The Truth About Male and Female Sexual Dysfunction

No one ever counted themselves lucky to have erectile dysfunction—but maybe they should. Because having erectile dysfunction might just save your life.

Erectile dysfunction (ED) is one of the earliest symptoms of coronary artery disease—showing up as a warning sign up to three years before a heart attack or stroke.¹

According to the Centers for Disease Control and Prevention, coronary artery disease kills more than 385,000 people every year.² And one shocking study reported that men with erectile dysfunction have 8-times the risk of heart failure over about a 2.5 year follow-up period than men without this problem!³

In addition to heart failure, sexual dysfunction can also indicate other serious, underlying disease factors—including neurological damage, diabetes, multiple sclerosis, and more.^4-13

Conventional drug options generally treat the symptoms of sexual dysfunction—without improving the underlying causes that can lead to serious disease.^14,15

The good news is that there are proven and safe natural therapies that reverse the root causes of sexual dysfunction for both men and women—reducing your risk of heart disease and increasing your life span in the process.

Sexual Dysfunction Is Not a Disease

 

If you judge by drug advertisements, you’d never guess that male sexual dysfunction is frequently the result of underlying health issues. These include vascular problems, prostatic disease, neurological damage, diabetes, metabolic syndrome, obesity, multiple sclerosis, and even medication side effects.^3,6,8-13

Similarly—although studies of sexual dysfunction in women have lagged behind those in men¹⁶—female sexual dysfunction has also been found to be a common result of diabetes, urinary incontinence, cancer, medical or surgical treatments, and other biological factors.^5,7,13,17

One sexual symptom commonly associated with aging—decreased libido—is now clearly tied with poor physical health in males and females—and not necessarily with age itself.^16,18,19

Many people don’t seek treatment for sexual dysfunction.²⁰ And those who do seek treatment are often prescribed drug treatments for specific sexual symptoms—without any investigation into potential underlying cofactors.

The main reason for this is that, increasingly, sexual complaints are labeled as drug-treatable “diseases” in themselves—discouraging mainstream doctors from pursuing any deeper investigation into the patient’s health.¹⁵

Why Mainstream Solutions Don’t Work

Coronary artery disease strikes epidemic numbers of aging humans. Erectile dysfunction can be one of the earliest symptoms of heart disease.¹ Reduced libido and loss of fertility are also potential predictors of vascular disease.²¹

Unaware of these links, many aging men turn to drug prescriptions—such as Viagra^®, Cialis^®, or Levitra^®—to treat sexual symptoms. These drugs work by relaxing the smooth muscles that line the arteries, thus increasing blood flow into arteries that supply the penis.

But these drugs work for only about half of erectile dysfunction patients, their effect is only temporary (although they can cost as much as $15 a pill),¹¹ and their side effects can range from indigestion,²² flushing,²³ visual disturbances,^24-26 hearing loss,^27,28 and headache^29,30 to more serious health problems, such as neurologic disorders³¹ and heart attack.³²

Above all, these medications do not treat the underlying cause of erectile dysfunction, heart disease, and peripheral artery disease: chronic endothelial dysfunction.

But you don’t have to rely on costly, dangerous, and often ineffective prescription drugs that only treat the symptom (erectile dysfunction) of a much larger health threat (coronary artery disease). Innovative scientists have determined three natural ingredients enhance endothelial function, and as a result simultaneously improve sexual capability and protect against heart attack and stroke.

Published research reveals how the interaction of these three natural ingredients tackles male sexual dysfunction from multiple angles.

How to Reverse Male Sexual Dysfunction

Healthy endothelial cells release nitric oxide synthase, an enzyme that catalyzes production of the chemical compound nitric oxide from the amino acid L-arginine. Nitric oxide triggers relaxation of the smooth muscle in the arteries of the penis, providing the adequate blood flow necessary to support an erection. However, dysfunctional endothelial cells, disabled by plaque buildup, can no longer produce enough nitric oxide synthase.³³

Fortunately, scientists have had remarkable success treating male sexual dysfunction with a nutrient blend that targets the underlying mechanisms of erectile dysfunction. This formulation includes:

• Pycnogenol^® , a French maritime pine bark extract
• L-arginine aspartate, an amino acid chelate, and
• Icariin, a flavonoid compound used in Chinese herbal medicine.

Pycnogenol^® and L-arginine aspartate work together to stimulate nitric oxide synthase, yielding sufficient bioactive nitric oxide to produce and maintain an erection.³⁴

Icariin further supports the ability to maintain an erection by blocking phosphodiesterase-5 (PDE5)—the enzyme responsible for causing erections to subside.³⁵ This enzyme-blocking effect mimics the primary mechanism of Viagra^®—although Viagra^® delivers no other benefit.

Human trials have clearly demonstrated that this nutrient blend produces a broad array of clinically proven health effects including:

• Normal erectile function^34,36,37
• Enhanced sperm quality and quantity^38-40
• Increased male fertility³⁹
• Higher sexual interest⁴¹ and greater intercourse frequency ³⁴
• Enhanced sexual performance⁴¹
• Lowered blood cholesterol levels³⁴ and
• Reduced blood pressure.^34,36

This combination may provide additional health benefits, because stimulation of nitric oxide is also known to:

• Act as a neurotransmitter that is involved in long-term memory^42-44
• Modulate the release of neurotransmitters⁴⁵
• Promote a healthy immune system⁴⁶ and
• Play a critical role in blood clotting through its modulation of vascular tone, coagulation, and fibrinolysis.⁴⁷

What You Need to Know

The Truth About Sexual Dysfunction

• Commonly afflicting both men and women, sexual dysfunction frequently signifies underlying disease factors such as cardiovascular, neurological, metabolic, and other disease pathways.
• Men with erectile dysfunction have an 8-fold greater risk of heart failure.
• For men, drug options do not treat the underlying physiological causes of sexual dysfunction. And for women, there simply are no available drug options (except for hormone replacement).
• Researchers have identified several new natural compounds that regulate the multiple underlying pathways, reversing the root causes of sexual dysfunction for both men and women—which can also help prevent chronic, age-related diseases for which sexual problems can be a warning.
• Pycnogenol®, L-arginine aspartate, and icariin have been demonstrated to safely and naturally treat male sexual dysfunction.
• Similarly, Cordyceps sinensis, maca (Lepidium meyenii), and EstroG-100^TM have been shown to provide safe treatments for female sexual dysfunction, and for menopausal symptoms.

Proven Results in Clinical Trials on Men

Multiple human studies have shown that supplementing with the components of this natural combination restores male sexual function,^34,37-41 reverses low male fertility,^38,40 and can even double the frequency of sex.³⁴

In one study, patients aged 25 to 45 who were suffering from erectile dysfunction were treated for three months with arginyl aspartate (which provided the equivalent of 1.7 grams per day of L-arginine). After one month, only 5% of patients experienced normal erections. But during the second month, 80 milligrams daily of Pycnogenol^® was added to the arginine regimen, at the end of which a significant 80% of patients were experiencing normal erections. During the third month, the Pycnogenol^® dose was increased to 120 milligrams daily, at the end of which a compelling 92.5% of all participants achieved normal erectile function!³⁷

Another clinical trial examined the effect of treatment with these two compounds on 50 middle-aged men with low testosterone levels who were suffering from erectile dysfunction and poor fertility (due to impaired sperm motility and morphology). The patients took 3 grams of L-arginine aspartate, 120 milligrams of Pycnogenol^®, and 120 milligrams of testosterone undecanoate daily. By the 11-month mark, 76% of the men had achieved normal sexual function—and after 12 months, sperm quality and quantity had improved to such a point that an astounding 40% (20 out of 50 patients) had achieved fertilization.³⁹

Other clinical studies further confirmed the ability of Pycnogenol^® and L-arginine aspartate to restore erectile function,³⁴ reverse low male fertility values by improving sperm quality ^38,40 and semen volume,³⁸ and double intercourse frequency.³⁴

Icariin (or Yin Yang Huo)—a flavonoid compound extracted from plants in the Epimedium family—is the third ingredient of this trifecta based on its ability to block the action of PDE5, the enzyme that causes erections to subside.^35,48-50

In human endothelial cell culture studies, as well as in animal models, icariin has been shown to enhance the production of nitric oxide.^51-53 Additionally, scientists have noted that icariin behaves similarly to testosterone—a significant feature, since testosterone is crucial for healthy sexual function.⁵⁴ Animal research has shown that administration of Epimedium extracts improves erectile function in aged rats.⁵⁵ Together, these multiple mechanisms of action suggest that icariin can help maintain healthy erectile function.

Potent Formula Reverses Female Sexual Dysfunction

 

We don’t hear much about female sexual dysfunction—mainly because there are limited guidelines pertaining to the diagnosis and treatment of the condition.⁵⁶ In reality, loss of libido and other forms of sexual dysfunction plague more women than men—and sadly, 40% of affected women do not seek help from a physician.⁵⁷ It wouldn’t help much if they did, because mainstream doctors have limited protocol options (other than possibly hormone replacement) for this common condition.⁵⁶

Female sexual dysfunction involves the disruption of multiple physiological mechanisms—and modern medicine has no consistently safe and effective treatment that targets these various, underlying pathways.

It’s important to note the difference between disinterest and dysfunction. Preferring at times not to engage in sexual activity does not indicate a woman has female sexual dysfunction. Disinterest, or even occasional dysfunction, can be a normal response to a variety of life situations. However, many women are frustrated and depressed by complaints that include decreased libido (low desire or arousal), anorgasmia (inability to achieve orgasm), dyspareunia (painful intercourse),and urogenital atrophy (vaginal itching, soreness, dryness, and pain).⁵⁸

Fortunately, recent scientific discoveries have found a solution—and it doesn’t involve taking a single prescription drug. Female sexual dysfunction can be traced to six underlying pathways that—if simultaneously regulated—result in a reversal of the full range of symptoms!

Research scientists narrowed down an extensive search of natural plants to three complementary botanical-based compounds:

• Cordyceps sinensis extract
• Lepidium meyenii (maca) extract
• EstroG-100 ^TM three-extract blend

The combined effects of Cordyceps sinensis and maca modulate all six diverse, underlying biochemical mechanisms—restoring a woman’s normal sexual desire and function.

Also, the blend of three unique extracts known as EstroG-100^TM modulates the hormonal activity behind menopausal symptoms—which are frequently the trigger for female sexual dysfunction.

Proven Results in Clinical Trials on Women

Cordyceps sinensis

Scientists have found that the active substances in the medicinal mushroom Cordyceps sinensis were able to improve female sexual dysfunction in just 40 days!

In a double-blind, placebo-controlled study, scientists tested the Cs-4 strain of Cordyceps on elderly female patients suffering from sexual dysfunction. The test group took Cordyceps Cs-4 in dosages that translate to 375 milligrams of commercially prepared product (because it is formulated as an 8:1 extract). Up to 86% of the women in the Cs-4 group significantly improved both hyposexuality signs and symptoms—in only 40 days!⁵⁹

The pharmacologically active substances in extract of Cordyceps sinensis—derived from the Cs-4 strain of this medicinal mushroom—were found to act along 5 of 6 distinct pathways of female sexual dysfunction to:

• Balance levels of estrogen and testosterone by modulating the hypothalamus-pituitary axis (HPA)⁵⁹
• Promote the downstream flow of sex hormones by optimizing adrenal function^59,60
• Increase energy levels and sexual interest by supporting mitochondrial function ^59,61
• Promote normal vaginal lubrication and sexual function by boosting antioxidant action and inhibiting the destruction of nitric oxide, ^60,62 and
• Moderate inflammation by controlling levels of pro-inflammatory cytokines, thus blocking their dampening effect on sexual desire and activity.^63,64

Maca

Studies show that an extract of Lepidium peruvianum, a high-altitude root plant popularly known as maca , can improve female sexual dysfunction in as little as six weeks!⁶⁵

In a double-blind, placebo-controlled study, postmenopausal women were given either placebo or powdered maca that translates to 583 to 875 milligrams a day of product (because it is formulated as a 4-6:1 extract).⁶⁵ Measured on a standard sexual dysfunction scale, the participants who took maca scored more than 34% lower (meaning better) than placebo subjects. They also tested 30% lower (meaning better) on a subscale of anxiety and depression symptoms—a substantial improvement in just six weeks!⁶⁵

Maca works by providing the optimum balance of nutrients utilized by the body’s neuroendocrine system.⁶⁶ Evidence shows that this allows maca to regulate 3 of 6 different pathways of female sexual dysfunction—two of those also regulated by Cordyceps plus one other. Maca can:

• Modulate the hypothalamus-pituitary axis (HPA)^65,67
• Regulate adrenal function,^65,68and
• Optimize levels of brain neurotransmitters—in turn reducing the risk of decreased libido, depression, and sexual dysfunction. ^65,69

EstroG-100™

The third compound contains three plant extracts: Phlomis umbrosa, Cynanchum wilfordii, and Angelica gigas Nakai (Korean Angelica).

When blended in correct proportions within a single formulation known as EstroG-100 ^TM, these extracts naturally and selectively regulate estrogenic activity (enhancing activity in some tissue while inhibiting it in other tissue). This in turn prevents many of the symptoms of menopause—including female sexual dysfunction.⁷⁰

Scientists conducted a double-blind, placebo-controlled study of 64 women with moderate or severe menopausal symptoms. The test group was given 257 milligrams of the EstroG-100™ blend twice daily.

As a result, the average Kupperman Menopausal Index score (a measure of menopausal symptoms) decreased by 62% in the EstroG-100™ group, but only by 19% in the placebo group. And the average vaginal dryness score decreased by 59% in the treatment group versus just 27% among placebo subjects.⁷⁰

These substantial menopausal and sexual improvements resulted after only 12 weeks—without weight gain or other negative effects! ⁷⁰

Treat the Sexual Side Effects of Antidepressants

Adverse sexual effects—which can include loss of sexual drive, failure to reach orgasm, and erectile dysfunction—are among the most common negative effects of taking antidepressants.^71,72 Men are more often affected by these sexual side effects, but women report more serious sexual symptoms. ⁷²

To offset antidepressant-related sexual dysfunction, doctors often prescribe additional medications.^73-75 But these added drugs bring their own adverse reactions⁷⁶—and some even reverse the mood benefit of the antidepressants!⁷⁷

Fortunately, a natural extract has been shown to treat sexual dysfunction—in both men and women—when it is a side effect of taking antidepressant drugs.

Scientists tested an extract of saffron on men who were experiencing sexual dysfunction as a result of their prescription antidepressant. ⁷⁶

In a double-blind trial, researchers enlisted 36 married men whose symptoms of major depressive disorder had been successfully stabilized on Prozac^® (fluoxetine)—but who had complaints of sexual impairment. They were randomly assigned to add to their usual dosages of Prozac^®, 2 daily doses of either 15 milligrams of saffron or a placebo. Sexual function was assessed using a standard index.⁷⁶

After just 4 weeks, the men in the Prozac^®-plus-saffron group had experienced significantly greater improvement in erectile function and intercourse satisfaction than in the Prozac^®-plus-placebo group. The team determined that saffron is a “tolerable and efficacious treatment” for male sexual dysfunction induced by Prozac^®.⁷⁶

Next, scientists set out to determine if saffron could similarly offset the unwanted sexual effects experienced by women taking a prescription antidepressant. ⁷⁸

A team enlisted 38 women, all of whom had major depression that had been stabilized on Prozac^®—but who suffered from various types of sexual dysfunction induced by this antidepressant. In the double-blind study, half of the women were randomly assigned a supplement of 30 milligrams daily of saffron extract while the rest took a placebo. All participants continued to take their usual dosage of Prozac^®, and assessments were made using the Female Sexual Function Index (FSFI).⁷⁸

After 4 weeks—despite still taking the same antidepressant that had induced the unwanted sexual symptoms in the first place—women in the saffron group experienced significant improvement in total sexual function, arousal, lubrication, and pain.⁷⁸

Summary

Male and female sexual dysfunction is often an indicator of underlying disease factors—including cardiovascular, neurological, metabolic, and other disease pathways. Drug options for men generally provide only short-term relief from sexual dysfunction symptoms—but do not address the underlying physiological cause that can lead to serious disease. And women simply have no available drug options (other than hormone replacement).

Fortunately, scientists have identified several natural compounds—for both men and women—that reverse the root causes of sexual dysfunction. Proper use of these nutrients can help prevent age-related disorders for which sexual dysfunction is often an early warning sign.

In double-blind, placebo-controlled studies, Pycnogenol^®,L-arginine aspartate, and icariin have been shown to safely and naturally treat male sexual dysfunction.

Similarly, Cordyceps sinensis, maca (Lepidium meyenii), and EstroG-100^TM (a three-extract blend) have been scientifically validated in placebo-controlled trials to safely treat female sexual dysfunction and to alleviate the menopausal symptoms that can trigger it.

If you have any questions on the scientific content of this article, please call a Life Extension^® Health Advisor at 1-866-864-3027.

References

1. Jackson G. Prevention of cardiovascular disease by the early identification of erectile dysfunction. Int J Impot Res. 2008 Dec;20 Suppl 2:S9-14.
2. Available at: http://www.cdc.gov/heartdisease/facts.htm. Accessed May 20, 2013.
3. Banks E, Joshy G, Abhayaratna WP, et al. Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: A prospective cohort study. PLoS Med. 2013;10(1):e1001372.
4. Berman JR. Physiology of female sexual function and dysfunction. Int J Impot Res. 2005;17 Suppl 1:S44-51.
5. Butler RN, Lewis MI, Hoffman E, Whitehead ED. Love and sex after 60: how to evaluate and treat the sexually-active woman. Geriatrics. 1994;49:33-4,37-8,41-2.
6. Fode M, Krogh-Jespersen S, Brackett NL, Ohl DA, Lynne CM, Sønksen J. Male sexual dysfunction and infertility associated with neurological disorders. Asian J Androl. 2012 Jan;14(1):61-8.
7. Cortelazzi D, Marconi A, Guazzi M, et al. Sexual dysfunction in pre-menopausal diabetic women: clinical, metabolic, psychological, cardiovascular, and neurophysiologic correlates. Acta Diabetol. 2013 May 16. [Epub ahead of print]
8. Diaz-Arjonilla M, Schwarcz M, Swerdloff RS, Wang C. Obesity, low testosterone levels and erectile dysfunction. Int J Impot Res. 2009 Mar-Apr;21(2):89-98
9. Mehraban D, Naderi GH, Yahyazadeh SR, Amirchaghmaghi M. Sexual dysfunction in aging men with lower urinary tract symptoms. Urol J. 2008 Fall;5(4):260-4.
10. Gregorian RS, Golden KA, Bahce A, Goodman C, Kwong WJ, Khan ZM. Antidepressant-induced sexual dysfunction. Ann Pharmacother. 2002;36:1577-89.
11. Available at: http://query.nytimes.com/gst/fullpage.html?res=9901e5db163ef93aa1575bc0a96f9c8b63. Accessed May 21, 2013.
12. Bargiota A, Dimitropoulos K, Tzortzis V, Koukoulis GN. Sexual dysfunction in diabetic women. Hormones (Athens). 2011 Jul-Sep;10(3):196-206.
13. Nowosielski K, Drosdzol A, Sipiński A, Kowalczyk R, Skrzypulec V. Diabetes mellitus and sexuality--does it really matter? J Sex Med. 2010 Feb;7(2 Pt 1):723-35.
14. Banks E, Joshy G, Abhayaratna WP, et al. Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: A prospective cohort study. PLoS Med. 2013;10(1):e1001372.
15. Moynihan R. The making of a disease: female sexual dysfunction. BMJ 2003;326:45.
16. Lindau ST, Gavrilova N. Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing. BMJ. 2010 Mar 9;340:c810.
17. Laumann EO, Nicolosi A, Glasser DB, et al. Sexual problems among women and men aged 40-80y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res. 2005;17:39-57.
18. Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007 Aug 23;357(8):762-74.
19. Gott M, Hinchliff S. How important is sex in later life? The views of older people. Soc Sci Med. 2003 Apr;56(8):1617-28.
20. Baldwin K, Ginsberg P, Harkaway RC. Under-reporting of erectile dysfunction among men with unrelated urologic conditions. Int J Impot Res. 2003;15:87-9.
21. Montorsi F, Salonia A, Deho F, Briganti A, Rigatti P. The ageing male and erectile dysfunction. World J Urol. 2002 May;20(1):28-35.
22. Lim PH, Moorthy P, Benton KG. The clinical safety of viagra. Ann N Y Acad Sci. 2002 May;962:378-88.
23. Blonde L. Sildenafil citrate for erectile dysfunction in men with diabetes and cardiovascular risk factors: a retrospective analysis of pooled data from placebo-controlled trials. Curr Med Res Opin. 2006 Nov;22(11):2111-20.
24. Laties AM. Vision disorders and phosphodiesterase type 5 inhibitors: a review of the evidence to date. Drug Saf. 2009;32(1):1-18.
25. Santaella RM, Fraunfelder FW. Ocular adverse effects associated with systemic medications: recognition and management. Drugs. 2007;67(1):75-93.
26. Bella AJ, Brant WO, Lue TF, Brock GB. Non-arteritic anterior ischemic optic neuropathy (NAION) and phosphodiesterase type-5 inhibitors. Can J Urol . 2006 Oct;13(5):3233-8.
27. Mukherjee B, Shivakumar T. A case of sensorineural deafness following ingestion of sildenafil. J Laryngol Otol. 2007 Apr;121(4):395-7.
28. Hong BN, Yi TH, Kim SY, Kang TH. High dosage sildenafil induces hearing impairment in mice. Biol Pharm Bull. 2008 Oct;31(10):1981-4.
29. Choi HK, Ahn TY, Kim JJ, et al. A double-blind, randomised- placebo, controlled, parallel group, multicentre, flexible-dose escalation study to assess the efficacy and safety of sildenafil administered as required to male outpatients with erectile dysfunction in Korea. Int J Impot Res. 2003 Apr;15(2):80-6.
30. Kruuse C, Thomsen LL, Birk S, Olesen J. Migraine can be induced by sildenafil without changes in middle cerebral artery diameter. Brain. 2003 Jan;126(Pt 1):241-7.
31. Farooq MU, Naravetla B, Moore PW, Majid A, Gupta R, Kassab MY. Role of sildenafil in neurological disorders. Clin Neuropharmacol. 2008 Nov;31(6):353-62.
32. Kekilli M, Beyazit Y, Purnak T, Dogan S, Atalar E. Acute myocardial infarction after sildenafil citrate ingestion. Ann Pharmacother. 2005 Jul;39(7-8):1362-4.
33. Huang PL. eNOS, metabolic syndrome and cardiovascular disease. Trends Endocrinol Metab. 2009 Aug;20(6):295-302.
34. Stanislavov R, Nikolova V, Rohdewald P. Improvement of erectile function with Prelox: a randomized, double-blind, placebo-controlled, crossover trial. Int J Impot Res. 2008 Mar;20(2):173-80.
35. Ning H, Xin ZC, Lin G, Banie L, Lue TF, Lin CS. Effects of icariin on phosphodiesterase-5 activity in vitro and cyclic guanosine monophosphate level in cavernous smooth muscle cells. Urology. 2006 Dec;68(6):1350-4.
36. Aoki H, Nagao J, Ueda T, et al. Clinical assessment of a supplement of Pycnogenol^® and L-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother Res. 2012 Feb;26(2):204-7.
37. Stanislavov R, Nikolova V. Treatment of erectile dysfunction with pycnogenol and L-arginine. J Sex Marital Ther. 2003 May;29(3):207-13.
38. Stanislavov R, Nikolova V, Rohdewald P. Improvement of seminal parameters with Prelox: a randomized, double-blind, placebo-controlled, cross-over trial. Phytother Res. 2009 Mar;23(3):297-302.
39. (EBDR) European Bulletin of Drug Research. 2005;13(1):7-13.
40. Nikolova V, Stanislavov R, Vatev I, Nalbanski B, Pŭnevska M. Sperm parameters in male idiopathic infertility after treatment with prelox. Akush Ginekol (Sofiia). 2007;46(5):7-12.
41. Lamm S, Prelox^® for improvement of erectile quality, European Endocrinology. 2009;5(1):70–4.
42. Schuman EM, Madison DV. A requirement for the intercellular messenger nitric oxide in long-term potentiation. Science. 1991 Dec 6;254(5037):1503-6.
43. Jacoby S, Sims RE, Hartell NA. Nitric oxide is required for the induction and heterosynaptic spread of long-term potentiation in rat cerebellar slices. J Physiol. 2001 Sep 15;535(Pt 3):825-39.
44. Hawkins RD, Son H, Arancio O. Nitric oxide as a retrograde messenger during long-term potentiation in hippocampus. Prog Brain Res. 1998;118:155-72.
45. Prast H, Philippu A. Nitric oxide as modulator of neuronal function. Prog Neurobiol. 2001 May;64(1):51-68.
46. Nussler AK, Billiar TR. Inflammation, immunoregulation, and inducible nitric oxide synthase. J Leukoc Biol. 1993 Aug;54(2):171-8.
47. Corseaux D, Ollivier V, Fontaine V, et al. Hemostasis imbalance in experimental hypertension. Mol Med. 2002 Apr;8(4):169-78.
48. Jiang Z, Hu B, Wang J, et al. Effect of icariin on cyclic GMP levels and on the mRNA expression of cGMP-binding cGMP-specific phosphodiesterase (PDE5) in penile cavernosum. J Huazhong Univ Sci Technolog Med Sci. 2006;26(4):460-2.
49. Xin ZC, Kim EK, Lin CS, et al. Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities. Asian J Androl. 2003 Mar;5(1):15-8.
50. Dell’Agli M, Galli GV, Dal Cero E, et al. Potent inhibition of human phosphodiesterase-5 by icariin derivatives. J Nat Prod. 2008 Sep;71(9):1513-7.
51. Xu HB, Huang ZQ. Icariin enhances endothelial nitric-oxide synthase expression on human endothelial cells in vitro. Vascul Pharmacol. 2007 Jul;47(1):18-24.
52. Tian L, Xin ZC, Liu WJ, et al. Effects of icariin on the erectile function and expression of nitrogen oxide synthase isoforms in corpus cavernosum of arterigenic erectile dysfunction rat model. Zhonghua Yi Xue Za Zhi. 2004 Jun 2;84(11):954-7.
53. Liu WJ, Xin ZC, Xin H, Yuan YM, Tian L, Guo YL. Effects of icariin on erectile function and expression of nitric oxide synthase isoforms in castrated rats. Asian J Androl. 2005 Dec;7(4):381-8.
54. Zhang ZB, Yang QT. The testosterone mimetic properties of icariin. Asian J Androl. 2006 Sep;8(5):601-5.
55. Makarova MN, Pozharitskaya ON, Shikov AN, Tesakova SV, Makarov VG, Tikhonov VP. Effect of lipid-based suspension of Epimedium koreanum Nakai extract on sexual behavior in rats. J Ethnopharmacol. 2007 Dec 3;114(3):412-6.
56. Basson R, Althof S, Davis S, et al. Summary of the recommendations on sexual dysfunctions in women. J Sex Med. 2004 Jul;1(1):24-34.
57. Berman L, Berman J, Felder S, et al. Seeking help for sexual function complaints: what gynecologists need to know about the female patient’s experience. Fertil Steril. 2003 Mar;79(3):572-6.
58. Simon JA. Identifying and treating sexual dysfunction in postmenopausal women: the role of estrogen. J Womens Health (Larchmt). 2011 Oct;20(10):1453-65.
59. Zhu J-S, Halpern GM, Jones K. The scientific rediscovery of an ancient Chinese herbal medicine: Cordyceps sinensis parti. J Alt Complement Med. 1998;4(3):289-303.
60. Wan F, Guo Y, Deng X. Sex hormone-like effects of JinShuiBao capsule: Pharmacological and clinical studies. Chinese Trad Pat Med. 1988;9:29-31.
61. Manabe N, Sugimoto M, Azume Y, et al. Effects of the mycelial extract of cultured Cordyceps sinensis on in vivo hepatic energy metabolism in the mouse. Jpn J Pharmacol. 1996;70:85-8.
62. Wang Y, Wang M, Ling Y, Fan W, Wang Y, Yin H. Structural determination and antioxidant activity of a polysaccharide from the fruiting bodies of cultured Cordyceps sinensis. Am J Chin Med. 2009;37(5):977-89.
63. Liu Z, Li P, Zhao D, Tang H, Guo J. Anti-inflammation effects of cordyceps sinensis mycelium in focal cerebral ischemic injury rats. Inflammation. 2011;34(6):639-44.
64. Chiou YL, Lin CY. The extract of Cordyceps sinensis inhibited airway inflammation by blocking NF-κB activity. Inflammation. 2012 Jun;35(3):985-93.
65. Brooks NA, Wilcox G, Walker KZ, Ashton JF, Cox MB, Stojanovska L. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content. Menopause. 2008 Nov-Dec;15(6):1157-62.
66. Piacente S, Carbone V, Plaza A, Zampelli A, Pizza C. Investigation of the tuber constituents of maca (Lepidium meyenii Walp.). J Agricul Food Chem. 2002;50(20):5621–5.
67. Gonzales GF, Córdova A, Vega K, Chung A, Villena A, Góñez C. Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men. J Endocrinol. 2003 Jan;176(1):163-8.
68. Gonzales GF. Ethnobiology and ethnopharmacology of Lepidium meyenii (Maca), a plant from the Peruvian Highlands. Evid Based Complement Alternat Med. 2012;2012:193496. Epub 2011 Oct 2.
69. Dording CM, Fisher L, Papakostas G, et al. A double-blind, randomized, pilot dose-finding study of maca root (L. meyenii) for the management of SSRI-induced sexual dysfunction. CNS Neurosci Ther. 2008 Fall;14(3):182-91.
70. Chang A, Kwak B-Y, Yi K, Kim JS. The effect of herbal extract (EstroG-100) on pre-, peri- and post-menopausal women: a randomized double-blind, placebo-controlled study. Phtyother Res. 2012 Apr;26(4):510-6.
71. Csoka A, Bahrick A, Mehtonen O-P. Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors. J Sex Med. 2008;5:227-33.
72. Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry. 2001;62 Suppl 3:10-21.
73. Landen M, Eriksson E, Agren H, Fahlen T. Effect of buspirone on sexual dysfunction in depressed patients treated with selective serotonin reuptake inhibitors. J Clin Psychopharmacol. 1999; 19(3):268-71.
74. Gupta S, Droney T, Masand P, Ashton AK. SSRI-induced sexual dysfunction treated with sildenafil. Depress Anxiety. 1999;9(4):180-2.
75. Aizenberg D, Zemishlany Z, Weizman A. Cyproheptadine treatment of sexual dysfunction induced by serotonin reuptake inhibitors. Clin Neuropharmacol , 1995;18(4):320-4.
76. Modabbernia A, Sohrabi H, Nasehi AA, et al. Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial. Psychopharmacology (Berl). 2012;223(4):381-8.
77. Feder R. Reversal of antidepressant activity of fluoxetine by cyproheptadine in three patients. J Clin Psychiatry. 1991;52(4):163-4.
78. Kashani L, Raisi F, Saroukhani S, et al. Saffron for treatment of fluoxetine-induced sexual dysfunction in women: randomized double-blind placebo-controlled study. Hum Psychopharmacol. 2013 Jan;28(1):54-60.