Sex and Ageing
Over the past 25 years of practice I have lost count of the number of patients, both men and women, who have asked if herbs can help with the problems that they are experiencing in the bedroom. As we age, the inevitable happens: sometimes certain bits of our bodies just don’t work as well as they used to or as well as we want them to. We can accept that our knees might be a bit stiffer, our back gets sore in bed, or our hair starts going grey, but the great unspoken fact is that these are not the only bits that start to show signs of age.
Men and women are affected differently but both should understand what is happening in each of the sexes. Women have long known about the ‘menopause’, and doctors have developed pills called HRT to “get rid” of the menopause. The subject often hits the press, but what often goes unreported is that even taking HRT cannot stop the ageing process, because we all inevitably age and change. Of course, the ageing process affects men just as much as women and again there are pills (Viagra and Cialis) that can help.
However, simply relying on pills to correct all your health problems is a very short term approach to health. Health is complex and multi-layered and, just like a garden, we need to tend the soil properly, make sure the correct nutrients are there and that the right amount of attention is paid to the small details that all slot together to make the bigger picture.
Low libido, vaginal atrophy, erectile dysfunction... none of these are new problems. These are the same issues our ancestors had to wrestle with centuries ago. We are often told that a healthy sex life is part of well-being and is interlinked with our quality of life. So, with all this in mind, it is time to come out from behind the consulting room door and talk openly about what we, as natural medicine practitioners, can do to support our patients’ sexual health as they grow older.
Firstly, a word of warning
The internet is strewn with libido-enhancing supplements and wonder cures. These things are never what they seem to be and can often have unpleasant side effects. If you are taking medicines for other health problems, such as high blood pressure, then you should book a consultation with a qualified herbal medicine practitioner who will be able to offer advice and prescribe herbs and supplements that are appropriate to take alongside any existing medicines. At the end of this article I will go through some of the more commonly known supplements and herbs.
A word about hormones
Hormone replacement (replacing the hormones we make less of as we age) is controversial. A quick internet search will reveal a host of sites claiming to sell hormones, but going down this road is a bad idea and potentially dangerous. The idea that you can buy human Growth Hormone (GH) online and self-medicate simply doesn’t work. Unless a doctor is injecting it straight into your blood stream, you are probably getting something other than pure GH.
Using your diet to try to support the body in its natural hormone production is the safe and ideal way to manage the ageing body. Phytoestrogens are found in many foods such as apples, carrots, cherries and blueberries, so including these in your diet is helpful for both men and women.
Using supplements that contain amino acids, such as L-Arginine, L-Glutamine, L-Lysine, Colostrum, GABA, etc. to support pituitary production of GH, is claimed by some to be beneficial. I am still unsure about this though, and would only really consider this route as part of an overall approach.
Dehydroepiandrosterone (DHEA), and its sulphate DHEA-S, are sex steroid hormones that decrease with age and with certain illnesses and drugs. Although DHEA supplements are available and aimed at increasing libido, especially in postmenopausal women, there are question marks over its safety as there is the possibility of a link with hormone sensitive cancers.
Male sexuality and ageing
Erectile dysfunction (ED)
It is estimated that over half of men over the age of 40 have, or will have, some problems with erectile dysfunction. It is a worldwide problem, sometimes triggered by prescribed drugs or by other health problems (diabetes, depression or stress). In some cases, the problems are situational and correct themselves, in others they remain and become more of an issue.
Facts to remember:
Erection and ejaculation is controlled by both the parasympathetic nervous system (erection) and the sympathetic nervous system (ejaculate). These two halves of the nervous system also control many body functions - from taking a breath, to our response to stress. Herbs and supplements that support the autonomic nervous system will also help with ED.
We know that a little alcohol relaxes, but too much is not helpful, so moderation is the key. The same caution applies to big meals. Too big a meal before sex sends blood to the digestive organs and not to the reproductive ones. In the same way, working out before sex sends the blood supply to the large muscles, thereby reducing blood supply to the genital area.
I think it is worth mentioning the stress that comes from the pressure to perform. In a loving relationship, intimacy should not always be about erections or ejaculation. All couples, whatever their age, can explore the world of sex toys and understand that finding different ways to satisfy the other person’s needs can be just as fulfilling.
Some older men have problems with lack of, or infrequent, ejaculation. This may have also been a problem when they were younger which becomes more acute as they age. The key, as always, is communication.
Self help measures
Add spices to your food: Chilli, ginger, nutmeg and chocolate are all mild tonics.
Garlic and onions will improve gastrointestinal flora and have long been thought of as effective in enhancing libido.
Add 1 tablespoon of unsalted and unheated sunflower seeds to your diet. They are a good source of histidine. Histidine is essential for mucus lubrication as well as semen manufacture.
Amino acids are helpful to libido and erectile dysfunction, in particular Lysine and Arginine. Phenylalanine (one source is chocolate), may stimulate interest in sex. Tyrosine can improve sex drive, and histidine, in moderation, may improve sex drive in both sexes. Histidine is thought to be a key amino acid for bringing orgasm. However, too much histidine in men tends to cause premature ejaculation whilst too little might lead to problems with ejaculation.
Supplement with the following minerals
20 -50mg of Zinc to support reproductive health.
600mg of Magnesium may help sex drive as well as support heart health. Phosphorus, Calcium and Magnesium are all thought to help maintain sexual desire. Manganese is important, as is Selenium. Look for a balanced supplement with these minerals in.
Key points to remember
- go overboard on Omega -3 essential fatty acids. Extremely high doses have been cited as possibly causing erectile dysfunction.
- overeat or exercise right before sex.
- buy ‘miracle’ cures over the internet or buy supplements from unknown sources or from abroad.
See below for my advice on herbs.
Female sexuality and ageing
The much-written about physical symptoms of menopause are mirrored by a raft of emotional and psychological feelings that can affect a woman’s sexuality. A lack of sleep, hot flushes, tiredness, joint stiffness, mood changes and vaginal dryness can all stack up, causing thoughts of intimacy to be well and truly at the back of one’s mind.
This is also often a time in one’s life when teenage children and ageing family members need attention. This can add a big element of stress to the mix. Finding the time for intimacy is not always easy. Also, bear in mind that older women who might suffer from vaginal atrophy are unlikely to appreciate long bedtime sessions and this can lead to avoidance.
Recognising that there might need to be a change of pace in one’s lovemaking is an important first step, as is working to re-engage the mind-heart connection, turning off the ‘worry’ switch, and rediscovering the playful you. Look for ways to remind yourself that you are a sexual being - some women find erotic literature, or just imagining their own fantasies, can help them engage. Sex toys and using lubrication can gently help overcome vaginal atrophy and lubricants such as ‘Sylk’ or ‘Replens’ are both oestrogen free.
Add phytoestrogen foods to your diet: beans and pulses such as lentils, black beans and aduki.
Use linseeds daily. A tablespoon soaked and added to cereal or a smoothie.
Black cherry juice is good for sleeplessness as well as joint aches and pains.
Add seeds and nuts to your diet: almonds, cashews, sunflower, pumpkin and sesame.
Add Omega 3 and 6 oils (flax and borage seed) to your diet. Available as capsules or use as a dressing for salads, potatoes, grains, etc.
Creams that contain wild yam, liquorice, rose hip oil and essential oils of fennel and clary sage can ease vaginal dryness.
Calcium hydroxyapatite, magnesium, boron, Vitamin K and Vitamin D are all essential for bone health as well as sustained sex drive.
Take 400iu Vitamin E per day. Also insert Vitamin E vaginally at night to combat dryness. The oil filled capsules will dissolve internally, or use a pipette and oil.
Herbs to consider
It is always best to have a personal consultation with a Medical Herbalist to work out specific combinations of herbs, especially if one is already taking other medications that could interact.
Urtica dioica (stinging nettle root and seed)
There is a lot of clinical evidence for using Nettle to manage Benign Prostatic Hyperplasia (BPH) or enlarged prostate. The dose to maintain prostate health may be as little as ½ a cup of root infusion, 2-3 times per week. This herb is a natural source of histidine which increases mucous lubrication. This herb can benefit men and women.
Serenoa serrulata (saw palmetto)
This herb is used mainly for BPH but can also help to maintain prostate function as almost all men develop a degree of BPH as they age. Saw palmetto also has a hormone balancing action.
Tribulus terrestris (Puncture vine)
In men, this herb is used to treat erectile dysfunction and low libido. There are a number of studies which show that Tribulus acts by increasing testosterone levels and there is historic use of this herb for erectile disfunction and low libido. Other studies have shown that Tribulus needs to be taken for over two months to be effective. This herb is also used to ease menopause symptoms including vaginal thinning.
Panax ginseng (Korean ginseng)
Research has shown that Panax increases libido, in part by stimulating the hypothalamus which results in an increased production of sex hormones. Helpful to men experiencing fertility or erectile dysfunction, as Panax increases testosterone levels and blood flow to the penis.
Women in early menopause and experiencing hot flushes can benefit from Ginseng. Ginseng is regarded as an adaptogen as it is stimulating to the central nervous system and helps to improve mental alertness and energy.
To minimize the risk of Ginseng triggering insomnia, make sure you take it in the morning.
Lepidium meyenii (Maca)
Traditionally used as both a food and a medicine, this radish-like root appears to affect both the hypothalamus and the pituitary gland. It has a lot of tonic actions including increased libido and sexual function as well as diminished menopausal symptoms. Maca also contains high levels of nutrients such as iron, magnesium, calcium and potassium as well as protein, amino acids, plant sterols and other photochemicals unique to Maca.
Human studies suggest that in addition to increased levels of DHEA (see above) in men and women, Maca plays a role in fertility (sperm number and motility), sex drive, lowering bold pressure, and general well-being.
For women, it has traditionally been used to regulate menopausal symptoms.
Smilax ornata (Sarsaparilla species)
This is a non-specific hormone balancer which acts as a lymphatic tonic and a skin cleanser. Sarsaparilla has a balancing action on sex hormones but does not contain any testosterone. I often use this herb in menopause formulas when there are hormone driven skin problems.