Diminished libido—little or no sexual desire—is the most common sexual complaint among women. But repeated attempts by the pharmaceutical industry to solve the problem with one or another form of “female Viagra” have failed.
My viewpoint: Reviving a mature woman’s sex drive requires addressing multiple factors. These include…
Balancing hormones—which play a key role in both physical and mental aspects of arousal—particularly during the hormonal changes of perimenopause and menopause.
Treating the pelvic problems of aging, such as vaginal atrophy and dryness, which can cause painful sex.
Here are natural ways to boost libido that consistently work for the mature women in my medical practice. Choose one or two based on your particular needs. If you still have problems, consult a licensed naturopathic physician.
Several herbs and herbal combinations can help balance a mature woman’s hormones. Two of my favorites…
Maca. This powerful Peruvian herb is a good choice for women going through perimenopause or menopause because it is rich in plant sterols that balance and strengthen the entire hormonal system. The herb not only increases sex drive but also improves perimenopausal and menopausal symptoms such as hot flashes, night sweats and insomnia.
Additionally, it supports the adrenal glands, reducing levels of energy-depleting stress hormones.
Typical dose: 1,000 milligrams (mg), twice daily.
Two Immortals. This herbal formula from Traditional Chinese Medicine builds two types of chi, or life-energy—yin (feminine) chi and yang (masculine) chi—thereby boosting a woman’s libido, which requires both nurturing (yin) and stimulation (yang).
It also helps to balance hormones and control some symptoms of perimenopause (irregular menstrual bleeding and cramping) and menopause (hot flashes).
Many of my patients take it for six months to a year to rebuild their vitality.
Typical dose: Many companies manufacture the supplement, and dosages vary—follow the dosage recommendation on the label.
Two nutritional supplements are particularly effective at stimulating sexuality…
L-arginine. This amino acid works by boosting nitric oxide, a compound that promotes blood flow—including blood flow to your genitals.
A study in Journal of Sex & Marital Therapy showed that more than 70% of women who took a supplement containing L-arginine (ArginMax for Women) experienced increased sexual desire, more frequent sex and orgasm, enhanced clitoral stimulation, decreased vaginal dryness and improved overall sexual satisfaction.
Typical dose: 3,000 mg daily. Caution: Talk to your doctor before you take L-arginine, especially if you have low blood pressure, herpes, gastric ulcer, liver disease or kidney disease.
PEA (phenylethylamine). Called the “love supplement,” PEA boosts the neurotransmitter dopamine, enhancing feelings of well-being, joy and pleasure.
Typical dose: 60 mg once a day. (Higher doses can cause overstimulation, insomnia or anxiety.) Caution: Don’t take PEA if you’re nursing, pregnant or take an MAOI antidepressant medication such as selegiline (Eldepryl).
You also can boost PEA by exercising regularly, eating dark chocolate and taking a blue-green algae called spirulina.
Two aphrodisiacs are particularly effective for mature women because—by relaxing your body and improving your mood—they slowly and gently boost your libido.
Cordyceps. This mushroom is considered a potent sexual tonic in Traditional Chinese Medicine. It enhances both yin and yang chi, making it an ideal aphrodisiac for women.
Typical dose: 500 mg, twice daily.
What works best: Pills made by a hot-water extraction process that pulls out the herb’s most active constituents, such as the cordyceps supplement from JHS Natural Products.
Ginkgo biloba. Often recommended for memory loss because it improves blood supply to the brain, ginkgo also promotes blood flow to the vulva and vagina. Studies show that it may help restore libido in women taking antidepressants, which can destroy sex drive.
Typical dose: 40 mg, three times a day. The label should read, “Standardized extract of 24% ginkgo flavonglycosides (or flavone glycosides).”
Cholesterol-lowering statin drugs—taken by millions of older women—can lower libido, probably by damaging mitochondria, energy-generating structures inside cells. If you take a statin and notice a decrease in libido, talk to your doctor about your options.
The pubococcygeal (PC) muscle—a bowl-shaped “hammock” of pelvic muscle that contracts rhythmically when you have an orgasm and also supports your genital organs and bladder—is crucial to sexual pleasure.
New approach: Using a vaginal weight (a small, round weight inside an oval tube that is inserted into the vagina like a tampon) is the best way to strengthen the PC muscle, enhancing erotic sensation and sexual response.
What to do: To start, insert the tube for one to five minutes, twice daily, squeezing your PC muscle repeatedly to hold the tube in place. You can do this standing or lying down. Gradually work up to 20 minutes, twice daily, using progressively heavier weights. Do this for three months. You can order a set of vaginal weights at Vagacare.com. Cost: About $45.
Other benefits: Regular use of vaginal weights can help prevent and treat urinary incontinence and prevent prolapse of the bladder or uterus.
VAGINAL DRYNESS AND PAINFUL INTERCOURSE
Enjoyable sex requires vaginal tissue that is healthy and well-hydrated. But the midlife drop in estrogen levels causes a decrease of blood flow to the vagina, which can lead to vaginal atrophy and dryness. A simple remedy…
Vitamin E. The unique lubricating properties of vitamin E make it especially effective.
What to do: Pierce a soft 400 IU vitamin E gel capsule with a pin, squeeze the oil onto your finger, and apply it to the outside of the vagina and inside about an inch. Or use a vitamin E vaginal suppository. (I recommend the product from Earth’s Botanical Harvest, available online.) Apply the gel or insert the suppository nightly at bedtime for at least two weeks. Taper use to three times a week.
Estriol vaginal cream: If vitamin E and other topical lubricants aren’t enough to assist with painless sex, consider using a low-dose estrogen cream to enhance the connective tissue integrity and the moisture of the vaginal and vulvar tissue. These tissues are estrogen-dependent. When a woman goes into a lower-estrogen state around menopause, these tissues can become more fragile and dry and can actually break down or atrophy. Using estriol, a weak estrogen, can help to reconstitute these delicate tissues. Most patients use 1.0 mg to 2.5 mg of estriol applied topically to tissues three times a week.