The Search for Natural Products to Support Sexual Health

It’s hard to believe that 20 years have passed since the FDA approved Viagra® to treat erectile dysfunction.

Starting in 1998, this drug class generated a flurry of media headlines, endless TV ads, and lively public discourse about what was a socially repressed topic, i.e., loss of sexual function with age.

Viagra®, Cialis®, and Levitra® work rapidly to enhance penile blood flow through inhibition of an enzyme called phosphodiesterase type 5 (PDE5). This prescription drug class is known as PDE5 inhibitors.

Reduced penile blood flow, though an important aspect of erectile dysfunction, does not address other factors crucial for sexual satisfaction including interest and desire.

In addition, cost and safety are important considerations with prescription drugs of this class.

When Viagra® was launched it cost around $7 per pill. At one time the price rose as high as $65 per pill. Both these prices are outlandish since the active ingredient costs only pennies per pill.

Frightening reports of men experiencing blindness and permanent vision damage after use of these drugs has haunted this drug class for years, though this risk has been persistently downplayed by the pharmaceutical industry lobby.

Price gouging and safety concerns associated with prescription erectile-dysfunction drugs have prompted a search for safer alternatives.

We at Life Extension® found that many “natural” formulas promising immediate, dramatic increases in sexual performance were spiked with either the same drug(s) as Viagra® and Cialis® or very close structural analogs to prescription drugs. This immediately disqualified these products from our consideration.

That’s why we were excited when we recently learned about a ginger-like root that has a long tradition of use in South Asia.^1-3 Published studies show that in contrast to the rapid effects of PDE5 inhibitors on local penile blood flow, taking this natural ingredient over time can result in improvements in erectile function, response time, and intercourse satisfaction in a modest, sustainable, and most importantly, safe fashion.^1,4

Preclinical studies reveal how this plant extract gently supports local blood flow while enhancing brain responses to sexual stimuli.^3,5-9 In other words, this ginger-like root works on both the brain and the body to enhance the sexual experience. Human studies demonstrate noticeable results after about 30 days.^1,4

Due to controversies surrounding sex enhancement products, Life Extension also conducted a small study of the effects of this ginger-like extract in men with age-associated decreases in sexual satisfaction. We wanted to further assess safety and efficacy for this interesting ingredient.

In contrast to rapid vascular effects and potential safety risks associated with potent, prescription erectile-dysfunction drugs, this article reports on data supporting sustainable, modest improvements in age-related changes in sexual satisfaction with use of a ginger-like root extract over time.

It’s a mistake to limit discussion of male sexual dysfunction to localized erectile dysfunction.

Male sexuality is about more than the mechanical aspects of erection. Sexual health includes interest, response, desire, and satisfaction.

Regarding these multiple factors, a ginger-like root extract called Kaempferia parviflora has attracted considerable interest.

Unlike other approaches to erectile dysfunction that focus exclusively upon rapid effects related to localized penile blood flow, this botanical compound appears to stimulate and support sensory and physical responses to erotic stimulation for increased satisfaction.

Human Studies

Two human clinical trials in aging men show that this ginger-like extract improved parameters that indicate enhancement in the overall male sexual experience.^1,4

In the first study, 45 men (average age 65 years) were divided into three groups that received either a placebo, a 25 mg dose of Kaempferia extract, or 90 mg of Kaempferia extract daily for eight weeks.¹

Men taking the 90 mg/day dose had a quicker erectile response time to visual erotic stimuli compared to placebo. The time from stimulus to full erection was cut in half (from about 10 to about 5 minutes).¹

Men in the 25 mg group also had improvements in response time, but these did not achieve statistical significance, indicating that the dose was not high enough.

The supplemented men also experienced improvements in penile circumference (penile girth) over time. The circumference of those taking 90 mg/day rose by as much as 1-1.5 centimeters (about half an inch) in one month—an increase that was largely sustained at two months.

Penile length also increased about a centimeter in both the flaccid and erect state, after one month, compared with placebo.¹

Longtime supporters of Life Extension know the crucial importance of healthy testosterone levels in supporting sexual health, as well as a variety of other aspects of overall health, in aging men. This study revealed no significant changes in testosterone or other sex hormones between the placebo and treated groups, during or after the study.¹ This finding suggests that Kaempferia extract works by mechanisms beyond androgens (male sex hormones).

The researchers speculated that these findings may reflect involvement of the blood-vessel dilator nitric oxide.¹

Endothelial nitric oxide enables arteries to expand and contract with youthful elasticity. With aging, nitric oxide levels decline, setting the stage not only for erectile problems but greater risk of cardiovascular disorders.

Stated simply, an inadequate release of nitric oxide results in constricted blood vessels that obstruct healthy blood flow.¹⁰

Increased Sexual Satisfaction

In a second study completed in 2017, researchers at Life Extension conducted a small open-label (no placebo) clinical study in 13 healthy older men (50-70 years old) who experienced mild dissatisfaction with their sexual health, likely reflecting mild-to-moderate erectile dysfunction associated with aging.⁴

Men in this study took Kaempferia extract standardized to 5% of the active compound, 5,7-dimethoxyflavone (5,7-DMF), at a slightly higher dose of 100 mg.⁴ The active 5,7-DMF compound has been shown in lab studies to be important for Kaempferia’s mechanisms of action.⁶

Outcome measures were based on the men’s reported experiences while taking the supplement, as opposed to physiological measurements.

After 30 days, there was a significant average increase in International Index of Erectile Function scores. This is a validated 15-item questionnaire used to assess the severity of erectile dysfunction.^11,12 Higher scores indicate greater erectile function.

Furthermore, the average score for the single question, “When you attempted intercourse, how often were you able to penetrate your partner?” rose significantly.

On the global assessment question, “Has the product you have been taking improved your erections?” an impressive 61.5% of men reported that the supplement improved their erections, an indication of a strong positive sexual experience.⁴

No hormone changes and no indicators of safety problems were identified in this study.

These findings indicate that Kaempferia extract (standardized to 5% 5,7-DMF) can improve not only erectile dysfunction specifically, but also other important parameters of the male sexual experience.

Link between Erectile Dysfunction and Cardiovascular Disease

Men with erectile dysfunction have a higher risk of cardiovascular disease, and are more likely to die prematurely compared with men having normal erectile function. This is regardless of age and other cardiovascular factors.^13,14

That’s because initiating, achieving, and sustaining an erection all depend on the mechanics of controlled blood flow through arteries and veins—the same blood-flow parameters that are required for good heart health. This makes erectile function a close indicator of how well vascular (blood vessel) and endothelial (blood vessel lining) processes are working.^13,15

The most important common thread between erectile dysfunction and cardiovascular disease is endothelial dysfunction.^16,17 This occurs when vital cells lining blood vessels fail to properly control blood flow and pressure, resulting in impaired distribution of blood flow.

A major cause of endothelial dysfunction is nitric oxide deficit.

While the first symptom of nitric oxide deficit may be erectile dysfunction, it is also an early indicator of vascular disorders that may result in heart attack or stroke.^17-21

It’s critical for men to understand these facts, particularly because so many relatively young men are now experiencing erectile dysfunction, which may indicate early cardiovascular disease that would otherwise go undetected.^13,14

This means:

• Erectile dysfunction may be an early warning sign of underlying atherosclerotic disease, but also

• Ideal treatment for erectile dysfunction would carry benefits, rather than certain risks, for the cardiovascular system.

This is what makes the underlying mechanism of Kaempferia ginger-like extract so exciting.

How It Works

Animal and laboratory studies have taught us much about how Kaempferia extract improves sexual and cardiovascular health.

Two studies in sexually mature rats showed that ingesting the extract for four weeks improved the animals’ sexual motivation, as indicated by the time taken to mount a female.^5,22

One of those studies also documented a significant increase in blood flow to the genitals, an important indicator of vascular health.⁵

In another study of aging rats, Kaempferia supplementation for three weeks resulted in improved copulatory and sexual behaviors, including shorter times to mounting females and penetrating them, and an increased number of mounting and insertion attempts.³

Based on these and other findings, scientists suspect that Kaempferia has multiple key mechanisms of action.

The first mechanism seems to activate brain responses to sexual stimuli.

Kaempferia extract appears to increase the overall desire to engage in sex once presented with sufficient sensory stimulation. This is an action unique to Kaempferia that is not a feature of the most common erectile-dysfunction drugs.

The second mechanism involves improvements in blood-vessel function throughout the body—with special impact on a highly sensitive recipient of blood flow, the penis. By improving arterial and endothelial function, Kaempferia extract permits better delivery of arterial blood to the penis.

This action produces the clinical effects of improved erectile response times, while increasing the overall size of the erect penis.^1,4

Kaempferia exerts this effect in large part by promoting the production of nitric oxide, which helps relax arteries everywhere in the body. It is this particular action that shows so much promise in preventing multiple types of cardiovascular disease as well as erectile dysfunction.^4,7-9,23

Additional Research

Studies in lab animals reveal that Kaempferia significantly improves blood flow through the spermatic artery, which provides blood to the testes.⁵

More detailed analyses show that the increased blood flow arises from favorable shifts in intracellular signaling molecules such as cyclic GMP (cGMP) and nitric oxide. These effects are also found in animals treated with the drug sildenafil (Viagra®).⁹ However, these vascular effects are far more potent with prescription PDE5 inhibitors.

In this study, the vascular benefits of Kaempferia were identified not only in arteries supplying the penis and testes, but also in the heart, contributing to overall cardiovascular health.

In isolated portions of rat aorta, the active component of Kaempferia, 5,7-DMF triggered significant relaxation, which would produce a larger space for blood to flow through. These shifts were also traced to higher levels of muscle-relaxing nitric oxide and cGMP, as well as beneficial shifts in calcium ion movements.⁷

Kaempferia extract was shown to share an important mechanism of action with drugs sold for erectile dysfunction, i.e. inhibition of the enzyme PDE5.⁶ Again, however, vascular effects mediated through inhibition of this enzyme are far more potent with PDE5 inhibitor drugs, though safety risks are also linked to this drug class’s potency.

This enzyme (PDE5) normally sends a signal to reduce blood flow through arteries in the penis, which causes penile vascular pressure to drop and the erection to wilt. Inhibiting the PDE5 enzyme helps sustain the erection effectively.⁹

Taken together, these findings on Kaempferia extract show it can benefit male sexual health for the very reasons it favorably affects systemic vascular health. By allowing arteries to relax and offer minimum resistance to blood flow, this ginger-like root extract offers intriguing potential systemic benefits.

Summary

Sexual dissatisfaction plagues millions of American men.^1,13,14

Men with diminished sexual function are at greater risk of early death from cardiovascular disease.

Drugs like Viagra® or Cialis® rapidly improve blood flow to the penis and help sustain an erection. However, price gouging and worrisome safety concerns plague this potent drug class. In addition, they are of little use in promoting the psychosocial/emotional aspects of a sexual encounter.

Kaempferia parviflora provides the opportunity for a more comprehensive approach with sustained use over time.

Data suggest that a specific Kaempferia extract taken over time helps safely support and enhance the sensory experience of sex, making an erection (and subsequent satisfaction) more likely.

This ginger-like extract safely supports production of blood vessel-relaxing nitric oxide, which helps increase blood flow to the penis and arteries throughout the body.

In-vitro research shows that this extract targets the same enzyme as powerful drugs prescribed for erectile dysfunction.

Human studies show that, over time, Kaempferia supplementation gently supports erectile function, with modest improvements in penile circumference (girth), and length, all the while supporting a generally more satisfying sexual experience.

Most importantly, because erectile dysfunction can be an indicator of life-threatening cardiovascular disease, supplementing with Kaempferia extract may offer the dual benefit of safely supporting sexual performance while potentially providing sustained, gentle support for the aging vascular system.

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

References

1. Wannanon P, Wattanathorn J, Tong-Un T, et al. Efficacy assessment of Kaempferia parviflora for the management of erectile dysfunction. OnLine J. of Biological Sciences. 2012;12(4):149-55.
2. Saokaew S, Wilairat P, Raktanyakan P, et al. Clinical Effects of Krachaidum (Kaempferia parviflora): A Systematic Review. J Evid Based Complementary Altern Med. 2016.
3. Wattanathorn J, Pangphukiew P, Muchimapura S, et al. Aphrodisiac Activity of Kaempferia parviflora. American Journal of Agricultural and Biological Sciences. 2012;7(2):114-20.
4. Hirsh S, Huber L, Stein R, et al. An open label study to evaluate the effect of Kaempferia parviflora in support of erectile function and male sexual health among overall healthy males 50–70. The FASEB Journal. 2017;31(1 Supplement):636.1.
5. Chaturapanich G, Chaiyakul S, Verawatnapakul V, et al. Effects of Kaempferia parviflora extracts on reproductive parameters and spermatic blood flow in male rats. Reproduction. 2008;136(4):515-22.
6. Temkitthawon P, Hinds TR, Beavo JA, et al. Kaempferia parviflora, a plant used in traditional medicine to enhance sexual performance contains large amounts of low affinity PDE5 inhibitors. J Ethnopharmacol. 2011;137(3):1437-41.
7. Tep-Areenan P, Sawasdee P, Randall M. Possible mechanisms of vasorelaxation for 5,7-dimethoxyflavone from Kaempferia parviflora in the rat aorta. Phytother Res. 2010;24(10):1520-5.
8. Wattanapitayakul SK, Suwatronnakorn M, Chularojmontri L, et al. Kaempferia parviflora ethanolic extract promoted nitric oxide production in human umbilical vein endothelial cells. J Ethnopharmacol. 2007;110(3):559-62.
9. Weerateerangkul P, Palee S, Chinda K, et al. Effects of Kaempferia parviflora Wall. Ex. Baker and sildenafil citrate on cGMP level, cardiac function, and intracellular Ca2+ regulation in rat hearts. J Cardiovasc Pharmacol. 2012;60(3):299-309.
10. Hermann M, Flammer A, Luscher TF. Nitric oxide in hypertension. J Clin Hypertens (Greenwich). 2006;8(12 Suppl 4):17-29.
11. Available at: https://auanet.org/documents/education/clinical-guidance/erectile-dysfunction.pdf. Accessed March 6, 2018.
12. Available at: https://www.pfizerpatientreportedoutcomes.com/system/files/pdf/scoring_iiefversion2.pdf. Accessed March 6, 2018.
13. Capogrosso P, Montorsi F, Salonia A. Erectile dysfunction in young patients is a proxy of overall men’s health status. Curr Opin Urol. 2016;26(2):140-5.
14. Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol. 2017;6(1):79-90.
15. Musicki B, Bella AJ, Bivalacqua TJ, et al. Basic Science Evidence for the Link Between Erectile Dysfunction and Cardiometabolic Dysfunction. J Sex Med. 2015;12(12):2233-55.
16. Guay AT. ED2: erectile dysfunction = endothelial dysfunction. Endocrinol Metab Clin North Am. 2007;36(2):453-63.
17. Solomon H, Man JW, Jackson G. Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart. 2003;89(3):251-3.
18. Heeba G, Hassan MK, Khalifa M, et al. Adverse balance of nitric oxide/peroxynitrite in the dysfunctional endothelium can be reversed by statins. J Cardiovasc Pharmacol. 2007;50(4):391-8.
19. Korda M, Kubant R, Patton S, et al. Leptin-induced endothelial dysfunction in obesity. Am J Physiol Heart Circ Physiol. 2008;295(4):H1514-21.
20. Sambe T, Mason RP, Dawoud H, et al. Metformin treatment decreases nitroxidative stress, restores nitric oxide bioavailability and endothelial function beyond glucose control. Biomed Pharmacother. 2018;98:149-56.
21. Naseem KM. The role of nitric oxide in cardiovascular diseases. Mol Aspects Med. 2005;26(1-2):33-65.
22. Chaturapanich G, Chaiyakul S, Verawatnapakul V, et al. Enhancement of aphrodisiac activity in male rats by ethanol extract of Kaempferia parviflora and exercise training. Andrologia. 2012;44 Suppl 1:323-8.
23. Jansakul C, Tachanaparuksa K, Mulvany MJ, et al. Relaxant mechanisms of 3, 5, 7, 3’, 4’-pentamethoxyflavone on isolated human cavernosum. Eur J Pharmacol. 2012;691(1-3):235-44.
24. Hattenhauer MG, Leavitt JA, Hodge DO, et al. Incidence of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1997;123(1):103-7.
25. Johnson LN, Arnold AC. Incidence of nonarteritic and arteritic anterior ischemic optic neuropathy. Population-based study in the state of Missouri and Los Angeles County, California. J Neuroophthalmol. 1994;14(1):38-44.
26. Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol. 2004;171(6 Pt 1):2341-5.
27. Feldman HA, Johannes CB, Derby CA, et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med. 2000;30(4):328-38.
28. Roumeguere T, Wespes E, Carpentier Y, et al. Erectile dysfunction is associated with a high prevalence of hyperlipidemia and coronary heart disease risk. Eur Urol. 2003;44(3):355-9.