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erythrocytes, platelets, endothelial cells, monocytes, lymphocytes, granulocytes, neuronal cells, fibroblasts, retinal cells, hepatic cells and neuroblastoma cells). Competition between the omega-6 and omega-3 fatty acids occurs in prostaglandin formation. Eicosapentaenoic acid (EPA), an omega-3 fatty acid, competes with arachidonic acid (AA), an omega-6 fatty acid, for prostaglandin and leukotriene synthesis at the cyclooxygenase and lipoxygenase level(Fig. 1). When humans sexual enhancement ingest fish or fish oil, the EPA and docosahexaenoic acid (DHA) from fish or fish oil lead to (1) a decreased production of prostaglandin sexual enhancement E2 (PGE2) metabolites, (2) a decrease in thromboxane sexual enhancement A2, a potent platelet aggregator and vasoconstrictor (3) a decrease in leukotriene B4 formation, an inducer of inflammation and a powerful inducer of leukocyte chemotaxis and adherence, (4) an increase in thromboxane A3, a weak platelet aggregator and a weak vasoconstrictor, (5) an increase in prostacyclin PGI3, leading to an overall increase in total prostacyclin by increasing PGI3 without a decrease in PGI2 (both PGI2 and PGI3 are active vasodilators and inhibitors of platelet aggregation) and (6) an increase
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