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LIBIDO PROBLEMS

DECREASED DESIRE FOR SEX IS OFTEN a side effect of an illness, an injury or a drug. Circulatory problems, diabetes and high blood pressure can all cause erectile dysfunction and should be treated by a doctor. However, you may wish to consult a marriage­guidance counsellor or other type of expert if you have trouble regaining your enjoyment of the things that bring you pleasure. Psychological issues such as stress, anxiety, guilt and depression can be addressed through therapy.

Many drugs can decrease libido. If you experience this common side effect, see your doctor about trying other drugs or natural alternatives to them. If you're taking a prescription drug regularly, don't discontinue it or add herbs to your regimen without your doctor's advice.
One physiological cause of decreased libido is reduced hormone levels, specifically of the sex hormone testosterone. Both men and women can experience this phenomenon. It can be medically treated.

Erectile dysfunction, another cause of sexual problems in men, is not necessarily related to loss of desire, though it can certainly affect libido. Men who experience such dysfunction should see a doctor to diagnose any medical problems first. Any drug or herb that addresses this problem is bound to get considerable attention. (Before you fork over a lot of money for the next 'herbal Viagra', for example, be sure to do your research on whether that remedy works and is safe for you to take.)

Finally, some people find that, as they age, their desire for sex wanes. But the belief that such decreases in libido are normal or unavoidable is only a myth. And there are natural ways to support your body's continued health and your own enjoyment. For people who simply want to know how to enhance an already satisfying sex life, there are some herbal preparations worth a try.

While some products marketed as natural aphrodisiacs are ineffective and even dangerous, newer research shows that sometimes herbalists of yore were on to something. A number of herbs or other natural products have physical effects that may qualify them as aphrodisiacs. And if you define 'aphrodisiac' as anything that adds extra zing to lovemaking, then the possibilities are as boundless as the erotic imagination.

FEEDING YOUR DESIRE
Food can be the music of love - but there's also no accounting for tastes. Here are a few nutritional libido-boosters to investigate.

Oysters. Scientists scoffed at oysters' sexual reputation until nutritionists discovered that the molluscs are exceptionally rich in the essential trace mineral zinc, which is related to male sexual health. Men with zinc­deficient diets are at high risk for infertility, prostate problems and poor libido. University of Rochester researchers have restored sperm counts in infertile men using zinc supplements. Whole grains and fresh fruits and vegetables also contain zinc, but processed foods are often low in the mineral.

Caffeine. If your sweetheart's thoughts turn to dreamland just as yours turn to dalliance, a cup of coffee with a chocolate bar on the side just might keep him or her awake long enough to make the most of the evening. But caffeine does more than simply keep the sandman at bay. One study found that regular coffee drinkers are considerably more sexually active than persons who don't drink coffee.

Chocolate. Finally, an excuse to indulge! Chocolate contains not only caffeine but also high levels of phenylethylamine (PEA). Sexual medicine specialist Dr Theresa Crenshaw, author of The Alchemy of Love and Lust and co-author with Dr James Goldberg of Sexual Pharmacology, calls PEA the molecule of love. It's a natural form of stimulant and a natural antidepressant, according to Dr Crenshaw. Both love and lust increase blood levels of PEA; and these levels plummet after a heartbreak.

Some experts say the PEA in chocolate gets metabolised so quickly that it couldn't have much effect. Perhaps. Nevertheless, giving chocolates is a longstanding, worldwide courtship ritual. Maybe it's the silky texture and creamy taste. Then again, maybe it's the PEA.

Oat bran. Oat bran can provide an indirect sexual boost because of its effect on blood flow. It's now common knowledge that eating oat bran helps reduce artery-clogging cholesterol. Clear arteries to the genitals mean that more blood is available to produce erection in men and vaginal lubrication in women.

BEWARE THE TURNOFFS
If you want to rev up your sex life, first make sure that you don't shut it down. A surprisingly large number of everyday items don't mix with amorous intentions.

Alcohol. In Macbeth, Shakespeare wrote that the substance used worldwide to coax reluctant lovers into bed `provokes the desire, but takes away the performance'. Truer words were never penned. If people of average weight drink more than two beers, cocktails or glasses of wine in an hour, the alcohol becomes a powerful central nervous system depressant. It interferes with erection in men and impairs sexual responsiveness in women.

Smoking. One herb is bad news for sex: tobacco. Smoking narrows the blood vessels, impairing blood flow to the penis and causing an increased risk of erection impairment. In women, the same mechanism limits blood flow into the vaginal wall, decreasing vaginal lubrication.

Antidepressants. A popular family of antidepressants, the selective serotonin re-uptake inhibitors (SSRIs), which includes Prozac, elevate mood - but at a price. They carry a considerable risk of sexual side effects, including loss of desire and difficulty reaching orgasm in both sexes, erection impairment in men and lubrication problems in women. According to Dr Jamie Grimes, chief of outpatient psychiatry at the Walter Reed Army Medical Center in Washington, DC, they cause sex problems in more than half of those who use them. Many other classes of antidepressants have similar sex-impairing side effects.


If you take an antidepressant, what can you do to preserve sexual function? Ask your physician about switching to one without this side effect or trying a lower dose. St John's wort, a herbal antidepressant, has no known sexual side effects.

Other legal drugs. Many prescription and over-the-counter medications can cause sexual impairment - even the antihistamines that people take for allergies and cold symptoms. If the label says the drug may cause drowsiness, it can impair sexual desire or performance. Ask your doctor and chemist about the possibility of sexual side effects every time you get a prescription.

High-fat, high-cholesterol diet. A study by researchers at the University of South Carolina School of Medicine found that, the higher a man's cholesterol, the more likely he is to suffer erection impairment.
Researchers tested the cholesterol levels of 3,250 men aged 25 to 83, then asked them to complete questionnaires that explored sexual issues. Compared with the men whose total cholesterol was below 180 milligrams per decilitre of blood, those with levels above 240 were almost twice as likely to report erection problems.

Cholesterol levels relate directly to consumption of dietary fat and cholesterol, found primarily in meats and dairy products. Ironically, many people consider meat a `virility food'. In fact, it's the opposite. Men who want to enjoy sex without erection problems should forgo the steak and eat salads instead.

DRUG TREATMENT

Hormone Replacement Therapy
Oral testosterone (Restandol), testosterone patch (Andropatch). Function: boost low testosterone levels in men. Side effects: possible behavioural changes, possible stimulation of pre-existing prostate cancer.

Testosterone with oestrogen. Function: restore normal levels of testosterone in women. Side effects: acne, masculinising effects such as slight growth of facial hair.

Other Drugs
Sildenafil (Viagra). Function: increases the amount of blood in the penis to cause stronger erections. Side effects: headache, stomach pain, nasal congestion, colour blindness, significant drug interactions.

HERBAL REMEDIES

Ginseng (Panax ginseng)
The Chinese and Koreans insist that ginseng strengthens exhausted sperm and impotent genitals. Western scientists remain sceptical, but they acknowledge that several Asian animal studies show that ginseng stimulates sexual activity. While it is traditionally thought of as a man's remedy, some herbalists use it for women. Ginseng doesn't produce a quick fix and must be used regularly for several months before its effect becomes noticeable. Typical dosage: up to 2 cups of tea per day (steep 1/2 teaspoon of powdered root in 1/4 litre of hot water for 10 minutes); or follow manufacturer's instructions for packaged products. Caution: consult your doctor before using ginseng if you have high blood pressure. Do not use if you are pregnant.

Saw Palmetto (Serenoa repens)
Early American folk healers recommended the fruit of this small palm tree, which is native to the south-eastern United States, as a diuretic and treatment for benign prostate enlargement, a common problem among men over the age of 50. Through the years, they extended saw palmetto's use to invigorating the genitals and enlarging women's breasts. Scientific research shows that saw palmetto won't boost anyone's libido or bra size, but it is a mild diuretic. About a dozen studies have shown that saw palmetto extract is about as effective in treating benign prostate enlargement as the drug Proscar. Typical dosage: up to three 585-milligram capsules of non-standardised product per day; or 20 to 30 drops of tincture up to four times per day.

Wild Yam (Dioscorea villosa)
This tuber's sexual reputation springs from its use as a treatment for gynaecological ailments. Wild yam is a potent source of diosgenin, a chemical that resembles female sex hormones and was used in the manufacture of the first oral contraceptives before the creation of synthetic hormones. There is no credible evidence that wild yam arouses women sexually, but salves made from it can make intercourse more comfortable for them and are a fine substitute for oestrogen creams used as vaginal lubricants. Typical dosage: use as needed.

Oats (Avena sativa)
Many owners and trainers swear that horses fed wild oats become friskier and more libidinous. When humans behave that way, we say they're 'sowing their wild oats'. The research is scant, but many herbalists recommend wild oats, often in combination with ginseng and yohimbe, in tea blends that supposedly possess aphrodisiacal effects. Typical dosage: up to 2 cups of tea per day (steep 1 tablespoon of dried tops in 1/4 litre of hot water for 10 to 15 minutes); or 25 drops of tincture three times per day.

Ginkgo (Ginkgo biloba)
Ginkgo, which has no traditional reputation as an aphrodisiac, is the newest arrival among sex-promoting herbs. During the past decade, a great deal of research has shown that it improves blood flow through the brain. Today ginkgo is widely used in Europe to treat strokes and cerebral insufficiency, or poor circulation in the brain. Ginkgo also boosts blood flow into the penis. Typical dosage: 3 capsules per day, each containing at least 40 milligrams of standardised extract.

Damiana (Turnera diffusa var. aphrodisiaca)
Whereas many traditional aphrodisiacs have shown at least some stimulating effects, nothing even remotely libidinous has ever been discovered about damiana, despite the aphrodisiaca in its scientific name. This herb is safe, however, so it won't hurt you or your parther. And if you really believe it's an aphrodisiac, the placebo effect may turn it into one for you. Typical dosage: up to six 400-milligram capsules per day; or up to 3 cups of tea per day (steep 1 teaspoon of dried herb in 1/4 litre of hot water for 10 to 15 minutes); or 20 to 60 drops of tincture in water three times per day.


SWEAT IS SEXY
Want more sexual heat? Then work up a sweat. One indisputable aphrodisiac is exercise. Dr James White, professor emeritus of physical education at the University of California at San Diego, recruited 95 healthy but sedentary men with an average age of 47 to follow one of two exercise programmes. One involved low-intensity, 60-minute walks four times a week, the other an hour of aerobics for the same amount of time. After nine months, both groups reported increased sexual desire and pleasure, but the aerobics group reported the greatest increase.

Exercise leads to fithess. And fithess, says Dr Louanne Cole, a California sex therapist, boosts self-esteem. `You feel healthier and more attractive and you project that, so you look more alluring to prospective lovers,' she explains.

The same could be said for weight loss - shedding a kilo or two often boosts interest in sex. A psychologist at the Duke University Diet and Fithess Center in Durham, Noth Carolina, noticed that people who lost weight at the centre often remarked that they felt more sexual. She surveyed 70 male programme participants aged 18 to 65 before and after a weight loss of 3 1/2 to 14 kilograms. After losing weight, they all reported more sexual desire. Excess weight makes most people feel less desirable and more anxious about being seen naked, she says. In other words, fat causes stress and stress interferes with desire. Carrying extra weight also requires a good deal of energy. Dropping the weight frees that energy for other uses.