The lowdown on libido lifters

Ever felt like the sexual part of you have gone to sleep? Have you always enjoyed sex, but lately you find you are gradually losing interest? You are not alone. You belong to a growing number of women searching for remedies to boost a flagging sex drive.

In a recent survey, 87% of women seeking routine gynaecological care reported lack of sexual interest as their chief worry, and are looking for ways to correct the problem.

But the fact is that libido in women is not always on the up and up. A woman’s desire for sex can be squelched by birth control pills, breast-feeding, the shutdown of hormones with menopause, mood-elevating drugs, and other things.

There is generally no “quick fix” for women’s sexual desire problems, says Sandra Leiblum, PhD, director of the Centre for Sexual and Marital Health at the Robert Wood Johnson Medical School in New Jersey. Loss of female sexual desire is usually a complex problem that goes beyond hormones or plumbing, she says. Fixing it requires “a blend of biological, psychological, and relationship solutions.”

A number of passion picker-uppers are available and work by trying to make up for lost testosterone (the hormone that drives desire), by arousing the clitoris, or both. However, none is backed by conclusive evidence, however, and only one is FDA-approved for enhancing female libido.

Viagra for women

Viagra, the famously successful erection-stimulating drug, is now being offered to women to boost their sex drive. Viagra helps the body produce nitric oxide, which plays a role in blood flow to the clitoris, labia, and vagina. It can raise sensation and increase lubrication. Whether it really perks libido or not is questionable, though.

Viagra was tested on 500 women in an international study, which found that it prompted no more sexual interest than a dummy pill.

Many participants may have had non-arousal-related problems, says the study’s investigator, Rosemary Basson, MD, clinical professor of obstetrics, gynaecology, and psychiatry at the University of British Columbia in Vancouver. The picture may be more positive when future studies focus on women whose low libidos stem from estrogen loss. Losing estrogen means less blood flow to the genitals.

Other possible treatments for women are formulations containing the amino acid L-arginine. Women who have used this nitric oxide booster report increased arousal. Combined with other enhancers, desire may also be boosted, according to preliminary results from an ongoing study.

For a month, women with low libido took Arginmax, a dietary vitamin and mineral supplement containing L-arginine, ginseng (an herb touted for energy enhancement), gingko biloba (a blood flow booster), and damiana (a time-honoured women’s libido herb). “The positive reports and no side effects suggest this may be a good non-drug option,” says Mary Lake Polan, MD, MPH, professor and chair of the Department of Obstetrics and Gynaecology at Stanford University Medical School, who led the study.

Another non-drug option is the EROS-CTD (for clitoral therapy device). This prescription device is placed against the clitoris: There, vacuum pump action increases blood flow. Pilot studies involving postmenopausal women showed that more than three-fourths of the women reported overall sexual satisfaction after three months of weekly use.

Viagra, and other treatments that focus mainly on the genitals aren’t likely to become the ultimate passion booster for females. “The connection between arousal and desire is complex in women,” says Leiblum.

Unfortunately, we lack research about these connections, says Polan. We do know that some women report feeling sexually numb despite being able to feel arousal in their clitoris, she says. This may happen because of a disconnect somewhere in the nerve pathways that link their genitals to their central nervous system and brain, where sex drive originates.

We do know that some women report feeling sexually numb despite being able to feel arousal in their clitoris, says Polan.

These pathways have not been identified. But perhaps treatments that stimulate the genitals may reawaken desire for some — though not all –women,” says Polan.

Another approach that is now being tried involves the antidepressant Wellbutrin (bupropion). Many antidepressants kill desire because they boost serotonin, a libido-hampering hormone. Bupropion, however, raises dopamine, a hormone associated with libido.

In a recent preliminary study, nearly 40% of nondepressed women suffering low sexual desire reported they were satisfied with their libido after taking a slow-release form of bupropion for two months. Until results from a planned larger trial are in, however, the drug should not be used as a first-line treatment, researchers say.