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Sparking Desire

Couple in bed Couple in bed
Celadrin

Women’s sexual health is a complex subject, but there are herbal supplements that can help support it.

Both women and men have the potential for sexual enjoyment and gratification. Some might say this spark of passion is what makes the world go round. Studies have shown that sexual intimacy deepens relationships and helps to stave off depression. Sex is a hot topic (no pun intended). Religions and governments have an almost infinite array of rules about who can have sex, what kind of sex they can have, and in what circumstances. It is a sobering fact that, in some parts of the world today, having the wrong kind of sex is punishable by death.

But what happens when this powerful and volatile drive dissipates, or disappears entirely? Often the first step is to determine if the problem is psychological or physiological—or both. In men, the problem can be erectile dysfunction (ED), meaning the heart is willing but the body parts need an assist. The two best known drug interventions for ED are Viagra and Cialis, which accounted for sales in 2015 of an incredible $4 billion dollars. For comparison purposes, that is a higher level of sales than Domino’s Pizza. Both of these drugs work to increase blood flow to the penis and better blood absorption by the penile tissue. For men for whom the cause of decreased libido is depression, antidepressant drugs are prescribed—ironically, with the adverse effect listed that sex drive may be diminished. All these interventions have adverse effects, some quite serious. There are a variety of nutrients of benefit to men, such as ginkgo, ginseng, mesoglycan, and maca (to list only a few) that have been clinically shown to promote male sexual health.

But what about women? When a woman suffers loss of libido, it is rarely caused by changes in circulation. There is a higher level of complexity. Biologists and psychologists have suggested that the sex drive behaves quite differently in men and women. Women’s sex drives are not only the manifestation of the biological urge to procreate, but designed to secure a mate to participate in making sure their offspring launch successfully. With age, women generally (but not always) experience some level of decrease in desire, while men less so. In fact, about 12 percent of women between the ages of 45 and 64 have a serious decline, which is called “hypoactive sexual desire disorder.” While some natural practitioners debate the legitimacy of this diagnosis, it remains that a number of women are quite concerned and unhappy with their loss of sexual desire, especially if it is a cause of contention with their partner. Another survey found that in women between 50 and 59, about half reported any sexual intercourse in the previous year. By age 70 to 79, that number drops to 27 percent.

One contributor to reduced sex drive can be pain with sexual activity, which needs to be medically assessed. However, there are many women for whom pain is not the issue. It is the desire for sex that has been diminished.

A useful insight for women is that sex changes with maturity. In the young, powerful sexual desire leads to sexual activity. But as we age, that shifts. Sexual desire may not come first. One expert states that around menopause, sex has to become more “intentional,” meaning you decide to have sex and start sexual activity with the goal of becoming sexually aroused. The order is reversed. However, there are supplements that can be useful in supporting sexual enjoyment and sex drive.

Sea Buckthorn

Sea buckthorn is a rich source of omega-7 fatty acids, which are rare in the plant world. Another rich source is the macadamia nut. A proprietary blend of sea buckthorn seed and fruit oil called SBA-24 has been shown in clinical studies to reduce inflammation and increase hydration of the mucous membranes in the vagina. Improving vaginal hydration is an important factor for comfortable, enjoyable sex.

Black Cohosh

One of the best known herbs for women’s health is black cohosh. In fact, the bestselling medicine in the U.S. about 125 years ago was called Lydia Pinkham’s formula and contained a copious amount of alcohol and a few herbs, most prominent among them black cohosh. However, black cohosh as a standardized women’s medicine was developed in Germany over the last several decades. The majority of studies on black cohosh are on extracts with triterpene glycoside standardizations. It has been proven to help with the vasomotor symptoms of menopause (ie, hot flashes and night sweats) and there is evidence that it improves vaginal mucosa as well. This herb is still erroneously identified as a phytoestrogen, but this is untrue. It works by attaching to selective estrogen receptors. Therefore, this herb may indirectly support healthy sexual function.

Rhodiola

Richard P. Brown, MD, associate professor of clinical psychiatry at Columbia University in New York has been interviewed on his view of the usefulness of rhodiola in both men and women. He stated that “Rhodiola can boost sexual desire in both men and women. While no one knows exactly how the plant improves sexuality, it probably works on the dopamine system in the brain which is very important to sexual functioning and libido.” And Philip R. Muskin, MD, professor of clinical psychiatry also at Columbia University, and chair of the APA scientific program committee, voiced his agreement in an interview with WebMD, stating “Rhodiola appears to have a beneficial effect in enhancing sexual function. It improves satisfaction, pleasure, erections, response to orgasms.”

Professional opinions aside, there have been studies that back up these claims that rhodiola exerts effects on the dopamine system in the brain, and improves both mood and stamina—key components to engaging in sexual activity. Dopamine also plays a central role in the brain chemistry of desire. Quality rhodiola is standardized to rosavins and salidrosides, which are compounds associated with the herb’s effectiveness.

Ashwagandha

There are both animal and human studies examining this respected ayurvedic herbal medicine for male sexual function. However, just this year, a placebo-controlled study was published specifically on KSM-66 ashwagandha root extract showing improvement in several areas of sexual function in otherwise healthy women. They found significant increases in parameters of arousal, lubrication, orgasm, and reported sexual satisfaction. Though the women in this study were aged 21 to 50, it may still be worth including in a daily sexual health regimen at any age. More study is needed to fully understand the mechanism of action, but this adaptogen demonstrates activity in neuroendocrine and hormonal pathways, which makes it useful for either gender.

Korean Red Ginseng

One of the most valued adaptogenic herbs in the world and a staple of traditional Chinese medicine, Panax ginseng (not to be confused with American or Siberian ginseng) has great value for women experiencing decreased libido and sexual enjoyment. In a placebo-controlled study of menopausal women, red Korean ginseng (a type of Panax) was shown to significantly increase sexual arousal. These benefits disappeared quickly when women stopped taking the herb, so, as with most herbs, continued use is required for continued benefits.

Maca

Maca is a well-known root vegetable and natural medicine grown in the South American highlands, especially in Peru. It has long been used in folk medicine for stamina, energy, endurance, and sexual function. In a study published this year of both pre- and post-menopausal women with sexual dysfunction related to anti-depressant medication use, maca was shown especially effective in post-menopausal women in alleviating this serious side effect.

Another study specifically on otherwise healthy post-menopausal women with sexual dysfunction showed that maca significantly improved libido, while easing anxiety and depression. A further note in the study points out that these benefits were not due to increasing estrogens or androgens as measures of both were taken before, during, and after administration of the herb and remained unchanged.

Sex and the Single Herb

Many commercially available products combine these ingredients—and others not here mentioned—into formulas targeting female sexual function. My concern is that the majority (but not all) of the studies have been on individual herbs, often with a specific dose and standardization. Therefore, if choosing a combination, it may be important to determine if a) the formula is clinically studied and/or b) the herbs in the combination product are included at their clinically proven levels. Otherwise, the herbs may be at sub-therapeutic levels.

I believe it is important to offer women clinically validated herbal medicines that fulfill on the promise of alleviating sexual dysfunction. Sexual health is still not discussed as openly as heart health or joint health, but remains a key area of need for many women. VR

References:

www.cbsnews.com/news/hard-luck-why-viagra-is-about-to-lose-its-no1-status-to-cialis/.

www.statista.com/statistics/264827/pfizers-worldwide-viagra-revenue-since-2003/.

www.prnewswire.com/news-releases/lilly-reports-fourth-quarter-and-full-year-2014-results-updates-2015-guidance-300028390.html.

www.menopause.org/for-women/sexual-health-menopause-online/sexual-problems-at-midlife/decreased-desire.

Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women. Obstet Gynecol 2008;112:970-978.

West SL, D’Aloisio AA, Agans RP, et al. Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Arch Intern Med 2008;168:1441-1449.

Basson R. Is it time to move on from “hypoactive sexual desire disorder”? Menopause 2010;17:1097-1098.

Larmo PS, Yang B, Hyssala J, Kallio HP, Erkkola R. Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: A randomized, double-blind, placebo-controlled study. Maturitas. 2014.

Erkkola R, Yang B. Sea Buckthorn oils: towards healthy mucous membranes. AgroFood Industry Hi-Tech. 2003;May-June.

womenshistory.about.com/od/lydiapinkham/a/Lydia-Pinkham.htm.

Wuttke W, Gorkow C, Seidlová-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Menopause. 2006 Mar-Apr;13(2):185-96.

www.webmd.com/erectile-dysfunction/news/ 20040505/natural-sex-boosters-gaining-ground.

Cropley M, Banks AP, Boyle J. The Effects of Rhodiola rosea L. Extract on Anxiety, Stress, Cognition and Other Mood Symptoms. Phytother Res. 2015 Oct 27.

Dongre S, Langade D, Bhattacharyya S. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. Biomed Res Int. 2015;2015:284154.

Oh KJ, Chae MJ, Lee HS, et al. Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study. J Sex Med. 2010 Apr;7(4 Pt 1):1469-77.

Dording CM, Schettler PJ, Dalton ED, et al. A double-blind placebo-controlled trial of maca root as treatment for antidepressant-induced sexual dysfunction in women. Evid Based Complement Alternat Med. 2015;2015:949036.

Brooks NA, Wilcox G, Walker KZ, Ashton JF, Cox MB, Stojanovska L. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content. Menopause. 2008 Nov-Dec;15(6):1157-62.

Cheryl Myers is an integrative health nurse, author, and an expert on natural medicine. She is a nationally recognized speaker who has been interviewed by the New York Times, Wall Street Journal and Prevention magazine. Her many articles have been published in such diverse journals as Aesthetic Surgery Journal and Nutrition in Complementary Care, and her research on botanicals has been presented at the American College of Obstetrics and Gynecology and the North American Menopause Society. Myers is the head of Scientific Affairs and Education for EuroPharma, Inc.