Understanding Risks

There are several conditions in which you should never use testosterone replacement therapy. These include:

• Breast cancer (in males)
• Prostate cancer

In some other cases testosterone replacement therapy may not be right for you. If one of the conditions below is applicable to you, your doctor will decide whether (in your specific case) testosterone replacement therapy is the right solution.

• Liver disease
• Heart or blood vessel disease
• Edema (swelling of face, hands, feet, or lower legs)
• Enlarged prostate
• Kidney disease
• Diabetes mellitus (sugar diabetes)

To help your doctor determine your best treatment plan, you should also discuss the following:

• If you have ever had any unusual or allergic reaction to androgens or anabolic steroids.
• If you are an adult male who plans to have children; high doses of androgens may cause infertility.
• If you are bedridden.
• If you are now taking any other prescription or nonprescription (OTC) medicine, especially anticoagulants (blood thinners

Testosterone Replacement Therapy

In many instances, testosterone replacement in men with andropause can be highly effective and beneficial. It's not for every man, of course, even those who show symptoms on the previous quiz may have other health problems at the root of it all. Still you should discuss with your doctor if you would be a good candidate for testosterone replacement therapy.

What should I expect from testosterone replacement?

In various clinical studies, very good responses to testosterone have been reported for men with low-testosterone and they include:

• Improvement in mood and sense of well-being
• Increased mental and physical energy
• Decreased anger, irritability, sadness, tiredness, nervousness
• Improved quality of sleep
• Improved libido and sexual performance
• An increase in lean body mass, a decline in fat mass
• An increase in muscle strength (hand grip, upper and lower extremities)
• Potentially, a decrease in the risk of heart disease

With testosterone therapy, one's attitude improves, reinforcing self-esteem and self-confidence at work, as well as an increased energy at home and in social activities. Most men will feel more vigorous, experience improved energy levels, mood, concentration, cognition, libido, sexual performance and an overall sense of well-being. These effects are usually noted within 3 to 6 weeks. Other potential benefits include maintenance or improvement in bone density, improved body composition, muscle mass and muscle strength, as well as improvement in visual-spatial skills.

Lifestyle

Of course, any ongoing strategy to reduce the symptoms and risks of andropause should incorporate lifestyle approaches such as optimal diet, regular exercise, stress-management and the reduction of tobacco and alcohol intake.

Ingredients:

• Eurycoma Longifolia: Eurycoma Longifolia, commonly known as Tongkat Ali in Malaysia and Pasak Bumi in Indonesia, is a shrub-tree found growing wild along the hilly slopes of the rainforest of Malaysia and other parts of Southeast Asia. Tongkat Ali (Ali's walking stick) has been commonly prescribed in Malay and Asli's herbal medicine as a febrifuge and a remedy for intermittent fever (malaria), ulcer, and as a aphrodisiac for men. In Indonesia, the plant is called "Pasak Bumi" and the roots are used for traditional treatment of dysentery and tertian malaria. In Vietnam, the plant is called "Cay Ba Binh", the tree that cures a hundred diseases. Longjack is in the Superior Class of herbs having powerful and numerous benefits in the system.

Primary Benefits

• Improve testosterone production
• Improve physical and mental performance
• Enhance energy level, endurance, and stamina
• Reduce mental fatigue and exhaustion
• Tone skin and muscle
• Improve immune system

Do Androgens Decline in Men & Women?

Testosterone level decreases steadily with age. Studies show that the level of testosterone is at its peak (100%) around age 20, and ends at only 20%-50% at age 80, with an average decline of 2% yearly. In fact, many men's testosterone levels diminish to below the deficient threshold of 350 ng/ml at age 50 to 60. Normally, 500-1,100 ng/ml of testosterone should be in the blood. Therapeutic levels range around 1500ng/ml (Dr. Suhaimi Muhammad, Institut Teknologi MARA, Pahang Branch).

For women, the ovaries are responsible for 40% of the body's production of testosterone. As testosterone levels decline, women will experience fatigue, weight gain, low physical and mental energy, and lack of sexual desire. While HRT often addresses low Estrogen production, often low testosterone and progesterone production is not supplemented.

You can click here to see clinical references

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Tribulus Terrestris:

Tribulus Terrestris is an herb also known as the puncture vine, and has been used for centuries in Europe as a treatment for impotence and as a stimulant to help enhance sexual drive and performance. On the athletic front, this potent herb has been studied and observed to enhance LH (luteinizing hormone) production and raise testosterone levels. The increased testosterone levels by Tribulus Terrestris will have a positive effect on strength and stamina. Atheletes are using Tribulus Terrestris to help ensure their own natural levels of testosterone are at a normal level at all times. Tribulus Terrestris does not work the way prohormones such as Androstenedione and DHEA. It is a natural stimulant of LH. In fact, a person that has used a prohormone, should use Tribulus Terrestris on the "off cycle" to help their own testosterone levels return to normal, which is what the prohormone will suppress. On the "off cycle", many men feel weak, tired, and moody because their own natural testosterone levels have been suppressed. Tribulus Terrestris will help alleviate these symptoms.

Clinical studies in Bulgaria showed Tribulus Terrestris improved reproductive functions, including increased sperm production and testosterone levels in men. Among women, Tribulus Terrestris increased the concentration of hormones including estradiol, with testosterone being very slightly influenced, thereby improving reproductive function, libido, and ovulation.

What does it do?

• Increases the Natural Level of Testosterone.
• Increases Strength and Stamina
• Alleviates Tired, Week Moody Feelings on the "Off Cycle" of a Prohormone
• Stimulates Sexual Drive and Performance
• Increases Sperm Production
• Improves Reproductive Function, Libido, and Ovulation

You can click here to see clinical references

Epimedium Sagittum

Epimedium Sagittum may not sound serious, but in reality, it could provide a serious boost to those who need it. An all-natural phyto-aphrodisiac, it's based on the latest scientific research into male performance and well-being.

Epimedium Sagittum is a traditional botanical medicine used in China and Japan. Although this herb (which also goes by the names Yin Yang Huo, Inyokaku, and Herba Epimedii, Horny Goat Weed) has a history of traditional use for disorders of the kidneys, joints, liver, back and knees, its principle use is as an aphrodisiac.

According to one herbal author, Epimedium Sagittum has testosterone-like effects. It stimulates sexual activity in both men and women, increases sperm production, stimulates the sensory nerves, and increases sexual desire. Epimedium Sagittum's aphrodisiac effects has been verified in both animal and human research. Mice treated with a Epimedium Sagittum preparation produced "apparent effects on the improvement of sexuality". It was also shown to improve sperm producing capability. Since Epimedium Sagittum has been traditionally used for kidney disease, it's interesting that research has demonstrated a sexual potentiation effect and improved quality of life in patients with chronic renal failure who were given Epimedium Sagittum.

Research has shown that Epimedium Sagittum significantly increases testosterone in mice. This certainly appears to be the herb's mechanism of action, although Epimedium Sagittum may have more than one. For example, it has been established that sexual arousal is linked to the activity of cholinergic neurotransmitters. However, an enzyme called acetylcholinesterase (AChE) inactivates cholinergic neurotransmitters within 1/500 of a second. As it turns out, research shows that Epimedium Sagittum is capable of inhibiting AChE. Such an inhibition may support higher levels of the key cholinergic neurotransmitters associated with sexual arousal. In addition, research has shown that Epimedium Sagittum has anti-fatigue effects and helps prevents adrenal exhaustion. Horny Goat Weed ( epimedium ): Will it make you horny, too? by Ray Sahelian, M.D.

Epimedium is a pungent ornamental herb found in Asia and the Mediterranean. The Chinese call epimedium Yin Yang Huo, which loosely means "licentious goat plant." Legend has it that the name horny goat weed came from a herder who noticed his goats becoming more sexually active after eating the plant. Supplement companies have adopted the provocative name by which it is known in the U.S.

Horny goat weed was named epimedium because it is similar to a plant found in the ancient Asian kingdom of Media, now a part of Iran. Epimedium is a genus of many related plant species and some are used for medicinal purposes, including Epimedium sagittatum, Epimedium brevicornum, and Epimedium koreanum. Although epimedium has a history of traditional use for disorders of the kidneys, joints, and liver, its principle use in the United States is as an aphrodisiac and to combat fatigue.

What the Research Says about Epimedium

Very little research has been published in the Western medical literature regarding this plant. Our Chinese study investigated the therapeutic effect of epimedium sagittatum on 22 patients with chronic renal failure on hemodialysis. Twelve patients with hemodialysis were served as controls. Epimedium sagittatum had a sex enhancing effect and improved their quality of life.

Epimedium Mechanism of Action

The exact way that epimedium works remains unclear. Animal studies have shown that it may influence levels of neurotransmitters such as norepinephrine, serotonin, and dopamine and reduce cortisol levels. The leaves of epimedium sagittatum contain a variety of flavonoids, icariin, sterols and an alkaloid called magnaflorine. It's quite possible epimedium sagittatum influences several aspects of human sexual biochemistry. Icariin is thought to help with erectile function.

You can click here to see clinical references

Muira Pauma

Muira puama (Ptychopetalum olacoides) is a Brazilian shrub with a long history in South American folk medicine as an aphrodisiac and sexual tonic for promoting virility and treating impotence.6

Human studies have substantiated the use of muira puama for improving libido and treating erectile dysfunction. In one study conducted at the Institute of Sexology in Paris, France under the supervision of Dr. Jacques Waynberg, 262 male patients experiencing lack of sexual desire and the inability to attain or maintain an erection were treated with 1 to 2.5 grams of muira puama extract a day.

Following two weeks of treatment, 51 percent of those suffering from erectile dysfunction reported significant improvement. Additionally, 62% of the patients suffering from loss of libido reported that the muira puama extract had, in the words of the researchers, "a dynamic effect." A second study conducted by Dr. Waynberg included 100 men who complained of impotence, loss of libido and sexual difficulties due to "asthenia," described as fatigue, loss of strength, or debility. Following treatment with Muira puama, 66% of the men reported a significant increase in frequency of intercourse. Of 46 men complaining of loss of desire, 70% reported that treatment with muira puama increased libido.

Another important measure of sexual function, stability of erection during intercourse, was improved or restored in 55% of the patients. Other benefits reported included a reduction of fatigue, improved sleep, and increased morning erections. Treatment with muira puama was much more effective in cases with the least psychosomatic involvement. Of the 26 men diagnosed with common sexual asthenia without noticeable sign of psychosomatic disorder, the treatment was effective for asthenia in 100% of cases, lack of libido in 85% of cases, and for inability of coital erection in 90% of cases.

You can click here to see clinical references

Maca: Lepidium meyenii

From The Healing Power of Rainforest Herbs:

Maca is a hardy perennial plant cultivated high in the Andes Mountains, at altitudes from 8,000 to 14,500 feet. It has one of the highest frost tolerances among native cultivated species. Maca has a low-growing, mat-like stem system, which can go unnoticed in a farmer's field. Its scalloped leaves lie close to the ground and it produces small, self-fertile, off-white flowers typical of the mustard family to which it belongs.

The part used is the tuberous root, which looks likes a large radish (up to 8 cm in diameter) which is usually off-white to yellow in color. Unlike many other tuberous plants, maca is propagated by seed. Although it is a perennial, it is grown as an annual; seven to nine months is required to produce the harvested roots. The species L. meyenii was described by Gerhard Walpers in 1843. It has been suggested that the cultivated maca of today is not L. meyenii but a newer species L. peruvianum Chacon, based on various specimens collected since 1960 in the district of San Juan de la Jarpa, in Huancayo province of Peru. While most maca sold in commerce today still refers to the L. meyenii name, economic botanists believe most is L. peruvianum. In 1994 less than 50 hectares were devoted to the commercial cultivation of maca; by 1999 over 1200 hectares were under production due to rising demand in the U.S. and abroad.

The area where maca is found, high in the Andes, is an inhospitable region of intense sunlight, violent winds, and below-freezing weather. With its extreme temperatures and poor, rocky soil, the area rates among the world's worst farmland; yet, over the centuries, maca has evolved to flourish under these conditions. Maca was domesticated about 2,000 years ago by the Incas, and primitive cultivars of maca have been found in archaeological sites dating as far back as 1600 B.C.

TRIBAL AND HERBAL MEDICINE USES

To the Andean Indians and indigenous peoples, maca is a valuable commodity. Because so little else grows in the region, maca is often traded with communities at lower elevations for such other staples as rice, corn, green vegetables, and beans. The dried roots can be stored for up to seven years. Native Peruvians traditionally have utilized maca since pre-Incan times for both nutritional and medicinal purposes. It is an important staple in the diets of these people, as it has the highest nutritional value of any food crop grown there. It is rich in sugars, protein, starches, and essential nutrients (especially iodine and iron). The tuber or root is consumed fresh or dried. The fresh roots are considered a treat and are baked or roasted in ashes (in the same manner as sweet potatoes). The dried roots are stored and, later, boiled in water or milk to make a porridge. They also are made into a popular sweet, fragrant, fermented drink called maca chicha. In Peru even maca jam, pudding, and sodas are popular. The tuberous roots have a tangy, sweet taste and an aroma similar to that of butterscotch.

This energizing plant is also referred to as Peruvian ginseng (although maca is not in the same family as ginseng). Maca has been used for centuries in the Andes to enhance fertility in humans and animals. Soon after the Spanish conquest in South America, the Spanish found that their livestock was reproducing poorly in the highlands. The local Indians recommended feeding the animals maca; so remarkable were the results that Spanish chroniclers gave in-depth reports. Even colonial records of some 200 years ago indicate that payment of (roughly) nine tons of maca was demanded from one Andean area alone for this purpose.

In Peruvian herbal medicine today, maca is reported to be used as an immunostimulant; for anemia, tuberculosis, menstrual disorders, menopause symptoms, stomach cancer, sterility (and other reproductive and sexual disorders); and to enhance memory. Maca has been growing in world popularity over the last several years due to several large U.S. marketing campaigns touting its energizing, fertility enhancement, hormonal balancing, aphrodisiac, and, especially, enhanced sexual performance properties. Other (anecdotal) herbal medicine uses in the U.S. and abroad include increasing energy, stamina, and endurance in athletes, promoting mental clarity, treating male impotence, and helping with menstrual irregularities, female hormonal imbalances, menopause, and chronic fatigue syndrome.

PLANT CHEMICALS

The nutritional value of dried maca root is high, resembling those of cereal grains such as maize, rice, and wheat. It contains 60-75% carbohydrates, 10-14% protein, 8.5% fiber, and 2.2% lipids. The protein content of maca exists mainly in the form of polypeptides and amino acids (including significant amounts of arginine, serine, histidine, aspartic acid, glutamic acid, glycine, valine, phenylalanine, tyrosine, and threonine). It also has about 250 mg of calcium, 2 g of potassium, and 15 mg of iron in 100 g of dried root-and important amounts of fatty acids (including linolenic, palmitic, and oleic acids). Maca contains sterols (about 0.05% to 0.1%) and other vitamins and minerals. In addition to its rich supply of essential nutrients, maca contains alkaloids, tannins, and saponins.

A chemical analysis conducted in 1981 showed the presence of biologically active aromatic isothiocyanates (a common chemical found in the mustard family of plants and shown to be a wood preservative and insecticide). Chemical research shows maca root contains a chemical called p-methoxybenzyl isothiocyanate, which has reputed aphrodisiac properties. At least four alkaloids are also present but have not yet been quantified. Fresh maca root contains about 1% glucosinolates-plant chemicals found in many plants in the family Brassicaceae (broccoli, cabbage, cauliflower, and other cruciferous vegetables). While no novel glucosinolates have been reported in maca yet, several of the chemicals found in this group of known plant chemicals are documented to be cancer-preventive. Maca's main plant chemicals include: lkaloids, amino acids, beta-ecdysone, calcium, carbohydrates, fatty acids, glucosinolates, iron, magnesium, p-methoxybenzyl isothiocyanate, phosphorus, potassium, protein, saponins, sitosterols, stigmasterol, tannins, vitamin B1, vitamin B2, vitamin B12, vitamin C, vitamin E, and zinc.

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Nutritional Profile of Dried Maca Root

(Average 10 gram serving) Component per 10 g Amino Acids per 10 g Minerals per 10 g Protein 1-1.4 g Alanine 63.1 mg Calcium 25 mg Carbohydrates 6-7.5 g Arginine 99.4 mg Copper 0.6 mg Fats (lipids) 220 mg Aspartic acid 91.7 mg Iron 1.5 mg Fiber 850 mg Glutamic acid 156.5 mg Iodine 52 mcg Ash 490 mg Glycine 68.3 mg Manganese 80 mcg Sterols 5-10 mg Histidine 41.9 mg Potassium 205 mg Calories 32.5 HO-Proline 26.0 mg Sodium 1.9 mg Isoleucine 47.4 mg Zinc 380 mcg Leucine 91.0 mg Vitamins per 10 g Lysine 54.5 mg Fats/Lipids per 10 g B2 39 mcg Methionine 28.0 mg Linoleic 72 mcg B6 114 mcg Phenylalanine 55.3 mg Palmitic 52 mcg C 28.6 mg Proline 0.5 mg Oleic 24.5 mcg Niacin 565 mcg Sarcosine 0.7 mg Serine 50.4 mg Threonine 33.1 mg Tryptophan 4.9 mg Tyrosine 30.6 mg Valine 79.3 mg

BIOLOGICAL ACTIVITIES AND CLINICAL RESEARCH

Maca's fertility-enhancing properties were reported as early as 1961, when researchers discovered that it increased fertility in rats. Marketing and resulting sales of maca for sexual function has been fueled by clinical research since. The majority of this research, however, has been performed or funded by two main marketers of maca products in the U.S. and abroad! Also suspect to the independent scientific community are studies that "measure libido enhancement" - these are known to be highly subjective. Study protocols can also be easily orchestrated to provide desired outcomes and results; therefore, many trained industry and medical professionals note this brand of (product-sponsored) research with mild interest at best. The first study reporting maca's effect on sexual function was published in 2000 (and performed by a marketer of maca) and described the beneficial effects of using maca in impotent mice and rats. Another, published a year later, indicated similar effects in male rats. Studies in 2001 reported a beneficial effect on male sperm production in rats and improvement of sperm count and motility in nine healthy adult men. In 2002 a study reported improved sexual performance in inexperienced male rats; another "self-perception on sexual desire" test in healthy men reported aphrodisiac or libido enhancement effects. In several of the rat and mice studies, the animals were administered up to 4 g per kg of body weight of a "concentrated maca extract" to achieve the reported results. This would (approximately) equate to a 300 g (10 oz.) dose for an average (170 lb.) man! None of these studies, however, indicated a possible mechanism of action - or related these observed effects to constituents or chemicals contained in maca root.

It may well be that maca's beneficial effects for sexual function and fertility can be explained simply by its high concentration of proteins and vital nutrients. Dried maca root contains about 10% protein - mostly derived from amino acids. Amino acids (the building blocks of proteins) are required in the diet to drive many cellular functions in the body - including sexual and fertility functions. Amino acids are required to manufacture neurotransmitters such as dopamine and noradrenaline. These substances transmit signals in the nervous system and play a major role in the process of sexual arousal and physical performance during sex. The main amino acids that these neurotransmitters require include phenylalanine, tyrosine, and histidine (all three of which are found in good supply in maca). The amino acid arginine, of which maca is a significant source, is thought to assist in the generation of nitric oxide-which is thought to counteract male impotence (although this is not clinically validated). Many libido- and sexual-enhancement health supplements on the market today contain arginine for this reason. Arginine has also clinically proven to play a role in male fertility through its action of increasing sperm production and motility. It is highly likely that some of the sexual and fertility effects reported were due to maca's high arginine content. The amino acid histidine also is found in maca root in high amounts. This amino acid plays an often-overlooked but important role in sexual function: during ejaculation and orgasm. The body utilizes histidine to produce histamine, and histamine in the corpus cavernosum (penile erectile tissue) ultimately is responsible for the way ejaculations happen. Men suffering from premature ejaculation often show increased histamine activity; they may be helped by a simple antihistamine, or the amino acid methionine (which counteracts the formation of histamine from histidine). This is the same mechanism that explains a side effect of prescription antihistamines - aorgasmia (or the inability/difficulty to achieve an orgasm).

Conversely, men and women having difficulties achieving orgasms may be helped by histidine supplementation - this may increase histamine levels in the sexual tract, which in turn make orgasms and ejaculations easier. An additional pro-sexual effect of histidine (as well as arginine) may lie in its vasodilating effect, increasing blood flow to the sex organs. Again, the significant, natural histidine content of maca may have played a role in the rat studies reporting a greater number of copulations. But it does make one wonder - is the benefit of additional copulations at the expense of shorter duration and/or premature ejaculation? Surely this subject is best suited for truly independent (and not product-sponsored) research.

Other benefits and anecdotal reports touting maca for hormonal balancing, endocrine and thyroid function enhancement, and even immune system enhancement are likely related to maca's amino acid and nutrient content as well. The endocrine system drives many functions in the body, including the production of many types of hormones (which, in turn, regulate many other bodily processes). Although hormones are chemically diverse, they are constructed simply from amino acids and cholesterol. If given sufficient levels of starting materials (natural amino acids), the body may use them as needed to construct hormones which keep the body in balance. Where diet and nutrition are poor (a common problem in the Andes, home to so few green, leafy vegetables), maca is a vital part of the diet - providing the necessary nutrients to keep the body healthy and functioning efficiently. The marketing claim made that maca actually increases testosterone or sex hormones has been clinically disproved just recently.

In a 2003 double-blind placebo human trial, men taking a maca root extract (1.5-3 g daily) evidenced no changes in any reproductive hormonal level tested, including testosterone (which actually showed a slight decrease!).

BIOPERENE

In studies, Bioperene (Black pepper - piper nigrun fruit extract) increases absorption of other nutrients from 30 to 250% via a process called thermogenesis. Recent studies have shown that it can greatly increase the bioavailabbility of other compounds - such as vitamins, minerals, and herbal substances.

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