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By Serge Kreutz (2002)
Practically all men experience an enlargement of the prostate as they age. Early symptoms usually set in after the age of 40. As the enlargement of the prostate gets worse, the most disturbing symptom is a persistent difficulty to pass water. This can become very uncomfortable and painful.
A standard treatment for an enlarged prostate over the past decades has been to remove surgically a substantial part of the prostate. That gets rid of the urination problem but unfortunately, nerves passing along the prostate often get cut as well. This will almost certainly mean a rather abrupt end to a man's sex life. That vital organ's function will, after the operation, primarily be that of a channel through which urine flows with little obstruction.
Not an appealing perspective for a large number of men.
Next on the scene arrived Proscar, an oral medication with the generic name finasteride. Proscar has been proven to often shrink an enlarged prostate. It does so by interrupting some hormonal processes that are at the root of benign prostate hyperplasia, the conversion of testosterone into dihydrotestosterone.
The conversion of testosterone into dihydrotestosterone is effected by the enzyme 5-alpha reductase. Proscar inhibits 5-alpha reductase and thereby the conversion of testosterone into dihydrotestosterone, thus interrupting the chain that leads to cell growth in the prostate. But even though nerves are not cut as they often are in the case of surgery, all is not well at the sex front for those on Proscar. Studies have proven what many men experienced when on Proscar: erections are hard to achieve and maintain.
There are three herbal preparations that have classically been used to facilitate urinary flow in older men: saw palmetto, nettle root, and pygeum africanum. Since the beginning of the nineties, when in the US, restrictions on the promotion and sales of herbal medications were lifted, saw palmetto and, to a lesser extent, the other two herbals have been touted as a cheaper and healthier alternative to Proscar that work just as well. And, most of all, the three herbal preparations are claimed NOT to interfere with sexual function (One US company marketing saw palmetto even promoted saw palmetto as the "sex pill of the nineties".)
The best studied among the three herbals is saw palmetto. There is no doubt that saw palmetto works. It does so in pretty much the same manner as Proscar: by inhibiting the enzyme 5-alpha reductase. Unfortunately, saw palmetto is comparable to Proscar in another aspect. Personal experience suggests that saw palmetto also interferes with the erectile function. There will just be less sensation in the male organ, comparable to what happens to the sensation of one's legs if one sits for a long time.
Pygeum africanum and nettle root are less studied. While both will also result in making passing urine easier for men with enlarged prostates, most probably by effecting a reduction of the size of the gland, the mechanism by which this happens is not precisely known.
The endocrine system works via receptor sites. In principle, one can interfere with hormonal processes in two manners: either by interfering with the hormones themselves, or by interfering with receptor sites. Phytoestrogens, for example, often have effects on women, which usually would be attributed to testosterone, the quintessential anti-estrogen. This is thought to happen because phytoestrogens are weaker than a woman's body's own estrogens. When phytoestrogens bind to estrogen receptor sites, they inhibit a woman's body's own stronger estrogens from binding to these sites, thus tilting the estrogen testosterone balance in favor of testosterone. In women, even a slight tilt towards testosterone will usually result in an increased sexual appetite.
It has been speculated that pygeum africanum and other herbals used in the treatment of an enlarged prostate work by interfering with the binding sites for dihydrotestosterone. We are not aware of scientific studies that would have dealt with the effect of pygeum africanum on erectile functions.
Alternative option: tongkat ali
Scientific research on tongkat ali has been summarized by Associate Professor Dr. Johari Md. Saad, Ph.D., University of Malaya, Malaysia.
For decades, the indigenous populations of South East Asia have been using Eurycoma longifolia for its high medicinal value. How the concoction worked for them is difficult to explain, but many swear by its close to supernatural benefits.
In Malaysia, the plant is better known as "tongkat ali" which literally means "Ali's walking stick".
Traditionally, it is valued for its aphrodisiac properties and treatment of diverse ailments ranging from cuts and wounds, skin infection, fever, malaria, high-blood pressure, diabetes, and to increase energy and stamina.
Scientific Research
As early as 1968, scientific research was conducted on Eurycoma longifolia (tongkat ali). At that time, the scientists were looking for natural chemical and have identified the following phytochemical components extractable into organic solvents. The following components were found in tongkat ali: www.tongkatali.org
Terpenoids, stigmasterol, sitosterol, sterol, saponins, quassinoid, campesterol, benzoquinpones, alkaloid, scopoletin, piscidinol, nilocitin, methoxycantin-one-oxid, methoxycantine-one, meliane, longilene, longilactone A and B, hydroxyeurycomalactone, hydroxycantin-one-oxid, hydroxycantine-one, hydroxydehydro-eurycomalactone, hispidone, eurylene, durylactone, eurycomanone, eyrycomanol-oD-glycopyranoside, eurycomanol, eurycomalactone, epispelin, dihydroxyklaineanone, dihydroxyeurycomanone, dihydroeurycomalactone etc.
It is believed that these components are biologically active in rendering some of the observed properties. Water-based tongkat ali extract can be obtained from the Medan, Indonesia-based company Sumatra Pasak Bumi with the web site address www.tongkatali.org. Sumatra Pasak Bumi is a major tongkat ali wholesale company and supports scientific research by providing free tongkat ali extract.
Currently, the above-listed components of tongkat ali are characterized and intensive studies on the properties of these components are being vigorously examined by scientists around the world. Many of the effects reported for tongkat ali are related to an upregulation of testosterone. Testosterone is the most important representative of the male sex hormones collectively known as androgens produced by the gonads. Its secretion stimulates the differentiation of the male reproductive tract in the embryo, the decent of the testes in to the scrotum, the further development of the reproductive tract and penis during puberty and maturation of the sperm. It is also responsible for the development of male secondary sex characteristics such as moustache, beard enlargement of the larynx (deep voice) and increase production of the sebaceous glands, all of which are associated with masculine features. Testosterone also plays a role in the development and maintenance of male libido (sexual desire) and sexual behavior.
Testosterone have other "non-sexual" roles: it serves the important function for protein biosynthesis in accelerating muscle build-up, increases the formation of red blood cells, speeds up regeneration and recovery time after illness or injury. It stimulates the entire metabolic activity especially in the energy metabolic pathways and burning of body fat.
If you ask any elderly men about their endurance and sexual desire- the answer would be non-affirmative. What is the cause? Aging? The answer is a definite "Yes"! But how is aging responsible for this syndrome? The answer lies in the testosterone level, which declines with age. Research shows that during puberty, its level is peaking. Its level is at their lifetime peak at the age of 25, and steadily decrease with age. Some clinical studies indicate that generally on average, testosterone levels drop as much as 2% on yearly basis after the age of thirty. The rate of decline is very much a factor of lifestyle. Individuals who exercise regularly have a much slower rate of decline. This is due to exercise to a certain extend stimulates the hormone secretion. A more prominent decline was observed in individuals who are heavy smokers and alcoholic.
Tongkat ali does not act in the same way as other claimed aphrodisiacs, which take effects immediately.
Tongkat ali has to be consumed regularly over time. The mode and mechanism of actions are different.
Tongkat ali acts through the enhancement of testosterone and also c-GMP productions. As it enhances the synthesis of the hormone it takes a longer time period to exert its effects. The benefits are felt gradually after a period of time. Optimal effectiveness should be felt within a week of continuous uninterrupted use. When the testosterone level increases, the health and vitality are restored.
Tongkat ali water-based extract is not a stimulant. Aphrodisiac effects of tongkat ali varied depending on the lifestyle and also the physical and physiological state of the individuals.
Cancer Cells Inhibitor
Researchers in America and Japan reported that some plant chemicals in the group of quassinoid and alkaloids found in tongkat ali have the effect of inhibiting the growth of cancer cells in animals in laboratory experiments. Examples of the chemical cells are breast cancer cells, colon cancer cells and leukemia.
Anti-Fever Effects
In 1995,it was reported that the quassinoid extracted from tongkat ali has an anti-fever effect. From this experiment, the quassinoid was 2 times more effective than aspirin.
Anti-Malarial Effect
Studies on the biological effects of tongkat ali began in the 1980s. Studies showed that the roots of tongkat ali have a group of plant chemicals called quassinoid alkaloid and peptide that has the property to kill malaria parasites.
Anti-oxidant Properties
Studies conducted by the Forest Research Institute Malaysia (FRIM) as well as the department of Bio-medical Science, Universiti Kebangsaan Malaysia (UKM) discovered that tongkat ali contains SOD (Superoxide dismutase), a kind of anti-oxidant enzyme. The studies showed that tongkat ali inhibited the chain reaction of radicals that can be harmful to the body system.
Quality of tongkat ali extract
Most, if not all, tongkat ali products available in the market today are pulverized (sawdust) root. Until they are scientifically analyzed in the laboratory, there is no way to verify which plant roots or plant parts are being used. Besides that, the raw roots are fungus-prone. Unless stringently quality controlled, even grounded root powder in capsules can deteriorate over time and are subject to attack from fungi and microorganisms, which could cause toxic and side effects over long-term usage.
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