Invigo: Powerful Male Enhancement Pills

Amla -Best natural source of vitamin C

The use of Amla fruit (Emblica officinalis, Phyllanthus emblica) has been a fundamental part of India's practice of Ayurvedic Medicine for centuries, and is one of the planet's most concentrated sources of natural vitamin C.1 And despite centuries of use in Ayurvedic medicine, most health-savvy consumers are still unaware of just how concentrated it truly is. So to help put things in better perspective, let's do some simple comparisons.

It has been estimated that, gram for gram, Amla fruit extracts contain as much as 35 times as much vitamin C as limes, 30 times more than oranges, and a mind-boggling 160 times more than apples. That said, 100 grams of Amla will typically yield over 500 mg of vitamin C.2 What's even more impressive, the vitamin C found naturally occurring in Amla is non-acidic and therefore won't cause the discomfort that many have experienced when taking traditional vitamin C supplements.3

This helps illustrate two very powerful points of interest. First, Amla appears to be an extremely potent antioxidant that utilizes a natural source of vitamin C. The vitamin C in Amla bonds with tannins, thus preventing it from being destroyed by light and heat. This helps ensure better utilization within the body. Next, supplementing Amla makes it possible for people with various stomach and digestive sensitivities to reap the life-enhancing benefits of a compound they might otherwise be unable to take.4

As mentioned earlier, these high concentrations of vitamin C have made Amla a staple among Ayurvedic practitioners. And while much of this can be attributed to the extract's strong antioxidant properties, Amla's potential extends far beyond healthy cells. Research continues to show that, based on its unique profile of active constituents, Amla seems to offer a number of beneficial effects that could not be achieved via synthesized natural-form vitamin C. We now know that Amla contains notable amounts of cytokine-like substances, such as zeatin, z. nucleotide and z. riboside, amid rich concentrations of minerals and amino acids.5

Based on its cooling, antipyretic, antiseptic and rejuvenating properties, Amla has been equally revered for the role it plays in digestion. So much in fact, that it is one of the three main fruits that comprise Triphala, a digestive tonic that contains Amla, Harada and Behada fruits. Long before it piqued the interest of vitamin C researchers, the use of Amla was considered by many Ayurvedic practitioners to be highly effective in rejuvenating the digestive system.6 It has mild laxative properties that encourage normal digestion, assists in the utilization of fats and cholesterol, modulates immune function, facilitates the elimination of toxins, fortifies the liver, supports normal cholesterol balance and prevents lipid peroxidation. And because of its strong antioxidant properties, Amla can help fight free radicals within the GI tract.7,8

Regardless of how you choose to look at it, Amla's complex profile of naturally occurring compounds makes it one of the most versatile extracts available to ever hit the consumer market. Be sure to look for a formula that contains Phyllanthus emblica extracts yielding at least 50% natural ascorbic acid, by weight.

References

1. Kaviratna AC, Sharma P (translators), Caraka-Samhita, Second Revised Edition [volume 3], 1996 Indian Books Centre, Delhi

2. Arora, BB. Development of Unani Drugs from Herbal Sources 1985, P.234 Vitamin C from Amla in equivalent to Vitamin C from Synthetic sources.

3.Ghosal S, Triethi VK, and Chauhan S, Active constituents of Emblica officinalis: Part 1.-The chemistry and antioxidative effects of two new hydrolysable tannins, Emblicanin A and B, Indian Journal of Chemistry 1996; 35B: 941-948.

4. Anonymous, Case Study on Amla-related patent, Technology Information, Forecasting & Assessment Council (TIFAC) Bulletin, 2001; 7(3-4): 6-6.

5. Williamson EM (editor), Major Herbs of Ayurveda, 2002 Churchill-Livingstone, London.

6. Maharashtra Medical Journal June 1980 Volume XXV No. 35

7. International Journal of Indian Medicine July 1985 P.56.

8. Journal Research Ayurveda Sidhha 1985-6(3), P. 137-138.

Erectile Dysfunction Calculator | HealthcareMagic.com | Live Chat with Doctors

Erectile Dysfunction Calculator | HealthcareMagic.com | Live Chat with Doctors

Body Mass Index (BMI) Calculator | HealthcareMagic.com | Live Chat with a Doctor

Body Mass Index (BMI) Calculator | HealthcareMagic.com | Live Chat with a Doctor

Alcohol V/s Erectile Dysfunction

It is clear that the statistics on erectile dysfunction cases is far from being precise. Nevertheless, the number of men with erection problems tends to increase due to both medical states and people’s style of life. Moreover, the issue is becoming a rather widespread one for all the countries of the world. The situation is even more complex as too often men have difficulties in discussing their state with a professional. But gradually people become more tolerant to the realities of erectile dysfunction, ready for various forms of treatment that are offered for solving the problem.

The increased risk of erectile dysfunction is often associated with health problems connected with stress. Among the most common reasons of inadequate erection are diabetes, hypertension, injuries and some other medical conditions. Another key aspect of healthy sexual life is the man’s psychological state. Depressive disorders and excess anxiety may lead to erection issues. At the same time, alcohol and alcoholism have been long known as the factors that are directly connected with erectile dysfunction.

The role of alcohol in erection problems is widely covered in specialized literature and publications. It is a proven cause of certain risk factors, which in their turn may result in erectile dysfunction. Almost everyone knows that alcohol increases erotic attraction, but at the same time it affects sexual performance negatively, making it difficult to achieve and maintain a firm enough erection.

Sexual reactions of the body depend on our nervous system greatly. Being a depressant, alcohol changes reactions and stimulations in brain. Constant or large doses of alcohol inhibit nervous activity. As a result, it becomes problematic to sustain sexual intercourse after alcohol intake. Alcohol in the blood system expands or widens the blood vessels of the penis. Consequently, even a strong erection would not maintain as the blood flows off rapidly making the penis relaxed again. Even if not totally impossible, sexual intercourse becomes awkward and hardly brings satisfaction to any of the partners. Moreover, toxins from alcohol remain in the body for hours after drinking.

Erectile dysfunction is able to worsen the man’s life and health considerably. Good news is that erection problems can be overcome when they depend on one’s attitude to alcohol. Alcohol-related issues with sex will be gone as soon as the way of life changes. To begin with, go for a medical consultation to analyze possible interrelation between drinking and erectile dysfunction. Your physician might recommend a course of medicines along with professional consultations regarding drinking.

To free from erection problems, try new approaches to your lifestyle. Healthy habits will help to get rid and/or to prevent causes of erectile dysfunction, or at least to make them manageable. Moreover, drinking modestly is good not only for sexual life but for general state of health and condition. And vice versa, alcohol ruins the reproductive system along with other key organs.

Wellness is key to overall health

BY DR. YONG H. TSAI, ON CALL

Wellness, or good health, has traditionally been viewed as freedom from disease; thus, if you were not sick, you were considered healthy. This perspective is changing. The absence of illness is just one part of being healthy, and, in fact, does not indicate that you are in a state of well-being. Wellness is more, including the sense of total physical, mental, and spiritual well-being. It is a proactive, preventive process designed to achieve optimum levels of health, as well as social and emotional functioning. Wellness is the integration of body, mind, and spirit, and emphasizes the whole person.

Wellness research shows that people who take care of themselves and properly manage their lifestyles are healthier, more productive and have fewer absences from work. Studies have also shown that this "wellness" approach, which focuses on a self-care education program, resulted in less total medical visits and, additionally, a significant decline in medical visits for minor illness.

While traditional medicine concentrates on alleviating or curing disease, the wellness approach encourages patients to take personal responsibility for their well-being. Integrating advanced medical treatment options along with a wellness approach will not only improve medical effectiveness, but eventually decrease medical costs as well. Prevention of illness is an integral part of comprehensive medical care. Optimal outcomes can be achieved by prevention, early diagnosis and treatment of illness.

The new Affordable Health Care Act includes annual wellness exams for senior citizens through the Medicare beneficiary program. It is a new comprehensive preventive health exam that kicks in this year. This new benefit can be used every year and is free to seniors. Furthermore, the exam includes the usual evaluations of vital signs, height, and weight, yet also establishes a schedule for recommended screenings (such as bone density testing, colonoscopy, mammograms and cholesterol screenings) and a medical nutritional consultation. Through the exam physicians also seek to identify cognitive impairment, functional ability, and depression, three problems common to us seniors as we age.

Wellness is closely associated with your lifestyle. Each person has a responsibility to provide for himself or herself such health essentials as good nutrition, proper weight control, exercise and management of risk factors such as smoking, alcohol and drug abuse. Each of these factors play a role in wellness. Sometimes, it is difficult to initiate a wellness lifestyle yourself. There are many types of wellness programs including nutritional and mental health counseling, massage therapy, Tai chi, yoga and other exercise programs. Programs may even involve acupuncture or other alternative medicines. Entering a wellness program is critical to helping people identify their wellness problems and improving their overall well-being. This New Year's resolution need not be just a slogan, but an important first step to following the wellness lifestyle.

Dr. Yong H. Tsai is board-certified in rheumatology, allergy and clinical immunology and has been practicing in this area since 1993.

Five exercises for better sex

Sex is a physical activity, as we already know. Therefore, getting in shape, being fit and having a fabulous body will definitely improve your sex-life. Not only this, working out regularly will help increase your stamina and strength to perform. 

People who regularly exercise are more healthier, fitter and tend to have more attractive bodies. This should be enough motivation for folks who think that their weight is normal and hence, do not need to exercise. If the prospects of better health doesn't motivate you, perhaps exercising for the sake of better sex might. Here are some exercises that will help you to enhance your prowess in bed: 

Push-ups: 

Push-ups are great for obvious reasons. They help to strengthen the arms, shoulders and stomach muscles. Sporting a paunch might be a major turn off for quite a lot of people. Having firm, sexy abs is very attractive physical attribute. Having strong abs is very useful for males especially when it comes to the man-on-top position. 

Squats: 

Doing squats, a lot of muscles are put to work producing greater amount of hormones, which in turn will boost your sex drive. They improve one's strength and stamina of gluteus muscles and the upper legs thereby helping to improve one's performance. Doing squats also helps one achieve a firm and attractive bottom. 

Bench press: 

Doing bench presses, helps to strengthen the chest and shoulder muscles. Women find chest muscles sexually appealing and it will help men to support themselves longer without getting exhausted easily. As for women, doing bench presses will make the breasts firm and seem full. 

Cardio: 

Whether it is doing aerobics, running or swimming, doing cardio-vascular exercises help increase blood circulation in the body. Having a good blood flow and circulation helps in the process of arousal, which is especially essential for men performance-wise. Also, doing cardio helps release of endorphins in the brain, which are known as the happy hormones. 

Kegel's exercise: 

Last but not the least, Doing Kegel's exercise can help make a remarkable difference in your sex life. Pubococcygeal muscles also known as PC muscles are the muscles used to stop urinating midstream. That's because, for men, regularly doing Kegel's exercises will help them to control the muscles that contract during ejaculation and therefore prolong ejaculation. As for women, doing Kegel's exercises will help you gain gain control over the vaginal muscles, thereby getting greater sexual satisfaction. 

 http://timesofindia.indiatimes.com

Hair loss drug leads to loss of libido

Scientists have found that 5a-reductase inhibitors (5a-RIs), while improving urinary symptoms in patients with benign prostatic hyperplasia (BPH) and possible hair loss prevention, produces significant adverse effects in some individuals including loss of libido, erectile dysfunction (ED), ejaculatory dysfunction and potential depression. 

These findings suggest that extreme caution should be exercised prior to prescribing 5a-RIs therapy to patients for hair growth or for BPH symptoms. 

The study has been conducted by researchers from Boston University School of Medicine (BUSM), in collaboration with colleagues at Lahey Clinic and from Denmark and Germany. 

5a-RIs, finasteride (Propecia) and dutasteride, have been approved for treatment of lower urinary tract symptoms, due to BPH, with marked clinical efficacy. Finasteride is also approved for treatment of hair loss (androgenetic alopecia). 

Although the adverse side effects of these agents are thought to be minimal, the magnitude of adverse effects on sexual function, gynecomastia, depression, and quality of life remains ill-defined. 

In order to determine the potential extent of this problem, the researchers examined the data reported in various clinical studies concerning the side effects of finasteride and dutasteride. 

After a review of the literature the researchers found that in a subset of men, prolonged adverse effects on sexual function such as erectile dysfunction and diminished libido were reported, raising the possibility of a causal relationship. 

According to the researchers, the adverse side effects of 5a-RIs on sexual function, gynecomastia and the impact on the overall health have received minimal attention. 

However, in some patients, these side effects are persistent with regard to sexual function and with an emotional toll including decreased quality of life. 

"The potential widespread use of 5a-RIs for treatment of BPH, prostate cancer and male pattern hair loss may produce undesirable adverse side effects on overall health and in particular, vascular health and sexual function in a subgroup of susceptible patients," said lead author Abdulmaged M. Traish, a professor of biochemistry and professor of Urology at BUSM. 

"Furthermore, treatment of hair loss, a benign condition with 5a-RIs may produce persistent side effects in a number of young patients. 

"Honest and open discussion with patients to educate them on these serious issues must be pursued prior to commencing therapy because, in some patients, these adverse effects are persistent and may be prolonged and patients do not recover well after discontinuation from drug use," cautioned Traish. 

The researchers believe additional clinical and preclinical studies are warranted to determine the reason for why some of these adverse effects persist in some individuals. 

The study appears on-line in Journal of Sexual Medicine . 

http://timesofindia.indiatimes.com

ORIGINAL RESEARCH—EJACULATORY DISORDERS
Yoga in Premature Ejaculation: A Comparative Trial with Fluoxetine


Vikas Dhikav, MD,* Girish Karmarkar, MBBS, MD,† Mallika Gupta, MBBS,* and
Kuljeet Singh Anand, DM‡
*All India Institute of Medical Sciences, New Delhi, India; †Private Practice, Thane-Mumbai, India; ‡Dr. RML Hospital and
Post Graduate Institute of Medical Education and Research-Guru Gobind Singh-Inderprastha University—Neurology,
Delhi, India
DOI: 10.1111/j.1743-6109.2007.00603.x



A B S T R A C T
Introduction. Yoga is a popular form of complementary and alternative treatment. It is practiced both in developing and developed countries. Use of yoga for various bodily ailments is recommended in ancient ayvurvedic (ayus = life, veda = knowledge) texts and is being increasingly investigated scientifically. Many patients and yoga protagonists claim that it is useful in sexual disorders. We are interested in knowing if it works for patients with premature ejaculation (PE) and in comparing its efficacy with fluoxetine, a known treatment option for PE. 

Aim. To know if yoga could be tried as a treatment option in PE and to compare it with fluoxetine.

Methods. A total of 68 patients (38 yoga group; 30 fluoxetine group) attending the outpatient department of psychiatry of a tertiary care hospital were enrolled in the present study. Both subjective and objective assessment tools were administered to evaluate the efficacy of the yoga and fluoxetine in PE. Three patients dropped out of the study citing their inability to cope up with the yoga schedule as the reason.

Main Outcome Measure. Intravaginal ejaculatory latencies in yoga group and fluoxetine control groups.

Results. We found that all 38 patients (25–65.7% = good, 13–34.2% = fair) belonging to yoga and 25 out of 30 of the fluoxetine group (82.3%) had statistically significant improvement in PE.

Conclusions. Yoga appears to be a feasible, safe, effective and acceptable nonpharmacological option for PE. More studies involving larger patients could be carried out to establish its utility in this condition. Dhikav V, Karmarkar G, Gupta M, and Anand KS. Yoga in premature ejaculation: A comparative trial with fluoxetine. J Sex Med 2007;4:1726–1732.

Key Words. Premature Ejaculation; Yoga; Fluoxetine; Nonpharmacological Treatment; Complementary and Alternative Treatments

Premature ejaculation (PE) is the most common sexual disorder of young males. Normative data suggest that men with an intravaginal ejaculatory latency time of less than 1 minute have “definite” PE, while men with intravaginal ejaculatory latency times of between 1.0 and 1.5 minutes have “probable” PE [1]. Prevalence rates of 20–30% have been reported [2]. PE is generally defined as the occurrence of ejaculation prior to the wishes of both sexual partners. This broad definition, thus, avoids specifying a precise duration for sexual relations and reaching a climax. An occasional instance of PE may not be cause for concern, but if the problem occurs with more than 50% of attempted sexual relations, a dysfunctional pattern should be suspected and appropriate diagnostic and therapeutic measures must be initiated.

Yoga in Premature Ejaculation

A number of treatment options are used for PE. Although selective serotonin reuptake inhibitors (SSRIs) have the potential to improve the quality of life for men with PE and their partners [3–5], patients’ satisfaction and drug side effects may remain to be a problem. New treatments are therefore desirable. Because the condition has stigma and patients may not be aware that medical treatment options are available, nonpharmacological treatment options seem preferable.

Yoga is a popular nonpharmacological intervention. There are many types of yoga: hatha yoga is an element of raja yoga and deals mainly with physical postures and breathing. Karma yoga emphasizes spiritual practice to help the individual “unify” body, mind, and heart through certain practices in daily life and work. Bhakti yoga, a devotional form, generally encompasses chanting, reading of scriptures and worship practices. We focused mainly on hatha yoga by various asanas. An asana is a particular posture of the body, which is both steady and comfortable. In yoga, there are more than a hundred classical poses, and these probably have as many variations. These can be subdivided into two categories: active and passive. Active poses are supposed to tone specific muscle and nerve groups, and benefit organs and the endocrine glands. The passive poses are employed primarily in meditation, relaxation, and pranayama practices. We employed both active and passive poses during the present study (see Figure 1).

Each posture, or asana, is held for a period of time and is synchronized with the breath. Generally, a yoga session begins with gentle asanas and works up to the more vigorous or challenging postures. A full yoga session includes exercises of every part of the body, pranayama (prana = life; breath control practices), relaxation, and meditation.

Yoga is a popular nonpharmacological treatment method for a number of conditions, and there are claims of it being effective in bodily disorders including the sexual ones;we thought i tworthwhile to investigate its efficacy and to compare it to fluoxetine, a commonly used SSRI for PE.

Materials and Methods

We studied 68 patients (Table 1) attending the outpatient department of a tertiary care psychiatric hospital in North Delhi. A detailed history of each patient was taken. A general physical examination of all systems was performed. After establishing the diagnosis using Diagnostic and Statistical Manual IV, the patients were offered to choose between pharmacological (capsule fluoxetine– fluoxetine group) and nonpharmacological (yoga– yoga group) treatments. Three patients opted out of the study citing inability to adhere to the yoga regime. Because these opted out of the yoga group before the study began, we did not include them in the final analysis.

The wives of the patients were briefed about starting the stopwatch once the penetration began and then to stop it once the husbands ejaculated. They was asked to note down the intra-ejaculatory latencies in seconds in a diary.

Those who opted for drugs were given fluoxetine capsule (group 1) in dose of 20–60 mg/day as a single dose, while for those who opted for yoga (group 2) the protocol was explained (Table 2). The patients were encouraged to report any side effects occurring during the course of treatment in both groups.

Patients included in the study had PE, were fluoxetine naïve, had no history of trauma, diabetes, hypertension, or any other chronic physical or mental disorder. There was no history of substance abuse. The patients were not on any concurrent medications and had unremarkable general physical examinations. The mean age of onset of PE was 28 years and the mean duration was 1.7 1.5 years.

The patients were briefed by a sexologist and a yoga expert about the protocol they had to follow over 12 weeks (Tables 2 and 3). They were told to practice 12 asnas and 2 pranayanams for 1 hour/day.

The patients were examined after 4 and 8 weeks, respectively. Their intravaginal ejaculatory latencies were noted and analyzed. Although the average suggested duration was 1 hour, it was not rigidly fixed, and the patients were told to practice yogasanas depending upon their stamina. This was because in yoga, the advice generally given was that the patients should not exert themselves. Three repetitions of each asana were suggested. Differential relaxation was taught to the patients once they finished their daily yoga protocol with a breathing technique called as anulomvilom (breathing via alternative nostrils) and shavasan (Sanskrit—shav = a dead body, lying dead). That means in the end, the patients performed breathing as mentioned and laid still for few minutes. In this, they were able to relax those muscles, which were stretched during yoga. That is why this is named as “differential relaxation.” All patients were told to practice mehabhed mudra, which included doing perineal and pubococcygeal exercises for 10–15 seconds at a time and for 15–20 times a day. They could do it anywhere including at their workplace, while, e.g., traveling, reading, or watching TV.

Statistical Analysis

Statistical analysis was performed using SPSS  

version 10 (SPSS Inc., Chicago, IL, USA). Paired

t-test was used to calculate the P value. A P value of less than 0.05 was considered significant.

Results

We found that all 38 patients in the yoga group   

had subjective (Table 4) and statistically significant 

(P < 0.0001) improvement (Table 5). Twenty-five of 30 patients of fluoxetine (82.3%) had clinical improvement in PE (Table 5, P < 0.001). The patients were interviewed at the end of the 4th and 8th weeks. Results in both groups at the 4th week did not achieve statistical significance, while those of the 8th week were significant (P < 0.001—see Table 5). A subjective evaluation was carried out by asking the wife to rate the husband’s performance and her satisfaction after the end of the study period (Table 4). A side-effect profile of fluoxetine based upon patients reporting adverse effects was prepared (Table 6). None of the side effects, however, required drug discontinuation.

Yoga was well tolerated by patients who chose to enroll themselves for this form of treatment. There were no significant side effects or dropouts reported during the course of treatment.

Discussion

PE is an extremely common disorder affecting young males. SSRI, like fluoxetine, is a commonly used treatment option for PE [6,7]. Although SSRIs offer several advantages like convenience of administration and acceptable therapeutic response, they have disadvantages like failure in many patients and unacceptable side effects. Moreover, drug prescription requires a visit to a sexologist or psychiatrist, an idea with which many patients of PE may not be fully comfortable. This is due to stigma with PE. It has been said that most patients remain unaware that PE is a medical condition. A nonpharmacological treatment option in PE should, thus, presumably be a welcome idea.

An online medical dictionary defines yoga as   

“a way of life that includes ethical precepts, 

dietary prescriptions, and physical exercise.” A 

large survey shows that about one in every five 

adults has used at least one such therapy in the 

last 1 year [8]. 

Pranayama is the method of “proper” breathing. 

“The way” we breathe is supposed to have an effect 

on the nervous system. By regulating the breath 

and increasing oxygenation to the brain cells, it is 

supposed to “strengthen” the voluntary and involuntary nervous systems. At the  beginning of each 

of yoga, pranayama practice is performed in order 

to prepare patients for the asanas that follow.

The present study is an attempt to explore the  

therapeutic potential of yoga as a nonpharmacological treatment in PE and to compare it to fluoxetine, a known treatment option. Fluoxetine 

had a response rate of 83.3%, which is in agreement with some of the previously reported 

studies [9,10]. Although fluoxetine generally produces symptomatic improvement at the end of 3 

weeks, results of the present study suggest that 

improvement may not be noticeable until the 

end of 8 weeks, with yoga. Thus, relatively late 

improvement can be an important limitation of 

the present study. It could, however, be compensated somewhat by some form of counseling. An 

additional limitation is that the patients were  

given the option of choosing between yoga and 

fluoxetine, hence introducing a selection bias. 

Three patients chose not to participate in the 

present study because of their inability to adhere to yoga regime.

Although we do not know an exact mechanism by which yoga is useful in PE, several postulations could be made about its putative mechanisms of usefulness. Yogasanas and breathing exercises have long been considered in obtaining the “optimum mental and physical health state.” Yoga could perhaps be causing better anxiety control. This assertion is supported by several studies [11–14]. One of these studies [11] included 175 patients (98 males, 77 females) between age group 19–76 years who belonged to the heterogenous group. The study evaluated anxiety scores using the State Trait Anxiety Inventory and showed that scores dipped significantly after yogic exercises. The same study showed that a measurable decline in anxiety scores could be achieved as early as within 10 days if the patients adopt healthy lifestyle interventions consisting mainly of asanas, pranayama and relaxation techniques [11]. Others have reported that yoga promotes well-being, improves quality of life [12], and has an antidepressant effect [13]. Additional mechanisms contributing to a state of calm alertness include increased parasympathetic drive, calming of stress response systems, neuroendocrine release of hormones, and thalamic generators [13]. Relaxation induced by meditation helps to stabilize the autonomic nervous system with a tendency toward parasympathetic dominance. Physiological benefits, which follow, may help practitioners become more resilient to stressful conditions and may reduce a variety of important risk factors for various diseases, especially cardiorespiratory diseases [14]. Two published clinical trials in obsessive compulsive disorder, an anxiety disorder using a specific form of yoga known as kundalini yoga, have been described. This is a form of yogic exercise consisting of yogic kriyas, mantra chanting, following a particular dietary pattern, etc. [15]. A recent meta-analysis, however, has concluded that although results of studies involving yoga were positive, the methodology adopted was poor; hence, deriving conclusions were difficult. It emphasized the need of future well designed studies in this regard [16].

The yogasanas selected in the present study, in addition to their general putative health benefits,

were primarily aimed at improving the muscle tone and plasticity of the pelvic and perineal muscles. Asanas supposedly improve blood flow to these muscles and thus aid in their better contraction. This is probably responsible for local effect of yogasanas in the present study. Studies have shown that yoga can improve muscular efficiency [17,18]. In one such study [17], 42 volunteers were taken and their oxygen utilization during yogic and conventional exercises were studied. The study concluded that a yogic practitioner is likely to perform better on tasks such as cycling at average pace, walking at average speed, and tailoring, etc. Decreased fatigue and increased endurance were shown in another study after 6 months of training in yogic exercises [18].

It has been observed that a regular practitioner of yoga shows parasympathetic dominance [11].

Stimulation of the sympathetic nerves causes contraction of epididymis, ejaculatory ducts, and

seminal vesicles, and leads to ejaculation of semen. Increasing parasympathetic stimulation is assumably beneficial in enhancing ejaculatory control. We report a significant therapeutic effect of yoga in PE. This is in line with earlier studies, which have reported the efficacy of yogic exercises in the treatment of physical disorders [13–15]. 

What are the potential advantages of yoga as a treatment option in PE? It is popular with good acceptability, nonpharmacological, has no costs involved, and patients could be treated without medical or psychiatric intervention. Additionally, it could offer other associated health benefits as well to the patients [19,20]. Studies have shown that yogic exercises can reduce basal cortisol, catecholamines, metabolic rate, sympathetic activity, and oxygen consumption. Parasympathetic activity has been shown to increase [20].  

Physical efficiency, autonomic functions, body flexibility, and biochemical profile have been noted to improve following yogasnas [19]. A study involving 48 Indian soldiers found that performance on isometeric exercises was better after yoga training as measured by electromyography and spring pulling capacity [19]. 

Yogic exercises have been found to be useful in a variety of “mind–body” problems. PE is often perceived as a lifestyle problem [21], thus providing a window for such therapeutic interventions. Studies have shown that sufferers of PE have higher prevalence of lifestyle problems that can affect the individual at both emotional and physical levels. 

Non pharmacological treatment options, e.g., behavioral therapy and psychotherapy, have long been the mainstay of the treatment of PE [22]. These could be cumbersome and can have limited efficacy indicating that other non pharmacological treatments could be desirable. Although yoga was found to be a well-tolerated and effective treatment option for PE, the therapeutic response was delayed by 8 weeks. This is in contrast to SSRIs, which produce symptomatic relief by the 3rd or 4th week. Some form of counseling on the part of the physician and patience on part of patients may be required for satisfactory results.

The etiology of PE is multifactorial; hence, failure to appreciate this makes the diagnosis difficult and the treatment harder. Therefore, treatment of PE is undergoing change in recent times and it is suggested that an integrated approach should be adopted [23]. This combination therapy has become more relevant as patients relapse [23] frequently after taking drugs and has side effects like dry mouth, nausea, drowsiness, and reduced libido. Its use may also facilitate the development of other sexual dysfunctions, such as an ejaculation and erectile dysfunction [24]. Furthermore, it has been considered that because PE involves both psychosocial [25] and physiological components [26], both should be addressed. It is hoped that such a combination approach would result in prolonged ejaculatory latency, improved treatment satisfaction, and superior long-term outcome. We have tried to explore the possibility of yoga as a nonpharmacological treatment in PE. This is because, as stated earlier [22], nonpharmacological treatments have been important treatment options in this condition. A significant therapeutic benefit of yoga is reported in the study.

Conclusions

PE is the most common male sexual disorder that is both underdetected and undertreated. It is often distressing and patients do not come forward for treatment easily. This is due to shyness, stigma, feeling of inferiority, and shame in front of the partner. Yoga seems to be a well-tolerated, safe and effective non pharmacological treatment option for PE. The present study reinforces that the “mind– body” interventions could be beneficial in stress related mental and physical disorders. Because ours is a pilot study with a small sample size, it would be worthwhile to do more studies involving a large number of patients in a double-blind manner to establish yoga as a nonpharmacological treatment option for PE.

Corresponding Author: Vikas Dhikav, Dr. RML Hospital and PGIMER, GGS-IP University—Neurology, E\3, Flat Number-280 Sector-18, Delhi 110085, India. Tel: +91-9910011205; Fax: 011- 26865165; E-mail: vikasdhikav@hotmail.com,

va212001@yahoo.com

Conflict of Interest: None declared

References

1 Althof S. The psychology of premature ejaculation: Therapies and consequences. J Sex Med 2006;3 (4 suppl):324–31.

2 Shabsigh R. Diagnosing premature ejaculation: A review. J Sex Med 2006;3(4 suppl):318–23.

3 Moreland AJ, Makela EH. Selective serotoninreuptake inhibitors in the treatment of premature ejaculation. Ann Pharmacother 2005;39:1296–301.

4 Sharlip I. Diagnosis and treatment of premature ejaculation: The physician’s perspective. J Sex Med 2005;2(2 suppl):103–9.

5 Safarinejad MR, Hosseini SY. Safety and efficacy of citalopram in the treatment of premature ejaculation: A double-blind placebo-controlled, fixed dose, randomized study. Int J Impot Res 2006;18:164–9.

6 Waldinger MD, Zwinderman AH, Olivier B. On-demand treatment of premature ejaculation with clomipramine and paroxetine: A randomized,

double-blind fixed-dose study with stopwatch assessment. Eur Urol 2004;46:510–5; discussion 516.

7 Waldinger MD, Olivier B. Utility of selective serotonin reuptake inhibitors in premature ejaculation. Curr Opin Investig Drugs 2004;5:743–7.

8 Wolsko PM, Eisenberg DM, Davis RB, Phillips RS. Use of mind-body medical therapies. J Gen Intern Med 2004;19:43–50.

9 Metin A, Kayigil O, Ahmed SI. Does lidocaine ointment addition increase fluoxetine efficacy in the same group of patients with premature ejaculation? Urol Int 2005;75:231–4.

10 Manasia P, Pomerol J, Ribe N, Gutierrez del Pozo R, Alcover Garcia, J. Comparison of the efficacy and safety of 90 mg versus 20 mg fluoxetine in the treatment of premature ejaculation. J Urol 2003;170:164–5.

11 Gupta N, Khera S, Vempati RP, Sharma R, Bijlani RL. Effect of yoga based lifestyle intervention on state and trait anxiety. Indian J Physiol Pharmacol 2006;50:41–

12 Mamtani R, Mamtani R. Ayurveda and yoga in cardiovascular diseases. Cardiol Rev 2005;13:155–62.

13 Brown RP, Gerbarg PL. Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: Part I—Neurophysiologic model. J Altern Complement Med 2005;11:189–201.

14 Parshad O. Role of yoga in stress management. West Indian Med J 2004;53:191–4.

15 Shannahoff-Khalsa DS. An introduction to kundalini yoga meditation techniques that are specific for the treatment of psychiatric disorders. J Altern Complement Med 2004;10:91–101.

16 Kirkwood G, Rampes H, Tuffrey V, Richardson J, Pilkington K. yoga for anxiety: A systematic review of the research evidence. Br J Sports Med 2005;39:884–91.

17 Salgar DC, Bisen VS, Jinturkar MJ. Effect of padmasana—A yogic exercise on muscular efficiency. Indian J Med Res 1975;63:768–72.

18 Bhatnagar OP, Anantharaman V. The effect of yoga training on neuromuscular excitability and muscular relaxation. Neurol India 1977;25:230–2.

19 Ray US, Hegde KS, Selvamurthy W. Improvement in muscular efficiency as related to a standard task after yogic exercises in middle aged men. Indian J Med Res 1986;83:343–8.

20 Khalsa SB. Yoga as a therapeutic intervention: A bibliometric analysis of published research studies. Indian J Physiol Pharmacol 2004;48:269– 85.

21 Sotomayor M. The burden of premature ejaculation: The patient’s perspective. J Sex Med 2005; 2(2 suppl):110–4.

22 Sharlip ID. Guidelines for the diagnosis and management of premature ejaculation. J Sex Med 2006;3(4 suppl):309–17.

23 Perelman MA. A new combination treatment for premature ejaculation: A sex therapist’s perspective. J Sex Med 2006;3:1004–12.

24 Hellstrom WJ. Current and future pharmacotherapies of premature ejaculation. J Sex Med 2006;3 (4 suppl):332–41.

25 Richardson D, Wood K, Goldmeier D. A qualitative pilot study of Islamic men with lifelong premature (rapid) ejaculation. J Sex Med 2006;3:337–43.

26 Donatucci CF. Etiology of ejaculation and pathophysiology of premature ejaculation. J Sex Med

2006;3(4 suppl):303–8

Chlorophytum borivilianum - Safed Musli herb used in India

Chlorophytum borivilianum is being promoted as a sexual enhancement herb and has  historically been used as an aphrodisiac herb in India. It is also known as safed musli by Ayurvedic practitioners.

As of JUne 2010, we have not seen human research with Chlorophytum borivilianum herb.

Chlorophytum borivilianum: a white gold for biopharmaceuticals and neutraceuticals.

Curr Pharm Biotechnol. 2009 Nov; Thakur GS, Bag M, Sanodiya BS, Debnath M, Zacharia A, Bhadauriya P, Prasad GB, Bisen PS. Research and Development Centre, Bisen Biotech and Biopharma Pvt. Ltd., Biotech Research Park, M-7, Laxmipuram, Transport Nagar, Gwalior (M.P.), India.

Chlorophytum borivilianum Santapau & Fernandes (Liliaceae) also known as 'Safed Musli' is a traditional rare Indian medicinal herb which has many therapeutic applications in Ayurvedic, Unani, Homeopathic and Allopathic system of medicine. Its roots (tubers) are widely used for various therapeutic applications. It is used to cure physical illness and weakness, as an aphrodisiac agent and revitalizer, as general sex tonic, remedy for diabetes, arthritis and increasing body immunity, curative for natal and postnatal problems, for rheumatism and joint pains, increase lactation in feeding mothers, as antimicrobial, anti-inflammatory, antitumor agent, also used in diarrhea, dysentery, gonorrhea, leucorrhea etc. It has spermatogenic property and is found useful in curing impotency, now it is considered as an alternative 'Viagra'. Its root contains steroidal and triterpenoidal saponins, sapogenins and fructans which act as therapeutic agents and play vital role in many therapeutic applications. It is a rich source of over 25 alkaloids, vitamins, proteins, carbohydrates, steroids, saponins, potassium, calcium, magnesium, phenol, resins, mucilage, and polysaccharides and also contains high quantity of simple sugars, mainly sucrose, glucose, fructose, galactose, mannose and xylose.

Aphrodisiac properties of Chlorophytum borivilianum

Effects of Chlorophytum borivilianum on sexual behaviour and sperm count in male rats.

Phytother Res. 2008 Jun; Kenjale R, Shah R, Sathaye S. Department of Pharmaceutical Sciences, Mumbai University Institute of Chemical Technology, Matunga, Mumbai 400019, India.

This study was designed to evaluate the aphrodisiac and spermatogenic potential of the aqueous extract of dried roots of Chlorophytum borivilianum in rats. Roots of Chlorophytum borivilianum can be useful in the treatment of certain forms of sexual inadequacies, such as premature ejaculation and oligospermia.

A Comparative Study on Aphrodisiac Activity of Some Ayurvedic Herbs in Male Albino Rats.

Arch Sex Behav. 2009 January. Thakur M, Chauhan NS, Bhargava S, Dixit VK. Department of Pharmaceutical Sciences, Dr. H. S. Gour University, Sagar, MP, 470003, India.

The roots of Asparagus racemosus, Chlorophytum borivilianum, and rhizomes of Curculigo orchioides are popular for their aphrodisiac properties. The herbs have been traditionally used as Vajikaran Rasayana herbs because of their putative positive influence on sexual performance in humans. Lyophilized aqueous extracts obtained from the roots of A. racemosus, Chlorophytum borivilianum, and rhizomes of C. orchioides were studied for sexual behavior effects in male albino rats and compared with untreated control group animals. Administration of 200 mg/kg body weight of the aqueous extracts had pronounced anabolic effect in treated animals as evidenced by weight gains in the body and reproductive organs. There was a significant variation in the sexual behavior of animals as reflected by reduction of mount latency, ejaculation latency, post ejaculatory latency, intromission latency, and an increase of mount frequency. Penile erection (indicated by Penile Erection Index) was also considerably enhanced. Reduced hesitation time (an indicator of attraction towards female in treated rats) also indicated an improvement in sexual behavior of extract treated animals. The observed effects appear to be attributable to the testosterone-like effects of the extracts. Nitric oxide based intervention may also be involved as observable from the improved penile erection. The present results, therefore, support the folklore claim for the sexual enhancing properties of Chlorophytum borivilianum and these herbs and provide a scientific basis for their traditional usage.

Effect of Chlorophytum Borivilianum Santapau and Fernandes on sexual dysfunction in hyperglycemic male rats.

Chin J Integr Med. 2009 Dec; Thakur M, Bhargava S, Praznik W, Loeppert R, Dixit VK. Department of Pharmaceutical Sciences, Dr. Hari Singh Gour University, Sagar, Madhya Pradesh, India.

To investigate the effects of Chlorophytum borivilianum on sexual dysfunction, loss of body weight, and lack of libido in hyperglycemic rats induced with streptozotocin or alloxan. Wistar strain male albino rats were divided into five groups of six animals each: the control group (2% polyvinylpyrollidone solution), the streptozotocin control group, the alloxan control group (100 mg/kg), the streptozotocin + CB treated group (200 mg/kg), and the alloxan + CB treated group. CB can significantly ameliorate diabetes-induced sexual dysfunction. Polysaccharide and saponin-rich aqueous extract appears to have the most suitable effects on diabetes and its associated effects on sexual functionality.

Cytotoxic spirostane-type saponins from the roots of Chlorophytum borivilianum.

J Nat Prod. 2009 Jan; Acharya D, Mitaine-Offer AC, Kaushik N, Miyamoto T, Paululat T, Mirjolet JF, Duchamp O, Lacaille-Dubois MA. Laboratoire de Pharmacognosie, Unite de Molecules d'Interet Biologique, UMIB UPRES-EA 3660, Faculte de Pharmacie, Universite de Bourgogne, 21079 Dijon Cedex, France.

Four new spirostane-type saponins named borivilianosides E-H were isolated from an ethanol extract of the roots of Chlorophytum borivilianum together with two known steroid saponins. The cytotoxicity of borivilianosides F, G, and H and three known compounds was evaluated using two human colon cancer cell lines (HT-29 and HCT 116).