; they do not take away from the bottom line of your health and are without side effects. Products with arginine and ginkgo biloba; with arginine, choline and vitamin B5; with choline and vitamin B5; or containing yohimbine, improve not only sexual function, but immune, cardiovascular, wound healing, memory functions, and much more. In the early experiments with lab animals showing either mean life span extension or maximum life span extension, it was very clear that there were other benefits to living longer. The life extended animals were much more sexually active, and with recent studies concerning NO, it is now clear why - for the most part. They had healthier cardiovascular systems and healthier central nervous systems, functional benefits attributable to these ingredients. And women ... these functional enhancements are available to you too. Don't go over the Falls with Viagra but instead look to the future (arginine also enhances long-term memory as well as sexual benefits) in terms of your long-range health and virility. In the immortal parting words of Molly Bloom, while making love to the protagonist, in James Joyce's Ulysses, "Yes I said yes I will Yes." In light of what we know, the author might have had her say "NO, I said NO I will NO."

References

  1. Fox M. Viagra potency pill is a hit with US women too. Reuters. Tuesday April 28 4:10 PM EDT.
  2. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998;338:1397-1404.
  3. Xia Y, Zweier JL. Direct measurement of nitric oxide generation from nitric oxide synthase. Proc Natl Acad Sci. 1997;94:12705-12710.
  4. Burnett AL, Calvin DC, Silver RI, Peppas DS, Docimo SG. Immunohistochemical description of nitric oxide synthase isoforms in human clitoris. J Urol 1997 Jul;158(1):75-78.
  5. Berman JR, McCarthy MM, Kyprianou N. Effect of estrogen withdrawal on nitric oxide synthase expression and apoptosis in the rat vagina. Urol. 1998;51:650-656.
  6. Hoyle CH, Stones RW, Robson T, Whitley K, Burnstock G. Innervation of vasculature and microvasculature of thehuman vagina by NOS and neuropeptide-containing nerves. J Anat 1996;188(Pt 3):633-644.
  7. Hora M, Vozeh F. The physiology of erection. Cas Lek Cesk 1997;136:363-366.
  8. Barnes E, Mondi L, Cole W, Fulton G, Mann A. Time (Asian edition) May 11, 1998;151(18):cover story.
  9. Moody JA, Vernet D, Laidlaw S, Rajfer J, Gonzalez-Cadavid NF. Effects of long-term oral administration of L-arginine on the rat erectile response. J Urol 1997;158:942-947.
  10. Reckelhoff JF, Kellum JA, Blanchard EJ, Bacon EE, Wesley AJ, Kruckeberg WC. Changes in nitric oxide precursor, L-arginine, and metabolites, nitrate and nitrite, with aging. Life Sci. 1994;55:1895-1902.

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