일반적으로 남성의 성욕 및 성적흥분 고조 등은 노화에 따라 감소하며 50세 이후부터 급격하게 감소한다. 이와 같이 성기능이 감소하는 원인은 일차적으로 남성호르몬 생산이 감소하기 때문이며 그 외에 만성 질환 및 사회 환경적인 요인들이 수반되어 복합적으로 나타난다고 할 수 있다.
즉, 성적반응은 뇌와 생체 내 성호르몬을 생성하는 생식선 및 생식기관과의 신호전달에 의한 복잡한 생리학적 작용에 의해 이루어진다. 특히 남성의 주된 성기능 장애인 발기부전은 호르몬 및 신경전달물질로서 기능을 하는 nitric oxide(NO)가 매우 중요한 역할을 한다. 즉, NO는 혈관평활근에 작용하여 음경 및 음핵의 확장을 유도하는 작용을 한다. 따라서 노화 및 질병에 따라 호르몬 생성이 감소하면 그에 따라 성기능도 감소되는 경향을 나타낸다고 한다. 한 조사에 의하면 남성의 성기능 장애는 40대의 경우 39%, 50대의 경우 49%, 60대의 경우 58%미여 70세 이상에서는 약 85%정도로 나타난다고 보고되고 있다. 특히 현대사회와 같이 매우 복잡하고 다양하게 변화하는 시점에서 음주, 흡연, 피로 및 스트레스등이 성기능장애 유발을 더 촉진시키는 것으로 추측된다.
남성 성기능 개선과 관련된 성분 1. 홍삼 인삼은 전통적으로 남성의 성기능을 증가시킨다는 것이 알려져 있으며 주된 성분은 panaxsapogenin이다. 특히 국내산 홍삼이 매우 효과가 우수한 것으로 알려져 있으며 전 세계적으로 각광을 받고 있다. 홍삼에 발기부전 개선 효과가 있다는 연구결과는 이미 국내외 학술지에 다수 보고된 바 있다. 홍삼의 작용기전으로는 홍삼이 NO합성을 활성화시킴으로서 유리 NO의 생성을 촉진한다. 또한 긴장완화와 스트레스 해소에도 도움이 되며 성호르몬의 생성을 촉진시키는 작용이 있으며 혈관이완작용, 항우울작용, 항스트레스 작용 및 말초혈행 촉진작용 등이 상호 복합적으로 작용하는 것으로 추정되고 있다. 한 연구결과에 의하면 발기부전환자 90명을 대상으로 홍삼정(900mg)을 3개월간 투약하고 치료효과를 측정한 결과 홍삼을 복용한 그룹에서 60%의 치료효과를 얻었으며, 위약을 투약한 그룹에서는 30%만이 호전되어 홍삼의 치료효과가 우수하다는 것을 발표한 바 있다. 또한 정자결핍증 환자 29명(5명 무정자증)을 대상으로 고려인삼에서 추출한 성분을 복용한 결과 무정자증 5명을 제외한 24명에서 모두 정자수가 현저하게 증가하였으며 정자 운동성도 70%까지 증가하였다고 보고한 바 있다. 따라서 홍삼에는 고환에서의 세포분열을 촉진시키고 정자 생산능력을 강화시키는 기능을 하는 물질이 있는 것 같다고 제시하였다.
2. 로얄제리 로얄제리는 각종 아미노산 및 미네랄뿐만 아니라 콜린, 인산등이 함유되어 있어 물질의 합성대사에 관여한다고 보고된 바 있다. 또한 리친과 메치오닌이 함유되어 성장촉진 및 해독작용을 촉진함으로서 간기능 개선에도 효과가 있다고 한다. 따라서 로얄제리는 남성의 성기능 강화와 더불어 여성의 갱년기 장애에도 효과가 있는 것으로 알려져 있다. 여성의 노화현상을 억제하며 우울증, 불면증, 기억력감퇴 등의 갱년기 장애를 개선하는데도 효과가 우수하다.
3. L-알기닌 성적 기능 강화를 위해 가장 널리 사용되는 성분 중 하나는 L-알기닌이다. L-알기닌을 복용하면 NO의 생성을 촉진시켜 cGMP를 활성화시켜서 혈관을 이완시켜 혈류의 흐름을 촉진하여 음경으로의 혈류를 증가시킴으로 음경의 발기를 촉진한다. 임상적으로 50명의 남성을 대상으로 실시한 이중 맹검시험에서 L-알기닌 5g을 매일 6주간 복용할 경우 성기능이 약 10%이상 향상되었다고 한다. L-알기닌 2.8g을 2주간 발기불능 환자에게 투여한 결과 40%의 환자가 대조군에 비해 성기능이 증가되었다고 한다. 그 외에도 L-알기닌의 작용으로는 종양과 암세포의 성장, 전이 등을 지연시키며, 간의 해독 작용, 성장 호르몬 분비 작용, 면역증력 강화작용 등에도 효과가 DT는 것으로 알려져 있다.
4. 마늘 마늘의 알리신은 혈액순환을 통해 세포에 활력을 주고 생식샘을 자극하며 성호르몬의 부비를 촉진하므로 성욕을 강화시켜 주는 작용이 있다고 알려져 있다. 또한 알리신은 HDL-cholesterol 및 triglycerides농도에는 변화가 없으나 LDL-cholesterol 농도를 감소시키는 작용이 있으므로 심장질환에도 도움이 된다. 따라서 알리신의 작용기전은 혈액순환을 원활하게 순환시킴으로서 음경의 혈류를 증가시키는 것으로 추정된다. 또한 마늘은 면역증강, 동맥경화예방 등의 작용도 있다.
5. 은행 최근의 연구에서 은행은 우울증에 의한 발기불능 치료에 효과가 있다고 보고된 바 있다. 우울증에 의해 유도된 발기불능의 작용기전은 selective serotonine reuptake inhibitors(SSRIs)의 약리작용과 관련이 있다. 즉, 성적반응에 있어서 중추신경계의 주된 신호전달이 억제되기 때문이다. 은행의 작용기전은 아직까지 명확하지 않으나 NO의 이용률을 증가시켜 성적 기능에 대한 SSRIs의 효능을 경감시키는 것으로 추정된다. 또한 은행은 NO합성을 활성화시켜 세로토닌의 NO생성 억제를 차단하는 것으로 알려져 있다.
6. 아연 아연은 정자형성에 있어서 매우 중요한 작용을 한다. 체내에서 다량 분포하며 체중이 60kg인 사람에서의 체내 총량은 약 2g으로 철 다음으로 많이 함유되어 있다. 아연의 농도는 전립선에서 가장 높지만 총량은 뼈나 근육에서 압도적으로 높다. 특히 40대 이후에 나타나는 비 인슐린성 당뇨병 환자의 경우 흡수 능력이 약화되어 인슐린 내에 아연이 거의 함유되어 있지 않기 때문에 체외로부터 아연을 보충시켜 주어야 한다. 최근에는 아연의 흡수율을 증가시키기 위해 아연 올리고펩타이드를 사용함으로서 당뇨병성 발기부전증 치료에 효과가 있는 것으로 알려져 있다.
성기능 장애 유발 위해요소 ① 비만 비만인 사람의 경우 정상이네 비해 콜레스테롤 수치 증가, 고지혈증 및 중성지방 등도 증가된다. 이런 증상이 생기면 먼저 혈액순환에도 이상을 수반한다. 음경발기는 동맥의 혈액이 해면공동체인 음경발기조직의 모세혈관으로 들어와서 유입된 혈액이 정맥으로 들어오면 발기하게 된다. 그러나 비만인 경우 고 콜레스테롤 혈증을 유도하여 혈액순환이 원활하지 못해 발기의 메커니즘이 제대로 작동하지 않고 결국 발기부전으로 이어진다.
② 간질환 간은 피로에 대한 저항능력을 갖는 장기로 간의 문맥은 여러 근육들과 연결되어 있어 성기와도 관련이 있다. 따라서 간이 나빠진다는 것은 여러 근육의 저하를 초래할 뿐만 아니라 성기능감소와 관련이 있다.
③ 당뇨 및 고혈압 고혈압 및 당뇨가 발기부전을 일으킨다는 과학적인 증거는 이미 많은 임상실험연구에서 증명된바 있다. 특히 40세 이하의 젊은 사람에서 나타나는 발기불능의 원인은 당뇨와 관련이 있다고 한다. 인슐린 의존적인 당뇨병 환자의 경우 10년동안에 발기능력이 약 50%이상 감소하였다고 한다.
④ 호르몬 및 내분비 장애 발기부전과 관련된 중요한 호르몬은 테스토스테론과 프로락틴이다. 일반적으로 체내에 프로락틴이 증가하면 발기부전을 유발한다고 한다. 이와 같은 호르몬계 이상에 의한 발기부전은 약 5%미만으로 추정되고 있다.
⑤ 흡연 담배연기는 prostacyclin의 생성을 촉진하며 nitric oxide synthase(NOS)의 활성을 감소시켜 NO의 유리를 억제한다고 한다. 따라서 흡입된 니코틴은 음경의 혈관을 수축시키고 음경의 발기를 유지시키는데 필요한 혈액을 쉽게 빠져나가게 한다. 특히 담배는 당뇨 및 고혈압보다도 음경동맥의 혈압 감소를 유발하는 것과 높은 상관성을 나타내는 것으로 알려져 있다. 그러므로 만성적인 흡연자는 발기능력이 상실되며 최후에는 회복 불가능하게 될 수도 있다. 또 한편으로는 흡연은 음경동맥의 경화를 촉진시킨다고 한다. 특히 음경의 동맥 경화 정도는 담배를 피우는 양에 비례한다. 따라서 만성적인 흡입자는 발기를 일으키는 해면체 조직이 직접 파괴되며 음경해면체의 세포 숫자를 감소시키는 것으로도 알려져 있다.
⑥ 정신적인 원인 과거의 신체적 또는 정신적 학대, 자신감의 상실, 이미지 손상 및 죄책감 등이 원인이 될 수 잇다. 성기능 저하의 원인으로는 정신적인 원인인지 또는 기질적인 원인인지를 구분하기 어려울 때가 있다. 이와 같은 경우 먼저 심리적인 안정을 찾을 수 있도록 노력하고 정신과적 치료를 받는 것이 효과적일 것으로 여겨진다.
성기능 활성을 위한 생활 규칙 1. 적당한 운동 운동을 함으로써 뇌하수체를 자극하여 발기 메커니즘에 중요한 역할을 하는 남성호르몬의 분비를 촉진하고 성욕을 항진시키며 기질성 발기부전의 원인으로 작용하는 고혈압과 미만을 방지하여 발기부전을 예방할 수 있다고 한다. 일반적으로 성기능 활성을 위해 올바른 운동습관은 다리의 혈액순환을 좋게 하는 운도응로 음경으로 가는 혈관과 하체로 가는 혈관의 흐름을 원활하게 해주는 것이 좋다.
2. 충분한 수면 건강한 남성의 경우 수면중 하루에 3~5번 정도의 발기가 관찰되며 이때 음경의 발기조직에 신선한 산소가 공급되어 신진대사가 활성화된다고 한다.
3. 바른 식생활습관 발기부전의 주된 원인이 되는 당뇨병 및 고혈압을 예방하는 길이 발기부전을 예방하는 지름길이 된다고 한다. 혈중 내 콜레스테롤 수치를 정상으로 유지시켜주며 저지방, 고단백질 섭취, 신선한 야체와 과일을 섭취하는 것이 좋다고 한다. 특히 음주 및 흡연을 삼가고, 인스턴트식품은 가능한 섭취하지 않는 것이 좋다고 한다.
4. 긍정적인 삶의 자세 매사 일상생활에 활동적이고, 긍정적으로 생활하도록 노력하며 심인성 발기부전의 원인인 스트레스 및 우울증을 근본적으로 제거하려고 노력하는 자세가 중요하다고 한다.
5. 적절한 성생활 유지 평소에도 적당한 정도의 성생활을 유지하는 것이 노년의 성생활에 가장 중요하다고 한다.
<참고문헌: 한국약학대학협의회 위생약학분과회(2004). 건강기능식품. 대한약사회 >
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