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Alternative and Complementary Medicine and Sexuality

From the beginning of time, civilizations have been seeking alternative methods to enhance and improve sexuality and sexual performance. It is rumored that as she sailed down the Nile, Cleopatra soaked the sails of her boat in ylang-ylang, an aromatic essential oil supposedly used for sexual attractiveness, to attract and excite the famed Mark Antony. Sexual mythology also suggests that the sensual playboy Casanova ate chocolate oysters before his sexual escapades. It is also believed that ancient Romans and Greeks consumed figs before their sexual orgies because those foods were believed to contain essential minerals needed to produce sex hormones.

The human quest for sexual enhancers or natural substances is as old as the legendary quest for the Holy Grail.

According to the Cambridge History of Food, "Aphrodisiacs were first sought out as a remedy for various sexual anxieties including fears of inadequate performance as well as a need to increase fertility." The term aphrodisiac[1] has Greek roots: aphrodisiakos, from aphrodisiac, meaning sexual pleasures. In Greek mythology, Aphrodite was the goddess of love, beauty, sensuality, and sex. A more global definition of aphrodisiac is foods, scents, beverages, drinks, mineral supplements, or chemicals that are believed to increase or enhance sexual desire, performance, or stamina. The human quest for sexual enhancers or natural substances is as old as the legendary quest for the Holy Grail.

Women and men continue to try many unconventional sexual enhancers and therapeutics to facilitate treatment for sexual function complaints and arousal disorders. There are limited scientifically proven databases containing results of randomized control trial studies that demonstrate beneficial use of these methods for alleviating sexual dysfunction. In fact, many have some concerning side effects and can interact with prescription medications. It is always best to consult with your physician as to whether a particular product is right for you. This section highlights a few of the more frequently used products.

How can herbs affect sexuality?

Many herbal supplements are marketed as having sensuality-and sexuality-enhancing properties. Some of the more popular ones are described in the following subsections.

Yohimbine

Yohimbine[2] is an herb that is prevalent in West Africa. It has been used as an aphrodisiac. It is also combined with supplements in formulas to improve athletic prowess and is believed to treat both male and female sexual dysfunction. The active component, an alkaloid called yohimbine, has been used in clinical studies for erectile difficulties in men. There is no conclusive evidence that this product is effective for the treatment of female sexual complaints; however, it does stimulate the central nervous system and also acts as a monoamine oxidase inhibitor and calcium channel blocker. Caution should be exercised because it can potentially interact with numerous drugs, causing severe adverse effects.

DHEA

DHEA is the most abundant hormone secreted by the adrenal glands. It is used to enhance sexual performance, prevent atherosclerosis, and stimulate the immune system. It circulates in the blood as the sulfate ester, dehydroepiandrosterone-3-sulfate (DHEA-S), which is a precursor for other hormones, including estrogen and androgens. It has been shown to alter some of the activities of the cytochrome P-450 enzyme that metabolizes a number of drugs. Taking DHEA can elevate your estrogen level as well as your testosterone levels. Too much DHEA can cause serious side effects, and if you do choose to begin this supplement, be certain to understand your risks and be under the direct supervision of a sexual medicine healthcare provider.

In premenopausal women, high levels of DHEA have been associated with increased ovarian and breast cancer risk. High DHEA-S levels have also been shown to contribute to tamoxifen resistance and disease progression in breast cancer. Unfortunately, there have been limited well-designed randomized control trials that provide evidence to support use of DHEA for the treatment of sexual complaints.

Maca

Maca is a native Peruvian plant used in traditional medicine for strength and to enhance fertility. It is believed to help in sexual behavior in both men and women, and may be used in attempts to relieve menopausal symptoms. Maca was shown in animal studies to increase sexual function. Despite some of the medical literature, there is still insufficiently strong medical evidence to support of the use of maca for female sexual dysfunction. The therapeutic dose and toxicity of maca are unknown.

Wild Yam

Wild yam is derived from the root of a twining vine. Wild yam was traditionally thought to have antispasmodic properties and was promoted for gastrointestinal and menstrual dysfunction. Diosgenin, a chemical component found in wild yam, has been shown to have estrogenic and progestogenic effects in mice; however, there is no scientific evidence that this substance can be converted by the body into human hormones. Some wild yam extract creams have been marketed as a natural source of progesterone, although they contain synthetic progesterone that is not connected to wild yam. There is no evidence of its efficacy in alleviating sexual dysfunction.

Chaste Berry

Chaste berry is derived from the fruit of the chaste berry tree and contains steroidal precursors and active moieties including progesterone, testosterone, and androstenedione. Clinical studies suggest that in women it is efficacious in reducing symptoms associated with PMS, but there is no evidence to prove its effectiveness for sexual complaints. Chaste berry may interact with oral contraceptives, other hormonal therapy, and dopamine antagonists (such as haloperidol and prochlorperazine). Some of the common reported adverse effects include nausea, rash, headache, and agitation.

Horny Goat Weed

Horny goat weed, or Epimedium, is a Chinese herb used in traditional medicine to treat fatigue, arthritic and nerve pain, and sexual dysfunction. It is also known as Yin Yang Huo in Chinese medicine. However, there is no clinical evidence to support the use of Epimedium for sexual dysfunction. There is some evidence to support the fact that extended used can cause dizziness, nosebleeds, and thirst.

Ginseng

Ginseng is derived from the root of the ginseng plant and is used to improve athletic performance, strength, and stamina. It is also used as an immunostimulant for people with diabetes, cancer, HIV/AIDS, and a variety of other conditions. However, a systematic review of clinical trials on ginseng found no evidence of its efficacy for any of these indications. It has been promoted in the treatment of erectile dysfunction, but current studies to support this claim are limited.

  • [1] A substance believed to improve or enhance sexual function or pleasure. Some think it may stimulate feelings of love, intimacy, or desire.
  • [2] An alkaloid medicine derived from the South American plant Corynanthe yohimbe, which has alleged aphrodisiac properties.
 
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