man.active.Denk - Essential Nutrients for Male Sexual Health

1. Training Essential nutrients for your health

2. Whatis a Food Supplement?

3. Content • Key message • Introduction • Product information • Key benefits • Target groups • Composition • Intake • Ingredients • Male sexual functionanddifficulties • The roleoftestosterone in men‘shealth • Erectiledysfunction • Male erection • Prescription drugs vs. man active Denk • Good to know • Other Denk Nutrition products • References

4. 1. Key message • It is known that with age the sexual activity of men decreases, as it is more difficult to maintain a sustainable erection. 1 • But did you know that this problem can occur at any age? • man active Denk is tailored for men to be strong and sexually active, as the ingredients support a normal energy-yielding metabolism and improve daily stamina levels. • An ideal combination of nutrients for men to be active all day (and night). • For those who want more.

5. 2. Introduction • Loss of libido is a common problem that affects many men (and women) at some point in their life. • It's often linked to relationship issues, major life changes, stress or tiredness, but can be a sign of an underlying medical problem, such as reduced hormone levels, as well. • Everyone's sex drive is different – there's no such thing as a "normal" libido. Moreover, it is also not unusual for couples to have a disparity in their sex drives. • But if the lack of desire for sex is distressing or it is affecting the relationship, it's a good idea to get help.

6. 3. Productinformation Effectivenutrientcombinationformen

7. 3. Productinformation Effectivenutrientcombinationformen

8. 4. Key benefits • Effective nutrient combination with high quality plant extracts, L-arginine, caffeine, vitamins and mineralsfornatural libido and energyboost. • Supports the maintenanceof normal testosteronelevels in the blood. • man active Denk is not tailoredfor immediate short-term effect after administrationa longtermintakeforseveralweeksprovidesmorefunandspontaneity. • Formen to boosttheirperformance – in everyconditionoflife • Easy intake – independentof (sexual) activity.

9. 5. Target groups Menunderpressure to perform Stressedmiddle-agedmen Men at advancedage Menwanting to boosttheirperformance Menwanting to prevent a „sexual weakness“

10. 6. Composition INGREDIENTS

11. 7. Intake • INTAKE • 2 capsules per day to beconsumedwith a meal and withplenty of fluid • To betakencontinously and regularyfor at least 4 weeks • YOU HAVE TWO OPTIONS FOR INTAKE: 2 capsules per dayall at onceto beconsumedwith a mealandwithplentyof fluid 1 youtake the wholedaily dose at once  goodcompliancebecauseyou must keep in mindonce a day 2 capsules to beconsumedover the daywith a mealandwithplentyof fluid 2  youtake the wholedaily dose over the day(e.g. at noonand in the evening)  thiscouldbehelpfulifyouhave a sensitive stomachorifyoureact sensitive to caffeine

12. 8. Ingredients Vitamin C Vitamin C contributes to the reduction of tiredness and fatigue as well as oxidative stress. 2 Vitamin B6 contributes to the regulation of hormonal activity and to normal function of the nervous system. 2 Zinc contributes to the maintenance of normal testosterone level in the blood. 2 Folate contributes to the reduction of tiredness and fatigue and to normal blood formation. 2 Macais a root vegetable cultivated in the central Peruvian Andes. Maca root has a history of use to counter impotence and to induce sexual desire. 3, 4 L-Arginine stimulates blood vessels to open wider forimprovedbloodflow. 5 Ginkgo extract enhances general blood circulation to the genitals. The increased blood flow may contribute to sexual response. 3 Caffeine has a positive effect on cognitive and physical function, mood and energy. 6 Vitamin B6 Zinc Folate Macaextract L-Arginine Ginkgo extract Caffeine

13. 8. Ingredients Vitamin C • Vitamin C contributes to normal energy-yielding metabolism, normal psychological function, to the reduction of tiredness and fatigue and to the reduction of oxidative stress. 2 • Population research suggests that higher intake of dietary vitamin C is associated with improved physical performance and muscle strength. 7 • Also, taking vitamin C seems to improve maximal oxygen uptake during exercise. 8 • Through its positive influence on energy-yielding metabolism and physical performance, vitamin C may be able to boost libido and sexual pleasure.

14. 8. Ingredients Vitamin B6 • Vitamin B6 contributes to normal energy-yielding metabolism, to normal functioning of the nervous system, to normal red blood cell formation, to the reduction of tiredness and fatigue and to normal psychological function. 2 • Vitamin B6 is an essential co-factor in fatty acid metabolism that contributes to the regulation of hormonal activity because it has a role in controlling the action of hormones. 2 • Through its positive influence on energy-yielding metabolism and physical performance, vitamin B6 may be able to boost libido and sexual pleasure.

15. 8. Ingredients Zinc • Zinc plays an important role in reproduction in males and females. Spermatogenesis is for example a zinc dependent process and seminal fluid is particularly rich in zinc. 9, 10 • Low dietary zinc status has been associated with low circulating concentrations of several hormones including testosterone. 9, 10 • A sufficient zinc status is, in contrast, associated with adequate testosterone levels. 11

16. 8. Ingredients Folicacid • Folic acid contributes to normal blood formation, to the reduction of tiredness and fatigue and to normal psychological function. 2 • Thus, folic acid improves psychological and emotional causes for low libido in men and may thereby boost sex drive and sexual pleasure. 2

17. 8. Ingredients Maca • Macais a rootvegetablecultivated in PeruvianAndes. 3 • Historically, macahasbeenused tocounterimpotenceand to induce sexual desire. 3 • It may be helpful for improving sexual performance parameters in men. 3 • Driedmacarootisrich in essential aminoacids, iodine, iron, magnesiumandsterols. 3 • Macacanpositivelyaffectssexual behaviorparameters. 3

18. 8. Ingredients Ginkgo biloba • Ginkgo biloba is a native tree from China used for pharmaceutical purposes. 3 • Contains flavonoids and terpenoids as active substances. Flavonoids have antioxidant and free radical scavenging properties that might benefit the central nervous system and vascular conditions by improving theblood circulation. 3 • Ginkgo leaf seems to improve blood flow to capillaries throughout the body including in the CNS, eyes, ears, extremities and the genital region. 3 • Increased blood flow from such vasodilatory action may contribute to sexual response by improving penile vasocongestion. 3

19. 8. Ingredients L-arginine • The amino acid L-arginine, which occurs naturally in food, boosts the body's production of nitric oxide (NO). 12 • NO is a compound that facilitates erections by dilating blood vessels in the penis. 12 • Thus, NO helps the penis to enlarge to its full capacity, increasing the size, hardness, and frequency of erections. 12 • Some evidence shows that L-arginine improves erectile dysfunction by stimulating blood vessels to open wider for improved blood flow.12, 13, 14

20. 8. Ingredients Caffeine • Caffeine occurs naturally in more than 60 plants. 6 • It stimulates the central nervous system, heart rate, muscles,blood pressure and provides a short-term relief of fatigue. 6 • Moreover, caffeinehas a positive effect on cognitiveandphysicalfunction, moodandenergy. 6 • Thus, caffeinesupports an energeticandself-confidentfeelingthatsupports sexual arousal. 6

21. COMPONENTS OF MALE SEXUAL FUNCTION 1 9. Male sexual function DIFFICULTIES 1 Libido 1 = interest and desire for sexual activity Impaired sexual desire Erection 2 = the ability to obtain and maintain an erection Erectile dysfunction Orgasm 3 = ejaculation and climax Premature ejaculation

22. 10. The role of testosterone in men’s health • WHAT IS TESTOSTERONE? 16 • Testosterone is the main sex hormoneproduced primarily in the testicles. • It is responsible for the typical male characteristics, such as facial, pubic and body hair as well as muscle. • Testosterone helps maintain men’s following functions: • Brain • Sex drive • Aggression • Skin • Facialhair • Body hair • Muscle • Mass • Strength • Male sexorgans • Spermproduction • Prostategrowth • Erectile function • Bone • Density • Redcellproductionin bonemarrow

23. 10. The role of testosterone in men’s health • HOW COMMON IS LOW TESTOSTERONE IN MEN? 16, 17 • Testosterone levels generally peak during adolescence and early adulthood. • The testosterone level gradually declines with age • Typically about 1-3 % per year after age of 40. • TYPICAL SIGNS AND SYMPTOMS OF LOW TESTOSTERONE 17 • Low sex drive • Fatigue • Reduced erectile function • Loss of body hair and less beard growth • Mood changes man active Denk containszincandcaffeine. Zinccontributes to the maintenanceof normal testosteronelevel in the blood! Caffeinesupportsphysicalfunctionandenergy.

24. 11. Erectile dysfunction WHAT IS AN ERECTILE DYSFUNCTION? 1 Erectile dysfunction (ED), also known as impotence, is the inability to maintain an erection sufficient for sexual intercourse. Achieving an erection is a complex process involving the brain, hormones, nerves, muscles and blood circulation. If something interferenceswith this process, the result may be erectile dysfunction. HOW COMMON IS ERECTILE DYSFUNCTION? 1 There are different stages of erectile dysfunction from mild to complete. It can occur in any age but it’s more common in older men. Mild & moderate erectile dysfunction Complete erectile dysfunction • 50 % of men in their 50s • 60 % of men in their 60s • 5 % of men that are 40 years old • 15 % of men that are at age 70

25. 11. Erectile dysfunction CAUSES FOR COMPLICATIONS WITH ERECTION 1 Physical causes Psychological causes Environmental causes • Narrowing of the blood vessels going to the penis – commonly associated with hypertension, high cholesterol or diabetes • Hormonal problems (e.g. low testosterone) • Surgery or injury • Anxiety • Depression • Relationship problems • Stress • Alcohol abuse • Drug abuse • Smoking

26. 11. Erectile dysfunction • TREATMENT 1 • There are several different ways that erectile dysfunction can be treated.  • The urologist will help to determine the most effective course of treatment for the condition: • Medications (Sildenafil, Tadalafil, Vardenafil, Avanafil) • Hormone replacement • For some men, making a few healthy lifestyle changes may solve the problem. • Food supplementsas man active Denk canhelp to ensure a sufficientsupplyofimportantvitaminsandminerals-> an overallhealthimproveswellbeeing, physicalhealthand sexual life

27. 12. Male erection • MALE ERECTION 15 • The penile erectile tissue, specifically the cavernous smooth musculature and the smooth muscles of the arteriolar and arterial walls, plays a key role in the erectile process. • Flaccid state: • These smooth muscles are tonically contracted, allowing only a small amount of arterial flow into the penis for nutritional purposes. • The flaccid penis is in a moderate state of contraction. • Sexual stimulation: • The brain sends impulses to the cavernous nerves inthe penis. • The impulse triggers the release of neurotransmitters from the cavernous nerve terminals. • This results in the relaxation of the smooth muscles. FLACCID PENIS Vas deferens Testis

28. 12. Male erection • MALE ERECTION 15 • The relaxation of the smooth muscles results in the following events: • End of erection • The erection ends after climax. • The muscles in the penis contract again which stops theinflow of blood. • The veins open wider and extra blood flows back into the body. 4 The Tunica albuginea (connective tissue that surrounds the corpus cavernosumof the penis) is stretched to its capacity sustaining the erection. 1 2 3 Dilatation of the arterioles and arteries by increased blood flow The incoming blood is trapped in the corpus cavernosum like a sponge is filled with water. Relaxation of the arteries allows more and more blood to flow in the corpus cavernosum Expansion of the penis. ERECT PENIS Vas deferens Testis

29. 13. Prescription drugs vs. man active Denk

30. 14. Good to know • Tips for a better and more active sexual life • Avoid stress and stressful situations physical and mental stress reduce the sexual desire • Eat fresh and healthy food improves the wellbeing and physical health • Talk with your partner about your concerns and feelings an open and trustful relationship is more intimate • Do not smoke  smoking causes circulation disorders and favours erectile dysfunctions • Adequate exercise regularly movement improves the sexual performance • For people with diabetes: check blood sugar level regularly a high blood sugar level favours erectile dysfunctions

31. 14. Good to know • Conditions where man active Denk should not be taken: • If someone has a known allergy or sensitivity to one of the ingredients. • Consultation of a doctor or pharmacist is advised: • When someone suffers from pathologically increased bleeding tendency or during concomitant intake of certain anticoagulants (e.g. Warfarin, Clopidogrel, Phenprocoumon).There are studies that suggest that Ginkgo biloba • inhibits platelet aggregation. • when taken concurrently with warfarin increases the risk of a bleeding. •  Until more is known, monitor blood clotting closely in patients taking ginkgois recommended. • There are sporadic hints that preparations containing Ginkgo biloba could increase bleeding tendency therefore man active Denk should be stopped as a precaution before operations. • Inepileptic patients or patients prone to seizures. • In case of chronic illnesses or chronic drug intake.

32. 15. Other Denk Nutrition products The counterpartforwomen For female libido enhancement and overall health • Natural plant extractsandvitaminsfor a normal energy-yieldingmetabolism • Ideal nutrientcombinationforboostinglibido, enhancing sexual pleasueandincreasedenergylevels • Continousintakeforspntaneousfunandperformance

33. 16. References 1 UW Health (2018): Urology. Erectile Dysfunction. https://www.uwhealth.org/urology/erectile-dysfunction-ed/20537 2 European Comission (2012): Commission Regulation (EU) No 432/2012. 3 Rowland DL, Wendi T (2003): Review of Plant-Derived and Herbal Approaches to the Treatment of Sexual Dysfunctions. J Sex Marital Ther. 29 (3): 185-205. 4 Kilham C (2000): Maca herbs for erectile dysfunction and impotence. Total Health. 22: 48–49. 5 WebMD (2009): L-Arginine. 6 Bertil B et al. (1999): Actions of Caffeine in the Brain with Special Reference to Factors That Contribute to Its Widespread Use. Pharmacol Rev. 51 (1): 83-133. 7Cesari M (2004): Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. Am J ClinNutr. 79: 289-294. 8 Suboticanec-Buzina K (1984): Vitamin C status and physical working capacity in adolescents. Int J VitamNutr Res. 54(1): 55-60. 9Prasad AS (1996): Zinc status and serum testosterone levels of healthy adults. Nutrition. 12 (5): 244-348. 10Freake HC (2006): Zinc: Physiology. In: Encyclopedia of human nutrition. 2nd edition. 11Jalali GR (2010): Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysis. Renal Failure. 32 (4): 517-419. 12WebMD (2009): L-Arginine. 13 Scibona M (1994): L-arginine and male infertility. Minerva UrolNefrol. 46 (4): 251 – 253. 14 Schachter A (1973): Treatment of oligospermia with the amino acid arginine. J Urol. 110 (3): 311-313. 15Dean RC, Lue TF (2005): Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction. UrolClin North Am. 32 (4): 379-403. 16 Mayo Clinic (2019): Men’s health. The influence of testosterone in men. https://www.mayoclinic.org/healthy-lifestyle/mens-health/multimedia/the-influence-of-testosterone/img-20007271 17 Urology Care Foundation (2018): What is Low Testosterone? https://www.urologyhealth.org/urologic-conditions/low-testosterone

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