Sexual enhancement products for sale online : raising awareness of the psychoactive effects of Yohimbine, Maca, Horny Goat Weed and Ginkgo Biloba

Copyright © 2014 Ornella Corazza et al.This is an open access article distributed under theCreativeCommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedIntroduction. The use of unlicensed food and herbal supplements to enhance sexual functions is drastically increasing. This phenomenon, combined with the availability of these products over the Internet, represents a challenge from a clinical and a public health perspective. Methods. A comprehensive multilingual assessment of websites, drug fora, and other online resources was carried out between February and July 2013 with exploratory qualitative searches including 203 websites. Additional searches were conducted using the Global Public Health Intelligence Network (GPHIN). Once the active constitutes of the products were identified, a comprehensive literature search was carried out using PsycInfo and PubMed. Results. The most common sexual enhancement products available on the Internet were identified. Their active ingredients included yohimbine, maca, horny goat weed and Ginkgo biloba. These four substances were reported with the occurrence of adverse events and the induction of psychological symptoms, such as mood changes, anxiety, and hallucinations as well as addictive behaviours. Conclusions. Uncontrolled availability of sexual enhancement products that contain potentially harmful substances is a major public healthconcern.Thepossible impact on population health, particularly among subjects with psychiatric disorders, usually at risk for sexual dysfunction, may be significant. This new trend needs to be extensively studied and monitoredPeer reviewedFinal Published versio

Recognising female sexual dysfunction as an essential aspect of effective diabetes care

The following literature review will focus on sexual dysfunction in women living with diabetes, drawing on international studies in this specialist field. The key aim of this paper is generate a greater understanding and recognition of the issues facing these women and to determine a more proactive approach to identification, consultation and potential treatment options. The main findings highlight the unique role practitioners have with women with diabetes and how to facilitate partnership working. Nurses have the most frequent contact with people living with diabetes in any healthcare system. Nurses’ knowledge about sexuality in relation to diabetes should improve patient education, recognition and could signal undiagnosed or increased risk of sexual dysfunction to enable treatment so care can be optimised accordingl

The current treatment of erectile dysfunction

Erectile dysfunction (ED) is the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. It is the most frequent sexual dysfunction in elderly men and its prevalence increases with age. Ever since ED was recognized as a real health problem, several treatment options became available and some of them proved to be very efficient. PDE5 inhibitors are the mainstay treatment of ED. However, other treatment options such as intracorporal injections, surgery, vacuum devices and prosthesis are also available for patients who are unresponsive to PDE5 inhibitors. Since none of the treatment options available so far has proven ideal, research in the field of sexual medicine continues. The aim of this paper is to review the most advances in the treatment of ED

Behavioral Effects of Inhibition of Cyclic Nucleotide Phosphodiesterase 2 (PDE2) in Mice

Cyclic nucleotide phosphodiesterases (PDEs) are a super-family of enzymes that regulate intracellular levels of the second messengers, cyclic AMP and cyclic GMP. Multiple PDEs have been shown to play vital roles in the central nervous system, with involvement in mood, reward mechanisms, and learning and memory. PDE2 is of special interest due to its high level of expression in forebrain regions, which are specifically implicated in mood and memory processes. In the first set of experiments, the potential role of PDE2 in depression- and anxiety-like behaviors was investigated using the forced swim test, tail suspension test, elevated plus maze, hole-board and step-through passive avoidance tests, as well as the object recognition test (ORT). The PDE2-selective inhibitor, Bay 60-7550 (3 mg/kg) did not significantly alter any of the depression- or anxiety-like behaviors, but did significantly enhance memory in the ORT. In the next set of experiments, the ORT was used to investigate the effect of PDE2 inhibition on various stages of learning and memory. Bay 60-7550 was administered 30-120 min prior to training, 0, 1, or 3 hrs after training, or 30 min prior to recall testing. Next, inhibitors of the cAMP or cGMP signaling pathways were administered 30 min prior to the PDE2 inhibitors Bay 60-7550 or ND7001, to assess the role cyclic nucleotide signaling on PDE2 inhibitor-enhanced memory. Finally, changes in the phosphorylation of CREB at Ser-133 and VASP at Ser-239 were determined to confirm activation of cAMP and cGMP signaling by PDE2 inhibition at behaviorally relevant doses. Bay 60-7550 (3 mg/kg) significantly enhanced memory of mice in the ORT when given 30 min prior to training, immediately after training, or 30 min prior to recall. Inhibitors of the cGMP pathway blocked the memory-enhancing effects of both Bay 60-7550 (3 mg/kg) and ND7001 (3 mg/kg). Bay 60-7550 (3 mg/kg) significantly enhanced the phosphorylation of CREB and VASP, both targets of PKG. While PDE2 inhibition did not appear to play a major role in depression- and anxiety-like behaviors in these tests, future research will further elucidate the role of PDE2 in other mood-related behavior tests. Additionally, PDE2 does appear to play a major role in learning and memory, as seen in the ORT. Developing a greater understanding of the role of PDE-2 in these memory processes will allow for potential drug development for the intervention of a variety of human diseases related to cognitive decline and memory impairment, which plague millions of individuals each year

Regulation of hippocampal synaptic plasticity thresholds and changes in exploratory and learning behavior in dominant negative NPR-B mutant rats

The second messenger cyclic GMP affects synaptic transmission and modulates synaptic plasticity and certain types of learning and memory processes. The impact of the natriuretic peptide receptor B (NPR-B) and its ligand C-type natriuretic peptide (CNP), one of several cGMP producing signaling systems, on hippocampal synaptic plasticity and learning is, however, less well understood. We have previously shown that the NPR-B ligand CNP increases the magnitude of long-term depression (LTD) in hippocampal area CA1, while reducing the induction of long-term potentiation (LTP). We have extended this line of research to show that bidirectional plasticity is affected in the opposite way in rats expressing a dominant-negative mutant of NPR-B (NSE-NPR- BΔKC) lacking the intracellular guanylyl cyclase domain under control of a promoter for neuron-specific enolase. The brain cells of these transgenic rats express functional dimers of the NPR-B receptor containing the dominant- negative NPR-BΔKC mutant, and therefore show decreased CNP-stimulated cGMP- production in brain membranes. The NPR-B transgenic rats display enhanced LTP but reduced LTD in hippocampal slices. When the frequency-dependence of synaptic modification to afferent stimulation in the range of 1–100 Hz was assessed in transgenic rats, the threshold for both, LTP and LTD induction, was shifted to lower frequencies. In parallel, NPR-BΔKC rats exhibited an enhancement in exploratory and learning behavior. These results indicate that bidirectional plasticity and learning and memory mechanism are affected in transgenic rats expressing a dominant-negative mutant of NPR-B. Our data substantiate the hypothesis that NPR-B-dependent cGMP signaling has a modulatory role for synaptic information storage and learning

Management of erectile dysfunction post-radical prostatectomy

© 2015 Saleh et al.Radical prostatectomy is a commonly performed procedure for the treatment of localized prostate cancer. One of the long-term complications is erectile dysfunction. There is little consensus on the optimal management; however, it is agreed that treatment must be prompt to prevent fibrosis and increase oxygenation of penile tissue. It is vital that patient expectations are discussed, a realistic time frame of treatment provided, and treatment started as close to the prostatectomy as possible. Current treatment regimens rely on phosphodiesterase 5 inhibitors as a first-line therapy, with vacuum erection devices and intraurethral suppositories of alprostadil as possible treatment combination options. With nonresponders to these therapies, intracavernosal injections are resorted to. As a final measure, patients undergo the highly invasive penile prosthesis implantation. There is no uniform, objective treatment program for erectile dysfunction post-radical prostatectomy. Management plans are based on poorly conducted and often underpowered studies in combination with physician and patient preferences. They involve the aforementioned drugs and treatment methods in different sequences and doses. Prospective treatments include dietary supplements and gene therapy, which have shown promise with there proposed mechanisms of improving erectile function but are yet to be applied successfully in human patients

The effects of sildenafil ciltrate on the lateral geniculate body of adult Wistar rats (Rattus norvegicus)- A histological study

The histological effect of oral administration of sildenafil citrate (Viagra), commonly used as an aphrodisiac and for the treatment of erectile dysfunction on one of the visual relay centres namely the lateral geniculate body (LGB) of adult Wistar rat was carefully studied. The rats of both sexes (n=24), average weight of 202g were randomly assigned into three treatment (n=18) and control (n=6) groups. The rats in the treatment groups ‘A’, ‘B’ and ‘C’ received respectively, 0.25mg/kg, 0.70mg/kg and 1.43mg/kg body weight of sildenafil citrate base dissolved in distilled water daily for 30 days, through orogastric feeding tube, while that of the control group D, received equal volume of distilled water daily during the period of the experiment. The rats were fed with growers’ mash obtained from Edo Feeds and Flour Mill Ltd, Ewu, Edo State, Nigeria and were given water liberally. The rats were sacrificed on day thirty-one of the experiment. The lateral geniculate body (LGB) was carefully dissected out and quickly fixed in 10% formal saline for histological studies. The histological findings after H&E method indicated that the treated section of the lateral geniculate body (LGB) showed some varying degree of reduced cellular population based on its sparse distribution, degenerative changes, cellular hypertrophy, and intercellular vacuolations appearing in the stroma. Varying dosage and long administration of sildenafil citrate may have some deleterious effects on the neurons of the intracranial visual relay centre and this may probably have some adverse effects on visual sensibilities by its deleterious effects on the cells of the lateral geniculate body (LGB) of adult Wistar rats. It is therefore recommended that further studies aimed at corroborating these observations be carried out

Vascular function and cardiovascular risk factors in women with severe flushing

Background: Seventy per cent of postmenopausal women suffer from hot flushes causing significant morbidity in 25%. Oestrogen replacement provides symptom relief, but its use has declined following safety issues and there is, as yet, no good alternative. Pathophysiology is poorly understood, but one proposed mechanism is altered peripheral vascular reactivity. It has recently been suggested that the presence of flushing may be a marker of underlying cardiovascular risk. <p/>Aim: To measure (i) peripheral vascular reactivity in subcutaneous vessels (ii) routine and novel cardiovascular risk factors in postmenopausal women who flush, and compare results to a matched group of women who do not flush. <p/>Methods: Thirty-two postmenopausal women with at least 20 flushes/week and 14 nonflushing postmenopausal women were recruited. Cutaneous microvascular perfusion was measured using laser Doppler imaging, and endothelial function was assessed by iontophoresis (administration of vasoactive agents through the skin by an electric current) of acetylcholine [Ach] (endothelial-dependent) and sodium nitroprusside [SNP] (endothelial independent). Blood samples for risk factors were taken following vascular assessment. <p/>Results: Both study groups were well matched demographically. The response of the subcutaneous vessels was greater in women who flushed than those who did not, following administration of both the endothelium-dependent and independent vasodilators, (ACh, P ≤ 0·001, SNP, P = 0·001, 2-way anova). By contrast, levels of High Density Lipoprotein (HDL)-cholesterol and ApoA1 were significantly lower in the flushing women compared with the control women (P = 0·02 and 0·002, respectively), and levels of inter-cellular adhesion molecule-1 (ICAM-1) were higher (P = 0·03), findings robust to adjustment for confounders, suggesting an adverse cardiovascular risk profile. <p/>Conclusion: These results confirm a better vascular response in women but paradoxically, such women appear to have worse (not better) cardiovascular disease risk factors in particular lower HDL-cholesterol but also higher non-HDL-c to HDL-c ratio and increased ICAM-1. Further studies are needed to assess vascular risk factors in women who flush

Adaptive plasticity during stress and depression and the role of glutamate-nitric oxide pathways

Anxiety and mood disorders are amongst the most prevalent and disabling of all the psychiatric disorders. Under-diagnosis and current treatments that are often less than adequately effective, contributes to an enormous personal and economic cost to the patient, family and health-care organizations. Although distinctly separate disorders at neuropathological and phenomenological levels, brain-imaging studies in posttraumatic stress disorder (PTSD) and depression have emphasized that both illnesses may induce damaging effects on regions of the brain involved in regulating the response to stress. While controversy prevails as to whether these changes represent an adaptive process or are indeed pathological, they are associated with marked changes in memory and other cognitive functions. In depression, a history of prior episodes is correlated with a higher risk of relapse, while poor compliance with antidepressants not only predicts later relapse, it may result in a more rapid shrinkage of the abovementioned brain regions, possibly providing a basis for relapse and treatment resistance. Similarly, even with the introduction of effective medications for PTSD, many patients remain treatment-resistant. Stress in various guises may alter synaptic connectivity in the brain by bolstering glutamatergic excitotoxic mechanisms. Understanding these mechanisms may assist in developing more effective treatment strategies. This paper will review pre-clinical and clinical evidence supporting a role for the glutamatenitric oxide pathway as a putative mediator of the neuropathological changes evident in depression and stress-related disorders, particularly PTSD, and its potential as a novel target for psychotropic activity. South African Psychiatry Review Vol. 9(3) 2006: 132-13