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 Men's Sexual Health: Aging & Men's Sexual Performance 
Alex Santoso PhD ©

Age-Related Decline in Male Sexual Performance
One of the most common complaints of aging men is the decline in their sexual performance. Men's sexual peak usually occurs at around the age of 18. For most, it's usually downhill from there - for some, significant declines in sexual performance can occur as early as in their late 20s. Aging is usually correlated with a longer time to achieve full erection, a less firm erection, lower libido or sex drive, a decline in sexual stamina, inadequate sensation, and unsatisfactory ejaculation.

Aging and Decline in Testosterone Level
As men age, their production of DHEA, as well as testosterone and other androgens or sex hormones decline. It's been estimated that for every year over the age of forty, men's testosterone level drops by one percent1. About twenty percent of men in their sixties and fifty percent of men in their eighties have significantly reduced testosterone levels.

As testosterone is a key hormone in men's sexual functions, aging-related decline in testosterone levels has a negative impact on men's sexual performance.

Other Factors that Contribute to Poor Sexual Performance
For some men, the effect of aging on the decline in their sexual performance is further complicated with other factors, such as pain and fatigue. Pain caused by age-related diseases, such as arthritis and diabetes, can make sex less enjoyable. Likewise, fatigue and muscle soreness can impair men's sex drive.

As sexual performance is closely related to men's overall health, factors that affect general health, such as anxiety, stress, and psychological factors, can also affect sexual performance. Fortunately, any decline associated with these factors is usually reversed once the underlying factors are resolved.

Other causes of poor sexual performance include cigarette smoking and tobacco chewing, as well as alcohol and drug abuse.

Reversing the Decline in Sexual Performance
The good news is that much of the aging-related decline in men's sexual performance can be reversed. First, men should aim for a healthy, stress-free, and active lifestyle. Quitting smoking, alcohol, and drug use - if they are a factor - can contribute not only to better sexual performance, but also overall health.

Age-related decline in testosterone level can also be medically treated by testosterone replacement therapy. Here, the purpose of the therapy is to increase serum level of this hormone by oral administration, injection, or transdermal delivery of testosterone.

Although generally safe, testosterone replacement therapy may not be suitable for all candidates and can carry substantial health risks and side effects. In addition to requiring close monitoring of serum androgen levels, testosterone replacement therapy should only be administered by qualified physicians.

Natural Herbs for Age-Related Sexual Performance Decline
An herbal extract has been shown by clinical studies to be promising in reversing this age-related decline in men's sexual performance. Protodioscin, the main active ingredient in the herbal plant Tribulus terrestris, have been shown by clinical studies to increase the level of DHEA and testosterone in men2.

A clinical study on fifteen men with decreased sexual performance showed that nearly 90% of men treated with protodioscin (in form of Libilov Supplement) at 500mg 3x daily for 60 days experienced improved libido, erection, ejaculation, and orgasm as compared to before the treatment.

Here, protodioscin treatment resulted in significantly increased sex drive 33% of men after 30 days and in 80% of men after 60 days. Similarly, arousal improved in 53% of men after 30 days and 87% of men after 60 days. Orgasm sensation and ejaculate quality also improved significantly in 40% and 87% of men after 30 and 60 days, respectively3.

In another clinical study, 60 non-diabetic men with and without erectile dysfunctions and 15 diabetic men with sexual performance problems were given protodioscin (Libilov) at 3 x 250 mg per day for 3 weeks. The study found that in addition to increased DHEA levels in the treated group, the frequency of successful intercourse increased by 60%4. In addition, an improved sense of well-being, improved sensation, erection, ejaculation, and orgasm were also reported by the treated men In these and other clinical studies on Tribulus terrestris' protodioscin, no unwanted side effects or contraindications were found.

An Increasingly Popular Herb - Protodioscin Not Always Present
Because of its function in naturally improving men's sexual performance and the lack of unwanted side effects, Tribulus terrestris is slowly becoming a very popular herb. Unfortunately, not all commercially available Tribulus contains the active ingredient protodioscin.

1. Morley, JE. Testosterone replacement in older men and women. J Gend Specif Med. 2001; 4:49-53
2. Viktorov I, Bozadjieva E, Protich M, et al. Pharmacological, pharmacokinetic, toxicological and clinical studies on protodioscin. 1994, IIMS Therapeutic Focus
3. Arsyad KM. Effect of protodioscin on the quantity and quality of sperms from males with moderate idiopathic oligozoospermia. Medika 22 (8): 614-618 (1996)
4. Adimoelja A and Ganeshan Adaikan P. Protodioscin from herbal plant Tribulus terrestris L improves the male sexual functions, probably via DHEA. Int. J. Impotence Research. 1997:9; Supp. 1
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