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Women's Sexual Health 40-41_Supplement Science.v1_Layout 1 12/12/14 11:37 AM Page 40 SUPPLEMENTSCIENCE Women’s Sexual Health By Gene Bruno, MS, MHS, RH(AHG) Dean of Academics, Huntington College of Health Sciences exual dysfunction in men and twice daily over two menstrual cycles marker for measuring DHEA. women are relatively common, (starting in follicular phase). The results In a double-blind, placebo-controlled Swith research indicating that 40-45 of validated questionnaires showed a study,8 280 healthy women and men percent of adult women and 20-30 per- significant increase in scores for sexual (60-79 years old) were given 50 mg cent of adult men have at least one sex- functioning in those participants in the DHEA or placebo daily for a year. ual dysfunction (e.g. erectile dysfunc- Libifem group, including increases in Besides the reestablishment of a tion, hypogonadism/low T, low estradiol sexual cognition/fantasy, sexual arousal, "young" concentration of DHEA-S, and sexual dissatisfaction), the preva- sexual experience, orgasm and sexual women also experienced a small lence of which increases with age.1 drive/relationship. The placebo group increase in testosterone and estradiol. Other research2 shows that sexual dys- showed no difference except for a sig- Furthermore, there was a significant function is also more likely among men nificant increase in sexual drive/relation- increase in most libido parameters was and women with poor physical and ship at week 8 of treatment. in women >70 years old. emotional health, and is associated with After eight weeks, the Libifem group In a randomized, double-blind, place- negative experiences in sexual relation- also experienced a significant increase bo-controlled study,9 24 women with ships and overall well-being. in estradiol (an estrogen) compared to adrenal insufficiency received 50 mg Furthermore, studies3 have found a high the placebo group (p<0.05). DHEA or placebo daily for four months. prevalence of low sexual desire (43 per- Treatment with DHEA corrected the ini- cent) among women. This article DHEA tially low serum concentrations of addresses the sexual health of women, Produced in the adrenal glands and DHEA, DHEA-S, androstenedione and and nutraceuticals that may be benefi- testes, dehydroepiandrosterone or testosterone. Furthermore, DHEA signif- cial for this purpose (I will address the dehydroepiandrostenedione (DHEA) is a icantly increased the frequency of sexu- sexual health of men in the March 2015 prohormone, which is transformed into al thoughts (P=0.006), sexual interest issue of Vitamin Retailer). testosterone and/or estrogens.5 In (P=0.002) and satisfaction with both females, adrenal-derived testosterone is mental and physical aspects of sexuality Libifem important in maintaining normal pubic (P=0.009 and P=0.02, respectively). Libifem is a fenugreek seed extract and axillary hair, and after the DHEA also significantly improved over- standardized to 50 percent Fenuside, a menopause DHEA may also be an all well-being, as well as scores for proprietary term used to describe phy- important source of estradiol once con- depression and anxiety. tochemical constituents, which include verted peripherally. However, plasma furostanol saponins and steroidal DHEA decreases about 80 percent L-arginine + Yohimbine saponins. In a double-blind, random- between ages 25 to 75,6 and DHEA L-arginine is a semi-essential amino ized, placebo-controlled study,4 80 secretion has already decreased by a acid,10 which is converted into nitric healthy women (aged 21 to 49) in stable mean of 60 percent at time of oxide (NO) in the body. NO, causes relationships received 300 mg Libifem menopause.7 DHEA-S is the blood blood vessel vasodilation,11 which 40 VITAMIN RETAILER WWW.VITAMINRETAILER.COM ■ JANUARY 2015 40-41_Supplement Science.v1_Layout 1 12/12/14 11:37 AM Page 41 promotes circulation. Consequently, etc.) than the placebo group. Ernst, M., Schulte, H.M. and Allolio, B. through its role as an NO precursor, Vitex has other benefits for the Dehydroepiandrosterone replacement in women with L-arginine offers many benefits for car- female reproductive system. Research adrenal insufficiency. N Eng J Med 1999;341:1013–1020. diovascular health, as well as for sexual has shown that women with menorrha- 10 Castillo, L., Chapman, T.E., Sanchez, M., Yu, Y.M., function due to increased circulation to gia (i.e., heavy menstrual flow) have ele- Burke, J.F., Ajami, A.M., Vogt, J., Young, V.R. Plasma argi- the genital region.12 vated levels of the hormone prolactin.20 nine and citrulline kinetics in adults given adequate and The bark of the yohimbe tree Vitex may therefore be valuable in cases arginine-free diets. Proc Natl Acad Sci USA 1993;90:7749- (Pausinystalia johimbe, syn. Pausinystalia 7753. of menorrhagia, as it has been shown 11 Appleton, J. Arginine: Clinical potential of a semi- yohimbe) has a history of use as an decreasing elevated prolactin levels.21 It essential amino. Altern Med Rev 2002;7(6):512-22. aphrodisiac in West Africa.13 It is the has certainly been shown to be helpful 12 Wang, R., Ghahary, A., Shen, Y.J., Scott, P.G., alkaloid yohimbine, typically derived in other menstrual-related situations, Tredget, E.E. Human dermal fibroblasts produce nitric from yohimbe bark, which provides the oxide and express both constitutive and inducible nitric such as breast pain and amenorrhoea or oxide synthase isoforms. J Invest Dermatol predominant pharmacological activity, scanty/irregular periods.22 Vitex, howev- 1996;106:419-27. and has been used for about 90 years er, is not a fast-acting herb. 13 Betz, J.M., White, K.D., and der Marderosian, A.H. as a treatment for male and female sex- Consequently, it may need to be used Gas chromatographic determination of yohimbine in com- 14 mercial yohimbe products. J AOAC Int 1995;78:1189-94. ual difficulties. continuously for three to six menstrual In a randomized, double-blind, place- 14 Riley, A.J. Yohimbine in the treatment of erectile cycles before results are forthcoming. disorder. Br J Clin Pract 1994;48:133-6. bo-controlled, three-way cross-over Other current and evidence based 15 Meston CM, Worcel M. The effects of yohimbine 15 study, 24 postmenopausal women with uses for vitex include, but are not limited plus L-arginine glutamate on sexual arousal in post- Female Sexual Arousal Disorder to: insufficient lactation, infertility (due to menopausal women with sexual arousal disorder. Arch received treatment with either L-argi- Sex Behav 2002;31:323-32. decreased progesterone levels or hyper- 16 Wutke W, et al in Loew, Dand Rietbrock N, eds: nine glutamate (6 g) plus yohimbine prolactinemia) and teenage acne.24, 25 A Phytopharmaka in Forschung und Klinischer Anwendung; HCl (6 mg), yohimbine alone (6 mg) or good daily dose of vitex is 40 mg, stan- 1995. Steinkopff, Darmstadt. placebo. Sexual responses to erotic dardized 0.5 percent agnuside. 17 Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, et stimuli were measured approximately al. [Vitex agnus castus extract in the treatment of luteal 30, 60 and 90 minutes following treat- phase defects due to latent hyperprolactinemia. Results of Conclusion a randomized placebo-controlled double-blind study]. ment, and resulted in substantially There is no single nutraceutical that will Arzneimittelforschung 1993; 43(7):752-6. increased vaginal-pulse amplitude work well for every woman with a sexual 18 Dittmar FW, Böhnert KJ, et al. Premenstrual syn- responses to the erotic film at 60 min- drome: Treatment with a phytopharmaceutical. dysfunction. Nevertheless, the nutraceu- utes post administration compared with Therapiwoche Gynäkol 1992; 5:60-68. ticals presented in this article are likely 19 Schellenberg R. Treatment of the premenstrual syn- placebo. to offer some level of benefit to many drome with agnus castus fruit extract: prospective, ran- women with sexual dysfunctions. domized, placebo controlled study. BMJ 2001; 332:134-7. Vitex Agnus Castus VR 20 Ballinger CB, Browning MCK, Smith AHW. Menstrual irregularities and imbalances Hormone profiles and psychological symptoms in peri- References: menopausal women. Maturitas 1987; 9(3):235-51. in certain hormones can also have a 1 Lewis RW, Fugl-Meyer KS, Bosch R, Fugl-Meyer AR, 21 Milewicz A, Gejdel E, Sworen H, Sienkiewicz K, et negative effect on sexual health in Laumann EO, Lizza E, Martin-Morales A. al. [Vitex agnus castus extract in the treatment of luteal women. That’s where the herb Vitex Epidemiology/Risk Factors of Sexual Dysfunction. J Sex phase defects due to latent hyperprolactinemia. Results of agnus castus (aka, chaste berry, chaste Med. 2004;1(1):34-9. a randomized placebo-controlled double-blind study]. tree) can help. 2 Laumann EO, Paik A, Rosen RC. Sexual Dysfunction Arzneimittelforschung 1993; 43(7):752-6. in the United States: Prevalence and Predictors. JAMA. 22 Halaska M, Beles P, Gorkow C, Sieder C. Treatment It has been clinically established that 1999;281:537-544. of cyclical mastalgia with a solution containing Vitex vitex increases luteinizing hormone (LH) 3 Kingsberg SA, Rezaee RL. Hypoactive sexual desire agnus extract: results of a placebo-controlled double- and progesterone production through in women. Menopause. 2013 Dec;20(12):1284-300. blind study. The Breast 1999; 8:175-81. its activity on the neurotransmitter 4 Rao A, Steels E, Beccaria G, Vitetta L. Influence of 23 Veal L. Complementary therapy and infertility: an dopamine.16 Vitex also decreases elevat- Libifem, a specialized extract of Trigonella foenum-grae- Icelandic perspective. Complement Ther Nurs Midwifery 1998; 4(1):3-6. 17 cum (Fenugreek) on sexual function, hormones and ed prolactin levels. The net result is metabolism is healthy menstruating women, in a ran- 24 Kuhn MA, Winston D. Herbal Therapy & helping re-establish normal balance of domized placebo controlled study.
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