Advertising for them abounds. On the Internet, in health magazines, and anywhere else advertising is allowed. But do they actually work? Many will tell you they don’t, and they’re just a bunch of quackery. Others swear by them, and refuse to believe there could be any element of truth in the ‘quackery’ theories!

What are ‘they’?

‘They’ is the range of herbal remedies and supplements for conditions like erectile dysfunction (ED) and other health disorders. Many of ‘them’ are available over the counter in countries like the USA and remain largely unregulated by the USDFA. In other countries they’re more tightly regulated and may only be available by prescription. So let’s take a look at one of these types of products and a couple of the primary herbs found in it.

Herbal supplements for conditions like erectile dysfunction usually contain several important herbs. These herbs have been used for centuries in traditional medicine to treat both impotence and some of its related health conditions.   Impotence, or erectile dysfunction, is often associated with problems like chronic stress, anxiety, depression, and poor lifestyle choices (bad diet, smoking, alcohol, lack of exercise etc).   It can also be caused by underlying physical health conditions including type 2 diabetes, cardiovascular disease, and benign prostatic hyperplasia (BPH).

ED also affects more men over the age of 35, although younger men can and do suffer from ED as well. Interestingly, this research found that after the age of 65 reported cases of ED drop off significantly. This is despite the fact that historically we know a man’s chances of developing ED generally increases the older they get. It’s generally due to the increasing prevalence of health conditions that predispose a man to develop ED (cardiovascular problems, BPH etc).  So why do statistics tell a different story?  The aforementioned research suggested that it may be due to older men not being particularly bothered by the condition so they don’t seek medical treatment, and that older men may not be asked the question by their doctors as part of a routine health check.

But back to herbal remedies and the burning question – is there actually much scientific evidence to back up their continued use?

As it turns out, and this may surprise many people, there is indeed significant such evidence and research, much of it positive. Although it has to be said that there is also plenty of evidence to suggest that many herbal remedies do not in fact have the ‘oomph’ they’re reputed to have! But fortunately for ED sufferers who prefer herbal treatments, this is not the case with 2 of the primary herbs found in erectile dysfunction supplements!

Before we take a look at these herbs though we probably should have a quick ED 101.

Most of the tissues in our body have the ability to produce a messenger enzyme called soluble guanylate cyclase (sGC). Our lung, kidney, brain and vascular tissues are particularly good at it, which means these organ tissues contain very high levels of sGC. Soluble guanylate cyclase is one of those substances we don’t really want to be without. These molecules are responsible for regulating a huge range of activities that are pivotal to our survival. Like regulating our blood pressure, helping to heal wounds, assisting with memory formation, and a host of other activities.   In fact, the more we learn about certain types of health disorders, the more we’re finding that problems with sGC function are involved.

When you understand that sGC is the only known receptor for nitric oxide (NO), a free radical molecule that plays an incredibly important role in many physiological processes that go in our bodies, you begin to understand why we can’t live without sGC.

But let’s back up a step and explain that ‘things’ don’t just start to ‘happen’ at random in our bodies, or at least not in a normal, healthy body.   We’re far better designed than that!   Almost every process that goes on inside us requires some type of catalyst to trigger proceedings. These catalysts are usually signalling molecules, and one of the most important signalling molecules is nitric oxide. Nitric oxide is responsible for triggering processes that regulate, amongst other things, our

  • blood pressure
  • memory creation
  • olfactory function
  • reaction to infectious diseases
  • sexual function.
  • wound healing

Signalling molecules typically bind with special receptors in the outer membranes of other cells, which sends a ‘signal’ to that cell to start a particular process. In the case of nitric oxide, sGC molecules contain the only known NO receptors in mammals. Therefore it’s easy to understand how impaired sGC function can have some pretty serious consequences for our health. In a nutshell, without soluble guanylate cyclase we can’t respond to nitric oxide, which means all the above processes would be severely, if not fatally, impaired.

Soluble Guanylate Cyclase, Cyclic GMP, And Vasodilation

One of the many functions of sGC is regulating vasodilation (the relaxation and expansion of blood vessels to facilitate increased blood flow). It does this by catalysing the production of cyclic guanosine monophosphate (cGMP or cyclic GMP) within, in this case, cells in the smooth muscle tissue in blood vessels. Cyclic GMP’s job in turn is to trigger the series of events within smooth muscle tissue cells that ultimately leads to vasodilation. This is important for normal erectile function, which is the topic of this article, because it is increased blood flow to the penis that is responsible for creating and maintaining an erection.

Cyclic GMP does have other functions in other parts of the body, including modulating neurotransmission, lipolysis, gut peristalsis, secretion of intestinal fluids, phototransduction, bone growth etc.

So here’s how normal erectile function works:

  1. Sexual stimulation triggers the production of nitric oxide.
  2. Nitric oxide binds with special receptors on soluble guanylate cyclase (sGC) cells.
  3. In response to stimulation by nitric oxide, sGC triggers the production of cyclic guanosine monophosphate (cGMP or cyclic GMP) in smooth penile muscle tissue
  4. cGMP in turn triggers a series of events that causes vasodilation in penile blood vessels

Given that it wouldn’t exactly be convenient or healthy to walk around with dilated blood vessels 24/7, we therefore also have a process that switches off vasodilation and allows blood vessels, and blood flow, to return to normal. This responsibility for this process lies with an enzyme called phosphodiesterase-5 (PDE5). PDE5 destroys cyclic guanosine monophosphate thereby effectively turning off vasodilation.

PDE5 is in turn regulated by PDE5 inhibitors. These inhibitors tell it when to work, and when to stop working.   Men with normal penile function have normal levels of natural PDE5 inhibitors. Men with persistent erectile dysfunction problems typically don’t. In these guys their PDE5 continually destroys cyclic guanosine monophosphate before it gets a chance to work, which leads to erectile dysfunction.

Enter products like Viagra et al. These products contain synthetic PDE5 inhibitors that replace the body’s malfunctioning, or non-existent ones. They work very effectively too. Which gets us nicely back to the original topic of this article, which was herbal compounds in products like erectile dysfunction supplements. And whether or not they work.

Two plant compounds commonly found in ED supplements are Epimedium (horny goat weed) and Eurycoma longfolia (Tongkat Ali). Extracts from both plants have been used for centuries as part of traditional medicine and are known to be quite powerful aphrodisiacs. They are native to parts of south-east Asia and China.

Epimedium AKA Horny Goat Weed

Epimedium as a genus includes some 65 species. The one most commonly used as an aphrodisiac is Epimedium brevicornum. Research done late last decade confirmed that the reason for the plant’s popularity as an aphrodisiac is the compound icariin. Icariin is a natural PDE5 inhibitor. Whilst icariin in its natural state isn’t anywhere near as strong as sildenafil (Viagra) and other synthetic PDE5 inhibitors, the researchers found that by modifying it they could produce a compound that is the equal of sildenafil in terms of potency.   Icariin also has other promising medical uses, notably in the area of cardiovascular health.

Eurycoma longfolia AKA Tongkat Ali Or Malaysian Ginseng

Eurycoma longfolia is a plant native to several areas of south-east Asia. Research like this found that it can successfully reduce anger, confusion, and tension in moderately stressed adults. It also increased blood levels of testosterone in the test subjects. The mechanism by which it does this is thought to be via upregulating the release of free testosterone from sex-hormone-binding-globulin (SHBG). SHBG is a carrier protein that transports testosterone molecules in the blood stream.

We have many of these types of carrier proteins in our blood. Their role is to safely and harmlessly transport various types of hormone molecules in the blood stream until they’re needed for various functions. Whilst these hormones are attached to the carrier proteins they remain inactive. Upon release from their carrier proteins they can be activated or utilised by the body.

In the case of Eurycoma longfolia, this means that it doesn’t actually produce more testosterone per se.  Rather it increases the availability of what testosterone is already in the blood stream.

Further to these two herbs, there are a range of others that are used in ED supplements with anecdotal success.

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