Can You Rev Up Your Libido?

[BABY1]

TweetGot bedroom troubles? Waning sexual desire or erection problems are very common. Maybe you've been tempted to try ginseng, ginkgo, and similar supplements. There's no lack of products out there.

What are these supplements? Do they live up to their promises? Are there any studies showing they work? Do they have bad side effects? Are they worth the cash? Is a romantic bath for two a better solution?

Getting Sex Supplement Advice

For advice on women's supplements, we turned to Hilda Hutcherson, MD, clinical professor of obstetrics and gynecology at Columbia University Medical Center, and author of the book Sex and Pleasure: A Woman's Guide to Getting the Sex You Want and Need and Deserve.

The supplements are generally harmless, she tells WebMD. She has found that herbal oils and supplements do seem to help some women having trouble with sexual desire and vaginal dryness. Yet she always advises talking to your doctor before taking any supplements -- as some have dangerous side effects.

We also spoke with Christopher Saigal, MD, assistant professor of urology at UCLA School of Medicine, about men's supplements -- mostly for erectile dysfunction (ED). He's got an open mind about supplements that mimic Viagra, but he's also got definite opinions.

If you're buying an off-the-shelf supplement, the quality is worth questioning, Saigal says. "There is so much fraud in this industry," Saigal tells WebMD. "Go to a site that evaluates the contents, like ConsumerLab.com. One evaluation of ginseng showed that half the brands had contaminants like pesticides. So buyer beware. Look for high-quality products."

Sexual Desire, Supplements…and the Science

Ginseng: There are several types of ginseng, two of which are Siberian ginseng, which is occasionally used as an aphrodisiac, and red Korean or Asian ginseng, which is used in Chinese traditional medicine and has slightly more research behind it, Saigal says.

"Ginseng, like a lot of herbs, is thought to work by helping the body make more nitric oxide -- as does Viagra," he says. "A couple of good studies showed some effect from ginseng, so people can look at this as an alternative to Viagra. But it's not going to be as effective as Viagra or Levitra or Cialis."

Ginseng appears to help women, too, says Hutcherson. "Ginseng gives people energy and may improve mood, and you need energy and endurance for sex, right?"

Black Cohosh: In the past, black cohosh has been used to treat arthritis and muscle pain and was traditionally used for “female” complaints. Today, it is marketed to treat hot flashes, night sweats, vaginal dryness, premenstrual syndrome, and other menopausal symptoms.

"Black cohosh has estrogen-like properties, and increases blood flow to the pelvis -- which increases arousal and response to sexual stimulation," Hutcherson says. "More blood flow means more lubrication, and that's good for sex." The National Institutes of Health (NIH) is funding studies of black cohosh as a treatment for menopausal symptoms.

Chasteberry (Vitex): Chasteberry is native to the Mediterranean region and western Asia -- and is approved in Germany for premenstrual and menstrual problems. It is said to increase sexual desire by boosting the hormone progesterone and the brain chemical dopamine.

Chasteberry also decreases the brain chemical prolactin that interferes with sexual desire. "It works for some patients," Hutcherson says.

L-Arginine (Arginine): Arginine is an amino acid the body needs for many functions, like boosting immunity. The body also uses arginine to produce nitric oxide -- an effect similar to the way Viagra works. Arginine has been found to improve blood flow to the penis.

One study showed improvements when L-arginine, glutamate, and yohimbine were combined. (Yohimbine is FDA approved as a drug therapy for ED, so how much of the effect was due to arginine is unknown.) Another study showed "significant improvement in sexual function" when low dose (500 mg three times daily) L-arginine and pycnogenol were combined -- but not when L-arginine was used alone. Higher doses, around 5 grams daily, might be necessary for L-arginine to work by itself.

Arginine is generally safe, although there may be drug interactions -- especially with high blood pressure drugs. In addition, men taking Cialis, Levitra, or Viagra – or nitroglycerin (nitrates) for chest pain (angina) -- should be cautious as combining them with L-arginine can cause a potentially serious drop in blood pressure.

"It's something to try. And if it works for those arteries, it could also help the heart arteries, too. Men with heart disease might benefit most from taking arginine," says Saigal.

Ginkgo: Ginkgo has been used in traditional Chinese medicine for thousands of years. Ginkgo leaf extract is used today to boost mental power, help Alzheimer’s, and treat tinnitus, asthma, fatigue, and sexual dysfunction. Some studies show that gingko enhances the effects of nitric oxide -- which allows better blood flow to the penis.

"Ginkgo is one of those herbs that are pretty popular," says Saigal. "The thing is there's no great data for sexual function on it." Ginkgo is thought to help with sexual dysfunction related to antidepressant use, he notes. "One study showed that ginkgo made no difference; the other showed some slight difference. There may be a large placebo effect, but there have been anecdotal reports that it helps some people."

Yohimbe: Yohimbe is derived from bark of the yohimbe tree, native to Africa -- and traditionally used as an aphrodisiac. In current times, "this extract has been shown to be moderately effective in treating ED," says Saigal. "It may perhaps increase erections and libido, because it has some effect on the brain.

Some studies indicate that yohimbe may help ED in men taking antidepressants as well as other types of ED, although research in this area is limited. Caution: Some yohimbe bark extracts may not contain significant amounts of yohimbine, so they may not have these effects. "There's a buyer-beware issue," Saigal says. "A lot of supplements use names that sound like yohimbe but are basically worthless. Look at the content label. Make sure it's from the yohimbe tree." Also, look for the name of the active ingredient -- yohimbine or yohimbine hydrochloride.

In some people, yohimbine can cause high blood pressure, stomach upset, anxiety, or other psychological problems. Use cautiously and under the direction of your health care provider.

Maca: Maca is a vegetable native to Peru that is traditionally used as an aphrodisiac, says Saigal. "There have been rat studies, but studies to support its use are very limited," he says. "But because it's a vegetable, maca won't hurt you."

Pycnogenol: Pycnogenol is an extract of the bark from French maritime pine. It is believed that pycnogenol helps protect blood vessels and boost production of nitric oxide -- similar to L-arginine, yohimbe, ginkgo, and ginseng.

"Some studies show that taking L-arginine and pycnogenol together boosts nitric oxide production," says Saigal. "Those weren't randomized trials [meaning the combination wasn’t compared to placebo], but there was an effect." So there might be some effect in combining the two.

ArginMax: If female patients are interested in herbs, Hutcherson guides them to ArginMax (a combination of Panax ginseng, L-arginine, ginkgo biloba, damiana, multivitamins, and minerals).

Two large clinical studies found that ArginMax improved sexual function in menopausal and other women with low sexual desire, Hutcherson explains.

Zestra for Women: Zestra, a blend of botanical oils and extracts, is designed to increase female sexual desire, arousal, pleasure, and satisfaction when applied to the female genitalia, says Hutcherson. Zestra’s ingredients include borage seed oil, evening primrose oil, angelica extract, coleus extract, vitamin C, and vitamin E.

In a preliminary study, Zestra was shown to increase sexual sensation, arousal, pleasure, and satisfaction in "normal women" and women with arousal problems. Zestra also helped with sexual side effects related to antidepressants.

"You rub it on your clitoris, which is supposed to increase blood flow," Hutcherson explains. But "I don't know whether it's the Zestra that works or because they're rubbing the clitoris."

In a study funded by Zestra Laboratories Inc., 217 women were randomized to either Zestra or a placebo oil. In some aspects, such as sexual desire and arousal, the Zestra group fared better. In other aspects of the study, there was no difference between Zestra and placebo. The only side effect mentioned was mild to moderate genital burning in more women in the Zestra group.

Vitamin E: Vitamin E oil -- when applied to the vagina -- helps improve lubrication. "It is very effective," Hutcherson says

Cautionary Notes About DHEA Supplements

DHEA (dehydroepiandrosterone) is a natural hormone that is converted into male and female sex hormones in the body. DHEA is sold as an antiaging supplement that improves energy, strength, and muscle, plus it increases immunity and burns fat.

However, the NIH says, "there is no conclusive evidence that DHEA supplements do any of these things,” and "there is little scientific evidence to support the use of DHEA as a 'rejuvenating' hormone."

Long-term effects of DHEA supplements have not been studied -- but there are "early signs that these supplements, even when taken briefly, may have detrimental effects on the body, including liver damage."

Even if DHEA does rev your libido, it won't help erections, Saigal says. "If the goal is a better erection, getting more testosterone won't help. I advise using a pharmaceutical instead. I would say, start with [Viagra, Cialis, or Levitra] first -- especially since we don't know the long-term effects of DHEA."

Keeping Your Libido Healthy

Pills aren't the only answer. If flagging sexual desire is the problem, "find something that adds spice," Hutcherson says. "Find something interesting that stimulates your mind, since the brain is the largest sex organ."

Her libido-boosting suggestions:
Sleep in the bedroom. Have sex anywhere else -- the den, kitchen, or laundry room.
Seize the moment wherever, whenever, it hits.
Buy something new. New lingerie definitely qualifies.
Send hot sizzling notes to each other during the day.
Buy a sex toy. Read an erotic novel together. Watch an erotic video.

"There are so many things, you can never run out of ideas," Hutcherson says. "What helps most -- the best aphrodisiac -- is going on a field trip to an adult store together. Try different things, touch, giggle, have a good time. You find you can't wait to get home to try them."

Protecting Your Sexual Desire

To keep your libido in prime form, you've got to walk, jog -- do some kind of aerobic exercise -- daily. Maybe it doesn't sound sexy, but a two-mile walk every day keeps the blood flowing, Saigal says.

Losing weight (if you're obese) and eating a low-fat diet also helps restore sexual function, he adds. "You'll feel better about yourself, and your partner will be more interested in you. You'll also help your heart." And that’s very sexy.

[Skull]

TweetI need something to help my libido big time.I'm tapped out