In today’s society, where sex is in your face every time you turn on the TV or open a magazine, you may think that a lack of interest is abnormal. However, I’ve talked to enough patients over the years to know that intimacy takes numerous forms, and for many folks—and couples—sex just isn’t that important, especially as they get older. That said, if you are looking for safe, natural ways to improve libido (in both women and men), here are some of my top recommendations.
Address Underlying Causes of Low Libido
If you want to improve sex drive, the first thing you need to do is look for and address underlying causes of low libido. Many of my female patients tell me that fatigue, stress, and the sheer busyness of life push sex into the background. These factors can also apply to men. Others say that if a relationship isn’t working, sex is the last thing on their minds. And, men, don’t forget that romance, emotional closeness, and foreplay are important to women. To paraphrase comedian Billy Crystal, men just need a place to have sex, but women need a reason.
Other lifestyle habits that can be underlying causes of low libido in women and men include drinking too much alcohol, smoking, and not getting enough exercise. So to improve sex drive, it’s important to correct these habits.
Beware of Medications Linked to Low Libido
When it comes to causes of low libido, you should also be aware that dozens of over-the-counter and prescription drugs are notorious for dampening sex drive. At the top of the list are blood pressure meds, antihistamines, birth control pills, progestins (Provera), and antidepressants. For example, SSRIs reduce libido or ability to achieve orgasm in more than half of the women who take them, and the widely used allergy/cold medication Sudafed (pseudoephedrine) has been shown to reduce the firmness of erections. Other meds that can be problematic are narcotics and sleeping pills. Therefore, if you want to improve libido, you should avoid these and look for other—preferable natural—options.
Improve Libido With Regular Exercise
Regular exercise can have a profound effect on libido and sexual performance. It helps enhance blood flow and addresses weight issues, two of the underlying causes of sexual problems in women and men. For instance, one study showed that men who burned 200 calories or more a day in physical activity—a level that can be met with as little as two miles of brisk walking—had about half the risk of erectile dysfunction as did sedentary men.
Plus, exercising regularly just makes you feel better overall. It boosts endorphins—the feel good chemicals in the brain that improve mood—and gives you more energy. Aim for a minimum of 30–45 minutes of moderate to intense physical activity four or more days a week.
Take Supplements That Help Improve Libido
In addition to tackling lifestyle habits and underlying causes of low libido, there are several supplements that can help improve libido in women and men. Here are a few of the ones I recommend (look for them separately or in combination formulas online or in health food stores, and use as directed):
- L-arginine, an amino acid, is helpful because it enhances blood flow throughout the body, including to the genital area, which is essential for peak sexual performance and satisfaction in both men and women. For instance, as you may know, erections occur when nitric oxide (NO), a messenger molecule in the endothelial cells lining the arteries, signals the smooth muscles of the penile arteries to dilate, which engorges the penis with blood. If blood flow is compromised, you’re obviously more likely to have problems. Not surprisingly, NO also plays a role in sex drive and satisfaction. L-arginine is the direct precursor to NO. That’s why when taken as a supplement it’s beneficial for improving libido and overall sexual health.
- Pycnogenol®, extracted from French maritime pine bark, contains flavonoids, proanthocyanidins, and other phytochemicals with powerful antioxidant activity that protect the artery walls and provide overall support for the cardiovascular system. Like arginine, Pycnogenol also aids in the production of NO, making it an equally effective supplement for supporting sexual function.
- Epimedium sagittatum, commonly and appropriately referred to as horny goat weed, has been used in traditional Chinese medicine for centuries as an aphrodisiac and enhancer of male sexual function. Its active ingredient, icariin, is now known to target some of the same mechanisms as Viagra and related drugs. It inhibits PDE5, boosts nitric oxide production, and mimics some of the effects of testosterone. If you decide to try this herb, look for a brand with standardized levels of icariin.
- The root of maca (Lepidium meyenii), which is available as a lozenge, has long been used in the Andes to enhance vitality, fertility, energy, endurance, and stamina. It is suggested that maca may be beneficial in both women and men.
- An extract of Avena sativa (wild oats) is believed to mimic testosterone. As a result, herbalists speculate that the extract can help enhance sexual performance, satisfaction, and vigor.
Consider Bioidentical Hormone Replacement Therapy
If you have followed these recommendations to improve libido but your level of desire still isn’t quite where you’d like it to be, consider bioidentical hormone replacement therapy. It’s no secret that hormones are inextricably linked with sex. More specifically, in women, the hormonal surge during puberty that reshapes the female body also sparks the sex drive, and fluctuations during the monthly cycle cause it to wax and wane. Then along comes menopause, which affects not only libido but all aspects of sexual function.
Similarly, while some physicians scoff at the concept of male menopause, there is no question that testosterone production slows down around age 40 and steadily declines thereafter. There is also no doubt that this is a primary reason many older men lose interest in sex and, along with other factors, have problems with sexual performance. In these cases, testosterone therapy helps. But it's not beneficial just for men looking for an effective way to improve libido.
Although it’s true that estrogen and progesterone are the quintessential female hormones, and they have strong influences on sexuality, testosterone is the hormone of desire in both men and women. So while bioidentical estrogen balanced with natural progesterone is an effective treatment for vaginal dryness, hot flashes, night sweats, mood swings, and other menopausal symptoms, the addition of natural testosterone will usually improve libido for women as well.
Most hormones require a prescription. Although some bioidentical hormones are available from conventional pharmacies, I recommend ordering them from a compounding pharmacy. This allows them to be tailored to specific doses and combinations (i.e., adding testosterone to transdermal estrogen).
Note: Despite its maligned reputation, testosterone therapy is quite safe. Liver toxicity is only an issue with oral testosterone, which I do not recommend. And virtually all experts agree that the most serious concern—that testosterone could cause prostate cancer—is unfounded.