Case Studies: Herbs for Women’s Sexual Dysfunction

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Maca is considered an energy, yin, and sexual tonic.

Where does human energy, including sexual energy, come from, and how do we use it? Can human energy be expressed in different ways to be used as we choose? These are questions that have occupied my mind for many years, because I see vital energy as the key issue associated with many diseases and health concerns.

As a clinician, working with people who have low energy and/or a low sex drive can be challenging: Sexual dysfunction is often more than a purely physical phenomenon, and many complex emotional issues may be involved. Even if a physical problem is present, such as low testosterone levels, what emotional influences may be at work, affecting the body’s ability to reduce testosterone production? But sexual dysfunction is not necessarily all in one’s head, either. Lowered libido is a common symptom of anemia, or “blood deficiency,” in Chinese medicine. Hormonal imbalances, malnutrition, liver disease, heart disease, and many chronic illnesses can all disrupt normal sexual desire.

Two sexual dysfunction cases

I remember two very different patients, Rachael and Leslie. Rachael had been coming to the clinic for more than two years and originally came in for a variety of symptoms such as insomnia, poor appetite, weight loss, and general fatigue. After a few sessions, she expressed that she also had absolutely no interest in sex but told me she “had an interest in having an interest.”

Rachael’s lack of sexual energy was not surprising. After I looked closely at her tongue, felt her pulse, and noted the dark circles under her eyes and her red tongue with no coating, I made a preliminary diagnosis of a deficiency of vital energy reserve (kidney qi) and “kidney yin.” The yin substances in Chinese medicine relate to the fluids of the body as well as hormones and neurotransmitters. The kidneys store the body’s qi.

Although Rachael said she slept about nine to ten hours nightly and had a low-stress job, her energy resources were on empty. After we discussed her daily activities and health habits, I was convinced that her inactivity and highly strung nervous system, coupled with her naturally obsessive, intellectual personality and a strong desire to be successful, were good things for us to focus on. I also thought we should use herbal tonics for her kidney yin and kidney qi deficiency.

In contrast, Leslie’s lack of sexual desire was puzzling. She had a normal amount of energy–she worked hard and didn’t usually feel tired at the end of the day. Leslie was a marketing manager and characterized her job as extremely stressful. She was completely uninterested in sex and was perfectly happy to be single and without attachments. She had come into the clinic for mood swings.

Leslie looked healthy and vital, and her eyes were bright. We began a series of acupuncture treatments, and after a few weeks she said her moods were more even than they had been for some time. Her pulse was a bit fast and taut, and her tongue was fairly red on the tip, both signs of an active nervous system and the effects of stress. An experienced herbalist will usually prescribe an herbal formula based on a patient’s present condition, taking into account his or her constitutional makeup and symptoms. With Leslie, I thought her liver might be hyperactive, which would adversely affect her heart system, which corresponds to the nervous system in Western medicine.

Leslie’s herbal formula consisted of a tincture of my favorite Western herb to regulate and calm the liver, boldo (Peumus boldus). For her nervous system, I gave her a concentrated powder of California poppy (Eschscholzia californica). I wasn’t sure if it was the herbs or the acupuncture that made the difference, but Leslie’s tongue and pulse looked much better after about six weeks, and she said she felt calmer and was sleeping better. But her sexual energy, or lack of it, didn’t change one bit.

Meanwhile, Rachael was also coming in for acupuncture, and I was encouraging her to walk, garden, jump rope–just move somehow. She called herself a couch tomato. I almost recommended green tea for a little caffeine to get her moving, but her nervous system was already too strung out. For herbs, I gave her two formulas, one to help activate her blood and get her vital energy moving into her muscles and throughout her body, and the other to support her kidneys and yin.

Rachael’s program

For Rachael, I created a formula consisting of 40 percent puncture vine seed (Tribulus terrestris), 20 percent American ginseng root (Panax quinquefolius), 30 percent vitex (Vitex agnus-castus), and 10 percent Solomon’s seal root (Polygonatum biflorum). If Solomon’s seal is not available, omit it and add an extra 10 percent to the vitex amount. To make your own formula, blend the tinctures, and take 2 or 3 droppersful in a little water or peppermint tea, twice daily.

I also had Rachael take saw palmetto (Serenoa repens)–the “supercritical” (hexane-free) extract in capsules–to help regulate hormones. She took 2 capsules in the evening around dinnertime.

I combined 50 percent motherwort (Leonurus cardiaca), a traditional European herb for moving the blood, benefiting the heart, and regulating the thyroid with 25 percent prickly ash bark (Zanthoxylum spp.), a traditional American blood-moving herb. To this, I added 25 percent cayenne (Capsicum annuum) to move and warm the blood without harming the yin fluids. If the hot sensation of the cayenne is too much, try taking 2 capsules of cayenne powder, twice daily before meals. Along with this, you can take a tincture of 75 percent motherwort and 25 percent prickly ash bark, 2 to 3 droppersful twice daily. I also had Rachael take a teaspoon of maca (Lepidium meyenii) powder in her morning energy shake. Maca is a traditional herb from the Andes that is considered an energy, yin, and sexual tonic.

Rachael’s program was complex, and I often recommend patients just do as much as they can, even if they take only saw palmetto and maca for a few months and add the other herbs gradually. Rachael didn’t flinch at trying the herbs I recommended–and she did get results; after about three months, she was feeling more energetic. I had her discontinue the motherwort blend and saw palmetto but continue with the tribulus and American ginseng formula for another two months.

Strengthening a weakened body system takes time–at the very least, one month for every ten months the weakness is felt. After five months, Rachael told me she was dating again and even enjoying a few “adventures.” She didn’t define the term, and I didn’t ask, but she told me she was satisfied with the results.

Leslie’s results

Leslie also continued to come in, and she looked forward to her acupuncture treatments. She continued taking liver- regulating herbs and the California poppy extract, which she said helped keep her feeling good, even with a hectic schedule. After about three months, I switched the boldo to a gentler liver-relaxing formula of artichoke leaf (Cynara scolymus), gentian root (Gentiana lutea), dandelion root (Taraxacum officinale), and angelica root (Angelica archangelica).

Leslie’s sexual energy was still not present, but I finally got a major clue about why. After four months, she told me she had been taking a selective serotonin reuptake inhibitor (SSRI) for mild depression. Even though I had specifically asked about drugs, she hadn’t told me until she casually mentioned it during a weekly treatment. Low sex drive is one common side effect of SSRIs. Leslie and I talked about alternatives for SSRIs, including St. John’s wort (Hypericum perforatum) and ginkgo (Ginkgo biloba). I told her that recent research shows that St. John’s wort works as well as SSRIs for mild to moderate depression and has fewer side effects, but she wasn’t willing to try the herbs for the time being. She was convinced the SSRI was helping and was willing to accept the tradeoffs. She felt her quality of life had improved over the past year, and we agreed that was of primary importance. 8

Christopher Hobbs’s case studies are gleaned from his thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is an Herbs for Health editorial adviser and licensed acupuncturist. He is the coauthor of Vitamins for Dummies (IDG, 1999) and many other books.

“Case studies” is not intended to replace the advice of your health-care provider.

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