According to the National Institute of Health, erectile dysfunction is defined as the inability to obtain or maintain an erection that is sufficient for satisfactory sexual performance. Multiple studies have provided links between erectile dysfunction and the relationship between human growth hormone (HGH) and insulin-like growth factor I (IGF-1). Growth hormone stimulates the production of IGF-1 while IGF-1 is considered to be the main intermediary of growth hormone action. IGF-1 is also suspected to mediate endothelial nitric oxide production. Nitric oxide is considered to be a principal mediator of penile erection by increasing cGMP formation, which in turn causes relaxation of vascular smooth muscle. This allows engorgement of the penis with blood, thus the development of an erection. Growth hormone is also responsible for the production of cGMP formation in cavernous tissue.

There is a relationship between all of these hormones that has been shown to impact penile erection, specifically with HGH levels. In recent studies, it has been shown that in healthy male patients, HGH levels in systemic and cavernous blood increase during the swelling of the penis. In patients with erectile dysfunction there were decreased levels, approximately sevenfold, of growth hormone in the plasmid levels during flaccidity compared to the control group of healthy male patients during flaccidity. It has been proposed that the biological effects of growth hormone in erectile dysfunction may be determined by IGF-1-stimulated nitric oxide formation. It is also noted that when there are physiological concentrations of growth hormone present, there is an elevation of intracellular cGMP, thus suggesting that growth hormone levels may be of major importance in regards to the maintenance of male erectile capability. While all of these factors are decreased in the plasma of erectile dysfunction patients, HGH represents an important player regarding all of the aforementioned molecular factors and the relationships between them in regard to penile erections.

The decreased levels of growth hormone may lead to fatigue, loss of sexual desire, loss of erection, and decreased to zero sperm counts in the semen. Therefore, appropriate replenishment of HGH in the bodies systems may have the ability to increase all of the molecular factors necessary to regain the ability to have an erection, increase sexual drive, and replenish sperm counts. That being said, it is also understood that too much of an increase of HGH can have a negative effect on sexual functions and fertility; therefore, treatment with HGH needs to be monitored for optimal outcomes. It should also be noted that natural replenishment of growth hormone is possible by decreasing possible chronic stress, which in turn decreases the amount of cortisol produced by the adrenal gland and ultimately reregulating the rest of the bodies hormones. When the body is overly stressed it compensates by shutting down the production of unnecessary hormones, such as testosterone and estrogen. This in turn affects the systems that rely on those hormones, such as the reproductive system. All in all, the management of HGH in the body is most likely necessary for proper sexual functions, among other functionalities.

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