Insurers reacted and responded to these challenges based upon increased demand, both domestically and globally. Concurrently, a booming US economy coupled with increased insurance capacity caused insurers to demonstrate considerable flexibility in their approach. While pricing reach new lows, insurers responded by widening the scope of coverage based upon demand.
DE4 is similar to DE3 but restricts the exclusion to any 'component part or individual item' which is defective.Note - DE4 was generally intended for machinery erection risks where an individual component could be identified in a machine as defective.
erect on demand reviews
As cited earlier in this report, leading erection insurers, again mainly in Europe and Canada, use their own wording alternative to the aforementioned DE Clauses to suit engineering risks. In general, the LEG exclusions adopt the last sentence of the 1995 DE2 - DE5 clauses.
The use of plant or plant-based products to stimulate sexual desire and to enhance performance and enjoyment is almost as old as the human race itself. The present paper reviews the active, natural principles, and crude extracts of plants, which have been useful in sexual disorders, have potential for improving sexual behaviour and performance, and are helpful in spermatogenesis and reproduction. Review of refereed journals and scientific literature available in electronic databases and traditional literature available in India was extensively performed. The work reviews correlation of the evidence with traditional claims, elucidation, and evaluation of a plausible concept governing the usage of plants as aphrodisiac in total. Phytoconstituents with known structures have been classified in appropriate chemical groups and the active crude extracts have been tabulated. Data on their pharmacological activity, mechanism of action, and toxicity are reported. The present review provides an overview of the herbs and their active molecule with claims for improvement of sexual behaviour. A number of herbal drugs have been validated for their effect on sexual behavior and fertility and can therefore serve as basis for the identification of new chemical leads useful in sexual and erectile dysfunction.
Advancement in the understanding of pharmacological basis of erectile and sexual functions at molecular levels is turning out to be stepping stones towards isolating the crucial physiologic factors involved in sexual arousal, thus helping to narrow down the search for aphrodisiac substances of choice. Many people do not believe in love potions or aphrodisiacs, but countless numbers of men and women have used them down through the centuries, and there is clear proof that they are still in use today. The skepticism towards the concept of aphrodisiac is not unjustified, although a systematic evaluation and compilation of scientific information may provide a basis for the evidence-based utilization of herbal drugs for treatment of sexual dysfunction in general. The present review is an attempt to consummate the available scientific information on various herbal drugs, which have been evaluated for their effect on sexual performance and functionality. The review also includes known evidences collected for the involvement of herbal drugs on neural, nitric oxide and hormone-dependent mechanisms and their role on sexual functions. A number of plants have been discussed in detail and a few others are only tabulated; a major criterion for this arrangement was the ethnopharmacological relevance of the plant in the Ayurvedic system of medicine. Nonetheless, it is very important to mention that this does not entail a grading system for the plants described in the paper and some of the plants only listed in tabular form may also be of high scientific relevance.
Nitric oxide (NO) is an atypical regulatory molecule having the dual role as a secondary messenger/neurotransmitter. It has been implicated in diverse physiological functions [22]. Findings so far indicate that NO may also be a major neuronal messenger [23]. In particular, it is an established physiological mediator of penile erection [24] and in the brain; NO synthase is highly concentrated in structures directly or indirectly involved in sexual behavior (olfactory bulb, supraoptic and paraventricular nuclei, amygdala, septal structures, etc.) [25].
Recent studies suggest that NO is a major physiological stimulus for relaxation of penile vasculature and trabecular smooth muscle, essential for penile erection [26]. Relaxation of the trabecular smooth muscle of the corpus cavernosa leads to a decreased vascular resistance and increased blood flow to the penis. Alongside the increased flow, venous outflow is reduced by the compression of the subtunical venules. The combination of increased inflow and decreased outflow causes penile engorgement and erection. NO from the vascular endothelium of the sinusoids and from the nonadrenergic, noncholinergic, and cavernosal nerves appears to mediate the vasodilatation [27, 28]. The new drug used for the treatment of erectile dysfunction, and sildenafil acts by potentiating the effect of NO by inhibiting the specific enzyme phosphodiesterase-V that terminates the action of NO generated cGMP in the penile vasculature [29]. Many medicinal herbs and drugs derived from these herbs have been shown to have effects on the NO signaling pathway. For example, the saponins from ginseng (ginsenosides) have been shown to relax blood vessels (probably contributing to the antifatigue and blood pressure-lowering effects of ginseng) and corpus cavernosum (thus, for the treatment of men suffering from erectile dysfunction; however, the legendary aphrodisiac effect of ginseng may be an overstatement) [30].
Drugs used to treat various sexual problems are found to modify the action of neurotransmitters which could be facilitatory, inhibitory, or both. Androgens are known to influence NO production in the brain as well as in the periphery [31, 32]. NO is synthesized by the enzyme nitric oxide synthase (NOS) which plays an important role in many brain functions. NO function as a neurotransmitter and NOS is present in the regions of the brain that regulate sexual functions [33]. Interestingly, administration of testosterone to castrated male rats increases the number of NO synthase-labelled neurons in the mPOA, indicating an increase in NO synthesis [34]. NO is capable of stimulating dopamine (DA) release in the mPOA, which in turn stimulates penile erection. This mechanism may constitute one way in which androgens stimulate sexual arousal [35].
The plant Tribulus terrestris Linn. (Zygophyllaceae) popularly known as puncture vine is a perennial creeping herb with a worldwide distribution. Since ancient times it is regarded as an aphrodisiac in addition to its beneficial claims on various ailments such as urinary infections, inflammations, leucorrhoea, oedema, and ascites [95]. T. terrestris has long been used in the traditional Chinese and Indian systems of medicine for the treatment of various ailments and is popularly claimed to improve sexual functions. Administration of T. terrestris to male lambs and rams improves plasma testosterone and spermatogenesis [96]. It also found to increase the levels of testosterone, luteinizing hormone [97], dehydroepiandrosterone, dihydrotestosterone, and dehydroepiandrosterone sulphate [98, 99]. The corpus cavernosal tissues obtained from New Zealand white rabbits following treatment with T. terrestris were tested in vitro with various pharmacological agents and electrical field stimulation and was found to have a proerectile effect [100]. T. terrestris has been found to increase sexual behaviour in rats. Treatment of castrated rats with T. terrestris extract showed increase in prostate weight and intracavernosal pressure. There was an improvement of the sexual behaviour parameters as evidenced by increase in mount frequency and intromission frequency; decrease in mount latency, intromission latency, and penile erection index [101, 102]. T. terrestris administration in rats increased the NADPH-d positive neurons and androgen receptor immunoreactivity in the PVN region. Androgens are known to increase both androgen receptor and NADPH-d positive neurons either directly or by its conversion to oestrogen. The mechanism for the observed increase in AR and NADPH-d positive neurons in the present study is probably due to the androgen increasing property of T. terrestris [103]. T. terrestris also increased the synthesis of cyclic nucleotides in CCSM cells [101]. T. terrestris extract increased the levels of T, DHT, and DHEAS and that the effect was more pronounced in hypogonadal state. Such increase in androgen levels could be the responsible factor for the age-old claims of PTN as an aphrodisiac and therefore T. terrestris may be useful as an adjunct in mild to moderate cases of ED [104]. The ability of tribulus to increase the release of nitric oxide may account for its claims as an aphrodisiac [100, 102].
Ashwagandha (Withania somnifera (L.) Dunal, Family: Solanaceae) is also known as Indian ginseng commonly used in Ayurvedic medicine. It is best regarded as adaptogen, tonic with aphrodisiac properties. Some workers have reported the decrease mating behavior and antifertility effects of W. somnifera root on in mice [105]. The root extract induced a marked impairment in libido, sexual performance, sexual vigour, and penile erectile dysfunction [106]. It also showed antifertility activity in male rat [107]. But some scientist shows that W. somnifera has the capability of combating stress-induced infertility. It also protects swimming-induced reproductive endocrine dysfunctions in male rat [108]. Aqueous extract improved spermatogenesis, which may be due to increased interstitial cell stimulating hormone and testosterone-like effects as well as the induction of nitric oxide synthase [109]. 2ff7e9595c
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