The Solution
Treatment
Impotence
If the underlying problem is physiological, the 3 main treatments are drug treatment, vacuum pump (which induces erection by negative pressure) and prostheses. Phosphodiesterase 5 inhibitors are taken orally, other drug treatments listed below require penile injection. Phosphodiesterase 5 inhibitors (eg. sildenafil, tadalafil, vardenafil) are the drugs of choice due to their effectiveness and ease of use. The onset of action is about 30-60mins, and they are generally well tolerated. Phosphodiesterase 5 inhibitors are contraindicated in men taking nitrates. Of the injectable products, alprostadil is effective alone or with other agents, and least likely to cause penile fibrosis. Papaverine may be used alone or in combination.
Sexual Desire
There is a lack of pharmaceuticals available for the treatment of male sexual desire problems. Testosterone may be available in those with significantly reduced natural levels of testosterone, available in many different forms. For women, there are no specific pharmacological treatments that target decreased sexual desire. Balancing hormone levels may indicate the need for hormone-based pharmaceuticals.
Natural Therapies
For men and women:
Nutrition plays a big part in sexual health, as optimal nutrition provides not only the nutrients (such as B vitamins) for sexual performance, but also for psychological wellbeing. Improving your nutritional status may increase sexual health, both physically and mentally.
Ginkgo biloba may improve libido and overall sexual performance in both male and females, especially people with reduced sexual desire resulting from the use of antidepressant drugs. Ginkgo helps to improve blood flow and hence helps with male impotence when there are problems with the vascular system causing impaired blood circulation to erectile tissue. In addition, Ginkgo can improve mental function, clarity, memory and increased energy, and therefore can assist with the overall performance and enjoyment of sexual activities.
Horny Goat Weed (Epimedium sagittatum leaf), a Chinese native herb that has been used for more than 2000 years as a sexual enhancer. Modern research attributes its effects on blood flow to the penis. Epimedium sagittatum contains the phytoestrogen icariin, which has been shown to inhibit phosphodiesterase-5 (PDE5) increasing cGMP levels and increase the production of nitric oxide in the smooth muscle of the corpus cavernosum in men; resulting in relaxation of the smooth muscle, increasing the blood flow in penile arteries and promoting an erection [1]. In women, the increase in cGMP levels and production of nitric oxide in the smooth muscle,[1] leads to local vasodilation and improved blood flow to the labia and clitoris.
Taking zinc supplement is necessary as zinc is needed for the various stages in sexual acts. Zinc level drops after each sexual encounter, and this accounts for a large number of cases of low sexual performance. Zinc can improve sexual performance as it increases the intensity of orgasm in men. In addition, it is a mineral crucial to cell growth, immune function, fertility and reproduction.
Chiropractic and other maintenance therapies may also improve overall health including sexual health. Psychotherapy can be very beneficial when the cause of the problem is of psychological nature, such as stress and anxiety.
For women:
Chaste berry, a shrub native to the Mediterranean and Central Asia, and the America, have attracted a lot of attention from the pharmaceutical industry for its benefit to women’s sexual and productive system. In 1930s, some of the first scientific research on the plant found it to have a "strong corpus-luteum" effect, which increases progesterone. Chaste berry may regulate the pituitary gland, which detects increased estrogen levels and tells the ovaries to make less of it. It has been suggested that Chaste berry may help restore a normal estrogen-to-progesterone balance. Chaste berry may also provide significant relief for those women suffering from pre-menstrual syndrome (PMS).[2-3]
Panax ginseng is a natural herb that may be beneficial to stress and healthy libido. There has been encouraging results from research studies on improving sexual desire in women.
Lifestyle
Pressure of the fast paced modern life, demanding career and family life are the causes of many health problems including sexual disorders and dissatisfaction. Regular exercise and relaxation are needed to bring back the balance that is necessary for a healthy love life. Yoga and Pilates are recommended in improving your sexual health.
References
1. Xin ZC, Kim EK, Lin CS, Liu WJ, Tian L, Yuan YM, Fu J. Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities. Asian J Androl. 2003 Mar;5(1):15-8
2. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. BMJ. 2001 Jan 20;322(7279):134-7.
3. Berger D, Schaffner W, Schrader E, Meier B, Brattstrom A. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with pre-menstrual syndrome (PMS). Arch Gynecol Obstet 2000;264:150-3.
