“I can’t make love, I have a terrible headache.” This phrase
has become well-recognized, and even a subject of humor to epitomize a popular belief that women may often need an excuse to avoid love-making with a man whose sexual appetite is much more insistent that hers. In recent years, however, we have been hearing increasingly about men who are intimidated by women, or for one reason or another, cannot perform–“performance
anxiety.” Do women or men have a higher incidence of inhibited sexual
desire to the point where it becomes a problem in their life? Perhaps it
is much more equal than is popularly thought, but men are more reticent
to talk about it. It’s no joke to many men when it comes to what is called
in the Merck Manual (14th ed.) abnormal fear of the vagina.
Other intrapsychic (it’s all in the mind) causes in men for “inhibited
sexual excitement” (impotence) are listed as sexual guilt, fear of
intimacy, depression, and some recreational drugs (see sidebar).
In no other area of human health does the mind enter in more thoroughly
than in human sexuality–an ironic statement, because most of us realize
that this is precisely one area of human activity where the mind can often
do more harm than good. But in fact, statistics show that for both men and
women, up to 80% of sexual dysfunction and inhibited sexual desire are of
mental or emotional origin.
According to the Merck Manual, impotence in men is of two types: primary,
which is rare, and “generally indicates severe psychopathology;”
and secondary, “in which erectile dysfunction prohibits completion
of successful sexual intercourse in about 25% (or more) of opportunities.”
As mentioned, a full 80% of the secondary impotence is directly attributable to mental and emotional factors and only 20% to disease and functional abnormalities such as diabetes, cardiovascular diseases, surgery, and disorders of the hypothalamic-pituitary-gonadal hormone processes, which might lead to lowered levels of testosterone. Although low levels of testosterone might even be found in a majority of men with impotence, it is difficult to know whether psychological factors inhibiting sexual contact leads to lowered testosterone
levels, or visa versa.
Drugs, such as alcohol, can also be a factor. I recently read a study that
was carried out in the 60s in San Francisco with a group of volunteers,
which clearly showed that while cocaine (which is considered the ‘cadillac’
of sexual stimulants) and marijuana led to increased sexual interest and
improved performance, drugs such as heroin, alcohol, and a variety of downers
(such as reds and quaaludes) and amphetamines actually led to a mild to
strong decrease in these areas. Common prescription drugs can also lead
to impotence as a side-effect. This is especially notable with hypertensives,
sedatives, and tranquilizers.
A common myth in this culture is that older people loose their sexual desire
and ability to have satisfactory intercourse. Statistics and studies do
not support this, however. According to the Merck Manual again, “Aging
is not an inevitable cause of impotence, even into the 70s and 80s.”
Of course, the desire to have sex will cool off somewhat as we get older.
I’ve often felt how fortunate I am to not have the same desire in my 40s
as I did when I was 19!
The most common prescription for functional impotence is yohimbine hydrochloride.
The drug originated from a West African tree, Pausinystalia johimbe,
which has been sold for years on the herb markets of countries world-wide,
including the U.S. The alkaloid is an -adrenergic blocker, increases parasympathetic
tone and decreases sympathetic tone, as well as a central nervous system
(CNS) stimulant. There are a few modern studies showing that it is effective
for some types of impotence, especially ones of vascular, diabetic, or psychogenic
origins, and it can improve the quality and staying power of erections,
usually without increasing sexual excitement. However, the drug should
be used cautiously, because it is a CNS stimulant and can lead to side-effects
such as dizziness nervousness and anxiety (Physicians Desk Reference,
43rd edition). Yohimbe is also available in some products sold in health
food stores, but again, it should be used with caution.
Because many cases of impotence are associated with our mind and emotions,
it is appropriate to seek the services of a qualified psychologist, marriage
and family counselor or social worker. I prefer to work with practitioners
who do not view such problems as pathological, but as a process of self-discovery
and personal growth. It is important to clearly understand the root causes
of impotence, and often doing so, the problem will disappear on its own.
As an herbalist, and Traditional Chinese Medicine practitioner, I use herbs
as a major part of my “bag of tricks” in a clinical situation,
as well as personally and with friends and acquaintances. Besides herbal
therapies, I recommend proper exercise and deep breathing daily, to make
sure the circulation is moving. Hydrotherapy (cool showers, for instance)
can also be effective for this, and it is essential to eat a strong diet
that avoids foods rich in saturated fats, refined sugars, and processed
foods in general, and emphasizes high-fiber foods such as grains and legumes,
fresh lightly cooked vegetables, and a variety of fruits in season. Following
this diet and the other recommendations will often lead to improvement within
a few weeks.
I would organize herbal treatments and
programs under the following categories, depending on the needs of the individual.
- Relaxing herbs (when anxiety, tension and poor sleep is a root cause)
- Aphrodisiacs (to increase sexual desire)
- Testosterone enhancers (where testosterone levels are low)
- Circulatory stimulants (when circulation is poor, a person is often cold)
- Adaptogens (when a person is under a lot of stress)
- Tonics (blood, vital energy and vital essence, when a person is deficient or weak)
Because nervousness, tension and even anxiety may play a major role in impotence,
relaxing herbs can be of benefit. Herbs such as valerian, passion flower
(I like the name), California poppy, lavendar and wild oats can relax without
lowering sexual desire. The relaxing herb hops should be avoided, however.
Modern studies show that it is estrogenic, and has a long history of use
as an anaphrodisiac (lowers sexual desire).
Valerian should be used as a fresh plant liquid extract (1-2 droppers/3
times daily, or as needed). Passion flower is mild, but effective, and is
usually combined with other relaxing herbs to enhance their activity. California
poppy is one of the best muscle relaxers and scientifici studies show that
it can help relieve mild anxiety. In my experience, valerian and California
poppy are very effective together. Wild oats is well-known as a mild sexual
enhancer and relaxing herb. Use it in liquid extract form (2-3 droppers,
made from the fresh spikelets) or as a powdered extract.
Since time immemorial, people have been looking for that magic herb that
can strongly increase sexual desire and potency. Unfortunately, there is
no one herb that can do miracles, rather there are several that can help
build up sexual energy and vitality. Ginseng is probably the best-known
aphrodisiac. Although there are many types of ginseng, look for either “red
Korean,” or “red Chinese” (Kirin) ginsengs. In my experience,
these are stronger than white, unprocessed types. Ginseng is especially
effective for people over 40 who have weak digestive systems, are not getting
enough nourishment and are deficient, and have little or no sexual desire.
It should be taken daily (10-15 grams), in combination with some ginger
as a tea, liquid extract or powdered extract. To my knowledge, ginseng is
one of the only herbs known to stimulate the production or testosterone
in the body. In my experience, the following herbs are also worth trying
for their aphrodisiacal (is it a word?) properties.
- Turmeric (powdered extract, liquid extract–1 ddropper 2-3 x daily)
- Damiana (won’t work unless it’s very fresh–liquid extract only, 40
drops 3 x daily)
- Mira puama (German researchers have found some activity, popular in
- Ginger (warming, stimulating to the circulation and is mildly aphrodisiac–use
it on a regular basis as a tea or liquid extract in a little water)
- Chocolate (contains the alkaloids theobromine, and small amounts of
caffeine)–use the liquid extract, or the unsweetened powder.
After a thorough search of the available literature, and from personal experience,
I feel that herbs such as sarsaparilla and wild yam, which are often sold
in body-building formulas as a testosterone source are highly overrated.
Both herbs contain plant sterols, but there is no solid evidence that they
either stimulate or supply testosterone in the body. However there is one
Mexican study, which I can’t confirm, that suggests that sarsaparilla extracts
can have this activity. It may be fun to experiment–it isn’t bad-tasting,
but I’m not giving the story much creedence.
Red Panax ginsengs may be the best bet in this category, and there
is one animal study that shows that ginseng extracts can increase blood
Other herbs that may be helpful in a total herbal program can include circulatory
stimulants (ginger, prickly ash bark, turmeric, motherwort), and adaptogens,
which also can help support adrenal function (eleuthero, American ginseng,