Improvement of erectile function with Prelox: a randomized, double-blind, placebo-controlled, crossover trial | International Journal of Impotence Research

The results of this double-blind, placebo-controlled, crossing study verify findings from previous clinical trials on a broader, operate basis. 9, 10, 12 The synergy between e-NOS foreplay by Pycnogenol and the coincident provide with the substrate of e-NOS, L-arginine, establishes the footing for an enhanced production of NO. NO is the non-adrenergic/non-cholinergic neurotransmitter of primary importance for controlling relaxation of penile smooth brawn, in concert with acetylcholine and prostaglandins. 13 These erectogenic neurotransmitters act in concert with vasodilators produced by the endothelium, predominantly NO. NO diffuses to the placid muscle layers to stimulate guanyl cyclase, initiating intracellular production of cyclic GMP ( cGMP ), which subsequently triggers muscle relaxation as a second messenger. Whereas 5-phospho-diesterase inhibitors increase erectile affair by blocking the degradation of cGMP, frankincense prolonging its action, Prelox provides more NO to stimulate guanylcyclase, to produce more cGMP. therefore, both treatment principles enhance the quantity of cGMP—Prelox by providing more NO to stimulate its production, 5-phosphodiesterase inhibitors by blocking its enzymatic abasement.

The treatment with Prelox in this investigation increased IIEF scores from 11–17 to 26–30. According to an analysis of erectile function scores, scores above 25 no longer represent ED, but normal erectile function. 14 The double over frequency of intercourse after verum shows the success of discussion. Patients selected for this cogitation corresponded very closely to the group of patients in our first unfold survey in terms of age—36.6 versus 37 years—and ED. 9 Patients at this age answer best to treatment, whereas the treatment period for patients with an old age of around 50 years and disturbed ED had to be extended to 11 months to produce a 76 % rate despite extra testosterone treatment. 12 The reply pace in this discipline is higher than the 80 % achiever rate found previously in the unfold cogitation, with the combination of Pycnogenol and L-arginine aspartate. 9 This could be caused by the compressed operate of inhalation in our study and/or by the convenience of taking one formulation ( Prelox ) alternatively of the two medications, L-arginine aspartate and Pycnogenol individually in the former cogitation. The treatment impression with Prelox lasts for a couple of weeks, as can be seen by the beggarly IIEF scores for group B, getting Prelox in the first treatment period ( board 1 ). IIEF scores for orgasmic function are going down from 9.2 to 6.1 after the follow wash-out period, go far down to 5.2 after the end of the placebo treatment and end up with 5 after death wash-out menstruation. far investigations are needed to show whether a longer period of treatment is able to produce a longer persist effect.

psychoanalysis of e-NOS natural process in lysed sperm showed a amazingly clearly addiction of e-NOS formation on the historic period of our patients. similar effects of old age on NO-mediated effects had been observed in animal experiments. 15, 16 Loss of e-NOS bodily process in aging rat is reported to be caused by an altered phosphorylation of e-NOS. 16 further studies are needed to identify the mechanism by which Pycnogenol or its metabolites activate e-NOS or, alternatively, block its inactivation. Pycnogenol, reinforced by L-arginine supply, may overcome an prohibition of e-NOS action by interfering with its abnormal phosphorylation in aged organisms. An other possibility is that Pycnogenol enhances not only the action of e-NOS, but its deduction. It has been demonstrated in cell culture systems that incubation with Pycnogenol doubled synthesis of antioxidative enzymes ( superoxidedismutase and catalase ). 17 therefore, a foreplay of deduction of e-NOS is another choice for the mode of action of Pycnogenol. e-NOS has been detected in homo seminal vesicles ; it is not entirely confined to endothelial cells as previously assumed. In the testis, e-NOS was found in Leydig cells and Sertoli cells and in the epidymis and vessel deferens, illustrating the significant character of NO—and e-NOS—for the human male generative system. 18 Decreasing amounts of e-NOS in sperm with increasing age correspond to the general effect of aging on fertility. The addition of testosterone levels in treatment periods could be caused by the common relationship between testosterone levels and sexual stimulation. There is a positive feedback, as testosterone is released by sexual stimulation. 19, 20, 21, 22 The enhanced ability of patients to perform sexual sexual intercourse stimulates sexual health. sexual health, in turn, overcomes depression, which is often associated with ED. Depression leads to lower testosterone levels indeed more frequent sexual stimulation, enhanced intimate health, and fewer depressive episodes may cause positive feedback to testosterone production. 23, 24

The standardization of blood pressure after treatment is in accord with studies showing a standardization of blood coerce in slightly hypertensive patients by administration of ache bark extract. 25 supplementation with Pycnogenol lowered endothelin-1 in blood of hypertensive subjects and increased prostacyclin levels, frankincense reducing blood imperativeness. 26 The rebuff lowering of cholesterol, observed in this report adenine well as in clinical trials with Pycnogenol, may contribute to an anti-atherosclerotic effect. 6, 27, 28 All other parameters of routine clinical chemistry remained in the normal range. The small, but meaning increase in the act of erythrocytes and in the concentrations of albumin and hemoglobin remained well within the character ranges for male adults. As the treatment with Prelox was very well tolerated—none of the patients reported adverse effects and none of the patients left the study—Prelox has a very friendly risk/benefit ratio .

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