Sexual response is not just about sexuality, it is about overall health. When you aren’t functioning sexually, it is a sign of overall ill health. Sexual response is complex and sexual dysfunction refers to a wide variety of conditions. Because of this you should not go willy nilly into popping herbs, or for that matter Viagra. The herbal treatment of sexual dysfunction depends on a good differential diagnosis. So here are some basic questions.

1. First, do you trust your partner? Should you be having sex with them? Are you in love? Are you angry? Is your communication not good? Maybe you don’t want to be available to just anyone or with someone who does not value you. If your body is refusing to become aroused, maybe it is trying to tell you something about your partner or the state of your relationship. Address that first.

2. Are you stressed or exhausted from too much work? Have you been burning the candle at both ends? if you are stressed out from work or family obligations you may not have enough juice for sex.

3. Have you carved out time for each other in your busy schedules? Time for intimacy is at least as important as time at work or at the gym. You may need a sacrosanct schedule for time with your partner rather than trying to squeeze in intimacy between your other obligations.

4. How is your sleep? Sleep is restorative time, and most of us do not get enough of it. In the 1920s the average American got 9 hours of sleep a night. Modern Americans average 6 1/2 hours, but we have not evolved to need less in under a hundred years. A chronic lack of sleep can affect hormonal imbalance and nerve function, both of which affect sexual response.

5. Conversely, how is your exercise? While we certainly do not need to be marathoners to have good sex, we need enough circulation to cause engorgement and to carry hormones through our bloodstream. Too much exercise, coupled with low body fat can suppress hormones necessary for sexual desire- you need cholesterol to make hormones, and enough fat to protect your yin. Anorexia or the Female Athletic Triad can impair hormone production and sexual response. Too much body fat will reduce penis size, burying it at the base, and large bellies can restrict positions. Moderation in exercise and weight is best.

6. Are you anxious about your body? Your partner usually does not want a centerfold for a lover, even if he or she might qualify as one. People can be turned on by the contrast of dark hair against light skin, the vulnerability of a scar, a rounded belly, kindness, your eyes. Do you have a history of abuse that is affecting your ability to respond? It is unfortunately quite common, in both sexes. You have a right to work through fears, memories and irrational associations. Communicate with your partner and learn to ask for what you need.

7. Are you on medication that may affect sexual function? Many do. Prozac and similar SSRI antidepressants are known for their sexual side effects and many people do not get over them. Since the antidepressant effect is equivalent to a placebo, consider asking your doctor to titrate down the dose while you build up your fish oil, Vitamin D, magnesium, and trace mineral levels. Are you on statins or fibrate derivatives for your cholesterol? They can cause impotence. Viagra and similar drugs can cause headaches after sex, setting up aversion training. Indeed one of my patients had excruciating Viagra headaches and when I looked up his SSRI, statin and arthritis medication, all four drugs were clogging the same CYP40 liver detoxification pathway. His doctor dropped the arthritis medications and he used a reusable $7 silicone cock ring instead of the ($15-35) Viagra and the headaches stopped. The birth control pill can lower libido, interferes with pheromones and the ability to smell a good mate, plus it tends to cause yeast infections that will make sex painful. A barrier method may avoid these problems. Medications can cause direct sexual side effects, can clog the liver detoxification pathways where the building blocks of hormones are made or can make you feel so terrible that you are not in the mood for sex. Ask your pharmacist for a printout of the side effects of the medications, and see if nutrients, herbs, acupuncture, other physical medicine can substitute.

8. If hormones and neurotransmitters cannot make it through the cell membranes readily, it is difficult to respond sexually. Soften the membranes with fish oil and omega 3 fats. Include minerals in your diet to provide the building materials for minerals and transport molecules. Hydrate sufficiently, sipping rather than gulping. The minerals will help you build fluids and supple tissues. In Chinese medicine terms, Metal (minerals) gives rise to Water. This dietary advice will protect your yin and help you provide lubricating fluids.

9. And check your health, your cardiovascular system, endocrine balance, sleep apnea, menopausal change and other health issues. Women who have had hysterectomies, even if the ovaries are spared, may have delayed and dramatic drops in sexual desire. Consider bio-identical hormones compounded on orders from your gynecologist, but know that not all women are adversely affected and you may need no hormones at all. Menopausal symptoms are typically well-controlled with regular acupuncture, which is very relaxing and helps balance the system. In severe cases you might want to consider short term hormonal treatment, but herbs may provide a solution that is better recognized by your body.

10. Finally, do pelvic floor exercises, also called Kegels. For women the exercises help enhance vaginal grip and blood flow for engorgement, while increasing urinary continence. Male pelvic floor exercises increase erections and reduce dribbling, as does Iron Crotch Qigong. Dr. Grace Dorey undertook a survey of 55 men averaging 59 in age who had experienced erectile dysfunction for six months or more. With the exercises40 per cent regained normal erectile function and 35.5 per cent improved. This is comparable to improvements with Viagra but without side effects like macular degeneration or Viagra headaches. Most people do pelvic floor exercises too fast and with too limited an area. Try identifying the muscles by stopping urination in mid stream (but do not do your Kegels while urinating.) Then imagine you have a tail like a scorpion, bringing it around through your legs to your belly. As you visualize it, tighten the pelvic floor from the tailbone to the lower abdomen, including the anus and vagina or phallus and scrotum. Hold for 10 seconds before releasing, repeating at least 10 times twice a day.

Now we can look at herbs. Sexual dysfunction comes in three major areas: circulatory, psychological and hormonal and are often overlapping.

Circulatory problems are common in older adults, especially those who are obese. In fact erectile dysfunction (ED) is a leading indicator of cardiovascular or eye problems, since occluded or inflamed blood vessels will be found throughout the body. If you have a diet that is too high in carbohydrates, which give you insulin resistance, or you eat foods that are allergenic or which cause sensitivities, then your inflammation levels are going to be too high. In response to inflammation, your body will produce a natural bandage of cholesterol which can occlude the blood vessels. The cholesterol is to protect your blood vessels from blowing out, so it is a better strategy to change your diet to something less inflammatory and to use anti-inflammatory turmeric , niacin and fish oil than to reduce cholesterol directly with statins. Red rice yeast is better, but is still a statin. Indeed statins can cause sexual dysfunction in both men and women and they are no more anti-inflammatory than two cups of coffee.

So cardiovascular herbs like Angelica sinensis (Dang gui) or Salvia miltorizia (dan shen), and invigorating herbs like ligusticum rhyzome (Chuanxiong), safflower stamens (Hong hua), saffron cayenne, frankincense and myrrh, turmeric, and zeodary can increase cardiovascular function. Hawthorn and linden may also be helpful to nourish the tissue. And a course of horse chestnut pills can help regain blood vessel integrity (but should not be taken long term.)

Beyond that the invigorating spices can all stimulate sexual blood flow: cinnamon, cloves, ginger, cardamon, black pepper, cayenne and nutmeg have all had reputations for delightful stimulation. Chocolate with its bitter edge and high flavanoids can also be included. They taste good, get the juices flowing and incite the imagination. All have been considered aphrodisiac herbs.

The spices can also be used topically to enhance blood flow. Mix freshly ground cinnamon, and a touch of cayenne into melted shea butter, let infuse then strain for a lubricant that enhances sexual response. (Not safe for latex.) You can use essential oils but the chance of burning is greater. You can also make up a lubricant with two tablespoons of flax seed and 2 cups of boiling water. When the water thickens, add cinnamon and cayenne or other aromatic spices and let infuse for 5 minutes. Strain and keep in the refrigerator until ready to use.

Psychological Issues can interfere with sexual desire. Depression, anxiety, mental chatter and fear can all affect sexual response. One of my favorite herbs for someone with a sour attitude is mimosa bark, Albizia julibrissin. The bark has little taste so can be cooked into teas or food. I especially like to mix it with hawthorn, rose petals, rhodiola, cherry bark and honey to make an aromatic elixir, often with a touch of cinnamon. Albizia makes you happy. It isn’t exactly an antidepressant, but will often lift black clouds.

Damiana, Turnera diffusa, is great for sexual desire inhibited by anxiety, repressed sexuality or depression. The herb is warm, pungent, and stimulating, will move blood, reduce anxiety and soothe the nerves. It is good for new parents who find their sexuality displaced by parental responsibilities. Good in a coffee brew or mixed with milky oats and a little nutmeg in a honey elixir.

Oats are good in two forms: the green milky-stage oats which need to be tinctured within 24 hours of harvest and in the form of oatstraw which can be dried. The milky stage oats are more of a nervine, and are good mixed with licorice and shatavari or tian men dong for sexual neuresthenia. Oatstraw is rich in calcium, minerals and vitamins. Its steroidal saponins nourish the pancreas, liver and adrenals and help stabilize blood sugar levels. It reduces cholesterol and improves circulatory functioning. It is a nervine, that nourishes strong nerves, helps people deal with stress (Vitamin B complex), maintains restful sleep patterns.

Hormonal Issues can masquerade as psychological issues, and there is often a large overlap. Few of us can separate an off mood from a hormonally induced mood change.

Adaptogens are good for balancing the hormones but will not continue to tonify you after you reach balance. I prefer to use adaptogens over herbs that will directly stimulate certain hormones because they have a nonspecific, balancing effect on the HPA axis, responsible for most hormones. Korean red or Chinese ginseng are the best known adaptogens, but are most suited for the elderly or those who run cold. Eleutherococcus (formerly called Siberian ginseng), American ginseng and Jiaogulan (Gynostemma pentaphyllum), all work with people who run warmer. Ashwaganda (Withania somnifera) is calming adaptogen; it improves endocrine and nervous system function, muscle tone, and libido. While it has the strongest effect on men, it also helps balance the endocrine system for perimenopausal women and will help rev up both sexes if hypothyroidism is an issue. Rhodiola rosea is is a cooling, dispersing adaptogen useful for chronic stress, fatigue, deficient or stagnant depression from too much stress, work or exercise and it has a delightful rose aroma which enhances libido. Tulsi (holy basil, Occinum sanctum) is a cooling and carminative adaptogen which is good for people with mental fog, fatigue, impaired memory and sexual dysfunction from excess cannabis use.

However if adaptogens are not enough, herbs that have a more direct effect on hormones can be quite useful. Vitex agnus casta, known as chaste tree because it reduces male libido, seems to have the opposite effect on women, especially during perimenopause or when excessive PMS interferes with sexual responsiveness. Shatavari (Asparagus racemosa) is a premier woman’s tonic which will enhance sexual desire and increase lubrication. Chinese asparagus, Tian men dong performs a similar function.

There are two herbs in Chinese medicine that work similarly for men. Suo yang (Cynomorium songaricum) and Rou cong rong (Cistanche salsa) are useful for deficient Kidney yang: impotence, low sperm count, low sperm motility and frequent urination. I like to mix them with ashwaganda, horny goat weed and a little gelatin made from shed deer antlers (Lu jiao) since you need to tonify yin when you tonify yang. The traditional Chinese formula to tonify yang, Jin gui shen qi wan (Formula from the golden cabinet) is the traditional formula to tonify yin (Liu wei di huang wan/Rhemannia 6) with cinnamon and aconite added to warm it up.

There are a number of herbs like maca or horny goat weed (Epimedium grandiflorum) that enhance libido. I like to mix them with the Jin gui shen qi wan. Horny goat weed also works as a tea that can be integrated into your morning chai. It helps impotence, premature ejaculation and increases circulation to the penis. It also increases sperm count and sperm motility. Use it with Red Ginseng, Suo Yang, and Ashwagandha for erectile dysfunction.

Related articles:

* In Praise of Physical Medicine ( )
* Iron Crotch Qi Gong for Male Sexual Health ( )
* Male Pelvic Floor Exercises for Sexual Health ( )
* Erectile Dysfunction and Chinese Herbal Medicine ( )

Author's Bio: 

Karen Vaughan is a health blogger, a New York State licensed acupuncturist and an herbalist trained in both western and Chinese herbal medicine. She has the advanced designation of Registered Herbalist from the American Herbalists Guild, one of two in New York City. Her MS degree is in Oriental Medicine from Pacific College of Oriental Medicine, New York. This degree offers four years of training in acupuncture and herbal medicine, grounded in both the Chinese classics and in western medicine. She has had post graduate training in Chinese gynecology, dermatology, tui na (Chinese physical therapy) and addiction treatment. Her blog and website are at