<ul><li>Chanita Villegas-Chua, M.D., FPOGS, FPSUOG, MFMSF, MSCE </li></ul>
 
<ul><li>2 Tasks: </li></ul><ul><li>Urination:  releasing urine from the bladder </li></ul><ul><li>Ejaculation:   </li></ul...
EJACULATION IS A THREE-STEP PROCESS:  <ul><li>Man becomes sexually aroused  </li></ul><ul><li>Penis responds by becoming e...
 
 
 
 
PENIS USES A SIMILAR MECHANISM <ul><li>Instead of using pressurized air to become rigid, the penis uses pressurized blood ...
<ul><li>Think of the corpora cavernosa as balloon-like  tubes </li></ul><ul><li>Arteries : bring blood into these two tube...
 
WHAT IS ERECTILE DYSFUNCTION? <ul><li>1992, the NIH definition: </li></ul><ul><ul><li>Inability to attain or sustain an er...
WHAT IS ERECTILE DYSFUNCTION? <ul><li>1992, the NIH definition: </li></ul><ul><ul><li>The degree to which it bothers the m...
WHAT IS ERECTILE DYSFUNCTION? <ul><li>Most common untreated medical disorder </li></ul><ul><li>>50% of men 40 – 70yo, incr...
WHAT IS ERECTILE DYSFUNCTION? <ul><li>Affects nearly 30M men in the US </li></ul><ul><li>Difficult subject for many people...
WHAT IS ERECTILE DYSFUNCTION? <ul><li>Key role : Corpora cavernosa and the smooth muscles of the arteriolar & arterial wal...
ED Signs,  Symptoms, Indicators
<ul><li>Inability to maintain erection </li></ul><ul><li>Normal erections occur during sleep and in the early morning; los...
ED RISK  FACTORS
Causes of Male  Erectile Dysfunction A.  Primary ED   - man has never been able to attain or sustain erections, due to psy...
Causes of Male  Erectile Dysfunction <ul><li>B. Secondary ED  - a man who could previously attain & sustain erections no l...
AGING
Obesity <ul><li>≥  20% of the desirable body weight </li></ul><ul><li>BMI ≥ 27kg/m2 </li></ul>
alcohol
POLLUTION
SMOKING
JUNK FOODS
Causes of Male  Erectile Dysfunction Diseases that worsen hardening of the arteries and increase the prevalence of erectil...
High Blood Sugar
HIGH  BLOOD  PRESSURE
Causes of Male  Erectile Dysfunction <ul><li>B. Secondary ED </li></ul><ul><li>2. Hormonal disorders: </li></ul><ul><ul><u...
GOITER
Causes of Male  Erectile Dysfunction <ul><li>B. Secondary ED </li></ul><ul><li>3. Neurologic disorders </li></ul><ul><ul><...
Temporal Lobe Seizure
Stroke
Spinal  Cord  Injuries
Causes of Male  Erectile Dysfunction <ul><li>B. Secondary ED </li></ul><ul><li>4. Other causes: </li></ul><ul><ul><li>situ...
Psychiatric And Psychological Disorders
25% of ED – Medications
WHY ERECTILE DYSFUNCTION? <ul><li>In older men, the arteries in the penis aren't dilating enough when the brain sends the ...
WAYS TO INCREASE BLOOD FLOW TO THE PENIS <ul><li>Increase the amount of nitric oxide produced in the penis  </li></ul><ul>...
 
ED IS POTENTIALLY REVERSIBLE <ul><li>Patients on medications for high blood pressure and for depression  </li></ul><ul><li...
ED IS POTENTIALLY REVERSIBLE <ul><li>Patients who use recreational drugs; Alcohol, Marijuana, Cocaine, Heroin  </li></ul><...
SEX AND YOUR HEART <ul><li>Because sex makes the heart work harder, sexual activity is not advisable for some men with cer...
SEX AND YOUR HEART <ul><li>Severe (unstable) angina  </li></ul><ul><li>Untreated or severe high blood  pressure  </li></ul...
<ul><li>Eat  whole, fresh, unrefined, and unprocessed foods. Include fruits (lots of richly pigmented berries to support v...
<ul><li>Avoid  sugar, dairy products, refined foods, fried foods, junk foods, caffeine  </li></ul><ul><li>Eliminate  food ...
COMPONENTS OF ENDUROMAX <ul><li>L – Argenine </li></ul><ul><li>Korean Ginseng </li></ul><ul><li>Saw Palmetto </li></ul><ul...
KOREAN GINSENG
GINSENG <ul><li>Panax ginseng , also called Asian, Korean or Chinese ginseng </li></ul><ul><li>Asian ginseng has &quot;hea...
GINSENG <ul><li>The word  Panax  comes the Greek word meaning &quot;all-healing“ </li></ul><ul><li>In much of Asia, ginsen...
<ul><li>“ adaptogen”, which means it increases resistance to physical, chemical, & biological stress & builds energy & gen...
<ul><li>Erectile Dysfunction –  in a study,  60% of the participants reported improvement in their symptoms compared with ...
L – ARGININE <ul><li>an amino acid that the body uses to make  NITRIC OXIDE , a substance that signals smooth muscle surro...
TONGKAT  ALI
TONGKAT ALI <ul><li>Eurycoma longifolia  & Longjack  </li></ul><ul><li>Dubbed the  &quot;Asian Viagra&quot;  in a May 1999...
TONGKAT ALI <ul><li>increase levels of testosterone: </li></ul><ul><li>- responsible for the growth and development of mal...
SAW PALMETTO
SAW PALMETTO <ul><li>to increase sex drive </li></ul><ul><li>Other uses: </li></ul><ul><ul><li>for urinary symptoms associ...
SAW PALMETTO <ul><li>Improve body strength </li></ul><ul><li>Beneficial for both sexes in supporting healthy hormonal bala...
TRIBULUS TERRESTRIS
TRIBULUS TERRESTRIS <ul><li>heightened sexual behavior and increased intracavernous pressure due to increase testosterone ...
TRIBULUS TERRESTRIS <ul><li>reduction in cholesterol </li></ul><ul><li>reduction in high blood pressure </li></ul><ul><li>...
TRIBULUS TERRESTRIS <ul><li>prevention of kidney stones </li></ul><ul><li>improvement of the profile of red and white bloo...
TONGKAT ALI <ul><li>Both produce testosterone but are  different from the action of testosterone products, which act like ...
IONIC TRACE MINERALS   <ul><li>Zinc is required for the production of testosterone, and the zinc content of the prostate g...
IONIC TRACE MINERALS   <ul><li>Magnesium is a trace mineral that is important for the production of sex hormones for enhan...
IONIC TRACE MINERALS   <ul><li>provides a balance of essential minerals in whom scientists and scholars officially agree, ...
SELENIUM <ul><li>Believed to be good for sperm production and mobility </li></ul><ul><li>nearly 50% of the selenium in a m...
 
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Enduromax

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Enduromax

  1. 1. <ul><li>Chanita Villegas-Chua, M.D., FPOGS, FPSUOG, MFMSF, MSCE </li></ul>
  2. 3. <ul><li>2 Tasks: </li></ul><ul><li>Urination: releasing urine from the bladder </li></ul><ul><li>Ejaculation: </li></ul><ul><li>releasing sperm and seminal fluid from the prostate gland </li></ul>
  3. 4. EJACULATION IS A THREE-STEP PROCESS: <ul><li>Man becomes sexually aroused </li></ul><ul><li>Penis responds by becoming erect </li></ul><ul><li>Stimulation of the penis causes ejaculation </li></ul>
  4. 9. PENIS USES A SIMILAR MECHANISM <ul><li>Instead of using pressurized air to become rigid, the penis uses pressurized blood </li></ul><ul><li>Penis contains two cigar-shaped structures, corpora cavernosa, that it uses to become erect </li></ul>
  5. 10. <ul><li>Think of the corpora cavernosa as balloon-like tubes </li></ul><ul><li>Arteries : bring blood into these two tubes, and veins carry blood away from them </li></ul>
  6. 12. WHAT IS ERECTILE DYSFUNCTION? <ul><li>1992, the NIH definition: </li></ul><ul><ul><li>Inability to attain or sustain an erection adequate for satisfactory sexual intercourse . </li></ul></ul><ul><ul><li>&quot;Erectile Dysfuntion&quot; is more precise than impotence (some associate with being sterile or lacking strength, vigor, or power) </li></ul></ul>
  7. 13. WHAT IS ERECTILE DYSFUNCTION? <ul><li>1992, the NIH definition: </li></ul><ul><ul><li>The degree to which it bothers the man and his partner </li></ul></ul><ul><ul><li>Different from other male sexual problems, such as premature (rapid) ejaculation, low sexual desire, or an inability to have an orgasm (climax) </li></ul></ul>
  8. 14. WHAT IS ERECTILE DYSFUNCTION? <ul><li>Most common untreated medical disorder </li></ul><ul><li>>50% of men 40 – 70yo, increases with age (Men can enjoy sexual activity throughout life, although the amount and force of ejaculation and muscular tension decrease) </li></ul><ul><li>  </li></ul>
  9. 15. WHAT IS ERECTILE DYSFUNCTION? <ul><li>Affects nearly 30M men in the US </li></ul><ul><li>Difficult subject for many people to discuss, often accompanied by embarrassment, guilt, and lack of self-esteem </li></ul><ul><li>Successfully treated over 95% of the time   </li></ul>
  10. 16. WHAT IS ERECTILE DYSFUNCTION? <ul><li>Key role : Corpora cavernosa and the smooth muscles of the arteriolar & arterial walls </li></ul><ul><li>If the arteries leading to the penis don't open up properly, difficult or impossible for it to become erect </li></ul>
  11. 17. ED Signs, Symptoms, Indicators
  12. 18. <ul><li>Inability to maintain erection </li></ul><ul><li>Normal erections occur during sleep and in the early morning; loss of these erections may signify underlying disease, often cardiovascular in origin </li></ul>
  13. 19. ED RISK FACTORS
  14. 20. Causes of Male Erectile Dysfunction A. Primary ED - man has never been able to attain or sustain erections, due to psychologic factors: sexual guilt, fear of intimacy, depression, and severe anxiety - Rarely caused by biological factors such as low testosterone levels and other hormonal disorders
  15. 21. Causes of Male Erectile Dysfunction <ul><li>B. Secondary ED - a man who could previously attain & sustain erections no longer can, approx. 10% is due to psychologic factors </li></ul><ul><li>1. Vascular disorders - major cause: </li></ul><ul><li>atherosclerosis (decrease amount of blood entering the penis) </li></ul>
  16. 22. AGING
  17. 23. Obesity <ul><li>≥ 20% of the desirable body weight </li></ul><ul><li>BMI ≥ 27kg/m2 </li></ul>
  18. 24. alcohol
  19. 25. POLLUTION
  20. 26. SMOKING
  21. 27. JUNK FOODS
  22. 28. Causes of Male Erectile Dysfunction Diseases that worsen hardening of the arteries and increase the prevalence of erectile dysfunction
  23. 29. High Blood Sugar
  24. 30. HIGH BLOOD PRESSURE
  25. 31. Causes of Male Erectile Dysfunction <ul><li>B. Secondary ED </li></ul><ul><li>2. Hormonal disorders: </li></ul><ul><ul><ul><li>elevated prolactin </li></ul></ul></ul><ul><ul><ul><li>hypothyroidism </li></ul></ul></ul><ul><ul><ul><li>Cushings syndrome </li></ul></ul></ul><ul><ul><ul><li>decrease level of testosterone (current study) </li></ul></ul></ul>
  26. 32. GOITER
  27. 33. Causes of Male Erectile Dysfunction <ul><li>B. Secondary ED </li></ul><ul><li>3. Neurologic disorders </li></ul><ul><ul><ul><li>multiple sclerosis </li></ul></ul></ul><ul><ul><ul><li>sensory & autonomic dysfunction </li></ul></ul></ul>
  28. 34. Temporal Lobe Seizure
  29. 35. Stroke
  30. 36. Spinal Cord Injuries
  31. 37. Causes of Male Erectile Dysfunction <ul><li>B. Secondary ED </li></ul><ul><li>4. Other causes: </li></ul><ul><ul><li>situational - involving a particular place, time, partner </li></ul></ul>
  32. 38. Psychiatric And Psychological Disorders
  33. 39. 25% of ED – Medications
  34. 40. WHY ERECTILE DYSFUNCTION? <ul><li>In older men, the arteries in the penis aren't dilating enough when the brain sends the signal </li></ul><ul><li>The man is aroused, and the nerves in the penis are producing NO; but the amount of cGMP produced is not enough to maintain an erection. </li></ul>
  35. 41. WAYS TO INCREASE BLOOD FLOW TO THE PENIS <ul><li>Increase the amount of nitric oxide produced in the penis </li></ul><ul><li>Increase the amount of cGMP produced in the penis in response to the nitric oxide </li></ul><ul><li>Eliminate the PDE in the penis so that the cGMP builds up instead of getting decomposed by the PDE </li></ul>
  36. 43. ED IS POTENTIALLY REVERSIBLE <ul><li>Patients on medications for high blood pressure and for depression </li></ul><ul><li>Patients who have endocrine problems, like thyroid or pituitary problems </li></ul><ul><li>Patients who have partner conflict </li></ul><ul><li>Patients who smoke cigarettes </li></ul>
  37. 44. ED IS POTENTIALLY REVERSIBLE <ul><li>Patients who use recreational drugs; Alcohol, Marijuana, Cocaine, Heroin </li></ul><ul><li>Patients who have an anatomical abnormality of their penis </li></ul><ul><li>Men <45 yo may have a correctable cause of vascular impotence like those due to diabetes mellitus </li></ul>
  38. 45. SEX AND YOUR HEART <ul><li>Because sex makes the heart work harder, sexual activity is not advisable for some men with certain heart problems. Some men have serious forms of heart disease, such as: </li></ul><ul><ul><li>A recent heart attack or stroke (within the past 2 or 3 months) </li></ul></ul><ul><ul><li>Certain heart rhythm problems </li></ul></ul>
  39. 46. SEX AND YOUR HEART <ul><li>Severe (unstable) angina </li></ul><ul><li>Untreated or severe high blood pressure </li></ul><ul><li>Severe heart failure </li></ul><ul><li>Severe heart valve disease (aortic stenosis) </li></ul>
  40. 47. <ul><li>Eat whole, fresh, unrefined, and unprocessed foods. Include fruits (lots of richly pigmented berries to support vascular integrity), vegetables, whole grains, soy, beans, seeds, nuts, olive oil, and cold-water fish (salmon, tuna, sardines, halibut, and mackerel) </li></ul>NUTRITION
  41. 48. <ul><li>Avoid sugar, dairy products, refined foods, fried foods, junk foods, caffeine </li></ul><ul><li>Eliminate food sensitivities. Use an elimination and challenge diet to determine food sensitivities </li></ul><ul><li>Drink 50% of your body weight in ounces of water daily (e.g., if you weigh 150 lbs, drink 2.25L/day) </li></ul>NUTRITION
  42. 49. COMPONENTS OF ENDUROMAX <ul><li>L – Argenine </li></ul><ul><li>Korean Ginseng </li></ul><ul><li>Saw Palmetto </li></ul><ul><li>Selenium </li></ul><ul><li>Tongkat Ali </li></ul><ul><li>Trace Minerals </li></ul><ul><li>Trebulus </li></ul><ul><li>Terrestris </li></ul>Plus a combination of other proprietary herbs!
  43. 50. KOREAN GINSENG
  44. 51. GINSENG <ul><li>Panax ginseng , also called Asian, Korean or Chinese ginseng </li></ul><ul><li>Asian ginseng has &quot;heating&quot; properties, which are good for improving circulation </li></ul><ul><li>The active compounds in ginseng are believed to be steroid-like components called &quot;ginsenosides&quot; </li></ul>
  45. 52. GINSENG <ul><li>The word Panax comes the Greek word meaning &quot;all-healing“ </li></ul><ul><li>In much of Asia, ginseng is prized as a revitalizer for the whole body </li></ul><ul><li>This is partly due to the shape of the root, which resembles the human body </li></ul>
  46. 53. <ul><li>“ adaptogen”, which means it increases resistance to physical, chemical, & biological stress & builds energy & general vitality </li></ul><ul><li>Good for Diabetes – lowers fasting blood glucose levels, mood, psychophysical performance, also resulted in improved Hb A1C levels </li></ul>GINSENG
  47. 54. <ul><li>Erectile Dysfunction – in a study, 60% of the participants reported improvement in their symptoms compared with 30% of those using the placebo; appears to be useful for erectile dysfunction if taken on a continuous basis </li></ul>GINSENG
  48. 55. L – ARGININE <ul><li>an amino acid that the body uses to make NITRIC OXIDE , a substance that signals smooth muscle surrounding blood vessels to relax, which dilates the blood vessels and increases blood flow </li></ul><ul><li>Relaxation of smooth muscle in the penis allows for enhanced blood flow, leading to an erection </li></ul>
  49. 56. TONGKAT ALI
  50. 57. TONGKAT ALI <ul><li>Eurycoma longifolia & Longjack </li></ul><ul><li>Dubbed the &quot;Asian Viagra&quot; in a May 1999 report in the New Sunday Times </li></ul><ul><li>used in Malaysia for many years by men to increase sexual desire, libido, sexual performance and to treat erectile dysfunction </li></ul>
  51. 58. TONGKAT ALI <ul><li>increase levels of testosterone: </li></ul><ul><li>- responsible for the growth and development of male reproductive organs, including the penis, testicles, scrotum, prostate, & seminal vesicles </li></ul><ul><li>- Normal levels maintain energy level, mood, fertility, and sexual desire </li></ul><ul><li>- used by bodybuilders to increase muscle mass and strength </li></ul>
  52. 59. SAW PALMETTO
  53. 60. SAW PALMETTO <ul><li>to increase sex drive </li></ul><ul><li>Other uses: </li></ul><ul><ul><li>for urinary symptoms associated with an enlarged prostate gland (also called benign prostatic hyperplasia, or BPH) </li></ul></ul><ul><ul><li>chronic pelvic pain </li></ul></ul><ul><ul><li>bladder disorders </li></ul></ul><ul><ul><li>hair loss </li></ul></ul>
  54. 61. SAW PALMETTO <ul><li>Improve body strength </li></ul><ul><li>Beneficial for both sexes in supporting healthy hormonal balance </li></ul><ul><li>Support healthy immune function </li></ul><ul><li>Increase libido </li></ul>
  55. 62. TRIBULUS TERRESTRIS
  56. 63. TRIBULUS TERRESTRIS <ul><li>heightened sexual behavior and increased intracavernous pressure due to increase testosterone </li></ul><ul><li>Other uses: </li></ul><ul><ul><li>urinary disorders </li></ul></ul><ul><ul><li>remedy for inflammation and arthritis </li></ul></ul><ul><ul><li>use it to improve strength & stamina </li></ul></ul>
  57. 64. TRIBULUS TERRESTRIS <ul><li>reduction in cholesterol </li></ul><ul><li>reduction in high blood pressure </li></ul><ul><li>inhibition of stress-induced clumping of blood platelets </li></ul><ul><li>increases in strength of contraction of the heart muscle </li></ul><ul><li>reductions in sodium & fluid retention </li></ul>
  58. 65. TRIBULUS TERRESTRIS <ul><li>prevention of kidney stones </li></ul><ul><li>improvement of the profile of red and white blood cells </li></ul><ul><li>strong anti-bacterial, anti-malarial, and anti-fungal properties </li></ul><ul><li>anti-inflammatory activity and action </li></ul>
  59. 66. TONGKAT ALI <ul><li>Both produce testosterone but are different from the action of testosterone products, which act like the body's own testosterone and therefore causes the Leydig cells to shut down their production of the hormone. For this reason, all exogenous testosterone products, including anabolic steroids, cause testicular and penile shrinkage. </li></ul>TRIBULUS TERRESTRIS
  60. 67. IONIC TRACE MINERALS <ul><li>Zinc is required for the production of testosterone, and the zinc content of the prostate gland and sperm, is higher than in any other body tissues </li></ul><ul><li>not only helps produce testosterone, but also helps to maintain semen volume and adequate levels of testosterone, therefore maintaining sex drive and keeping sperm healthy </li></ul>
  61. 68. IONIC TRACE MINERALS <ul><li>Magnesium is a trace mineral that is important for the production of sex hormones for enhancement such as androgen, estrogen & neurotransmitters that modulate the sex drive - such as dopamine and norepinephrine </li></ul>
  62. 69. IONIC TRACE MINERALS <ul><li>provides a balance of essential minerals in whom scientists and scholars officially agree, to be very necessary to maintain health & that no other nutrient can be substituted </li></ul><ul><li>increases the potency & effectivity of the other components </li></ul>
  63. 70. SELENIUM <ul><li>Believed to be good for sperm production and mobility </li></ul><ul><li>nearly 50% of the selenium in a man is in the testes and seminal ducts; men lose selenium in their semen </li></ul><ul><li>Getting enough selenium is vital for peak sexual performance and male sexual enhancement </li></ul>

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