BACK TO ASK THE HERBALIST INDEX

ANSWERS FROM KAREN MALLINGER
QUESTION: I have read many of the questions and answers on your website and am very pleased that you take the personal time to give such feedback to people with such problems. You truly serve the people and extend knowledge in a way that others cannot.   However, I write to to you in hope that you may help aid a problem of  mine.  I'm 18 years old (but very physically mature. I am told I look as if  I'm in my late 20s.) However, I seem to be having a problem.  Usually, I have no problems with erections.  Upon physical stimulation from an individual that I like and come in close contact with, I have a strong erection.  Recently, however, this has not been the case. I have been in close contact with a woman I am in love with.  I am very attracted to her and love her so much.  However, when we kiss or have close physical contact, there is no sexual reaction with my erection. It just stays the same.  It is really worrying me because this have never been the case before.
            I became worried and thought I could no longer have a reaction but whilst having a shower, I stimulated myself. However, it took very long to have an erection and when I did finally have an erection, it's not as strong as it usually is.  I have only noticed this for the past weeks now and it frightens me.At one point in time, I could have erections all the time, but now...it's not maintaining that is the problem. It's having the initial reaction that is the problem.   I have read about psychological impotence and have considered this, but I do no think this is the case.  What I can say, however, is that for the past two weeks, I have been extremely busy and stressed with my workload from Medical School.  I have only had about 3-4 hrs sleep per night.  I wonder if this has any contribution to my state?  If yes, what can I do to help?    I am very upset that I cannot make my girlfriend happy and she loves me dearly, too. It would be a great pleasure and help in my life if you could help answer some questions and offer advise as to what I should do.  I would appreciate that more than anything in the world right now.  I am really scared and worried, because I do not think someone at my age usually experiences such situations.    From the times when my penis would not never "sleep" and would ALWAYS be "awake"...to not just being lethargic all the time worries me. Please help me.   If there is any more information that you need from me, please feel free to ask.  Once again, I thank you for taking the time to read this email and I hope that you reply. I really would appreciate this.

ANSWER: OK. First of all, if you're in med school and only getting 3-4 hours sleep a night, they YES! that most definitely is a problem! I don't care how young you are, you cannot abuse your body like that and expect it to be firing on all cylinders, so to speak. You need to get plenty of sleep and be eating well. Stress is a very important component here, so with your schedule, I'd suggest some sub-lingual B complex.
          Second, and this is just my "wisdom" from being much older than you, if your girlfriend really loves you, the fact that you cannot please her physically with an erection should hardly be an issue. I know you're young so I'll give you some motherly advice. There is more than one way to please a woman, and often, it doesn't involve a throbbing member at all! How's that for advice? Try not to be so self conscious about it and take care of your health. You might also want to try a little ginseng. Make sure it's American ginseng and organic if at all possible. And look for a variety of ways to please your girlfriend. You both may be very pleasantly surprised!

HERBS FOR ERECTILE DYSFUNCTION
QUESTION: I am diabetic but my condition is under control. My problem is that even though I crave sex, I have a problem with erection. My doctor prescribed Viagra but I found that it makes me sick and raises my blood pressure. In fact most of the medicines that I have been advised to take have the same effect. Is there any herb that might not have the same side effect?

ANSWER: Most herbs that help in that area are going to raise your blood pressure, but then, so is an erection! Ginseng is the most commonly used herb for such things.

QUESTION: I’m a 23 year old unmarried male. I’m probably suffering from early ejaculation (in 1.5 to 2 minutes) probably due to habit of masturbation for long time. Someone told me to massage the penis with oil as mustard oil. is it true that mustard oil or any other oil can strengthen the vein and is one and a half minute a really serious matter.  Please guide me.
Thanking you in anticipation.

ANSWER: I'm not aware that any type of massage oil is going to help your problem. What you need to do is practice NOT ejaculating and that's a matter of control. Constant masturbation didn't help things much. And speaking from a woman's point of view, yes, 1.5 minutes IS a big problem!

QUESTION: My wife doesn't seem to want sex nearly as often as she used to. She said she thinks my penis has become smaller. I'm about 7 inches erect and have no problem being aroused. Is there something I can do to make my penis larger? I don't want to be a world-record holder, just a little bigger, enough to please her again. I don't know how big I was before the complaints. Never measured.

ANSWER: Ahem! Well, I can't speak for making your penis larger. My experience is that size is not that important! I do have a tincture that may be helpful for your wife. It's called Holly's Happiness and is sort of like Viagra for women. I've had rave reviews on it!  You'll find it on my website at http://www.allgoodegifts.com/ in the Apothecary under tinctures.
 
QUESTION: I have a disabled son and he fondles himself in school and any where he wants.  He is 13 and the school system is really giving me a hard time.  Are there any Herbs that might help me help him control his sensation.  Is there something that decreases the sexual sensation or masturbation.  Please help
if you can.

ANSWER: If he is doing this in a public school, I have to side with the school on it. If he is so disabled that he is uncontrollable, then he needs to be in a different school that can properly meet his needs. If not, then it sounds like behavior modification is what he needs, not something to suppress his natural hormones. He's an adolescent. Their hormones are raging at this stage and interfering with that chemical function can produce undesirable results. You could be opening a box you don't want to with that particular approach.

QUESTION:  I'm 16, and recently I've been having frequent vaginal discharge that wet my panties, I'm also feeling major pain w/ penetration,  I'm bleeding slightly after sex. can u tell me what i may be experiencing?

ANSWER: Truthfully?   Probably sex too soon. If you're feeling pain, that's not supposed to happen.   If you're only 16, you're probably not developed enough yet, especially if you are a small girl. Bleeding after sex? Which part of this don't you understand? When you experience anything like that, you should stop   immediately! You could be doing serious damage! Have you been to see a doctor?   The discharge could be a venereal disease, or STD. Hard to tell.    My advise to   you is to stop what you're doing and see a doctor to make sure everything is  OK. The symptoms you describe are not a normal part of the sex experience.

QUESTION: I'm a 21 year old women and I need a little help. I think I have mild depression, seems to come and go. I get stressed very easily and feel down a lot. Not overly down just more then I think I should. It is affecting other things now like my sex drive. I have a had a boy friend for 4 years and now I don't ever feel like sex. I don't think it should be like that when your only 21. Of course he understands but I think if there is something that I can try maybe it would help.  Is there herbs or oils that can be used for depression?? How can I use them, I am new to herbs so all the help is greatly appreciated!!.

ANSWER:  Not having much of a sex drive if you are a healthy 21 year old doesn't sound right to me. You could very well be depressed. Have you seen a doctor or a therapist? You don't want to treat something if that's not what's going on.  I'd get a firm diagnosis before attempting to treat the symptoms. There are many wonderful holistic remedies for depression, but again, if you aren't sure that's what's going on, it's best to wait. If you know for sure that you are suffering from depression and don't want to use any of the synthetics on the market, many people have had success with St. John's Wort. You can find it in the drug store in the herb and supplements section.

QUESTION: Can you tell me what herbs or vitamins are good for increasing sexual drive, performance and sensitivity?  (P.S. I'm a 32 year old male.)

ANSWER:  Well, the following herbs are reported to have "aphrodisiac" qualities. I must confess I cannot comment on the effectiveness of them! Damiana, Yohimbe Root, Muira puama and Ginseng. Sassafras root, licorice root, marshmallow root, sarsaparilla root and cinnamon bark mixed together make a wonderful tea. Of course, Vitamins C, and E are essential to keep your system strong. And the following foods are great for all around male health and vitality: Chicken, cultured milks like buttermilk, fish, dark green leafy vegetables, fresh fruit, pumpkin seeds, sesame seeds, squash seeds, (especially helpful for the male glandular system) and yogurt.

ANSWERS FROM DAVID BRILL
QUESTION:  I am a 32 year old woman who is very busy with work and family,( which I am sure promotes my problem) but for quite some time now I have had no sex drive. I  began taking Maca about three weeks ago, (recommended by my health food store) but have not noticed any changes in my sexual urges. I know that Maca is also recommended for other problems women encounter but I have been unable to find any information on it. Would you please give me all the information about it and recommend the most complete herbal information book available to the public? Also, I have read your herbal mixture solution but have yet to try it. (Shatavari, Damiana, Dang Qui, Celery Seed, Chastetree berry) I am assuming this is liquid form your suggesting so, when you say <1 part> how much is 1 part? How much of the mixture do you think should be taken? How often would this mixture be safe to take? Do women have any fear of hormonal changes, ex..(estrogen increase or decrease) to be concerned about? ...

ANSWER:  a part is any unit of measure you want to use, millimeters, ounces, etc.  Yes I usually recommend a liquid herbal extract, if this is what you would use the suggested dosage would be 3-5 mils or 1/2 - 1 teaspoon probably 3 times a day.  We do custom blending and carry single or premade compound formulas.

I have already answered a question on Maca which is on the website, search the site and if you cannot find the answer there, I will be glad to reforward it to you.  I would give the herb a couple of months before evaluating results; it is a tonic herb which takes longer to impart its effect.

As to books: I like the authors: Jim Duke, David Hoffman,  Penelope Odey and many others, if you want to call the store and ask for my wife Susanna she would be glad to guide you to a book she would think is appropriate for you.

QUESTION:  My husband and I do not have sex any more because he is taking too many blood pressure tablets and this apparently has caused 'a climax' not to occur readily.
I am 52 and in the past 6 months I have discovered that I get night (and day) hot and cold flushes. I find that I have found myself in an 'old peoples' mode of sexual desire and am wondering whether I am going through menopause or does it have something to do with my husband's condition and lack of sex. (Oh by the way - he has the viagra tablets, but I think he is worried about taking them regularly in case something happens to him). We have been through the stage of blaming me ... saying I am too fat, but I am only 63 kilo and quite fit - so everyone tells me.
Signed ... In a quandary.

ANSWER:  Without knowing all the detail here is the simple answer:

Many men have found relief from drug induced sexual problems with the regular use of Ginkgo a peripheral circulation herb.

I am not quite sure what you are asking me to provide for you, please elaborate.


QUESTION:  I WANT TO KNOW IF DOWN BENDING OF THE PENIS
CAUSES REVERSE FLOW OF BLOOD IN CAPERCAVERNOSOM AND RELAXING OF PENIS
WITHIN ONE MINUTE.  COITUS SOMETIMES SUCCESSFUL . SOMETIMES PENIS RELAXES IN
UTERUS. DEPRESSION SINCE 19880.USED ALLOPATHIC

ANSWER:   Many prescription depression medications come with the side effect of penile erection problems.  Recent studies suggest that Ginkgo effectively relieves this problem you may want to employ this herb to help with this sexual side effect.


FEMALE AROUSAL
Question:  I want to try Damiana because I am haveing trouble being aroused and it
might also help with some of the cramps I get during PMS.  So does it cancel
out birth control?

Answer:  I am sorry for seemingly prying but most herbs have multiple uses, I have gotten into long exchanges with some questions because the person didn't tell me upfront what they wanted to use the herb for.  This puts them and I into a goose chase.

Damiana has been reported as used for an aromatic, diuretic, tonic, stimulant, mild laxative, blood purifier, expectorant, antidepressant, testosterogenic, aphrodisiac, yang tonic.

That said, I have never seen anything on the herb drug interaction of Damiana and any Birth Control Drugs.

One possible side effect is insomnia in overuse or overdose.

This herb is Contraindicated in Pregnancy, Pelvic inflammatory disease, prostatitis and over stimulated libido.

One possible blend to use to increase sexual energy is 1p Damiana, 1p Dang qui, 1 p Celery seed, 1 p Chaste tree, 1 p Asparagus Root.  1 p is one part.

Finally the herb Shatavari, is used in India for this issue, its nicknamed there, "she with one thousand husbands" because it reportedly causes a women to have insatiable lust.  It is also an Asparagus root local to India.

PREMATURE EJACULATION
QUESTION:   .  I am male, single, 31 and have a problem of "immature ejaculation".  For the past 7 years, I am in sexual contact with a woman who is 15 years older than me.  I ejaculate one or two seconds before or after intercourse. The problem is getting worse since past two years but before that, I used to have sex for more than 10 minutes.  Because I am getting married in next month, so this must be treated before it and the cure should be permanent for life.  Please also suggest any cream or lotion for the penis strength and power. I don't want to use unnatural ways of making longer duration sex like "Viagra".
I am now looking forward to hearing from you soon.

ANSWER:   There are many factors involved with premature ejaculation without knowing all the details I am not sure I can help.

Schisandra berry, Latin Name:  Schisandra chinesis or S. sphenanthe has been traditionally used in China for premature ejaculation

Fenugreek, Latin Name:  Trigonella foenum-graecum has been traditionally used in Mid East, TCM, Ayervedic for premature ejaculation

Agrimony, Latin Name: Agrimonia pilosa or A. spp to astring the jing to correct premature ejaculation and clears and problem with burning or pain in the male urinary and reproductive tract

Without more information this is all I can offer, I have answered similiar question before please read my response online at the herbnet website.

SATAVARI
QUESTION:  Does Shatavari really increase sexual desires?  If not what herb will. your help is greatly appreciated

ANSWER:  Shatavari, Latin Named Asparagus racemosis is considered "The Viagra for Women" in India.  They commonly refer to it as the herb called "She with a thousand husbands."

A formula that has been used to increase sexual energy and help with other FRS problems is suggested as a combination of 1/4 p Licorice root, 1 p fresh oat tops,
1 p Damiana, 1 p Dang Qui, 1 p Celery seed, 1 p Chaste tree berry, 1 p Shatavari.  This formula releases inhibition and increases circulation to the pelvic region.  It also gives her the itch for sex.   It will also help with some PMS issues, help with vaginal dryness, nervous system/psychological/emotional problems (especially associated with sex), regulates menstrual cycles.  And finally will help women coming off birth control pills and in general to help normalize the female reproductive system.


                      

SEXUAL PROBLEMS 
QUESTIONS: Sexual dysfunction is a common side effect of SSRIs (Selective Serotonin Re-uptake Inhibitors, i.e. Prozac). I understand that there is an herb that may combat these untoward effects. Do you know which herb may help people who suffer from this?

ANSWER: I would discuss switching to the herb Saint Johnswort with your doctor, it has been tested as effective as Prozac for mild to moderate depression and does not have this side effect.

QUESTION: What increases blood flow to the gential area? I see on T.V. where this helps sex function. It takes a very long time for me to get aroused & many times I can not climax. I've had this problem increase since about age 30; (now 39) when I broke my tail bone. Also I really don't have a sex drive where I think about it or desire it. (I take these meds: Temormin, Paxil, Premarin) Thanks...

ANSWER: 
The Indian herb Shatavari has the nick name "She with a thousand husbands" because it reportedly increases sexual desire in women so that they cannot be satisfied. I am wondering if the lowered libido is being caused by the common side effect seen by patients who take Paxol. 
If you are taking it for depression you may want to talk to your Dr about trying Saint Johnswort which has been tested just as effective for depression as Paxol and no side effects. Also, See my other answers on sexual desire and performance.

QUESTION: since the birth of my last child and my tubal, i have lost most of my desire to have sex.
Are there any herbs out there that i can take that will help? i know my husband will be very happy if there are.

ANSWER: I am wondering if you are breast feeding since the birth of your child this can cause lowered libido. Also, See my other answers on sexual desire and performance.

Question: I have been unable to find a chemical answer to the problem of delayed
ejaculation during sex and I am trying to find out about possible herbal
solutions to this problem.  It takes too long to reach orgasm 

Answer: I am not sure if it is a physical, psychological, emotional or stress related problem?
Your partner may also be a factor in this issue? Your and your partners age is a factor.
       One possibility for you is BPH which can be corrected with Saw palmetto.
To increase a female partners sexual energy use 1p damiana, 1p Dang qui, 1 p celery seed, 1 p Chaste tree, 1 p Shatavari.  Shatavari is an Indian herb nicknamed "She with a Thousand Husbands"
         There are so many things which can effect sexual performance and pleasure the total picture needs to be taken into consideration before building a correct recommendation. 
         The possibilities that can be considered are a state of sexual neurasthenia, lack of circulation, physical conditioning, or lack or to much lubrication.
           For sexual neurasthenia, use Fresh Oat Extract, for Circulation, Ginkgo, for lubrication you may need to adjust its level by adding some. If it is a lack of sexual arousal, herbs such as the Chinese herb Yin yan huo, lustful sheep plant, stinking lesivious goat plant" Latin Name: Epimidium macranthum, E. grandiflorium and Yohimbe may help. These herbs are not to be intended for long term use
             To relieve tension and performance anxiety use Kava or Hops but remember to much will put you to sleep, just enough gets rid of the tension and anxiety.
           If it is a "too much lubrication" problem there are herbs for your partner to take. You have not told me if you use a rubber but they tend to lessen stimulation. If this is your birth control technique you may want to try another. Use of past and present masturbation techniques can prejudice your penis to certain rhythms and pressure sensation. I would avoid masturbation and concentrate on having sex with your partner.
         Positions, where you have sex and the type of bed you sleep in are also factors.

ERECTIONS
QUESTION: 
Hi, I'm a 22 old male who has a mild case of keeping an erection. Sometimes 
I can have a long one and other times I can't have an erection at all. 
Sometimes I'll have an erection but it wouldn't be real hard. In most cases 
it's hard for me to stay erect for at least 1 minute. I want to try some 
herbs to help me with a good erection. I want to know is Yohimbe a good 
herb to have for a longer harder erection? I'm not looking to taking 
anything super strong like viagra cause I can get an erection sometimes its 
just keeping one for a while. And if so what kind and what kind of dosage 
should I take. I have one from only natural. It says it has a 1000 
milligrams. My girlfriend is not too happy so if you can help me I would 
appreciate it.

ANSWER: I may be able to help but it is hard to tell with the information at hand.

I am not sure if it is a physical, psychological, emotional or stress related problem?

Your partner may also be a factor in this issue?

To increase a female partners sexual energy use 1p Damiana, 1p Dang qui, 1 p celery seed, 1 p Chaste tree, 1 p Shatavari.

Shatavari is an Indian herb nicknamed "She with a Thousand Husbands"

There are so many things which can effect sexual performance and pleasure the total picture needs to be taken into consideration before building a correct recommendation for anyone. 

Psychological Impotence is usually associated with younger men. Causes can be stress, performance anxiety, fatigue from overwork, relationship problems, anxiety/ depression, causing pregnancy anxiety. The majority of men will experience psychological impotence as some time in his life. To test for psychological impotence men will sleep with a rice paper band on. If they have erections at night or wake up with an erection (if the band breaks), they have psychological impotence. Men with physiological impotence do not achieve erections.

According to noted and internationally known herbal medicine author Jim Duke This is his list of Herbal APHRODISIACS (A-3) (IMPOTENCE (A-1)/FRIGIDITY (A-2))
Ashwagandha (2), Anise (2), Cardamom (2), Damiana (2), Dong quai (2), Epimedium (2), Fava bean (3), Fenugreek (2), Ginkgo (3), Ginseng (2), 
Nettle (1), Oats (1), Parsley (2), Quebracho (2), Sarsaparilla (2), Sunflower (1), Velvet bean (3), Yohimbe (3) Those rated 3 have the highest success, 2 then 1 in order of importance.

His book Green Pharmacy is a great book on herbal medicine.

The possibilities that can be considered are a state of sexual neurasthenia, lack of circulation, physical conditioning, or lack or to much lubrication. Other issues that are related to this problem are performance anxiety and stress in your life.

For sexual neurasthenia, use Fresh Oat Extract, for Circulation, Ginkgo, for lubrication you may need to adjust its level by adding some. If it is a lack of sexual arousement, herbs such as the Chinese herb Yin yan huo, lustful sheep plant, stinking lesivious goat plant" Latin Name: Epimedium macranthum, E. grandiflorium and Yohimbe may help. These herbs are not to be intended for long term use

To relieve tension and performance anxiety use Kava or Hops but remember to much will put you to sleep, just enough gets rid of the tension and anxiety.

For stress use adaptogens:

When I ask people if they are under stress most say no. My feeling is if you don't have stress in your life, you are dead. Stress refers to any reaction physical, mental or emotional to stimulus. Stress is an unavoidable part of life. Areas that can cause stress for people are: deadlines at work, problems with loved ones, need to pay bills, getting ready for vacations or holidays. Simpler less obvious examples of stress are: crowds, encounters with people, loud noise, light, pain, traffic jams, change in temperature, lack of sleep, over work and welcome changes to ones life. Stress itself is not bad, how we handle stress is what is important.

Adaptogens help the body deal with stress the most common and well known are the Ginsengs. 

Ginseng, Panax ginseng (Chinese or Korean Ginseng) or P. quinquefolium (American Ginseng) have been studied in thousands of tests. With over 5000 years of use in China as an old man's tonic and hundreds if not thousands of years of use for indigenous North Americans as the "Chief of the Medicine Plants". Ginseng has an amazing background. Ginseng gets its Latin name Panax from the word Panacea meaning cure all. It was reserved for the rich in historical China and today single aged "man root" can bring hundreds and thousands of dollars on the black market. What can Ginseng cure or correct, according to scientific evidence just about anything. It brings the life force or vital energy up eliminating the natural slow down of old age. These studies suggest improved physical and mental performance. The mental improvements are demonstrated by increased memory and learning capacity. This improvement is associated with enhanced circulation to the brain. Additional medicinal uses include reducing cholesterol and protection to the liver from chemical toxins and poisons. Further studies have shown Ginseng's ability to increase respiratory function, improve fluid metabolism and calm your spirit. Ginseng is appropriately used for shock, collapse and heart weakness. It has been associated with longer life and increased disease resistance. In vitro studies show the reversal of cancerous cells to normal cells when Ginseng was introduced. Siberian Ginseng a completely different plant species than Panax and has a Latin name Eleutherococcus senticosis. This herb is also in the same class as Panax Ginseng and P. quinquefolium listed as an Herbal Adaptogens with characteristics minimally outlined as helping the body deal with life's stress and improving immune system response.

My suggestion here would be to start with Siberian Ginseng, then go to American Ginseng then finally if the first two fail the Chinese Ginseng. Fresh Oats is food for the nervous system, and normalizes the nervous system. Fresh oats will help with constant stress such as the kind you are experiencing now as suggested by your signs. Ginkgo would help with circulation especially to the small capillaries of the extremities (i.e. your penis). For mild to moderate depression Saint Johnswort is as effective as Prozac and many other prescription drugs.

If it is a "to much lubrication" problem there are herbs for your partner to take. You have not told me if you use a rubber but they tend to lessen stimulation. If this is your birth control technique you may want to try another. Use of past and present masturbation techniques can prejudice your penis to certain rhythms and pressure sensation. I would avoid masturbation and concentrate on having sex with your partner.

Positions, where you have sex and the type of bed you sleep in are also factors.

Your question on Yohimbe use is a good one, Yohimbe can be used to provide sexual arousal for men. The effects can last a long time. Some describe it as a perpetual hard on. From what I have read, cooking the herb with Vitamin C increases the potency. The cautions here is, it can cause depression in high doses, and permanent erection called priapism which is very painful. I would be careful with its use and it is not intended for long-term use.

My biggest concern for you would be why would a young man of your age have a problem like this. I would try to find out if I were you. Talk to a doctor, healthcare provider, herbalist in your area. Sometimes counseling is very helpful, find a specialist that deals with this issue, take your girlfriend.

If you would like to pursue this more please call for an appointment. I charge a dollar a minute for the consult, preparation and recommendation. I am sorry but this is all I can quickly help you with.

p.s. Please keep in touch I would like to hear if any of this has been helpful. If you would like a more personalized approach please call to set an appointment, face to face - person to person is best but a thorough phone interview would suffice, plan on a couple hour phonecon. 

This is an article I read on the Net, it may provide some insight for you:

The Viagra Alternative

Walk into any health-food store and you'll find countless products that purport to enhance your sex life: Passion Blend, Man Power, Super Sex, the list goes on. But do these products work? And how do they compare with that hugely popular little blue pill, Viagra? 

The drug Viagra has proved a best-seller for a good reason: For many people, it's effective. Despite side effects such as headaches and anecdotal reports of possible links to heart attacks, it has helped millions. And although it's prescribed for impotence, or erectile dysfunction, in men, some ongoing studies are aimed at women as well. One, at the Women's Sexual Health Clinic at Boston University School of Medicine, suggests that Viagra does indeed improve female sexual response. 

While there's no doubt that popping a pill is convenient, sexual dysfunction is a complex issue, with many causes and manifestations. And doctors caution against taking a quick-fix approach to symptoms that are often part of a bigger problem. "The critical thing is to address the underlying cause," says naturopathic physician Michael Murray, N.D., of Bastyr University in Seattle. 

According to the 1994 Massachusetts Male Aging Study, age-associated impotence is frequently tied to chronic illnesses, such as arteriosclerosis ("hardening of the arteries"), hypertension, diabetes, and depression. And researchers at the Women's Sexual Health Clinic say many of the same diseases affect female sexual function as well. Other causes include prostate enlargement (in men); endometriosis, fibroids, and PMS (in women); and age-related declines in hormone levels in both sexes. Sexual dysfunction is also a common side effect of many prescription and over-the-counter drugs, including those for depression, high blood pressure, insomnia, and allergies. 

If you're concerned about sexual problems, a good place to start is to review your overall health and current medications with your doctor. It's also essential to address any psychological or relationship issues through counseling or other forms of therapy. Exercise, a healthy diet, less stress, and a daily multivitamin can also go a long way toward preventing problems. "If you take good care of yourself by protecting your blood vessels and nervous system, the likelihood is sexual function can be preserved in both men and women," notes Steven Lamm, M.D., author of The Virility Solution. 

Herbal Jump-Start
"Treating the primary cause should improve symptoms," says Dr. Lamm, "but it will do nothing in one night." While Viagra is often effective and fast acting-it typically boosts blood flow within 30 minutes to several hours-some people prefer non-drug alternatives. Several interesting supplements have recently come to light and may provide benefits within days to weeks, thereby improving outlook. Unfortunately, studies of their effects on sexual response are limited-especially in women. 

The herb ginkgo biloba, commonly taken as a memory booster, may provide benefits. It presumably acts by enhancing blood flow and seems relatively free of side effects. In a pilot study at the University of California at San Francisco, ginkgo reversed sexual problems in 84% of men and women who were taking antidepressant drugs such as Prozac. A larger trial is under way. 

Another promising supplement is the heart-healthy amino acid arginine, which also enhances blood flow. In a study of 50 men at Tel Aviv University, 31% of those with impotence improved after six weeks of taking arginine, versus only 9% with a placebo. (As with Viagra, you should avoid arginine if you are taking the heart medication nitroglycerin, because the combination may cause a dangerous drop in blood pressure. For the same reason, you should probably not take arginine with Viagra.) 

The supplement DHEA may also provide benefits in men and women who have low levels of this hormone. DHEA helps our bodies make estrogen and testosterone, and a recent trial at the University of Vienna found it helped men with impotence. 

Additional herbs that have shown some benefit in small studies include the stress reliever Panax ginseng and the hard-to-find Brazilian herb Muira puama. In a study at Yonsei University College of Medicine in Korea, 60% of men who took Panax ginseng were better able to achieve an erection, versus 30% in those who took a placebo; in animals, the herb appears to boost testosterone levels. And at the Institute of Sexology in Paris, more than half of men who took Muira puama responded positively within two weeks. 

Finally, many potency formulas contain the African tree bark yohimbe, which some studies have shown may correct impotence and possibly heighten libido. However, this herb can cause a dangerous rise in blood pressure, as well as anxiety and other side effects. Many doctors prefer the purified form of the herb, the FDA-approved drug yohimbine, instead, because it has a guaranteed purity and potency. 

Additional Remedies
Other popular but unproved therapies that may provide a boost for sexual function include aromatherapy (vanilla for confidence; rose for mood), hypnosis, meditation, acupuncture, and homeopathy. In a recent study from the Netherlands, twice-weekly acupuncture relieved impotence in 39% of men after four weeks. Off-the-shelf homeopathic remedies such as Vigorex, an ultra-diluted solution of oats (Avena sativa) that is thought to free up testosterone, are also popular, though expert Dana Ullman, M.P.H., advises that people see a professional homeopath to get individually tailored remedies. 

Passion Potions
Can Super Sex, Biagra, or any of the countless other high-priced passion potions and aphrodisiacs sold at health-food stores or pharmacies restore your sex drive? Probably not. Many contain a long list of ingredients, some of dubious value. Check the label carefully to make sure the product delivers an adequate dose of natural compounds that have been shown to help (see chart below). "Unless it has a sufficient amount of the active ingredient, the product is not likely to be effective," says Dr. Murray. 
           Instead of a blend, you may be better off buying an individual ingredient tailored to your particular condition. Allow at least several weeks to see if it works for you. 

In Search of that Lovin' Feelin' :
Arginine 
Who Might Benefit? Men or women who have circulatory disorders that may be contributing to sexual problems; boosts blood flow.  Suggested Dose 1 gram 3 times a day; sold as L-arginine. 

DHEA 
Who Might Benefit? Men or women with low levels of this hormone, as determined by doctor; helps the body make estrogen and testosterone. Suggested Dose 5 mg each morning for women; 10 mg for men; increase dose if doctor advises. 

Ginkgo biloba 
Who Might Benefit? Sometimes recommended for men or women on Prozac or other antidepressants; boosts blood flow. Suggested Dose 80 mg 3 times a day, standardized to contain 24% flavone glycosides and 6% terpene lactones. 

Ginseng (Panax) 
Who Might Benefit? Men with impotence. May also benefit men or women with stress-induced loss of libido. 
Suggested Dose 100 to 250 mg twice a day, standardized to contain at least 7% ginsenosides. 

Muira puama 
Who Might Benefit? Called potency wood in Brazil; only one small study in men has been conducted to date. Suggested Dose As tea, 1 tsp. dried herb per cup of water each morning. 

Yohimbe 
Who Might Benefit? May boost blood flow, but has serious side effects. 
Suggested Dose Opt for the prescription drug yohimbine instead. See your doctor. 

Additional Herbs: 
Avena sativa (oat extract, said to free up testosterone); damiana (Mayan herb that may boost blood flow); guarana (caffeine-rich soda imported from Brazil); maca (Peruvian herb used for menopause and impotence); tribulus (possible testosterone and libido booster). Little or no research has been done on these herbs. An appropriate dose cannot be determined at this time. 
         Further reading: Stephen Lamm, M.D., The Virility Solution re, 1999); Marc Bonnard, M.D., The Viagra Alternative (Healing Arts Press, 1999)