WHAT TO DO WHEN YOU’VE LOST THAT LOVIN’ FEELING*. THE SCIENCE BEHIND REGAINING YOUR LOST LIBIDO.

Lost libido can be an early warning sign or further proof something is not quite right with your health, your diet or your lifestyle.  Not feeling the urge to merge should not be ignored. It might in fact be an important clue in detecting what is happening and hidden in your body.

Diagnosing the reasons for a flagging libido can be complex as your body’s physiological and mental health need to be in tip-top condition for sexual desire to meet motivational influences (8). 

Up to 30% of women in the USA suffer from low libido which more than likely is similar in Australia (14).

Common causes of failing libido:

•          Out of balance hormones like oestrogen, testosterone, prolactin and thyroid can deprive the libido of its major fuel (8).  Changed hormone levels aren’t just a problem for menopausal women. In all women sex hormone levels decline by 50% from the early 20s into the mid 40s (4).

•          In men a poor functioning thyroid impacts not only the urge but the mechanics as well.  Hypothyroidism as caused by Hashimoto’s seems to lead to reduced sexual desire and faulty ejaculatory reflex. Hyperthyroidism as caused by Graves may result in both premature ejaculation and erectile dysfunction (10).

•          Diabetes (5) can cause erectile dysfunction in men and in women in can dampen desire (3).

•          Undiagnosed or reoccurring urinary tract infections (12).

•          Chronic illness (7).

•          Depression (2) and many conditions having a psychological origin rather than a physical one can also impact negatively (7).  This is not a problem to ignore!  The American Journal of Cardiology highlights the increased risk of cardiac events in men who are depressed and experience erectile dysfunction (11).

•          Medications such as glucocorticoids, oral contraceptives (4) anti-depressants (15), and beta blockers (9).  It’s a good idea to always discuss these side effects with your GP so you can look into alternatives that may work better for you.

With Valentine’s Day around the corner are there any evidence-based, quick fixes for lifting libido out there?

A range of herbal remedies have some very early scientific evidence to support their use:

•          Maca improved sexual function and sexual desire in healthy menopausal women 16.

•          Shatavari when libido is flagging associated with peri-menopause.

•          Damiana when there is also anxiety and low mood with low libido.

•          Withania when there is stress and thyroid problems with low libido.

•          Tribulus when libido is flagging in men.

•          Passionflower when there is also anxiety and insomnia with low libido.

•          With a special mention for zinc (1).  

Show me the science!

If you want to check-out the research supporting these claims and when not to use them here is more detail about each remedy.

Shatavari, from the Indian word for “she who possesses a hundred husbands”, is commonly prescribed in traditional medicine practices to boost libido especially during menopause.  Certainly Shatavari’s chemical structure means it may have a phytoestrogenic effect (13) and this hypothesis has been supported in early animal based evidence. This herb should not be used by pregnant women (1).

Damiana’s traditional use as an aphrodisiac has early scientific evidence supporting the claim with detected action on progesterone and oestrogen receptors as well as in inducing testosterone (1).

Damiana has not only been detected to work with men.  A placebo-controlled trial found after 4 weeks of use 77% of the women in the treatment group reported an increase in sexual satisfaction compared with 37.2% of the placebo group.  These promising results were not only from the action of Damiana as the trial used a combination with Ginkgo and L-arginine. This herb should not be used by pregnant or lactating women (1).

Withania’s one double-blind, clinical trial found a 3 gram dose taken for 1 year improved the sexual performance of 71.4% of healthy aging males.  Don’t use Withania to excess though because another study found in high doses it reduced sexual performance.  This herb should not be used by pregnant women (1).

Tribulus trials on animals (primates, rabbits and rats) found it improved libido and sperm production possibly increasing DHEA and testosterone but the exact mechanism is not yet known. This herb should not be used by pregnant or lactating women (1).

Passionflower’s early animal trials identified significant improvements in libido after 30 days of treatment.  Care should be taken when pregnant and if other sedative medicines are being used (1).

Zinc deficiency it is believed leads to reduced production of sperm and fertility.  Early trials on humans show that supplementing zinc may increase sperm count in men who are deemed “sub-fertile”.  The dosage to achieve this was 66 mg (in combination with 5mg folic acid) which led to a 74% increase in normal sperm count.  This dosage should only be taken after discussion with a medical professional as excessive zinc intake can be dangerous.  Zinc is best taken at night.

Zinc rich food sources include meat, liver, eggs and seafood especially oysters and shellfish and might be the reason behind the claim that oysters are an aphrodisiac.

Nuts, legumes, whole grains and seeds also contain zinc but the high phytate (say f-eye-tates) content leave the zinc pretty hard to absorb.  Phytates can be reduced through fermentation or sprouting (1).

In health,

Sonia x

*Lyrics from Righteous Brothers’ You’ve Lost That Lovin’ Feeling. In honour of Valentine’s Day how about 3.5 minutes of Maverick in Top Gun?  Top Gun was I think the first time I heard the Righteous Brothers and it was sung by a libido-raising Tom Cruise.  I can still remember seeing Top Gun with my girlfriends for the first time….. probably how the groups of girls going off to see Fifty Shades of Grey feel now? Enjoy! Click here for the Youtube

**Lyrics from Justin Timberlake’s super cool SexyBack. And if you feel you need to fast forward to the 21st century after that trip down my memory lane.  I love this director’s cut version of JT: Click here for the Youtube 

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References:

1. Braun, E. & Cohen, M. (2011). Herbs & Natural Supplements: An evidence-based guide (3rd ed.). Sydney: Churchill Livingstone Elsevier.

2. Bonierbale, M., & Tignol, J. (2003). The ELIXIR study: Evaluation of sexual dysfunction in 4557 depressed patients in France. Current Medical Research and Opinion, 19(2), 114-124.

3. Burke, J. P., Jacobson, D. J., McGree, M. E., Nehra, A., Roberts, R. O., Girman, C. J., … & Jacobsen, S. J. (2007). Diabetes and sexual dysfunction: Results from the Olmsted County study of urinary symptoms and health status among men. The Journal of Urology, 177(4), 1438-1442.

4. Burger, H. G., & Papalia, M. A. (2006). A clinical update on female androgen insufficiency: Testosterone testing and treatment in women presenting with low sexual desire. Sexual Health, 3(2), 73-78.

5. Erol, B., Tefekli, A., Ozbey, I., Salman, F., Dincag, N., Kadioglu, A., & Tellaloglu, S. (2002). Sexual dysfunction in type II diabetic females: A comparative study. Journal of Sex &Marital Therapy, 28(S1), 55-62.

6. Frank, J. E., Mistretta, P., & Will, J. (2008). Diagnosis and treatment of female sexual dysfunction. American Family Physician, 77(5), 635-642.

7. Halvorsen, J. G., & Metz, M. E. (1992). Sexual dysfunction, Part I: Classification, etiology, and pathogenesis. The Journal of the American Board of Family Practice, 5(1), 51-61.

8. Hartmann, U., Philippsohn, S., Heiser, K., & Rüffer-Hesse, C. (2004). Low sexual desire in midlife and older women: Personality factors, psychosocial development, present sexuality. Menopause, 11(6, Part 2 of 2), 726-740.

9. Ko, D. T., Hebert, P. R., Coffey, C. S., Sedrakyan, A., Curtis, J. P., & Krumholz, H. M. (2002). β-blocker therapy and symptoms of depression, fatigue, and sexual dysfunction. Journal of the American Medical Association, 288(3), 351-357.

10. Maggi, M., Buvat, J., Corona, G., Guay, A., & Torres, L. O. (2013). Hormonal causes of male sexual dysfunctions and their management (hyperprolactinemia, thyroid disorders, GH disorders, and DHEA). The journal of sexual medicine, 10(3), 661-677.

11. Roose, S. P., & Seidman, S. N. (2000). Sexual activity and cardiac risk: Is depression a contributing factor? The American Journal of Cardiology, 86(2), 38-40.

12. Salonia, A., Zanni, G., Nappi, R. E., Briganti, A., Dehò, F., Fabbri, F., … & Montorsi, F. (2004). Sexual dysfunction is common in women with lower urinary tract symptoms and urinary incontinence: Results of a cross-sectional study. European Urology, 45(5), 642-648.

13. Sachan, A. K., Das, D. R., Dohare, S. L., & Shuaib, M. (2012). Asparagus racemosus (Shatavari): An Overview. International Journal Of Pharmaceutical And Chemical Sciences, 1(2), 588-592.

14. Warnock, J. (2002). Female hypoactive sexual desire disorder. CNS drugs, 16(11), 745-753.

15. Werneke, U., Northey, S., & Bhugra, D. (2006). Antidepressants and sexual dysfunction. Acta Psychiatrica Scandinavica, 114(6), 384-397.

16. Shin, B. C., Lee, M. S., Yang, E. J., Lim, H. S., & Ernst, E. (2010). Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complementary and Alternative Medicine, 10(1), 44.

Reduced sex drive in women can have a profound negative impact on their quality of life.  When sexual desire decreases there really isn’t a pill you can pop or food you can eat that will miraculously create the urge to merge (Arcos, 2004).

There is no one solution because we women are complex! It could be due to altered hormone levels, decreased vaginal lubrication, and/or pain – especially common with thyroid disorders and throughout menopause.  Or flagging libido could be a hint at a more serious underlying health concern needing investigation (Arcos, 2004).

 So what can you do when you want to ‘Marvin Gaye and get it on’ as the song sings?

As an evidence based practitioner I abhor the massive ads on billboards and social media claiming miracle responses in pills and potions for this very complex issue.  It is not a well researched topic in the scientific literature so I can’t support strong claims on the effectiveness of any product unless I see the research… in short …show me the data (Just warning you now if you follow that link you’ll get 2 glorious minutes of early-Tom Cruise &  a half naked Cuba Gooding under the guise of it being related to evidence based solutions …surely permissible on a post about female libido?) 

So do we give up? No not at all! There are many strategies that have been shown time and again to work to restore desire it’s just that if they don’t work for you it’s time to do some investigative work with a trained professional to get to the bottom of why your libido is lost.

I often find myself using these strategies with my clients with some degree of usefulness.

Arginine

L-arginine, an amino acid, is the precursor to nitric oxide involved in the relaxation of (vascular and nonvascular smooth muscle of) the clitoris and vagina (Kellogg-Spadt & Albaugh, 2003).

Arginine is a widely used and typically helpful therapy for assisting men to achieve erection and it seems in the early research on women it could also be useful to enhance female orgasm and female desire (Youngworth, Chek, & Zaslau, 2001).

If you have a history of the herpes simplex virus you need to know that high doses of L-arginine can potentiate oral and/or genital herpes outbreaks.

Damiana

Damiana is a plant used traditionally in herbalism as an aphrodisiac for women.  It is thought it works to enhance dopamine levels in the brain (Kellogg-Spadt & Albaugh, 2003).

Although there are no quality studies on Damiana used alone anecdotal reports tout the effectiveness of a daily cup of Damiana tea for increasing female sexual desire (Ratsch, 1997; Watson, 1993).  A cup of organic, herbal tea which tastes quite nice is a pretty cheap, low risk strategy to try and you never know it might just work for you!

L-arginine & Damiana used together

Preliminary double-blind, placebo-controlled studies of oral supplements containing L-arginine and Damiana have demonstrated that up to 70% of pre and postmenopausal women experience significant improvement in desire and sexual responsiveness after 4 to 6 weeks of daily use (Trant & Polan, 2000).

Relaxation

The cycle of sexual response begins in the brain, where a memory, an image, a scent, a song or a fantasy can act as a trigger to prompt sexual arousal.  Thus, the brain may be a key and good starting place for treatment of sexual dysfunction (Arcos, 2004). 

My prescription is for at least 15 uninterrupted minutes in a relaxing bath with Marvin Gaye’s soulful notes.

Just like they say in the song, let’s Marvin Gaye and get it on…. 

In health,

Sonia x

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References:

Arcos, B. (2004). Female sexual function and response. The Journal of the American Osteopathic Association, 104(1_suppl), 16S-20S.

Billups, K., Berman, L., Berman, J. Metz, M., Glennon, M., & Goldstein, I. (2001). A new non-pharmacological vacuum therapy for female sexual dysfunction. Journal of Sex and Marital Therapy, 27,435-420.

Kellogg-Spadt, S., & Albaugh, J. A. (2003). Herbs, amino acids, and female libido. Urologic Nursing, 23(2), 160.

Modelska, K., & Cummings, S. (2003). Female sexual dysfunction in postmenopausal women: Systematic review of placebo-controlled trials. American Journal of Obstetrics and Gynecology, 188(1), 286-293.

Meston, C.M., & Worcel, M. (2000). The effects of l-arginine and yohimbe on sexual arousal in postmenopausal women with SAD. Proceedings from the Female Sexual Function Forum, Boston, MA.

Munariz, R., Talakoub, L., & Garcia, S. (2001). DHEA treatment for female androgen insufficiency and sexual dysfunction. Proceedings from the Female Sexual Function Forum, Boston, MA.

Ratsch, C. (1997). Plants of love. Berkeley, CA: Ten-Speed Press.

Trant, A.S., & Polan, M.L. (2000). Clinical study on a nutritional supplement for the enhancement of female sexual function.  Proceedings from the Female Sexual Function Forum, Boston, MA.

Watson, C.M. (1993). Love potions. New York: GP Putnam Books.

Youngworth, H., Chek, K., & Zaslau, S. (2001). A topical therapyfor female sexual dysfunction: Results of a pilot study with1 year follow-up. Proceedings from the Female Sexual Function Forum, Boston, MA.

THAN ANY OTHER CAUSE, INCLUDING BREAST CANCER – DO YOU KNOW YOUR RISK FACTORS?  

My mum died of a sudden and fatal heart attack after years of being regarded as the “healthy one” having dodged the family narrative of autoimmune diseases, arthritis and dementia. 

When my mum died I started researching what would have caused an otherwise healthy woman to have such a massive heart attack.  I was shocked to learn heart disease is the #1 cause of death for Australian women.  4 x as many women die of coronary heart disease than from breast cancer in Australia!

Even more frightening it is very common for a woman having a heart attack to discount and ignore her symptoms as the tremendous chest pain that men report is not likely for a woman.

In one study, 58% of women reported the comparatively gentle symptom of breathlessness. Others reported vague symptoms of weakness, unusual fatigue, cold sweats and dizziness yet no chest pain.

The morning of my mother’s heart attack she chatted on the phone with a friend sharing how she felt really tired but she couldn’t work out why.  She told her friend she thought she just needed pep up with a strong cup of tea so she was heading to the shops to get some milk for her cuppa.  Less than 1 hour after this phone call to her friend my mum had a massive heart attack at her local grocery store and did not survive.

If you suffer any combination of these more subtle symptoms for more than a few minutes, particularly if you are a woman, please seek medical help quickly:

•          Ache or pain in the upper back, jaw or neck

•          Sudden difficulty breathing

•          Sudden overwhelming fatigue or weakness

•          Flu-like symptoms: nausea, vomiting, cold sweats

•          Sudden anxiety, malaise and loss of appetite.

February is Heart Research Month a great time to think about our heart health, and for me, to honour my mum Roslyn. Let’s have a closer look at the top 3 risk factors you can do something about  that have a huge impact of your heart:

•          High blood pressure:  shockingly 2 – 3 x more common in women than in men.

•          Smoking: even more harmful in women than in men.

•          Diabetes: again even more scary for women than men diabetes increases the risk of heart attack by 3 – 7 x in women compared with 2 – 3 x in men.

Frighteningly Heart Research Australia claim “women are much less likely than men to change risky behaviours” relating to their heart health. 

High blood pressure, smoking cessation and diabetes are all health issues that can be managed, controlled and reduced.

Always make sure you speak with your GP to get an accurate picture of your current heart health and as a naturopath I believe it is my role to increase your chance of sticking to and committing to decisions that make for a long and healthy life through:

•          Education based on valid scientific research

•          Mood-supporting herbs and supplements to help reduce the cravings and anxiety that can accompany withdrawal from sugar, salt and cigarettes

•          Ongoing coaching and motivation to address your risk factors and goals.

Do you know your risk factors?  What is stopping you from loving your heart?

In health,

Sonia x

For more information check out the Red Feb here. 

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References:

Albarran, J. W., Clarke, B. A., & Crawford, J. (2007). ‘It was not chest pain really, I can’t explain it!’An exploratory study on the nature of symptoms experienced by women during their myocardial infarction. Journal of Clinical Nursing, 16(7), 1292-1301.

National Center for Health Statistics (US). (2014). Health Risk Factors.

Subcommittee, S. S. (2007). AHA statistical update. Circulation, 115, e69-e171.