SEXUAL HEALTH

As men age, concerns with fertility and sexual health arise. Erectile dysfunction (ED) is the inability to achieve or maintain an erection that is satisfactory for sexual intercourse. Prevalence of ED increases with age, with approximately 20% before age 30, 25% between age 30 to 39, 40% between age 40 to 49, 60% between age 50 to 59, 80% between age 60 to 69, and 90% above age 70. (1) ED is found as a comorbid condition to a variety of metabolic disorders and heart conditions. For example, the estimated prevalence of ED among patients with atrial fibrillation is 57%. (5) Both type 1 and type 2 diabetes mellitus also increase the likelihood of ED roughly 3.5-fold. (14) 

Typical treatment of ED is varied and may consist of testosterone therapy, pharmaceutical interventions, or psychological and behavioral interventions. Many of the ingredients presented below focus on improving function and sexual satisfaction as assessed by the International Index of Erectile Function (IIEF), which is a questionnaire that assesses sexual activity, intercourse, stimulation, ejaculation, and orgasm, allowing insight into some of the possible mechanisms and areas of focus for treatment. (21)

Based on the research findings, the ingredients in the protocol below have shown efficacy in improving a variety of factors associated with improving male sexual function. 

Korean ginseng (Panax ginseng)

2000 mg, total per day, minimum 8 weeks (6)(10)(13)

• International Index of Erectile Function (IIEF) score improved accounting for improvement in erectile function (ED) and overall satisfaction among patients after 8 weeks of supplementation with 1000 mg twice per day of tissue-cultured mountain ginseng extract when compared to placebo (13)
• 66.6% of patients with mild or moderate ED reported improved erection specifically rigidity, penetration, and maintenance as shown by an improvement in IIEF-5 score when given 1000 mg of Korean red ginseng 3 times per day compared to placebo (6) 
• Improved IIEF scores for penetration and maintenance and improved penile tip rigidity as shown by RigiScan; 60% of patients noted that treatment helped with global efficacy (10)
• Meta-analysis of six RCTs showed benefits of Korean red ginseng for ED response rate (RR 2.40) and psychogenic ED response rate (RR 2.05) compared to placebo (11) 
• Significant improvement in total and all IIEF domain scores in individuals with mild-to-moderate ED given 1400 mg ginseng berry extract daily for eight weeks (4)

Tribulus terrestris