Wednesday, September 10, 2014

Viagra and hormonal causes of ED

Viagra (Sildenafil) relaxes muscles and increases blood flow to particular areas of the body. Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Erectile Dysfunction is highly prevalent, is age related and can be progressive. At least 50 percent of all men ages 40 to 70 years old have some degree of E.D. Effects on physical and emotional health can be profound. The usual body builder will likely use some anabolic hormonal augmentation to achieve desired physical “cosmetic effects”.

The most common anabolic pharmacologic agents used are:
1.Testosterone of different kinds (injectibles, testosterone mixtures etc.); sometimes topical testosterone also.
2.Nandrolone anabolic agents, which are more anabolic than androgenic, which may include Nandrolone Undecanoate (Deca), Oxandrolone, Stanazalol, Oxymethalone and many others.

When you look at the chemical structures of the nandrolones you will see that many look like the synthetic progestin (progesterone) family of hormones. That is why many of the nandrolone anabolic agents have central nervous system depressing effects like the progestins. Some years ago male sex offenders were given injections of methyl provera acetate (a potent synthetic progestin) to suppress deviant sexual behaviors. The progesterone / progestin sex hormones are central nervous system and sexual depressants.


The nandrolones since they do not convert (aromatize) to estrogen have negative (depressing) sexual effects in the brain with loss of sexual desire and erectile dysfunction. The estrogen component of natural T is necessary to relax blood vessels and facilitate sexual desire in the brain.
Other agents used by body builders may include:
a) Cytomel (T3)-the potent form of thyroid to increase metabolism and burn fat. T3 can cause excitement and can decrease penile blood flow.
b) Diuretics – used before contests to remove fluid to enhance muscle vein prominence.
c) Stimulants before training or to lose weight. All stimulants decrease penile blood flow.

Post Cycle Therapy (PCT) includes agents like Clomid, Tomoxifen, HCG (human chorionic gonadotropin), and Arimidex. Except for HCG all the others either lower or block estrogen levels and can sometimes be anti-sexual.

However when HCG is used estradiol levels go up in a natural proportion to testosterone and many body builders report enhanced sexuality and function. Their testes also may increase in size with HCG.
Male sexual behavior is an interaction between the intra psychic (mind), biology (the body) and relationship (the couple). E.D. can occur from some abnormality in either one of these areas or a mixture. A shift of these domains can affect the other. The results are variable and need to be looked at a case-by-case basis.

Testosterone modulates nitric oxide expression in the penis, which is necessary for erections. Those men who have very low testosterone levels often experience poor results to the erectile drugs like Sildenafil (Viagra) and the others. They also lose morning erections. It is necessary for testosterone to be present to convert (aromatize) to estrogen to have a positive sexual effect in the brain and other tissues (penis).

The goal of most bodybuilding is to achieve a maximum cosmetically aesthetic physical appearance rather than athletic performance goals. Most body builders are not involved in professional competitions, but often follow competitive body building principals in order to achieve the best look cosmetically. This is a big problem.

Body builders can run into problems by sacrificing their cosmetic look goals over their natural internal health. One of the biggest issues is that body builders do cycles of “stack “of multiple androgens and other anabolic agents including many anabolic steroids, insulin, growth hormone etc. Those who start at a young age on various “cycles” may later develop androgen induced hypogonadism or AIH.  A basic rule is that the longer the “cycles” and the older the body builder that more problems will occur over time with erectile function and lowered natural T production. Some get to point later where they cannot make enough of their own natural internal testosterone to have normal erectile function.

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