Natural Health

HERBAL APHRODISIACS: SOME REALLY WORK

By Michael Castleman

Seven years ago, when Pfizer’s erection drug, Viagra, took the world by storm, the company set out to prove that “vitamin V,” as some called it, could do as much for women as men. And why not? Viagra coaxes extra blood into the genitals of both men and women. In men, this aids erection, and in women, Pfizer researchers theorized, it should increase sexual arousal and responsiveness. Only it didn’t. Last year [2004], after eight years of research involving 3,000 women, Pfizer gave up on its efforts to win FDA approval for Viagra as a treatment for low libido and arousal problems in women.
 
But ironically, the drug that doesn’t affect women’s sexuality, has spurred many women to look for solutions to their sex problems.  “Among my women patients,” says Mary Lake Polan, M.D., chair of the department of obstetrics and gynecology at Stanford University, “sexual complaints are quite common. They’ve become even more so since the publicity around Viagra brought these problems more into the open.” This new, post-Viagra feeling of sexual entitlement spurred Polan to study ArginMax, one of several new supplements designed to put more zing into sex (see below).
 
It’s just not enough to feel physically and emotionally healthy anymore. Back in the 20th century, advocates of holistic, natural health celebrated the interconnectedness of mind, body, and spirit, the union of physical and emotional health, and our connections to those around us and the natural world. Since Viagra, in the 21st century, sexual connections have become more integrated into the mind-body-spirit equation. A great deal of research shows that physical and emotional vitality boost sexual health (see sidebar). Viagra may be a bust for women, but it has altered the sexual landscape by making many men and women feel entitled to better sex lives. “With all the publicity around erection medications,” says Fair Oaks, California, sex therapist Louanne Weston, Ph.D., “both men and women seem more willing to admit that they have sex problems and to look for ways to resolve them.”
 
No wonder that since Viagra’s arrival, health food store shelves have become crowded with supplements that promise sexual fireworks. Of course, the search for sexual enhancement is nothing new. For centuries, many herbs and foods have been touted as aphrodisiacs, among them yohimbe bark (see below) and seafoods. But traditionally, aphrodisiacs were relegated to folklore. Today, scientists are beginning to investigate them for sexual enhancement. “Unfortunately,” says Mark Blumenthal, executive director of the American Botanical Council, the nation’s leading nonprofit devoted to education about herbs, “the claims often go far beyond the research. Not much is known about many of these herbs. There’s a real need for more research. But quite often, sceintists find that historical and folkloric claims have some truth.” And to the extent that purportedly aphrodisiac herbs have been researched, the latest research shows that many traditional herbal aphrodisiacs stimulate more than just the imagination.
 
* Coffee
If your honey’s thoughts turn to dreamland as yours turn to dallying, a cup of coffee just might keep your lover awake long enough to make the most of the evening. “Coffee is a powerful central nervous system stimulant,” says Chris Kilham, an ethnobotanist at the University of Massachusetts, Amherst, and author of Hot Plants: Nature’s Proven Sex Boosters for Men and Women. “It excites nerves all over the body, including the ones involved in sex.” But caffeine does more than simply keep the Sandman at bay. In one study, University of Michigan researchers surveyed 744 married couples, age 60 or older, and discovered that women who were daily coffee drinkers were more likely to call themselves sexually active--62 percent versus just 38 percent of the women who abstained from coffee. In addition, coffee was a boon to erection. Fifty-nine percent of non-coffee-drinking men reported erectile dysfunction (ED). Among coffee drinkers, the figure was only 36 percent. It’s possible that the caffeine buzz from coffee (or to a less extent, tea) boosted these elders’ sexual energy. It’s also possible that healthier, more libidinous elders were more likely to drink it, so coffee’s effects on sex remain unclear. “Caffeine is a powerful central nervous system stimulant,” Blumenthal explains. “When people get a caffeine buzz, some feel a sexual buzz as well.”
 
Dose and Safety: Most coffee drinkers consume one to two cups a day. Coffee causes insomnia, jitters, and irritability. It has also been accused of contributing to heart disease and cancer. But the largest, most authoritative studies show that one to two cups a day do not increase risk of heart disease or cancer.
 
* Cocoa, chocolate.
In addition to caffeine, cocoa and chocolate stimulate the release of endorphins in the brain. “Endorphins,” explains Hank Wuh, M.D., author of Sexual Fitness, “are pleasure messengers that signal feelings of well-being and happiness--and may help you become more receptive to sex.” Chocolate also contains L-arginine, an amino acid involved in sexual responsiveness (see ArginMax below). Finally, chocolate contains phenylethylamine (PEA), the “molecule of love,” according to Theresa Crenshaw, M.D., author of The Alchemy of Love and Lust. PEA is a natural form of amphetamine. It’s also a natural antidepressant. Both love and lust increase blood levels of PEA, but after a heartbreak, PEA levels plummet. Chocolate contains high levels of PEA, which may explain why the broken-hearted sometimes binge on chocolate. It’s a way to raise their PEA levels. “Cocoa and chocolate are not great sex enhancers,” Kilham explains, “But they recreate the brain chemistry of being in love. And if being in love makes you feel more sexual, then cocoa and chocolate might do that.” Critics contend that chocolate’s PEA is metabolized so quickly that it couldn’t have much sexual effect. Perhaps, but giving chocolates has become a worldwide courtship ritual.  Maybe it’s the silky texture and creamy taste. Or maybe it’s the PEA. The artificial sweetener, NutraSweet (aspartame), also increases blood levels of PEA. Maybe lovers should forget the champagne, which contains alcohol, a depressant that dampens sexual function, and instead, toast one another with diet soda containing NutraSweet.
 
Dose and Safety: My wife swears there’s no such thing as too much chocolate. However, chocolate contains caffeine (see Coffee). And--sorry, honey--chocolate may also cause heartburn, migraine headaches, and allergic reactions.
 
* Damiana
The ancient Mayans used this herb as a sex-booster. One species’ scientific name includes aphrodisiaca. With a name like that, you’d think this Latin American herb would have attracted considerable research interest. Oddly, only one study has investigated its sexual effects. Italian researchers showed that damiana “improves the copulatory performance of sexually sluggish or impotent rats. These results seem to support damiana’s folk reputation as a sex stimulant.” Or maybe not. One animal study isn’t much, and a pharmacological analysis of this plant concluded: “No substantive data are available to support its aphrodisiac effects.” Kilham agrees: “As far as I can tell, sexual claims for damiana are baseless.” Wuh says damiana is a mild stimulant that can cause tingling in the urethra (urine tube) and genitals, sensations that can be experienced as sexual. “Damiana really needs to be more thoroughly researched,” Blumenthal explains.
 
Dose and Safety: The typical dose is 3 to 4 g of powdered leaf in tablets or capsules, taken twice a day. No significant adverse effects have been reported. “At this point,” Blumenthal says, “about all we can say about damiana is that it’s safe.”
 
* Ginkgo.
Ginkgo has no historical reputation as an aphrodisiac, but since the 1980s, many studies have shown that it improves blood flow through the brain, slowing the progression of Alzheimer’s disease. Ginkgo also boosts blood flow into the genitals. At the University of California, San Francisco (UCSF), researchers gave ginkgo (240 mg/day) to 63 men and women suffering sexual side effects from antidepressants: libido loss, ED, loss of vaginal lubrication, and loss of orgasm. After up to two years, the herb helped 76 percent of the men, and 91 percent of the women. There was no placebo group, however, placebos usually benefit around one-third of those who use them. The response rate in this study was twice that, suggesting real benefit. However, in two other studies, ginkgo provided no benefit for antidepressant-induced sex problems. But those studies were comparatively brief--just a month or two. Apparently, it takes longer for ginkgo’s sexual benefits to appear.  “There’s no question that ginkgo opens blood vessels and improves blood flow,” Blumenthal says, “so it’s certainly plausible that it would improve blood flow into the genitals. The research so far is intriguing, but thin. I wish there were more studies.”
 
Dose and Safety: Participants in the UCSF study took 60 mg of ginkgo extract four times a day or 120 mg twice a day. Possible side effects include: stomach upset, headache, jitters, rashes, dizziness, and heart palpitations. Ginkgo is also an anticoagulant. It may increase bruising and prolong bleeding.
 
 
* Ginseng.
For centuries, Asians have considered ginseng a tonic, meaning that it subtly strengthens the entire body. It’s only a short step from this claim to sex enhancement. Recent research suggests that ginseng increases the body’s production of nitric oxide, a compound essential to erection. Korean researchers gave 45 men with erection problems either a placebo or ginseng (900 mg three times a day). After eight weeks, the ginseng group experienced significant erection improvement. Another Korean study came up with similar results. “I’m persuaded that ginseng helps with erection problems,” Blumenthal says. Colorado physician Linda B. White, M.D., coauthor (with Steven Foster) of The Herbal Drugstore, adds that ginseng “enhances overall physical vitality. As vitality increases, people often feel more interested in sex.” “Ginseng provides an unquestionable boost for libido and men’s erections,” Kilham says. “The problem is, people often don’t take enough of it. You have to use what that Korean study used, around 900 mg three times a day.”
 
Dose and Safety: Take the dose used in the Korean study--900 mg three times a day. There are few reports of significant problems, however, possible side effects include: caffeine-like stimulation, jitters, and lower blood sugar (which is good for many diabetics).
 
 
* Maca.
When the Spanish conquered Peru, the fertility of their horses and livestock declined high in the Andes. The Incas showed them the cure, this Andean ground cover. The Spanish were impressed and maca’s local reputation as a fertility-enhancer and aphrodisiac spread to Europe. Turns out the Incas were right about fertility. In a recent animal study, Peruvian researchers showed that maca does, indeed, prevent altitude-induced decreases in sperm count. Maca also appears to be a sex stimulant. Chinese researchers treated male rats with either a placebo or the herb for 22 days, then placed each one with sexually receptive females. Subsequently, the females’ vaginas were examined for sperm. Compared with females mated with control rats, those mated with maca-treated animals were more than twice as likely to contain sperm, demonstrating greater sexual activity in the maca-treated animals. “You give maca to animals,” Kilman explains, “and they copulate like there’s no tomorrow.” Maca might also be a sex-booster in humans. In the one trial to date, Peruvian researchers gave men a daily placebo or maca (1500 or 3000 mg). After eight weeks, the men who took the herb reported greater sexual desire. “Maca has a long history of historical use as a food,” Blumenthal explains, “so I’m persuaded that it’s safe. As for it’s sexual effects, the jury is still out.” “Personlly,” Kilham says, “I think maca is one of the two or three best sex-enhancing plants on the planet. But you have to use a lot of it to get an effect, on the order of 500 mg/day. Peruvian doctors routinely give it to men who complain of erection problems.”
 
Dose and Safety: It’s not clear what dose should be taken. In the clinical trial, the men took 1500 or 3000 mg. Other sources suggest up to 6000 mg a day. No one really knows. No significant side effects have been reported, but this herb has not been well researched.
 
* Muira puama.
Known as “potency wood,” this Amazon shrub is a traditional aphrodisiac. French researchers surveyed the sexuality of 202 healthy women complaining of low libido, then gave them a combination of muira puama and ginkgo. Two-thirds reported improved sexual function: greater libido, more frequent intercourse, increased likelihood of orgasm, more intense orgasms, and greater sexual satisfaction. “The research is scant,” Blumenthal says, “but often, when a plant gets a name like ‘potency wood,’ there’s something to that claim.”
 
Dose and Safety: The typical dose is 1 to 2 ml of muira puama extract in water two to three times a day. No serious side effects have been reported, but this herb has not been well researched.
 
* Tribulus Terrestris. In India, this herb is an age-old treatment for sex problems. It contains protodioscine, a compound the body converts into the male sex hormone dehydroepiandosterone. Tribulus also increases production of nitric oxide, a compound that increases blood flow into the genitals. To date, no human trials have investigated its sexual effects. But in two animal studies, the herb increased erection firmness and sexual frequency of male rats. The researchers concluded: “Tribulus appears to possess aphrodisiac activity” --at least in rats. “Animal studies don’t always translate into human effects,” Blumenthal explains. “We need human trials. But tribulus increases nitric oxide, so I wouldn’t be surprised if it improves sexual function.”
 
Dose and Safety: The typical dose ranges from 250 to 750 mg a day. No serious side effects have been reported, but this herb has not been well researched.
 
* Yohimbe.  For centuries, the bark of the West African yohimbe tree was reputed to restore faltering erections. Scientists scoffed--until the 1980s, when several studies showed that a chemical in the bark, yohimbine, increases blood flow into the penis. More recent studies have confirmed yohimbine’s benefits. Years before Viagra, the Food and Drug Administration (FDA) approved yohimbine as a prescription treatment for erection problems under the brand names Yocon and Aphrodyne.
 
Yohimbine may also boost women’s sexual arousal. University of Texas researchers gave 25 women complaining of arousal difficulties either a placebo or a combination of yohimbine and L-arginine (see ArginMax). The women then viewed erotic videos. Compared with those taking the placebo, the women who took the herb combination product reported greater sexual arousal.
 
Dose and Safety: Sexual benefits have been produced using 6 mg to 18 mg. Possible side effects include: increased heart rate and blood pressure, nervousness, irritability, headache, dizziness, tremor, and flushing.
 
NOTE: Yohimbine drugs are available by prescription only, however, many yohimbine preparations are available over the counter (OTC) at health food stores and supplement shops. Unfortunately, according to an analysis by FDA chemists, many OTC products contain only trace amounts of yohimbine. If you’re interested in using yohimbine for a sexual boost, ask your doctor for a prescription.
 
 
Commercial Combination Products
 
Experiment with individual aphrodisiac herbs if you like, but these days, it’s easier to find commercial products that combine some or many of these herbs. Dozens line health food store and supplement shop shelves with come-on names like Man Power, Maximum Potential for Men, and Rendezvous for Her. But the mere presence of sex boosting herbs is no guarantee of benefit. The dose may be too low. To date only three combination products have good studies to back them up:
 
* ArginMax.
ArginMax for Women is a multivitamin that also contains ginseng, gingko, damiana, and L-arginine, an amino acid involved in the synthesis of nitric oxide, which is key to sexual responsiveness. Several studies (but not all) have shown that L-arginine increases blood flow into the genitals. Stanford researchers gave a placebo or ArginMax for Women to 77 women with various sex problems. After two months, the ArginMax group reported significant increases in libido, frequency of lovemaking, and sexual satisfaction. ArginMax caused no significant side effects.
 
ArginMax for Men is similar, except that instead of damiana, it contains zinc, which is important to men’s reproductive health. University of Hawaii researchers gave either a placebo or ArginMax to 21 men with erection problems. A month later, 89 percent reported improvement.
 
Dr. Polan, an ArginMax for Women researchers, says she was “surprised” by her findings. “I didn’t expect ArginMax to be work, let alone be as effective as it was.” She is quick to point out that ArginMax is not an aphrodisiac in the popular sense of the term--something that quickly throws libido into overdrive. It takes several weeks to experience benefit, and not everyone does. “Both ArginMax studies had small numbers of subjects,” she explains, “so I’m not ready to get up on a soapbox and declare these products sure cures for male or female sexual dysfunction. On the other hand, ArginMax is safe. It costs only about a dollar a day. Mainstream medicine has no good treatments for female sexual dysfunction. And many men can’t take Viagra because of medical problems. My attitude is: If you have sex problems, why not try ArginMax? It just might help.”
 
Dose and Safety: Follow package directions. Ginseng and ginkgo both have anticoagulant action. You may notice increased bruising. If bleeding becomes a problem, stop using ArginMax and consult your physician. ArginMax is not estrogenic, so it can be used by women who cannot take estrogen.
 
* Zestra.
Developed by a research pharmacist, Zestra is a genital massage lotion for women  that increases blood flow into the clitoris and vulva. Its ingredients include: borage seed oil, evening primrose oil, angelica root, and coleus extract. Borage and evening primrose oil are rich in gamma-linolenic acid, which increases the skin’s synthesis of prostaglandin E1, which improves blood flow and nerve conduction. Angelica root and coleus also improve blood flow. In the one study published to date, 20 women used either a placebo or Zestra, and kept diaries documenting their reactions. Zestra significantly increased their arousal, genital sensation, sexual pleasure, and orgasm. “I’ve recommended Zestra to many patients,” says gynecologist Elizabeth Baron-Kuhn, M.D., who practices in the Chicago area. “In my experience, it works very well. It helps women feel younger and have more enjoyable sex.”
 
Dose and Safety. The recommended dose is a fingerful massaged into the vulva five minutes before intercourse. The effect lasts about 45 minutes. Some women experience a mild burning sensation. Zestra is not easy to find in stores. To obtain it, call 1-877-4-ZESTRA or visit www.zestra-women.com
 
* Xzite.
This is the only sex supplement whose active ingredients are Chinese herbs. Creator Barry Heck, M.D., a research physician in Los Angeles, says he relied on translated Chinese medical documents to screen 300 Chinese herbs, and selected the three most frequently recommended for women’s sexual problems: chrysanthemum, lovage, and spiny panax. Heck says these herbs increase synthesis of nitric oxide, which increases blood flow into women’s genitals. Efrem Korngold, O.M.D., a practitioner of Chinese medicine in San Francisco, confirms that the three herbs in Xzite “could improve libido and genital sensitivity.” In a study at UCLA, 48 women took Xzite or a placebo daily for two weeks. Those taking Xzite reported increased vaginal lubrication, sexual desire, clitoral sensitivity, and frequency of orgasm.
 
Dose and Safety: 1 capsule daily (500 mg). Headache and abdominal distress are possible.
 
Sidebar:
BEYOND SEX-BOOSTING HERBS:
OTHER NATURAL SEX ENHANCERS
 
Mention aphrodisiacs and most people think of herbs, pills, and potions. In fact, chemical aphrodisiacs take a back seat to how couples live their lives and make love. “Sexual quality is something lovers create together,” says Palo Alto sex therapist Marty Klein, Ph.D. “Creative lovemaking is a powerful turn-on.” Want to heat things up?
 
* Get regular exercise. University of California researchers enrolled 78 sedentary men in one of two exercise programs--vigorous aerobics or mild walking. The aerobics group experienced significantly greater sexual enhancement and sexual improvement was closely linked to individual improvements in fitness. Exercise also improves women’s sexual satisfaction, according to a five-year study of 27 women by a University of Vermont researcher.
 
* Maintain recommended weight. Brown University researchers surveyed 32 overweight women about their sexuality and then enrolled them in a weight-loss program. After losing weight, the women reported “significant increases in frequency of sexual activity.”
 
* Don’t smoke. Sexual responsiveness depends in part on blood flow into the genitals. Smoking constricts the arteries, reducing genital blood flow.
 
* Drink responsibly. In Macbeth, Shakespeare wrote that alcohol “provokes the desire, but takes away the performance.” Truer words were never penned.  Alcohol is a central  nervous system depressant that wilts erections and impairs women’s sexual responsiveness.
 
* Manage your stress. “There’s a great deal of research showing that stress decreases libido,” Dr. White explains. “Stress management helps preserve sexual function.” Regular exercise helps manage stress, one reason why it helps sex.
 
* Use a lubricant. Some women don’t produce much vaginal lubrication, and after age 35, most women notice the beginnings of menopausal vaginal dryness. Poorly lubricated sex is uncomfortable--and a turn-off. The solution? A commercial sex lubricant: Astroglide, Probe, or others available OTC at drugstores.
 
* Prioritize sex.  New lovers say, “Forget renting a video. Let’s do it.” Old lovers say, “Which video?” and afterwards, they’re too tired for nooky. “To maintain an active sex life,” says Fair Oaks, California, sex therapist Louanne Weston, Ph.D., “make sex dates for times when you both have the energy for it. ” 
 
* Beat bedroom boredom. “The most neglected aspect of great sex is the context,” Weston explains. “When lovemaking becomes routine, the romantic setting is usually the first thing to go. Instead of a deep-pile carpet by a roaring fire in a ski chalet with a magnificent view, it’s a dark bedroom on musty sheets when you’re exhausted. Make the setting provocative. Try a scented candle, soft music, some massage lotion, or a non-bedroom setting.”
 
San Francisco health and sexuality writer Michael Castleman is the author of 12 books, including Great Sex: A Man’s Guide to the Secrets of Total-Body Sensuality. Visit www.greatsexthebook.com.