Nitric Oxide and Erectile Dysfunction!

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If you watch any TV then you’re most likely familiar with the Cialis and Viagra commercials targeted toward men with erectile dysfunction.  Nitric Oxide research played a critical role in the development of these two products.  But the importance of Nitric Oxide goes beyond male sexual health since erectile dysfunction now points to an underlining cardiovascular issue. 

For example I went to my doctor for my annual checkup.  He asked me if I was having any erection problems.  I’m not going to reveal my answer but I asked him why he wanted to know.  His answer had nothing to do with poor sexual health.  The reason why he asked that question is because erectile dysfunction (ED) is an early warning sign for diabetes and/or circulatory problems. 

Important Statistics!

It’s estimated that erectile dysfunction affects 50% of the male population over age 40!  According to the Endocrine Society, 10% men in their sixties have a chronic ED problem which increases to 25% of men in their seventies and jumps to 40% of men in their eighties.  When I read these statistics I thought they might be on the high side.  That was until another piece of information came to my attention.

Google lists over 17 million web pages that incorporate the word “Viagra.”  That compares to 3.3 million web pages for the word “aspirin” and 936,000 web pages for the word “Tylenol.”  There are a lot of people (I suspect mainly men) who are looking for information on Viagra and what it can do for them.  If my doctor is correct that ED is an early warning sign for diabetes and cardiovascular disease, then there’s an even more important issue that needs addressing than performance in the bedroom.  More and more research is showing that ED is really a function of poor cardiovascular health.

How Viagra Works!

The development of Viagra is a fascinating study.  It incorporates male physiology, chemistry, and the nervous system all working together to create an erection.  It also provides keys to slowing down the aging process and improving cardiovascular health. 

Since Viagra is designed to help males achieve an erection we need to talk a little anatomy.  In its simplest terms, an erection is the change in position of the male sex organ from a limp position to a firm, hard and upright position.  When you want to move any part of your body you use muscles.  This doesn’t work for the male organ since skeletal muscles are not involved in an erection.  It’s all done by pressure.  More specifically blood pressure.

The male organ contains two cigar-shaped structures called corpora cavernosa that run the length of the organ.  Arteries bring blood into these two structures with veins carrying the blood away from them.  In a non-erect state, the blood flow from the arteries is restricted while the veins are open to drain the blood away.  When a man becomes aroused, the arterial blood vessels open up so that pressurized blood can enter the corpora cavernosa.  The veins leaving the male organ are constricted.  This action traps the pressurized blood allowing for the size increase and full erection.

First Clue to ED!

If the arterial blood vessels supplying the male organ do not open properly, it’s almost impossible for a male to have an erection.  This is the leading cause of erectile dysfunction.  Prior to 1983, most doctors thought the problem of poor sexual health was primarily mental not physical.  That was until the 1983 meeting of the American Urological Association in Las Vegas.  At that meeting Dr. Giles Brindley injected his male organ with the drug phentolamine.  The result was an instant erection.  And to prove his point, Dr. Brindley dropped his pants to display his drug-induced erection.  Needless to say not everything done in Las Vegas stays in Las Vegas.

Dr. Brindley’s bold presentation showed that an erection was a physiological issue more than a mental issue.  To understand what happened we need to talk about muscles.  Yes, I know I said muscles were not involved.  Technically speaking I’m still going to hold this position.  There are three groups of muscles:

• Skeletal – Skeletal muscles are those muscles that attach to the bones allowing us to move.
• Cardiac – The cardiac muscle powers the heart.
• Smooth – Smooth muscles are found in blood vessels, the intestines and the stomach.  They usually act involuntarily.

Dr. Brindley injected himself with phentolamine.  It’s a drug that relaxes smooth muscle.  Because of the location where he injected himself, the smooth muscles of the arterial blood vessels relaxed allowing the corpora cavernosa to completely fill with pressurized blood.  Instant and uncontrolled erection!

Second Clue to ED!

The second clue to ED centers on the body’s ability to control blood flow.  Without some type of control there would be an even amount of blood flow to most of the body.  This might be OK if we’re vegetables and inactive but we aren’t.  We are constantly on the go so the body has designed a mechanism to help divert blood flow to the areas that need it the most.  Think of your circulatory system as an elaborate design of pipes with valves.  These valves can control both the blood flow as well as divert blood to the areas that need it the most.

This is going to get a bit technical but the control mechanism incorporates the following steps:

1. The brain sends a signal to a particular never fiber.  The nerve fiber ends in a NANC nerve cell located in the artery near the point where blood flow needs to be changed.  This NANC nerve cell creates nitric oxide which is also a dangerous free radical.
2. The NANC nerve cell releases nitric oxide into the blood and surrounding cells.
3. The nitric oxide acts as a signaling molecule to stimulate an enzyme called guanylate cyclase.  This enzyme keeps the nitric oxide from causing free radical damage by using it with GTP to produce a chemical called cyclic guanosine monophosphate (cGMP).
4. cGMP tell the smooth muscles of the arterial blood vessel to relax.  This allows increased blood flow.
5. There is another enzyme called phosphodiesterase (PDE) that deactivates the cGMP by turning it back into GTP.
6. When the cGMP is deactivated, the smooth muscle returns to its original constricted state.

Confused?  Think of a cycle.  Guanylate cyclase turns GTP into cGMP causing smooth muscles to relax.  PDE turns cGMP into GTP causing the smooth muscles to return back to their constricted state.  Nitric oxide turns this cycle on from a nerve impulse generated in the brain.

cGMP is produced as long as the brain is sending signals that initiate the production of nitric oxide.  Nitric oxide is produced as long as there is an adequate supply of the essential amino acid L-arginine and no damage to the surrounding endothelial cells.

Third clue to ED!

The most common reason men suffer from erectile dysfunction is lack of nitric oxide in the blood vessels of the corpora cavernosa.  When a man is aroused his brain does its job by sending the proper signal to the nerves located in his male organ.  The nerves produce nitric oxide.  But the amount of cGMP produced is not enough to maintain an erection since nitric oxide production is limited by damaged endothelial cells and lack of the essential amino acid L-arginine. 

The way Viagra solves this sexual health problem is pretty ingenious.  To increase blood flow to the male organ you have three options:

1. Increase the amount of nitric oxide produced in the arterial blood vessels.
2. Increase the amount of cGMP produced in response to the nitric oxide.
3. Eliminate the PDE that converts cGMP back to GTP so that cGMP builds up.  This causes the smooth muscles of the arterial blood vessels to properly relax and fill with blood.

Viagra uses option 3 to achieve an erection.  Why PDE?  Because there are 11 different kinds of PDE with only one type of PDE found in the male organ.  That type is called PDE5.  Talk about creative design.  All Pfizer had to do was find a chemical that would selectively block PDE5 and nothing else.  This chemical is sildenafil citrate.  Here’s how it works: 

1. A male takes Viagra.
2. The sildenafil citrate is absorbed into the bloodstream and carried throughout the body.
3. The sildenafil citrate attaches to the PDE5 enzyme in the male’s organ to disable it.
4. The male is sexually aroused and the man’s brain does its job.  A signal is sent to the nerve cell in the male’s organ which produces nitric oxide.
5. The nitric oxide turns on the cycle creating cGMP to relax the smooth muscles of the arterial blood vessels.
6. Since the PDE5 is disabled the cGMP doesn’t break down but builds up allowing the arterial blood vessels to fully dilate.
7. The man achieves a full erection.

Great stuff when it works perfectly but there are a few minor problems.

Side Effects of Viagra!

Almost every drug made by man has side effects and Viagra is no exception.  Viagra blocks PDE5 but can also affect PDE6 which is used by the cone cells in the retina.  This can affect color vision.  For some it changes the way they perceive green and blue colors.  For others they see the world with a bluish tinge for several hours.  Because of this pilots cannot take Viagra within 12 hours of a flight.

The other two main side effects are headaches and flushing.  The blocking of the PDE5 can spill over to other areas of the body causing vasodilatation.  This raises the risk for stroke and heart attack.  Because of this Viagra is a prescription drug rather than an over-the-counter drug.  Additionally, you need to be careful not to combine Viagra with nitric oxide producing drugs like nitrates.  Always consult a qualified physician before taking any product like Viagra.  For more information on Viagra I would refer you to an excellent article by Marshal Brain entitled “How Viagra Works.”

A Natural Alternative to Viagra!

I’m not discounting the benefits of Viagra, Cialis and Levitra to help men with erectile dysfunction.  All three, when properly used under the guidance of a qualified physician, have been able to change poor sexual health into good sexual health.  But understand that these drugs are treating a symptom more than the underlining problem.

The underlining problem is the insufficient production of nitric oxide to help start and maintain proper vasodilatation.  The creation of nitric oxide occurs in the endothelial cells that line the blood vessels.  When the endothelial cells are damaged by high blood pressure, high sugar levels, cholesterol, and smoking this decreases nitric oxide production.  That’s why my physician asked me if I was experiencing any erectile problems.  It’s a warning sign for other potential health concerns that could affect your overall wellness and cardiovascular health.

The main nutrient for the creation of nitric oxide is an essential amino acid call L-arginine.  Without going into detail, L-arginine has both a good side and a dark side depending upon how it is brought into your body.  Please see the page “Endothelial Cells” for more details.  

The key to addressing erectile dysfunction is to make sure you’re addressing your cardiovascular system.  Maintain normal blood sugar levels, keep your blood pressure in a normal range, keep your cholesterol under 200 and stop smoking.  By combining this with an adequate intake of L-arginine, many males have found that they don’t need to spend money on Viagra-like products to help them with their sexual health issues. 

One product that I recommend is ProArgi-9 Plus from Synergy WorldWide.  This product has been clinically shown to improve your cardiovascular system, properly bring L-arginine into your body, naturally produce adequate supplies of nitric oxide, and do it without side effects. 

Men, if you want to improve your sexual health then you need to improve your cardiovascular system.  Properly caring for your endothelial cells, so that they can properly produce nitric oxide will solve most erectile dysfunction issues and help to protect you from cardiovascular disease.

Together we can work to save a million lives!

Dan Hammer

The information contained in this blog is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contain in this blogging website has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor.

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