Sexual dysfunctions cover a wide variety of disorders, including male
impotence, premature ejaculation in males, spasms of the vagina, pain with
sexual intercourse, and problems with sexual desire (libido) and response. Men
over age 65 are at increased risk for impotence. Impotence, however, is not a
normal part of aging. The causes of sexual disorders vary, and include
psychological causes and some medical conditions, such as illness or
Signs and Symptoms
Premature or abnormal ejaculation in men
Inability to achieve or maintain an erection (impotency)
Pain during intercourse
Lack or loss of sexual desire
Difficulty achieving orgasm
Inadequate vaginal lubrication in
What Causes It?
Age 65 and over in men
Depression or anxiety
Stressful life events
Certain medical conditions
What to Expect at Your Provider's Office
Your health care provider will do a physical examination. He or she may ask
about your ethnic, cultural, religious, and social background, which can
influence your sexual desires, expectations, and attitudes. Blood tests can help
distinguish between psychological and physical causes for sexual dysfunctions.
Other tests for men may include penile tumescence measurements, which are done
while you are sleeping to determine whether an impotence problem is
psychological or physical.
Antidepressants can be taken by men and women whose sexual dysfunction is
related to depression. Vasodilators administered by injection are sometimes used
for impotence. Viagra (sildenafil citrate), a relatively new drug for treating
impotence, can have serious side effects in some men. Over-the-counter products
are available as creams or gels for women whose bodies produce inadequate
A variety of psychological, behavioral, and interpersonal therapies are also
available for many sexual disorders.
Surgery on the veins in the penis can be performed in severe cases, but this
treatment is still considered experimental. An implant in the penis may help
impotence if the problem does not respond to other treatment.
Complementary and Alternative Therapies
Sexual dysfunction secondary to decreased circulation, hormonal imbalance,
depression, or anxiety may be reduced with alternative therapies.
Vitamin C (250 to 500 mg one to two times per day) supports vascular
Vitamin E (400 IU per day), B6 (50 to 100 mg per day), and zinc (30
mg per day) to support hormone production.
Magnesium (200 mg twice a day) supports hormone
B-complex (50 to 100 mg per day) helps reduce
Herbs may be used as dried extracts (capsules, powders, teas), glycerites
(glycerine extracts), or tinctures (alcohol extracts). Unless otherwise
indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep
covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.
For sexual dysfunction related to poor circulation:
Ginkgo (Ginkgo biloba, 50 to 100 mg per day) increases
peripheral circulation and may improve sexual function.
Hawthorn (Crataegus monogyna), rosemary (Rosmarinus
officinalis), ginger root (Zingiber officinalis), and prickly ash
bark (Xanthoxylum clava-herculis) are circulatory stimulants. Use singly
or in combination, 3 cups of tea per day or 20 to 30 drops tincture three times
Yohimbe bark (Pausinystalia yohimbe) can be used for sexual
dysfunction, under the supervision of your provider.
For sexual dysfunction secondary to hormonal imbalance:
Chaste tree (Vitex agnus cactus) helps normalize pituitary
function but must be taken long term (12 to 18 months) for
Saw palmetto (Serenoa repens) may help hormone
Damiana (Turnera diffusa) may support testosterone levels. It
also tones the central nervous system and may help relieve anxiety.
Milk thistle (Silybum marianum), dandelion root (Taraxacum
officinale), and vervain (Verbena officinalis) support the liver and
may help restore hormone ratios. Use equal parts in a tea (1 cup before meals),
or tincture (15 to 20 drops before meals).
For sexual dysfunction associated with depression or anxiety:
St. John's wort (Hypericum perforatum), kava kava (Piper
methysticum), skullcap (Scutellaria lateriflora), lemon balm
(Melissa officinalis), passionflower (Passiflora incarnata), and gotu
kola (Centella asiatica). Combine equal parts in a tea (1 cup twice a
day) or tincture (20 to 30 drops twice a day). May take six weeks for
Contrast sitz baths promote circulation. You will need two basins that you
can comfortably sit in. Sit in hot water for three minutes, then in cold water
for one minute. Repeat this three times to complete one set. Do one to two sets
per day three to four days per week.
Therapeutic massage can reduce the effects of
Most sexual dysfunctions are long-term and require professional
Certain drugs and herbs used for treating these psychological or physical
disorders may have serious side effects. Marital counseling and other forms of
interpersonal therapy are also important.
American Psychiatric Association. Diagnostic and Statistical Manual of
Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association;
Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic
Guide to Herbal Medicines. Boston, Mass: Integrative Medicine
Hoffman D. The New Holistic Herbal. New York, NY: Barnes & Noble
Murray MT. The Healing Power of Herbs: The Enlightened Person's Guide to
the Wonders of Medicinal Plants. Rocklin, Calif: Prima Publishing; 1995:127,
Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed. Durango,
Colo: Kivaki Press; 1994:66.
Tierney LM Jr, McPhee SJ, Papadakis MA, eds. Current Medical Diagnosis
& Treatment 1999. Stamford, Conn: Appleton & Lange;
Review Date: August 1999
Reviewed By: Participants in the review process include: Richard A. Lippin, MD, President,
The Lippin Group, Southampton, PA; Marc Micozzi, MD, PhD, College of Physicians,
Philadelphia, PA; Pamela Stratton, MD, Chief, Gynecology Consult Service,
National Institute of Child Health and Human Development, National Institutes of
Health, Bethesda, MD.
The publisher does not accept any responsibility for the accuracy of
the information or the consequences arising from the application, use, or misuse
of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed