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Over-the-Counter Aphrodisiacs with Possibility

Many of the women I see in my office want a “natural” treatment for their sex life. They don’t want a prescribed medication if they can get their libido back in some other way. Many experiment with trying over-the-counter herbs fully aware that there may be more hype about love potions than actual fact, and hopeful that there is some truth to the marketing.

In this blog post I point to the medical research that has been done on the over-the-counter products that are out there now; these products are available to everyone, and yet they are not safe for everyone to use. The comments below outline for you what is known about these products from medical research.

The info comes from a 2015 review presented in Journal of Sexual Medicine. The review was done to answer the same question: Was there was any evidence to support all the claims of sexual wonder?  It turns out that fenugreek, Korean red ginseng, maca, L-arginine and tribulus terrestris are plant products that did show supporting evidence, even if the evidence was limited in scope. I have included a few details from this review of research below.

Fenugreek: Fenugreek is an herb, often used in Ayurvedic medicine, which contains building blocks used to create estrogen and testosterone. A 2015 study showed that fenugreek improved arousal, lubrication, and satisfaction in premenopausal women. There were minor intestinal side effects. The dose used in the study was 300 mg twice a day. Fenugreek should not be used by people taking blood-thinning medication (anticoagulants), or by women with hormonally active cancers.

Maca: Maca is a root vegetable from Peru and has long been used for fertility in the Andean culture. Three out of four of the random clinical trials mentioned in this review did show positive effects on sexuality. Study doses ranged from 1.5 to 3 grams of maca a day. Its mechanism of action is not fully understood. It is known to not alter estrogen and testosterone levels as fenugreek does. It does contain phytoestrogens, plant-based compounds that can inhabit the estrogen receptors in your body. This can be a good thing or a bad thing depending on who you are, your hormonal status, whether you have cancer, the medications you are on, and many other factors that researchers are currently trying to decipher. Maca is well tolerated. We do not yet have data on what doses are optimal or safe for women to take.

Ginseng: Korean red ginseng is an herb that has been shown in one double-blind study to heighten arousal in menopausal women. It works by encouraging the release of nitric oxide, which improves blood flow in the clitoris and vaginal walls. (This is the same biochemical pathway that is augmented by Viagra, Cialis and similar medications.) Ginseng has been shown to be estrogenic, so it should be avoided by women with hormonally active cancers, and by women who have bleeding disorders or are on anticoagulant medications.

Tribulus Terrestris: This herb contains a compound which converts to DHEA. DHEA is a building block for your testosterone. This review found two randomized placebo-controlled studies that demonstrated improvement in female sexual function using this herb. The herb was well tolerated and sometimes caused minor intestinal side effects.

Horny Goat Weed (Traditional Chinese Medicine herb), Potency Wood (Brazilian herb), Damiana Leaf (extract from a Mexican shrub), and Gingko (tree used in Traditional Chinese Medicine) have promise, yet lack research. Yohimbine (parts from an African plant) is a strong aphrodisiac and its side effects can be life threatening, so it is not recommended for any over-the-counter use.

L-arginine, a common amino acid, is taken by many men and some women for a Viagra-like effect. It is a precursor to nitric oxide and nitric oxide causes blood vessels to dilate and fill with blood all over your body, including the clitoral and vaginal areas. There is significant evidence that L-arginine is helpful in producing firmer erections in men. Research on L-arginine by itself in women is lacking. There is a small double-blind study of 108 women that showed an increase in sexual desire and sexual satisfaction after taking the supplement ArginMax. This is a multi-ingredient supplement which has L-arginine in it, along with a variety of vitamins and herbs, some of which we have just mentioned: Korean Ginseng, Ginkgo, and Damiana Leaf.

Medicine, to date, hasn’t generated enough evidence-based data to establish guidelines for safe use of herbs over time, so we are left somewhat on our own. I say somewhat as there are naturopaths, herbalists, and nutritionists who are well educated in the potential of these plant products and have used them clinically for decades. Be careful in experimenting! Herbs are powerful products, and as you can see above, they can increase hormones in your body that can contribute to cancers and blood clots.

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Question: Do I need to get my testosterone level tested?

Signed, a woman with little to no desire for sex

Of the low libido women who come to see me, roughly two or three out of twenty will have testosterone levels low enough that I identify it as a contributing factor to their low sex drive. Could that be you? It is important for you to know the answer. The list below gives you a reasonable idea if you are a woman who should get tested. Check the symptom list — If your testosterone levels are low you most likely will have at least three or four of these symptoms. It won’t just be that you have no desire for sex. Testosterone affects your whole body, so low levels affect your muscles and your mood too.

Here is the list of things that can happen when your testosterone is low:

  • You feel tired
  • You have less endurance
  • Your muscles aren’t strong, and even when you work out you don’t get much result
  • Your mood is low, and you feel a physical kind of depression
  • You are less optimistic than you used to be
  • Overall sexual touch doesn’t do as much for you as it used to–there is a dullness to the sensations in your vagina and clitoris
  • When your nipples are touched you no longer get aroused
  • Your vulva can feel as if it is burning
  • Your vagina has tears in the skin after intercourse, or can occur spontaneously
  • You will have less lubrication in your vagina when you are aroused
  • The amount of hair on your body is less, and the quality of your hair is thinner
  • You aren’t thinking about or planning for sex
  • Your memory is not as sharp as it used to be

GETTING TESTED: If you have three or four of these symptoms then ask your provider to test your levels.

Tests should include a Total Testosterone, and a Free Testosterone. SHBG (Sex Hormone Binding Globulin) will also be calculated to figure out how much of your testosterone is available for you to use, as it can be bound by this protein. If your tests show that you are deficient (below normal range) or low normal (low normal is the bottom 25% of the normal range) you may be a candidate for treatment.

More about testosterone in my book: Fanning the Female Flame

Click here to read about how PCOS can affect your sex life.

In the coming weeks, I’ll be writing about how to treat low testosterone.

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A Body Designed for Sexual Pleasure

There is quite a lot to celebrate about the fame body and how it responds to and is geared for sexual pleasure. It is quite marvelous. When arousal is triggered, cascades of events occur. Neurotransmitters release from a woman’s brain and she gets a nice tingly feeling in her genital tissue. Her nipples become firm, and the clitoris gets erect. Her vulva swells and the labia change from flesh or pink color to a dusky rose or purple. She feels sexually excited. The vaginal walls get suddenly wet. Her clitoris and its two 5 to 7cm long internal legs and surrounding significant vascular tissue engorge with blood. Some muscles contract and heart rate increases. Breathing is fast. There is a sense of tension.

On the outside of a woman’s vulva, women and their partners can see the glans of the clitoris, that external bump of tissue. This glans has the most nerve endings of any place on her body. This is similar to the head of a man’s penis which is thought to be the most sensitive part of the penis with the highest concentration of nerve endings. Both these glans are very sensitive to touch and they can be extremely so. Yet they are not the whole story of arousal and orgasm. Obvious on the male, yet hidden on the female are the shaft and the two internal legs. The shaft and the legs, are what cause the organs, both the penis and the clitoris, to swell when arousal happens. They become erect. That internal swelling can be felt through the upper vaginal Wallin the area we know as the G-spot. When swelling is significant enough and those clitoral legs are impacted by the swelling that surrounds the urethra, an internal orgasm occurs, a vaginal orgasm. There is also an area of the vaginal wall that is deeper inside, referred to as the A-spot or the Deep spot. This spot is in front of the cervix, and when stimulated can lead to orgasm. This is mediated by a different nerve and women report that it feels different than an external orgasm.

The only function of the clitoris and its 8,000 nerve endings is for a woman to experience pleasure, sexual pleasure. The clitoris does not secrete substances or hormones, it does not contribute directly to reproduction or urination, it does not support other processes in her body. It is there for her pleasure.

On top of this awesome genitalia there are the many other erogenous zones in the female body. Her lips, her breasts, her nipples and the skin at the nape of her neck or inner thigh are territories of sensual delight to be explored. Skin can be wonderfully erotic and is packed with nerve endings. Light feathery touch can be scintillating, exploration can be done with your lips, tongue, fingers. There are 2,500 nerve endings per square centimeter in female fingertips, for example, and a lot can be communicated with touch intended to excite and arouse.

Look at the female body and you can appreciate that the physical groundwork for exquisite pleasure has been pre-established. Having this sensitive equipment does not mean women get easily aroused. Many don’t. One has to have one’s arousal triggered for this cascade of events to occur. What triggers arousal is the million dollar question. Arousal is not something you choose – it is something you discover. Arousal can start long before you get in the bedroom, or it can start in the bedroom. It can start with a look, a touch, a smell. If a woman’s arousal is heightened and sustained on enough of her multiple channels, her orgasm happens.

Click here to read my blog post about women and sexual arousal.

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Create an environment for an “EVENT”

Women want to have an interesting and compelling time in the bedroom. They want experiences where they melt and merge with their partners, have exquisite sensations, and have feelings that are too big and beautiful to be described in words. If you want to invest in having this kind of a sex life, one practical and physical place to start is to “set the stage.” Believe it or not your bedroom furnishings can support your sex-life being great. Getting started doesn’t have to be difficult. Let’s start first by asking yourself these three questions:

  • Is your bedroom a place that looks like it is ready for a romantic and sexual encounter?
  • Does it inspire you to feel sensually alive?
  • Does the decor support your beauty?

The idea is to make the bedroom a place that turns-you-on…a room that reminds you of your own vibrant femininity and sexuality. You can achieve this by simply changing the feeling of the room through the use of textures, colors, lighting and accessories. Overall the décor should draw your eye to the bed and to the mind of sex and rest. Nothing else. It’s not a home office, Landry-sorting station, or TV room. The bedroom is a place for sex, tenderness, intimacy and sleep. Everything else that is not linked with either intimacy or rest has to go. BE RUTHLESS! Declare this room to be only about the sensual wonder and magic that is possible between you and your partner. Even if you’re not there yet, make the room feel and appear as if you are. Imagine a room decorated to match the most exciting sex life that you want to have.

Start by selecting a theme that makes you feel tender, open and excitable. If exotic places take you there, put in exotic elements. If a romantic style is what revs you up, create that. Maybe clean lines and simple surroundings make you feel most open for love, then keep the room understated. A quick Google search of “exotic,” “romantic,” or “contemporary” bedrooms will give you endless decorating ideas that you can use to radiate romance. I am not an interior decorator by nature, so I either need to see pictures of what others have created, or ask my more visually oriented decorating friends to come over for help. Recognize what works for you, decide on a theme then put your plan into action. By shopping at designer discount stores such as TV Maxx, Ross, and Tuesday Mornings, even second hand shops, each offer great selections and styles while helping to keep costs within an affordable range.

Textures- Use fabrics that invite you to touch them. Create a “want to stay awhile” kind of atmosphere by adding layers of silk, faux furs, mohair, cashmere, linen, and other soft, velvety cottons. May eat delicious for you.

Color- The colors of the sheets, bedspreads, walls, and pillows should be colors that are tens for your eyes, hair, and skin. You are the beauty that those colors are supporting. In this scenario the man’s favorites should not be the focus as we are wanting to showcase you at your sensuous best!

Lighting- Most “women” agree that bright light will kill a sultry mood in a heartbeat. Replace harsh white light bulbs with soft pink ones, even add a dimmer. Candles-it’s a no-brainer! The flickering of candlelight can add to the feel of romance in the room and a gorgeous forgiving glow to your skin. Worried about burning down the house? There are many electronic candles out on the market now that can mimic the same effect! Want to shake things up occasionally? Introduce strobe lights and/or black lights to the mix.

Accessorize- Frame romantic or erotic pictures of yourself with your mate and/or mirror and place them in featured positions. Adding accents of curved vases, sculptures, or anything that suggests a sensuous body will elicit a steamy mood.

If you like music, collect songs or albums on your iPod or player that make you feel sexy. Most of the women I talk to don’t have a list of songs that ‘get them in the mood.’ If that’s you…start listening to music with the question in mind: “What song(s) make me feel sensually alive and excited?” Then create a way in which you can quickly access and play them in your room. If you use oils, lubricants, contraceptives or other devices, find a workable and aesthetic way to store them close at hand. Also, benches, stools, and cushions are handy for different activities and positions and should be included int he furnishings.

Maybe after reading all this you are saying: “But, we’re parents of young children.” Even if part of their bedtime involves a regular visit to your bed, don’t make the room a Kids Zone! Kids stuff, including family pictures do not belong in this adult space. This is your play area. The bedroom needs to reflect an intimate, safe place where you can temporarily remove the “mom” mindset and block out the outside world.

Overall, what’s arousing to you is central to having a great sex life. Your arousal, the feminine person’s, is what we are more often looking to increase. You’re not decorating the most intimate space in your home for anyone else- so have fun, experiment, and try something new!

Click here to read my 12 low or no cost tips on how to keep the bedroom alive and interesting for both of you.

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