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Life Extension Magazine

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May 2003

Improve Your Sex Life And
Protect Against Heart Attack
By J. Phillip Vogel


Sexual stimulation and erection begin in the brain where neuronal testosterone-receptor sites are prompted to ignite a cascade of biochemical events that involve testosterone-receptor sites in the nerves, blood vessels, and muscles. Free testosterone promotes sexual desire and then facilitates performance, sensation and the ultimate degree of fulfillment. Without adequate levels of free testosterone, the quality of the male sex life is adversely affected. Studies have found that men with low testosterone routinely suffer from a decreased sex drive, genital atrophy, and impotence.40 Upon re-establishing youthful levels, subjects commonly report increased feelings of vitality, a higher sex drive, better sexual performance and even penile enlargement and increased genital sensitivity. Low testosterone levels achieved in men on androgen deprivation therapy are associated with decrease in size of the testicles and penis. These findings are reversible and men on the off-cycle of androgen deprivation therapy who have testosterone recovery note a return towards normal in the size of their genitalia.41

Recently, researchers in Taiwan examined the relationship between low testosterone levels and the male libido. In that study, the serum total testosterone levels of 53 symptomatic men older than 50 years were measured and compared to a control group of 40 young, asymptomatic men. The results showed that men with a diminished libido had a significant decrease in testosterone levels (mean 268 ng/dl) as compared with the control group (553 ng/dl). Furthermore, 89 percent of the subjects suffering from low testosterone reported a lack of energy; 79 percent reported erectile dysfunction; 70 percent reported a loss of pubic hair; and 66 percent reported a decrease in sexual endurance. From this data, the researchers concluded that low levels of testosterone are directly related to both advanced age and diminished sex drive.42

Why do testosterone levels fall?

Aging in males involves a torrent of hormonal, biochemical and physiological changes that accompany the down-regulation of the brain's ability to initiate testosterone production.

In some men, the testes lose their ability to produce testosterone, regardless of how much luteinizing hormone (LH) is being produced. In such cases, the pituitary gland is signaling the testes (via LH secretion) to produce testosterone. But since the testes have lost their functional ability, no testosterone is forthcoming. The pituitary gland, however, continues to secrete LH because there is not enough testosterone in the blood to provide a feedback mechanism to shut down LH production.43 In other cases, it's the pituitary gland that malfunctions and fails to produce sufficient amounts of LH, thus preventing healthy testes from secreting testosterone.44 In either case, blood tests can determine the levels of free testosterone and estradiol to help determine the appropriate therapeutic approach.

Other causes of low testosterone result not from faulty feedback mechanisms, but rather because of the aromatization (conversion) of testosterone to estrogen (see Figure 1). Studies have found that in many aging males, the already diminished levels of free testosterone are further compromised by being converted to estradiol-a high potency form of estrogen-via the action of the aromatase. One recent report even found that the estrogen levels of the average 54-year-old man are higher than the average 59-year-old woman.45 While estrogen is a necessary hormone for men, at high levels it has been associated with an increased risk of heart attack or stroke.46 Furthermore, high serum levels of estrogen trick the brain into thinking that enough testosterone is being produced, thereby reducing the natural production and availability of testosterone even more. This happens because at high levels, estrogen saturates testosterone receptors in the hypothalamus, which subsequently stops sending hormone signals to the pituitary gland. Another consequence of estrogen production is stimulation of sex hormone-binding globulin (SHBG) by estrogen. An increase in SHBG further binds testosterone and lowers the free testosterone level.

Optimal Reference ranges for testosterone and estradiol

Because the methods to test levels of testosterone and estradiol vary with the laboratory, it is always important to understand the reference ranges from your selected company. Below are the normal and optimal ranges of testosterone and estradiol for two major laboratories: LabCorp and Quest Laboratories.


Reference ranges used by LabCorp
Free Testosterone
9.3-26.5 pg/ml
18-26.5 pg/ml
3-70 pg/ml
10-30 pg/ml
Total Testosterone
241-827 ng/dL
500-827 ng/dL
Reference ranges used by Quest Laboratories
Free Testosterone
50-210 pg/ml
150-210 pg/ml
0-60 pg/ml
15-30 pg/ml
Total Testosterone
260-1000 ng/dl
500-1000 ng/dl

A word about prostate cancer

Men with existing prostate cancer should follow the opposite approach as it relates to testosterone. Prostate cancer patients are normally prescribed testosterone ablation therapy (using a drug that blocks the pituitary's release of LH and another drug that blocks the testosterone-receptor sites on the cells).47 Early-state prostate cancer cells can often be controlled by totally suppressing testosterone in the body. Late-stage prostate cancer patients are sometimes put on drugs that produce estrogenic effects to suppress prostate cancer cells that no longer depend on testosterone for growth.

Regrettably, prostate cancer patients on ablation therapy often temporarily suffer many of the unpleasant effects of low testosterone--called Androgen Deprivation Syndrome.48 Before initializing a therapy that boosts the free testosterone level, a blood PSA (prostate specific antigen) test and digital rectal exam are recommended for men over 40 or for those 35 years of age or older with a family history of prostate cancer. While restoring free testosterone to healthy physiological levels has not been shown to cause prostate cancer, it can induce existing cancer cells to proliferate faster.

Natural sources of testosterone

Considering the ramifications of low levels of testosterone in aging males, finding convenient, safe, and effective sources for returning those levels to youthful concentrations is paramount. While there are natural testosterone creams and injections available by prescription, research into herbal supplements has uncovered numerous examples of plant extracts that overcome testosterone deficiency by inhibiting aromatization and increasing production naturally.


One of the most promising herbal extracts for overcoming testosterone deficiency is the bioflavonoid chrysin. Extracted from several types of plants, chrysin has consistently shown an uncanny ability to inhibit the aromatization of testosterone.

In a study funded by the Life Extension Foundation, 22 male subjects were given 750 mg of chrysin and 10 mg of bioperine (a pepper extract known to increase absorption rates of chrysin) twice daily for 30 days. When compared with their baseline testosterone and estradiol levels, free testosterone levels rose by 40%, and estradiol levels decreased by as much as 40%. These results offer conclusive evidence that herbal extracts such as chrysin can effectively and quickly inhibit testosterone's aromatization to estrogen.49

Complementing Life Extension's efforts, researchers in India recently released the results of their examination on the effect of chrysin on age-related testosterone deficiency. In that study, aging rats were administered 1 mg/kg of chrysin per day for 30 days. Upon concluding these treatments, there was a significant improvement in overall sexual functions in the rats given chrysin, compared with control rats. The rats receiving chrysin exhibited increased libido when allowed to interact with non-estrous female rats, had increased sperm count, greater fertilization potential and greater litter size when they were allowed to interact with proven pro-estrous female rats. These results strongly suggest that bioflavonoids such as chrysin are an effective method of countering the deleterious effects of aging on male sexuality.50

Stinging Nettle


Another herbal extract known for its beneficial effect on free testosterone levels is Urtica dioica, commonly called nettle root. Traditionally used to treat hypertension throughout much of Europe, nettle has recently been the focus of several in vivo pharmacological studies designed to determine the nature and extent of its beneficial effects.

As previously discussed, globulins like SHBG actively inhibit the level of free testosterone by binding to it, thereby rendering it biologically inactive. Research has found, however, that nettle extract has a greater affinity for SHBG than does testosterone.51 As a result, SHBG more readily binds to the constituents of the nettle extract, successfully counteracting its effect and thereby increasing the level of free testosterone.

This "nettle effect" has some stunning biological ramifications. For example, researchers in Italy have just completed a series of in vivo studies that has determined that nettle has a direct positive effect on cardiac action. In their study, they found that when pre-contracted endothelial tissue is injected with nettle extract it elicits vasodilatation-the relaxation of the blood vessel walls. The researchers concluded that nettle can produce hypotensive responses through a vasorelaxing effect. This suggests that nettle can improve the symptoms of angina and reduce objective measures of myocardial ischemia in men with coronary artery disease.52

The prostate gland may also benefit from the effects of nettle root. In Germany, nettle has been used for decades in the treatment of benign prostatic hyperplasia-enlargement of the prostate gland. A metabolite of testosterone called dihydrotestosterone (DHT) in known to stimulate prostate growth. Much the same as its effect on testosterone's binding to SHBG, nettle inhibits the binding of DHT to its receptor sites on the prostate membrane.53

Muira puama

Muira puama is a South American folk medicine derived from a shrub, Ptychopetalum olacoides, which grows in the Amazon region of Brazil. Also called marapuama and "potency wood" it is considered to be an aphrodisiac and an effective treatment for impotence. Because of its purported libido-enhancing properties, Muira puama has been the subject of two published clinical studies conducted by Dr. Jacques Waynberg, an eminent medical sexologist and author of ten books on the subject.

The first study, conducted at the Institute of Sexology in Paris under Waynberg's supervision, consisted of and examination of the effect of muira puama on 262 men complaining of lack of sexual desire or inability to attain or maintain erection. After receiving 1.5 g/day of muira puama for two weeks, 62% of the patients with loss of libido rated the treatment as having a dynamic effect, and 52% of patients with erectile dysfunction rated the treatment as beneficial.54

Dr. Waynberg's second study, entitled "Male Sexual Asthenia," focused on sexual difficulties associated with asthenia, a deficiency state characterized by fatigue and loss of strength, both symptoms of a testosterone deficiency. The study population consisted of 100 men over 18 years of age who complained of impotence or loss of libido or both. A total of 94 men completed the study and were evaluated. Muira puama treatment led to significantly increased frequency of intercourse for 66% of couples. Of the 46 men who complained of loss of desire, 70% reported intensification of libido. The stability of erection during intercourse was restored in 55% of patients and 66% of men reported a reduction in fatigue. Other reported beneficial effects included improvement in sleep and morning erections.55

New Super Miraforte™

The findings from numerous published studies indicate that testosterone deficiency and estrogen overload may be some of the most serious metabolic complications that aging males face. It has long been known that low testosterone interferes with a man's emotional state and sex life. Startling new findings, however, reveal that testosterone deficiency predisposes aging males to lethal cardiovascular diseases.

Because of their documented libido-enhancing and testosterone increasing effects, chrysin, nettle, and muira puama are among the most crucial dietary supplements for sufferers of testosterone deficiency. Moreover, studies indicate that these extracts are particularly effective at alleviating the major symptoms of low testosterone including depression, fatigue, low sex drive, timidity and anxiety.

Super MiraForte™ is a pharmaceutical-grade combination of these plant extracts designed to increase free testosterone and suppress excess estrogen in aging men. Super Miraforte™ naturally and effectively helps to restore the proper balance between these powerful and crucial hormones.

The new Super Miraforte™ has 50% more chrysin than the previous version. When combined with Bioperin® to enhance absorption into the bloodstream, chrysin may be the most effective natural aromatase-inhibiting dietary supplement.

Males over age 30 seeking to increase their free testosterone levels, while reducing excess estradiol, may consider taking four Super MiraForte™ capsules a day. If blood tests and/or symptoms of testosterone deficiency do not improve after 60 days, consideration should be given to obtaining a prescription for topical testosterone cream and the aromatase-inhibiting drug Arimidex® (if estradiol levels are high). Those with existing androgen dependent prostate cancer should not use any kind of testosterone enhancing therapy. Women should not use Super MiraForte™ because its aromatase-inhibiting effects could cause estrogen deficiency and the development of menopausal symptoms. Aging males, on the other hand, often have too much estrogen and not enough free testosterone.

For information about prescription testosterone boosting drugs, refer to the Male Hormone Modulation Protocol.

What you should have learned from this article

Aging men suffer from a variety of ailments that directly relate to low levels of bioavailable testosterone. Mainstream doctors don't even consider a man's testosterone status when treating disease. Yet as you have just learned, insufficient testosterone can cause or contribute to the most common disorders and discomforts that aging men face.

While men clamor for drugs like Viagra®, their doctors overlook the fact that testosterone deficiency is a major reason for loss of sexual desire and ability to perform. Men who properly boost their levels of free testosterone while suppressing excess estrogen can enjoy a much more fulfilling sex life.

The lethal dangers of a testosterone deficiency are now documented in numerous published studies. Low testosterone results in increased coronary atherosclerosis and osteoporosis. These two diseases are not unrelated in as much as calcium depleted from the bone is often deposited into the arterial wall. Pathological breakdown of bone can increase cancer risk by releasing growth factors such as transforming growth factor beta 1 (TGF-B1 ) into the blood where they stimulate cancer cells to proliferate.

Obesity and Type II diabetes are at epidemic levels in the United States. Men who suffer from abdominal obesity (pot belly) are the most likely to suffer cardiovascular and other diseases. Low testosterone results in increased deposition of fat in the abdomen and decreased insulin sensitivity, resulting in higher than desired levels of insulin in the blood. Men seeking to lose weight and prevent Type II diabetes and its complications should restore free testosterone levels to youthful ranges.

Aging men often complain they don't "feel as young" as they used to. Some are clinically depressed. When testosterone levels are restored in depressed men with low testosterone, depression scores improve and men report enhanced feeling of emotional well being.

There are several ways to increase free testosterone and reduce excess estrogen (estradiol). A convenient and cost effective method of accomplishing this is to take four capsules a day of a dietary supplement called Super MiraForte™. A study of 22 males showed that the ingredients in Super MiraForte™ caused free testosterone levels to increase by an average of 65%, while estradiol levels decreased by as much as 40% after 30 days.

Not every man will achieve youthful free testosterone and estradiol levels by taking Super MiraForte™. Some men may have to ask their doctors to prescribe natural testosterone cream or gel along with an aromatase-inhibitor drug (such as Arimidex®). The testosterone cream directly boosts blood levels of testosterone while Arimidex blocks the conversion of testosterone to estrogen thus preventing a build-up of excess estrogen. Not all men need Arimidex. Doctors will not prescribe these drugs without the patient's blood being tested for free testosterone, estradiol and PSA (prostate specific antigen).

Those with androgen-dependent prostate cancer should not use any kind of testosterone-enhancing therapy especially if blood tests reveal a severe state of testosterone deficiency.

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