Bring On Aphrodite
Put a goddess at the wheel of your sex drive with these natural remedies

By Thea Deley

The creation of Viagra prompted a multiyear discussion about erectile dysfunction and its celebrated antidote. But enough already about men: Women have long suffered from similar problems, with little note or fanfare. Now it's time to talk about the topic's counterpart, female sexual dysfunction, also known as FSD.

Four out of 10 women experience sexual dysfunction at some point in their lives, according to the National Health and Social Life Survey (Journal of the American Medical Association, 1999, vol. 281, no. 6). Female sexual dysfunction (FSD) can be the result of one or a combination of underlying conditions, with the common symptom being personal distress caused by the recurrent inability to attain or maintain sexual activity. The study, based on data gathered from 1,749 women aged 18-59, found that the risk of experiencing FSD decreases if a woman is married, college-educated, lives in a higher income household, or has had more than five sexual partners. Still, while many women attribute a lack of libido to stress and a busy lifestyle, research shows that the source is primarily physical. According to Jennifer Berman, MD, and Laura Berman, PhD, both from the UCLA Female Sexual Medicine Clinic, 80 percent of FSD patients suffer from physiological problems or a combination of physiological and psychological problems. So, contrary to what is often thought, a sagging sex drive is not all in your head.

Measuring Sexual Desire
In 1966, Masters and Johnson were the first to record the physical responses women experience during sexual arousal and orgasm. Since then, almost nothing has been done to research the realm of female physiology and sexual disorders. It wasn't until 1998 that an international multidisciplinary panel of physicians and psychologists gathered to redefine sexual disorders in women. For the first time in history—just three years ago—medical problems were finally acknowledged as a cause of FSD.

One reason for the scanty attention given FSD is the complicated nature of diagnosing the true source of the problem. "The main theme with sexual dysfunction is that there are lots of variables," says Tori Hudson, ND, professor of gynecology at the National College of Naturopathic Medicine and author of Women's Encyclopedia of Natural Medicine (Keats Publishing, 1999). The overlapping physical and psychological variables make diagnosing FSD difficult. "As a practitioner, you're guided to tests based on what the patient says," Hudson continues. "If she says she has a low sex drive, a good practitioner looks for other hints: Is she fatigued? How's her sleep? What's going on in her personal life? After you hear the patient's story, do a physical exam, order whatever tests you think might be important, then you can come up with a diagnosis."

There are several considerations a practitioner must take into account before finding a solution. The following conditions are general guidelines for diagnosing FSD, along with natural treatment options.

Inadequate blood flow to the genitals and pelvic region. Restricted blood flow may preclude orgasms or decrease their intensity, reduce genital sensitivity and cause vaginal dryness. Many factors can contribute to blood-flow problems, including smoking, alcohol consumption, medication, heart disease, hypertension, excessive bicycle riding, genital/pelvic injuries, pelvic surgery, diabetes, poor circulation, high cholesterol, poor diet and lack of exercise. Fortunately, there are supplements that can help increase circulation naturally. These include ginkgo (Ginkgo biloba), cayenne (Capsicum frutescens), gotu kola (Centella asiatica), hawthorn (Crataegus oxyacantha), ginger (Zingiber officinale), vitamins C and E, niacin and magnesium. In high doses (3-4 g per day), the amino acid L-arginine can help form nitric oxide, which in turn helps relax the smooth muscles of the vagina and clitoris. Eating a high-fiber, low-fat diet focused on whole grains, fresh fruits and vegetables helps too, as does exercise such as brisk walking. Therapeutic massage, yoga and acupuncture may also promote circulation. Research continues into the efficacy of Viagra (sildenafil) and other drugs currently being developed specifically for women to enhance genital blood flow.

Vaginal dryness. While deficient vaginal lubrication is often associated with menopause or a low sex drive caused by psychological issues such as depression or anxiety, it may be a symptom of hormonal deficiencies. Endocrine disorders, postpartum hormone fluctuations and diabetes are just a few conditions that can cause hormonal imbalances in addition to menopause. Discuss hormone testing with your health care practitioner, then decide on topical, vaginal or oral estrogen and/or oral or transdermal testosterone based on your test results.

Before hormone testing, however, you may want to try herbs known to help treat this condition, including chasteberry (Vitex agnus-castus), black cohosh (Cimicifuga racemosa), red clover (Trifolium pratense) and Korean ginseng (Panax ginseng). Vitamin E works as well, either taken orally or used as a vaginal suppository. Omega-6 essential fatty acids (EFAs), found in flaxseed, sesame seed, pumpkin seed, hemp seed and safflower oils, and omega-3 EFAs, found in fish oil capsules and cold-water fish, such as herring, mackerel, halibut and salmon, may also help with vaginal dryness. Besides incorporating fish into your diet, also consider chewing licorice root (Glycyrrhiza glabra), eating plenty of isoflavones found in soy foods, drinking lots of water and fresh juice, and cutting out caffeinated beverages. Staying active sexually and practicing Kegel exercises may also help curtail vaginal dryness. Kegel exercises are a tightening and releasing of the pelvic-floor muscles, as if trying to stop a flow of urine. To practice, hold the contraction for 3-10 counts, release, then repeat 5-10 times.

Lack of sexual desire. A waning libido could be a symptom of diabetes, hypothyroidism, liver disease, coronary artery disease, hypertension, hyperlipidemia (increased blood lipids), anxiety, depression, menopause, hysterectomy or bilateral oophorectomy (removal of both ovaries). Medications such as antihypertensive agents, antidepressants, antiulcer drugs, anticancer drugs and progestin-dominant birth control pills may decrease sex drive. Supplementing with testosterone or DHEA (which the body converts to testosterone) may help. However, healthy ovaries and adrenal glands produce testosterone, so supplementing may lead to hormonal excess and masculinization. If you have a history of breast cancer, severe liver disease or severe deep-vein phlebitis, consult your health care practitioner before taking testosterone or DHEA.

Herbs that enhance libido include dong quai (Angelica sinensis), Korean ginseng (Panax ginseng), ginkgo (Ginkgo biloba), Mexican damiana (Turnera aphrodisiaca), Peruvian maca (Lepidium meyenii) and wild oats (Avena sativa). Also, higher levels of histamine in the blood may improve sex drive. Natural sources come from vitamin B5, the bioflavonoid rutin, and vegetables like broccoli, parsley, cherries, grapes, peppers, melons and citrus fruits. In addition, aromatherapy oils known to inspire romance include rose, clary sage, sandalwood and jasmine. Finally, aerobic exercise and acupuncture may also improve libido.

Painful intercourse or stimulation. If intercourse is painful due to a health condition, treating the primary problem may be enough to relieve the pain. Underlying problems range in severity and may include endometriosis; uterine fibroids; vaginal and urinary tract infections; inflammation and irritation around the vaginal opening; and inflammation of the bladder and urethra. If the pain stems from thinning of the vaginal lining due to hormonal deficiencies, hormone replacement therapy may improve the discomfort, as will improving blood flow to the pelvic region. Progressive exercises to accustom the vagina to penetration may help with vaginismus (see "What is Female Sexual Dysfunction?").

As research into FSD continues to expand, so will the number of treatment options. In the meantime, seeking out a practitioner experienced in this area—someone willing to explore all possible causes—can help restore the pleasurable sex life every woman deserves.

Thea Deley is a freelance writer specializing in alternative health.

Note: If you are pregnant or trying to become pregnant, consult your health care practitioner before taking any herbs. Many are contraindicated during pregnancy, including black cohosh, chasteberry, Korean ginseng, gotu kola, licorice and red clover.