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When I work with a woman to find her libido, I take it for granted that she has a ‘sexual self’. By sexual self I mean the part of her that desires to feel sensual erotic touch. She has a part that wants to be taken to an exciting edge and takes pleasure in falling off that edge into a good feeling. I assume she has an aspect that wants to powerfully engage with her partner, to melt and merge, and enjoy letting her boundaries go. Even if her sexuality isn’t active at the moment, I assume that she is hungry for these experiences and that in some way her desire for this is part of what propels her into my office wanting more from sex than what she is getting.

This is an assumption I hold, and like other beliefs I have it is not true for every woman I see. This belief about women gets bumped down and knocked out of place, and I feel the bump. It comes when she says “I came here for my husband” or “I am here for my marriage”. “ I, myself, don’t actually care if I have sex again, ever”.When I hear those lines, and I do, I think she can’t truly mean what she is saying. That can’t really be true. 

Her sexual self must have gotten lost in the woods. She must have an over-abundance of roles and responsibilities and she somehow can’t make time for pleasure. Or maybe sex is so frustrating of an experience and she is so tired of feeling frustrated that she is finished with sex. Maybe sex hurts. She couldn’t mean that she is actually tired of feeling sensual erotic touch. She couldn’t mean that she doesn’t want to be taken to an exciting edge and fall off into an exquisite feeling. She must have forgotten. Or she doesn’t know yet what is possible. Maybe there has never been an exciting edge for her, or an exquisite feeling.

And so, the search for her desire begins. It is like a stakeout where the surveillance is agreed upon. Was she ever excited for sex? If so, when was that? When did it disappear? Did it leave quickly, following surgery, or so gradually she didn’t notice it was missing. Was she with someone when it left, or was she alone? Has she looked for it before? If so, where?

Occasionally this mission ends on the first day, usually it lasts longer. Women can be complicated. They are multi-layered beings with many aspects, some quite deep and awe-inspiring. Female sexuality is not a one-hormone show. It can be intruded upon by hormone cycles, medications, relationship issues, illnesses, fatigue, unhealed sexual trauma, and lack of understanding. Any woman I see can be home schooling two kids, volunteering at church, and may be helping her parents in assisted living. She can be working 60+ hours/week as an attorney, have significant PMS and hormonal issues, and be on anti-depressants. She may be angry with her spouse for his business that failed, but trying not to be angry, and keeping her smile on for the family around the dinner table. 

When I look at a woman, I am looking at a complex being with many competing elements. Her sex life is “just” one thing that wants her attention and there are so, so many other things.  I cannot look at her sex life without seeing all the other things that compete with it.

And she, she has to find her sexual self, amidst all her others selves. Find it and give that aspect enough oxygen that it has a pulse of its own. A pulse that reminds her of the excitement and deliciousness of feeling sensually alive.
Too often the mother in her, or the nurse, or the problem solver, or the gardener outweighs the lover. These other aspects dominate her day, and define who she is to herself and to her family and friends. The lover in her may only get twenty minutes of floor time a few times a week. Hard to keep a handle on the part of yourself that you pull up so infrequently.

My personal preference is to keep the lover identity activated in all your roles — as mother, a nurse, teacher and even when you are gardening. You are an alive sexual, feminine being, why are you ever turning that off? Bring your lover with you to work. Bring her to the dentist. You aren’t going to sleep with your co-worker because you are an awake, vibrant, sensual being. You won’t lose your discretion when you claim your sexual self. In your every day world you can keep the aspects of you that you value alive. 

And absolutely don’t let your partner forget who you are. Remind him or her every day, in many ways. And, it’s important to know, there is a difference between what you show the world and what you show your partner, an important difference.

When you are an alive, vibrant, sensual being – you are not promising to have sex with someone, you are being yourself. When you flirt, lift your skirt to show some leg, wink suggestively, or wiggle your hips you are communicating the promise of something more. If you are doing this with a safe, healthy, available partner you can have a great deal of fun engaging these aspects of yourselves. If you are doing this at your workplace or by a construction site, it isn’t appropriate. It can be unsafe too, as your action can be interpreted as a promise for more, a promise that you don’t mean or intend to fulfill. So keep your sensual aspects alive during your day. You can do it cleanly, and transmit to the world and most importantly, to your partner that you are a female that enjoys her sexuality.  

Bottom line:   I am sticking to my assumption that women have sexual selves — aspects of themselves that enjoy sex and sexuality. These selves can be recovered if missing, and they can be enhanced if they need more oxygen. I am currently in the retrieval business, I’m your advocate. 

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.