It is important to preserve the functionality of the different parts of the body system, if life is to remain exciting.To achieve this, the knowledge of the biochemical events which underline the functionality or dysfunctionality of such body parts is crucial

1. BIOCHEMISTRY OF
PENILE ERECTILE
FUNCTION AND
DYSFUNCTION:ROLE OF
APHRODISIACS
IGHODARO,
O.M.
BiochemicalToxicology&Medicinal PlantResearch
Department of Biochemistry

4. WHAT ARE PENILE
FUNCTIONS ?
WHICH OF THE PENILE
FUNCTIONS REQUIRES
ERECTION TO OCCUR?

5. PENILE FUNCTIONS
 SEX

6. WHAT IS ERECTILE DYSFUNCTION (ED) ?

7. WHY TALK ABOUT ED ?
 Incidence and prevalence is high worldwide
(It affects up to 52% of men (40-70yrs)
 It weakens the bonding that comes with sex in
marital relationship

8.  It affects the totality of man- his psyche, confidence
and self esteem. His relationships , job performance
and attitude to life are compromised
 Every one in this room is either a man or has
something to do with man, so we are all affected

9. ANATOMY OF THE PENIS

10. WHICHCALLED COR COMPOSED OF
CORPUS SPONGIOSUM (WHICH
HOUSES THE URETHRA.

12. HOW DOES ERECTION OCCUR?
SEVERAL NETWORK OF SYSTEMS WORK TOGETHER TO
PRODUCE NORMAL ERECTION.

13. ERECTION
.

14. TUMESCENCE DETUMESCENCE

15. BIOCHEMICAL PATHWAY FOR ERECTILE
FUNCTION

17. HOW IS NITRIC OXIDE GENERATED ?
Nitric Oxide production follows neurological input. It involves
both autonomic and somatic nervous systems.
Precisely the parasympathetic nervous system and the Sensory
neurones

18. NO is generated from EC & carvernous nerve cell through Arginine-
Citrulline pathway

20. SMOOTH MUSCLE RELAXATION FOR PENILE
ERECTION
Acetylcholine > EC & CNC > NO > cGMP > low
ca2+
> SMR

21. SMOOTH MUSCLE CONTRACTION FOR
DETUMESCENCE
Adrenergic Norepinephrine, & EC Endothelins & prostaglandins increase
Intracellular Ca2+
& IP3 but decrease cAMP > SMC pip2

22. BIOCHEMISTRY OF ERECTION
(SUMMARY)
 A Neurotransmitter such as acetylcholine is released
via the parasympathetic system
 Acetylcholine binds to the receptor on the endothelia
cell & NANC nerve cell to generates Nitric oxide
 Nitric oxide activates Guanylate cyclase which
converts GTP to cGMP
 cGMP reduces intracellular Ca2+
resulting in smooth
muscle relaxation and consequent erection through
influx of blood into the cavernosum
 Erection is reversed through the action of type 5
PDE which exists primarily in corpora cavernosum.

23. CAUSES OF ERECTILE DYSFUNCTION
1.Organic
 Vascular
 Neurological
 Hormonal
 Anatomical
 Drugs
 Arteriogenic
2.Psychogenic
 Depression
 Anxiety
 Stress
 Performance anxiety

24.  Vascular disorders (VDs),
atherosclerosis, blood vessel
damage, arteriosclerosis,
cardiovascular disease
 Neurological disorders
Parkinson’s disease, stroke,
Alzheimer’s disease, spinal
cord & brain injuries
 Hypogonadism (Low
testosteron)
 Hyperprolactinaemia
 hormonal imbalance
due to hepatic & renal
disease
Vascular & Neurological
causes
Hormonal causes

25. ANATOMICAL CAUSES
 Peyronie’s disease
fibrous plaques within the shaft of the
penis. Deviation and angulation of the
erect penis. Francois Gigot Peyronie in
1743
 Micropenis
less than 3 inches long, less than 0.6% of
Men. Reduced prenatal sex hormones
(androgen). 2. Congenital malformation
Hormonal & sugery treatment
 Penile anomalies
(Epispadias,Hypospadias - a
congenital condition that causes the
urethra to develop abnormally

26. DRUG CAUSES
 Anti-hypertensives
Acebutolol, Acetazolamide,
 Anti-depressants
tricyclic and SSRIs
Doxepin and paroxetine
 Anti-psychotics
phenothiazines,
risperidone
 Anti-convulsants
phenytoin,
carbamazepine
 Anti-histamines
Claritin and Allegra
 Fibrates
Fenofibrate & Clofibrate
 H2 antagonists
cimetidine, ranitidine
 Recreational drugs
tobacco and alcohol

27. ARTERIOGENIC CAUSES OF ED

29.  Depression
 Anxiety
 Stress
 Performance anxiety
Anxiety & stress lead to increased production of
catecholamines which act as erection inhibitors
PSYCHOLOGICAL CAUSES OF
ED

31. APHRODISIACS
Aphrodisiacs are substances that improve or
enhance sexual performance. They include:

32. APHRODISIAC DRUGS
 Sildenafil (Viagra)
1 hour before sexual activity
Effect last 4-6 hour
Absorption is affected by fatty meal
 Tadalafil (Cialis)
30 minutes before sexual activity
36 hour window
Absorption not affected by food
 Vardenafil (Levitra)
30-60 minutes before sexual activity
Effect last 4-6 hour
Absorption delayed by fatty meal
Avanafil (Stendra)

33. APHRODISIAC HERBS
Commonly known as
damiana,
T. diffusa reduces post-
ejaculatory interval
(Enhances recovery time).
Its active compounds are
caffeine, arbutine, and
flavonoids
Turnera diffusa

34.  Has been widely used for
more than 75 years It has a
vasodilatory property.
 The increase in the flow of
blood to the penis helps in
bringing about erections.
 Increases sexual sensation
and stamina by stimulating
the pelvic nerve ganglia as
well as boosting adrenaline
supply to nerve endings.
Commonly kwon as
yohimbe (Idiagbon)
Pausinystalia yohimbe

35. o Commonly called poor’s
man candle
o It is locally known as
Osunsun, Osun
o Its Stem bark and twig
are often used for
managemeent of sexual
disorders
o Its mechanism of action
is not clear
Carpolobia alba G.Don

36.  Its root is one of the
finest aphrodisiacs in
the world
 Enhances nitric oxide
release in corpus
cavernosum via
acetylcholine and
transmural nerve
stimulation.
Panax ginseng

37. The pollen suspension
improves sperm count,
motility & morphology,
It contains estradiol
and flavonoid that have
positive effects on the
sperm quality. It cures
male infertility
Phoenix dactylifera
Commonly known as Date palm

38. Its ROOT has a testosterone
like effect.
Its used to cure impotency,
sterility, and enhances male
potency.
It has immuno-modulatory
properties
Chlorophytum borivilianum
Native to India. Locally called
safed musli.

39. Has been used by many
traditional medicine
practitioners for the
management of ED.
It is used to increase
libido and also for the
management of low
sperm count
Mondia whitei

40. Commonly known as
nutmeg.
The dried kernel is of
great value in the
management of male
sexual disorders
Myristica fragrans

41. APHRODISIAC FOODS
Contains
Phenethylamine a
stimulant that is
released in the brain
when we fall in love.
Tryptophan which
helps to produce
serotonin, a brain
chemical associated
with elevated moods
and sexual arousal. Dark Chocolate
CHOCOLATE

42. COFFEE
Coffee contain high
dose of caffeine
which boosts heart
rate and increases
blood flow,
while its alkaloids
can help to
maintain sexual
performance while
also increasing
stamina.

43. HONEY
Honey contains
boron,which may
regulate hormone
levels, and nitric
oxide, which is
released in the
blood during
arousal.

44. POMEGRANATE
Some studies have
shown that that
drinking pomegranate
juice daily lowers
Cortisol level, which
results in
corresponding
increased testosterone
in both men and
women
Pomegranate Champagne
Cocktail

45. ASPARAGUS
packed with calcium,
vitamin E and
potassium, which aid in
cleansing the kidneys
and urinary tract as
well as giving a dose of
extra energy.
The aspartic acid found in
asparagus helps to
neutralize excess
ammonia in our bodies,
which can lead to
fatigue and sexual
disinterest Roasted Sesame Asparagus

46. AVOCADO
Rich in vitamin E,
which boosts the
immune system and
helps give skin a
youthful appearance.
Asparagus, Avocado, and Arugula
Salad

47. FIGS
Contains
Antioxidants,
flavonoids, fiber
and potassium.
Produces strong
aphrodisiac flavor
sensation when
drizzled with
honey.
Fig and Honey Cocktail

48. HOW DO APHRODISIACS
WORK ?
 Increase the flow of blood to the coporal cavernosum
 Promote the release of nitric oxide from endothelial
cell or NANC nerve cell
 Minimize the sensitization of the accessory parts of
the male organ that facilitate ejaculation
 Inhibit PDE-5 and prevent the degradation of cGMP
Drugs such as paroxetine and sertraline

50.  Psychotherapy
 Oral Medications
 Hormonal Treatment
 Vascular Surgery
 Vacuum Erection Devices
 Intra-cavernosal Injections
 Urethral Suppositories /
Transurethral therapy
 Penile Prostheses
TREATMENT OPTIONS FOR ED

51. VACUUM ERECTION DEVICES

52.  Intracavernosal
Injections
Alprostadil, Papaverine,
Phentolamine
 Urethra suppositories
Alprostadil,

53. PENILE PROSTHESIS

54. REFERENCES
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relaxation of penile smooth muscle from diabetic men with impotence. N Engl J Med.
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 2. Ignarro LJ, Bush PA, Buga GM. Nitric oxide and cyclic GMP formation upon electrical field
stimulation cause relaxation of corpus cavernosum smooth muscle. Biochem Biophys Res Commun.
1990;170:843. [PubMed]
 3. De Groat, W, Booth A. Neural control of penile erection. London: Harwood, pp. 465–513, 1993
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bulbospongiosus muscles: a transneuronal tracing study using pseudorabies virus. J Comp Neurol.
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55. THANK
you
FoR
youR
TIME