A decrease in male sexual satisfaction may be the first sign of significant health problems boiling under the surface (1). A strong correlation was found between men aging and their sexual function significantly reducing in frequency. Surprisingly, there was no significant correlation found between men aging and their sexual satisfaction decreasing (1,2). There was, however, a strong correlation between diminished sexual satisfaction and diminishing health (3). Meaning, that when men feel that their sex life is not satisfactory, often, the problem is not age, it is diminishing health.
Stepping Into No Man's Land
It takes a lot of guts to talk about men's health because let's face it, even men do not like to talk about men's sexual health. Human sexuality is so closely interwoven with self worth, it is almost impossible to dissociate any conversion about sexual function from emotional and mental components (4). Further, when talking about men's health, it is easy to get seduced into talking about pelvic health which is the single most highly discussed aspect of men's health. While male pelvic health is worth talking about, getting lost in the world of penile sexual enhancement highly undermines the importance of overall health and the complexity of the male sexual response.
For Men's Health, The Devil Is In The Details
The male sexual response starts with a clear mind and a relaxed body. The parasympathetic nervous system (the one responsible for resting and digesting) perceives a sexual stimulus and starts producing neurotransmitters that are responsible for satisfaction seeking5. Dopamine, glutamine and norepinephrine hold the thought and energize it into what feels like that burning desire. (6)
Once the stimulus is perceived, the entire physiology of the man changes. His Sympathetic Nervous System (SNS)( responsible for fight or flight) engages abruptly (7,8). Suddenly, the nostrils widen, and the olfactory nerve becomes more sensitive to aromatic stimuli (9). Additionally, air brings aromas that bypass the thalamus, the brain's switchboard (10,11). Bypassing regulatory neurons exponentially expediting the process of taking the man to the closest memory of emotions experienced the last time he experienced such an aroma. Memories, hopes, dreams, fantasies and past experiences flavour the experience for better or for worse (11, 12). Nervous signals rush to the spinal cord and recruit thousands of miles of blood vessels to carry the excitatory signals all the way down... to the heart (13, 14). That is precisely the moment when the heart feels like it is dropping. That drop, signals that blood pressure is increasing, some heartbeats may be skipped, and the heart activates to eject the excitatory signal further. (15,16)
At this point, the man is fully aware of the need for sexual inhibition if his reaction is not taking place in an appropriate situation (17). Even when consciously inhibited, further tissues like the auditory nerve become more sensitive to sound, and the receptors on the skin become more sensitive to touch (18). Finally, the blood flow makes its way down the body to the pelvic region where the highly orchestrated invisible male sexual response triggers the visible erectile response. (7,8)
It Takes Many Means to Reach One End
The last paragraph was a highly simplified, vastly short description of only a fraction of what the male body experiences during sexual excitation. Why bother trying to demystify the male sexual response and honour its complexity? Simply to demonstrate that if any part of the previously mentioned cascade is not working properly, there is a significant chance that there will be a disruption in the sexual response. To most people, all the disturbances result in the same symptom...erectile problems. (3)
Starting from the Bottom Up
When evaluating why any man may be experiencing problems with sexual health, it is helpful to start by closely examining pelvic health. Investigating pain, discomfort, urinary symptoms, infection history and any changes to the reproductive organs may help pinpoint a problem that is easy to treat. Urinary problems and kidney problems play a large role when it comes to painful penile conditions (19). Botanicals like damiana are traditionally used for bladder and urinary conditions that affect sexual function. (20)
A regular annual visit to the urologist is highly recommended for men over the age of 40. It is important to emphasize the delicate nature of all the fine tubes that make up the male reproductive system. Any chronic infections can risk scarring and remodelling of the tubes. It is also important to note that mild to moderate infections, left untreated, may permanently change the shape of the tubing beyond repair (21,22).
In the case of any chronic inflammatory conditions of the male reproductive system, it may be beneficial to consider adding a safe proteolytic enzyme like serrapeptase to the treatment regimen. Serrapeptase is an enzyme that is unique in its safety profile as it only breaks down inflamed and dead tissue, leaving living tissue completely unharmed and ready to heal. It also has an affinity to scar tissue, inflammatory markers and bacterial biofilms, making it an excellent supportive agent when treating any stubborn inflammatory pelvic condition. (23)
"Prostate Health is NOT an 'Old Man' Problem"
Prostate Specific Antigen (PSA) Vs. Digital Rectal Examination (DRE)
The botanical Serenoa repens, better known as saw palmetto, on the other hand, is important for maintaining a healthy prostate and is likely good for maintaining the health of the prostate without impacting the Prostate Specific Antigen (PSA). (27, 28)
What most men do not know is that PSA levels can go up for many reasons other than BPH. Infections, irritation, and prostate disruption can all significantly increase PSA levels. In fact, recent sexual activity and a recent prostate Digital Rectal Examination (DRE) may significantly increase PSA. (29)
There was a past concern that saw palmetto may lower PSA measures masking prostate problems, however, several studies show that saw palmetto has no significant impact on PSA though it may significantly benefit prostate health. (28)
A well-trained, well-trusted physician may get a lot of insight from following up on the physical condition of a prostate gland. Always ask about the most appropriate time to check your PSA level. Supporting your prostate health is important even if you are a younger man.
In Sexual Health, It's Important To Have Nerve
In order for a man to be able to enjoy a healthy sex life, his neuronal pathways should be healthy enough to carry the excitatory signal from the brain, down to the heart and even lower to the pelvic region. Most inflammatory and metabolic conditions, when left untreated play a significant role in damaging the delicate peripheral nerves. Conditions like diabetes, atherosclerosis and autoimmune conditions can have a significantly negative influence on men's sexual health3. Unfortunately, if left untreated, neuropathies are likely to be permanent.
The botanical Epimedium brevicornu, better known as bishop's hat or horny goat weed, contains the active ingredient icariin. It is shown to act as a phosphodiesterase type 5 inhibitor (PDE5 inhibitor). A PDE5 inhibitor is a vasodilating compound which dilates the smooth muscle layer lining the blood vessels supplying various tissues with extra blood flow. The spongy component of the penis known as the corpus cavernosum and corpus spongiosum are directly impacted by PDE5 inhibitors. Though horny goat weed is used for sexual enhancement on the premise of its activity as a vasodilator that assists with penile blood flow, it has many other health benefit that positively impacts the sexual response indirectly. The following is just a short list of side benefits (30):
Prevent premature ejaculations
Prevent mitochondrial oxidative damage protecting nerve health
Promotes the formation of new vasculature after vascular injury
Increases free testosterone in the blood
Increases both memory and concentration by increasing acetylcholine levels
- Promising evidence of function as a penile rehabilitation agent as a neurotrophic (30, 31)
Getting In The Flow
Andropause and The Hormonal Male
It is no secret that like women, men experience a significant decrease in hormone levels as they age. Unlike women, however, the decrease in testosterone for men is more gradual. Symptoms of andropause include but are not limited to mood swings, irritability, muscle loss, gynecomastia (breast development), insomnia, lowered libido, erectile dysfunction, poor sexual performance and decreasing bone quality.
Supporting healthy hormone levels includes supplying the body with enough stimulus to support the synthesis of hormones. The single most important backbone to supply to maintain healthy hormone levels is Vitamin D3 (8). Ask your naturopath about the maximum safe dose of vitamin D for you if you are a male 40 years or older. Having enough vitamin D in your body can significantly increase your body's capacity at synthesizing hormones.
Importance of Fitness for Men
Male Hormonal Support
Nature Loves Balance
Men and women too, usually like to go into overdrive. There is this idea that if a little bit of something is good for you then a ton of it is a ton better. Nature on the other hand, thrives on balancing and maintaining the scale. Botanicals like tribulus are amazing at doing just that, maintaining the balance of testosterone. Tribulus terrestris unlike other botanicals, is not a stimulant, it is a modulator of testosterone levels. It maintains testosterone to levels that are most supportive of optimal health.
Mental Health: Being in the Mood
The Male Specific 'Refractory Period'
The refractory period is a phenomenon that only men experience. It acts as protective mechanism as males expend a lot of energy with every sexual encounter. Thus, the body saves itself from exhaustion by leaving a period after sexual activity where the neurons are no longer receptive to stimulation. Females do not experience the same refractory period, but they also expend much less energy per sexual encounter, making them less likely to deplete body resources with repeated sexual activity (48).
Decreasing the length of the refractory period has a lot to do with the body feeling rejuvenated enough to fulfil the physical demands of a possible sexual encounter. Replenishing the body with protein and nutrients may decrease recovery time. Greens and a broken protein supplement like Best Start may help the body by providing the much-needed, promptly available fuel. Other natural, quick sources of fuel like honey, royal jelly, pine pollen and bee pollen may also help rejuvenate the body and make recovery easier.
What Should A Man Look for in A Sexual Enhancement Supplement?
Find Out if A Sexual Enhancement Supplement is Actually Working
The Male Sexual Quotient (MSQ) is a simple, short questionnaire that is designed to help men gain a good insight into their sexual health. Both, the aspect of male sexual function and satisfaction are taken into account in the questionnaire. The questionnaire can be used to track sexual health for both personal as well as medical purposes. It was of great benefit to share the results of the questionnaire with your healthcare provider.
Never Give Into Shame
Studies demonstrate that roughly 3 million Canadian men over the age of 40 suffer erectile dysfunction. Failing to sustain an erection is an experience that every man will experience at some point or the other. It is important to have enough self-compassion to bypass any shame or embarrassment and talk to a healthcare provider. Taking a critical, healthy look at male sexual health may pave a satisfying way to long-term physical and mental health. On the other hand, every step a man takes towards his physical health, in one way or the other, is going to enhance his sex life and benefit his mental health. Supporting the body with a balanced, safe, healthy sexual enhancement supplement may prove to be beneficial to many other dimensions of life.
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