Is better sexual health and enjoyment possible with supplements, natural herbs and nutrients that are available without a prescription? Does diet or food selection play a role in sexuality? There is little doubt that this it true. There are quite a number of potent and natural herbs that help improve sexual desire and stamina. All vitamins and minerals are important in the long run, but there is no vitamin that I know of that noticeably improves sexual desire or performance within hours of ingestion. People seem to be very pleased when they have more sex than their friends and the use of such natural enhancers can increase the urge and lead to closer intimacy with one's partner.

Natural products for sexual health, supplements that work in a man and woman
Ray Sahelian, M.D. and his research staff have tested various doses and extracts of dozens of herbs from a number or raw material suppliers to determine the ideal dosage and combination for optimal aphrodisiac properties with the fewest side effects. After years of research, a unique proprietary blend with more than a dozen herbal extracts from the best raw material suppliers has been created. The exact dosages and extract potencies of this aphrodisiac blend is a close kept secret. Passion Rx supports and enhances healthy libido and sexual thoughts; Erectile function; better orgasms and climaxes; and genital organ sensation.

Now, the author of Natural Sex Boosters, has mixed together exotic herbs from the Amazon jungle, India, China, Malaysia, and Africa, that improve healthy desire and performance, as well as to simply enhance sexual pleasure and sexual health.
   The potent herbal extracts in Passion Rx include ashwagandha, catuaba, cnidium monnieri, coleus forskohlii extract, damiana herb, horny goat weed, maca, mucuna pruriens, muira puama, passion flower, rhodiola, shilajit, tribulus terrestris, and tongkat ali.  A version without yohimbe is also available.

Journal Sex Medicine 2015. A Urologist's Guide to Ingredients Found in Top-Selling Nutraceuticals for Men's Sexual Health. Use of supplements is common among men seeking urologic evaluation for sexual health matters. With a dizzying array of formulations available and little regulation on the dosage, purity, or ingredients found in these products, the health effects of nutraceuticals are often confusing to patients and medical practitioners alike. In this review, we set out to concisely summarize the data on ingredients found within the top-selling nutraceutical agents marketed for men's sexual health in order to provide a clinical guide for urologists. We used sales data from the most popular retail provider of men's health supplements to identify the top-selling products marketed toward improvement of men's sexual health. We summarized the available information related to the ingredients, dosage, cost, and mechanism of action for these substances and performed an extensive literature search to identify and review the current evidence available for each of the most common ingredients found in these nutraceuticals. The top-selling nutraceuticals marked for men's sexual health contain a blend of multiple supplements (up to 33 in one formulation identified), the most common being ginseng, tribulus, zinc, horny goat weed, B complex vitamins/trace minerals, fenugreek, L-arginine, maca, DHEA, ginkgo, and yohimbine. The currently available medical literature evaluating the efficacy of these substances is generally of low quality. Despite the dearth of evidence supporting nutraceutical agents in the men's health arena, these substances are still commonly used by patients. As these products can affect the health and well-being of men presenting to a urology clinic, a familiarity with commonly used agents can help the urologist appropriately counsel their patients.

Supplements do work, research with pine bark extract and nitric oxide supplement
Arch Ital Urology Andrology 2015. Improvement of seminal quality and sexual function of men with oligoasthenoteratozoospermia syndrome following supplementation with L-arginine and Pycnogenol. We evaluated the effectiveness of antioxidant co-supplementation therapy using Larginine and Pycnogenol in Japanese men with oligoasthenozoospermia and mild erectile dysfunction (ED). A total of forty-seven adult males with oligoasthenoteratozoospermia syndrome (OAT) were eligible for enrollment. The effectiveness of supplementation with a combination of L-arginine 690 mg and French maritime pine bark extract Pycnogenol 60mg for OAT and ED was investigated. The sperm concentration was enhanced significantly after treatment 2 and 4 months. This study suggests that the combination of Pycnogenol and L-arginine Edicare is helpful for infertile men to ameliorate simultaneously quality of sperms as well as erectile functions.

Food, diet, what we eat, does what we consume have an effect?
Garlic for better sex? Onions help. The combination of onions and garlic works even better
Through my years of experimentation with various plant products I have noticed that garlic consistently helps with erectile function. The effects usually begin a day after ingesting quite a few cloves or segments. I recently came across a study that validated my findings. An experiment done in China shows a comound in garlic called S-allyl cysteine restores erectile function. The investigators say, "Excessive production of reactive oxygen species by an overactive nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system in penile tissue is an important mechanism of erectile dysfunction (ED). S-allyl cysteine (SAC), a bioactive component derived from garlic, restored erectile function in diabetic rats by preventing ROS formation through modulation of NADPH oxidase subunit expression." Unfortunately since garlic breath stays on for at least a day, I usually am able to consume it only when I know I will not be interacting closely with people for at least a day or so. Many patients have volunteered to me similar experiences of sexual enhancement after consuming garlic.

Age and the elderly
Women become less sexually active and less interested in sex as they get older, on average, but there are still plenty of women who continue to have sex and maintain their sexual desire into their 60s and beyond. The most common reasons women cite for not being sexually active include lack of interest, lack of a partner, a partner's physical problems, and a partner's lack of interest in sex. A very small percentage of women say that their own physical problems are the cause. Journal of the American Geriatrics Society, 2009.

Psychological, mental
Taking a sexual history should be routine in all patients by family practice or internal medicine doctors. The causes of psychological sexual dysfunction and poor men's and women's sexual health are numerous, and it is difficult to list them all, but most often low libido is related to depression, performance anxiety, marital stress or relationship problems, life crisis, financial difficulties, religious repression, or some type of mental illness. return of sexual health is possible through various forms of therapy, stress release, vacation, etc.
   Young men and women who suffer from depression are much more likely than their non-depressed peers to have multiple sex partners in a given year.
   Young people may abstain from seeking sexual and reproductive health care because they fear their parents will find out.

Long hours of deep sleep provides for a better sex life in both men and women.

The sex drive of women plummets sharply as they juggle the increasing demands of partners, children and careers. One in 10 women questioned for a survey admitted losing interest in sex for at least six months in the past year. Married women were shown to be much more likely than single men or women to have sexual problems. Both men and women tend to suffer in silence when faced with sexual health problems like lack of sex drive, premature ejaculation or erectile dysfunction.

Restoration of couple's intimacy and sexual health vital to reestablishing erectile function.
J Am Osteopath Association. 2004 .
Yet even with a portfolio of effective treatment modalities, such as phosphodiesterase type 5 (PDE5) inhibitors, nonpharmacologic interventions for sexual health should be considered as means to support and augment the effects of these agents. Of equal value--and necessity--is the involvement of the man's partner in both the assessment and treatment processes. Because men see the primary care physician's office as a natural and expected place in which to address issues of sexual health, those healthcare professionals who are prepared to initiate discussion of ED can offer patients and their partners the possibility of effective and enduring treatment success and the restoration of a satisfying sexual health relationship.

Males who are young and who prefer pornography to real-world sexual encounters are sometimes unable to perform properly sexually with their partner.

There are a few major areas involved in male and female sexual health:

Hormonal
Androgens, such as testosterone, are a major component of female and male sexual health and good libido. Testosterone levels decline about 1 percent each year in men, which may contribute to lower male libido with aging. Testosterone also declines with age in women leading to an increase in dysfunction. Women who have had surgical removal of the ovaries notice a drop in sexual interest. Replacement of androgens can be helpful in those with age related sexual dysfunction. Testosterone is available by prescription only. An over the counter hormones, such as DHEA, converts into testosterone and thus has a positive influence on libido. Pregnenolone is another over the counter hormone that may increase testosterone levels and thus enhance libido.

Q. My doctor told me that I need testosterone to boost my sexual health ever since I've had my ovaries removed. Do you think herbs and supplements can restore sexual health without resorting to hormones? I really don't want to take testosterone.
   A. Most doctors don't realize that there certain natural herbal products have sexual health enhancement abilities as much as the hormones.

Cochrane Database Syst Rev. 2013. Hormone therapy for sexual function in perimenopausal and postmenopausal women. HT treatment with estrogens alone or in combination with progestogens was associated with a small to moderate improvement in sexual function, particularly in pain, when used in women with menopausal symptoms or in early postmenopause (within five years of amenorrhoea), but not in unselected postmenopausal women.

Daily exposure to sunlight early in the morning improves sexual satisfaction scores and boosts testosterone levels in men with libido or erection problems.

Vascular, blood vessels
Alterations in the flow of blood to and from the penis are thought to be a common cause of male erectile dysfunction. For instance, medical conditions such as atherosclerosis (hardening of the arteries), high cholesterol level, hypertension, or diabetes reduce blood flow to the penis and genital organs thus leading to difficulty with erection or genital swelling. Proper diet and exercise can bring back good sexual health. Additional factors that can impede blood flow include penile injury, surgery in the pelvic or abdominal area, and sitting on a bicycle too long. Men who log several thousand miles a year on their mountain bikes suffer scrotal damage that could reduce their fertility.  

Neural
Nerve damage from disorders such as diabetes, multiple sclerosis, Parkinson’s disease, and stroke affect the brain’s ability to respond to sexual stimulation. In women, abdominal or pelvic operations can occasionally lead to nerve damage. Sexual dysfunction is common in men undergoing surgical treatment for prostate enlargement or cancer.

Chemical
Some chemicals involved in the human sexual response and libido include dopamine neurotransmitter, acetylcholine, and nitric oxide. Sexual enhancement is quite likely through manipulation of these brain chemicals by using natural herbs.

Other Causes
Symptoms of itchy, tearing eyes and nasal congestion due to seasonal allergies interfere with individuals' ability to enjoy sex. Women with untreated seasonal allergies have reduced desire, arousal, ability to reach orgasm and intercourse satisfaction compared . Allergies affect men's erectile function, intercourse satisfaction, sexual desire and overall satisfaction with intimacy.
   Sexual dysfunction that commonly occurs in morbidly obese men improves after weight loss surgery. Exercise and weight loss may improve male sexual health in obese men, researchers in Italy report. Of more than 100 obese men with erectile dysfunction, nearly a third regained normal sexual health and function after participating in an intensive weight loss program. Evidence from epidemiological studies suggests that smoking, especially current smoking, significantly increases the risk of ED.

Medical diseases
Certain medical conditions reduce libido, performance, or enjoyment. These include hypertension, diabetes, high cholesterol, cardiovascular disease, peripheral vascular disease, and neurologic disorders, and insomnia.

Drugs and medications that interfere
Drugs that interfere with libido or sexual health include some anti-hypertensives, SSRIs, sedatives, and beta-blockers. Alcohol's negative affect on libido increases with age. Smoking can reduce genital blood flow. SSRIs may be useful in premature ejaculation, but so can the natural nutrient 5-HTP. Some people give kava a try.

Drugs responsible for adverse sexual effects in both sexes are the selective reuptake inhibitors (SSRI). They can cause erectile dysfunction and ejaculatory disorders, and in both sexes orgasmic and arousal disorders. Among the drugs whose mechanism is primordial are the neuroleptics firstly, among antalgics tramadol and strong opioid agonists are also potentially deleterious to different degrees on sexual function. Among antihypertensive drugs only thiazide diuretics increase the risk of erectile dysfunction. Among alpha blockers tamusolin and silodosin are frequently responsible for anejaculation. On a less serious level, 5α-reductase inhibitors are associated with sexual disorders in men treated for lower urinary tract symptoms (LUTS) linked to symptomatic benign prostatic hypertrophy. LH-RH antagonists and anti-androgens suppress desire in men, tamoxifen reduces this in women and can also cause dyspareunia and vaginal dryness.

Acta Pol Pharm. 2013. Management of drug induced sexual dysfunction in male rats by ethyl acetate fraction of onion.

Gen Hosp Psychiatry. 2015. Antidepressant-induced sexual dysfunction during treatment with fluoxetine, sertraline and trazodone; a randomized controlled trial. Compared with fluoxetine, and sertraline, trazodone was associated with the fewest sexual dysfunction. Fluoxetine was also associated with more sexual dysfunction than sertraline. Further research to better identify the differences among antidepressant drugs is recommended.

Childbirth, after pregnancy
Sexual pain is common after childbirth. Nearly nine in 10 women experience pain the first time they have sexual intercourse after childbirth. What's more, one-quarter still report painful sex a year later.

Sexual health in seniors
Many older adults maintain an active sex life, often into their 80s. However, ill health and lack of an intimate relationship are major impediments among individuals as they grow older.

Circumcised or not circumcised?
Women find sex just as pleasurable with circumcised men as with men who are uncircumcised. Some experts have speculated that removal of the foreskin might make sex less pleasurable for women. But in a study, conducted in Uganda, the overwhelming majority of women indicated that sex was equally satisfying. BJU International, December 2009.

Research studies
There is a poorly understood syndrome that is the opposite of the most common sexual complaint in women. Instead of failing to get aroused, women suffering from persistent sexual arousal syndrome (PSAS) experience constant, unprovoked feelings of excitement. Persistent sexual arousal syndrome occurs when a woman becomes involuntarily aroused for extended periods of time in the absence of sexual desire. But rather than being a pleasant sensation, it is embarrassing and very distressing for women. Some sufferers have reported being suicidal.

Obese women who start to lose weight will also see an improvement in the quality of their female sexual health, according to a U.S. study released in October, 2005. Even a moderate weight loss reduced complaints of feeling sexually unattractive and led to improved desire, according to the study presented at the annual meeting of The North American Association for the Study of Obesity (NAASO) in Vancouver.

Exercises that focus on strengthening the muscles at the base of the penis, known as the pelvic floor, appear to be a useful treatment for erection difficulties and male sexual health. The exercise training was provided by a physiotherapist who instructed the men to tighten their pelvic floor muscles as if they were trying to prevent gas passing. In addition, emphasis was placed on the ability to retract the penis and lift the scrotum using pelvic muscles.

For men with low sperm counts, sexual abstinence -- but only for a day -- increases semen quality. More prolonged sexual abstinence may actually reduce sperm numbers. After only two days of abstinence, sperm from patients with male factor infertility initiate a process of quality degradation. The findings are important for men trying to father children through in vitro fertilization, or even through the natural method.

Using condoms regularly does more than protect couples from unwanted pregnancies and sexually transmitted infections. Habitual use is crucial for women's sexual health since it also reduces the odds of women getting repeated bouts of pelvic inflammatory disease (PID), a condition that can result in pelvic pain and infertility, according to a study appearing in the August issue of the American Journal of Public Health.

Kissing of multiple partners by teenagers can raise the risk for meningitis.

Sexual health of penis, phimosis
Young boys with phimosis -- constriction of the foreskin opening that prevents it being retracted over the head of the penis -- can be treated successfully without surgery. After a few weeks of treatment with a potent steroid ointment, betamethasone, the foreskin can be easily retracted in the vast majority of cases. Urology, 2008.

Sexual health natural improvement questions
Does exercise lead to better sexual health?
   Without a doubt. Exercise can help you sleep deeper which does wonders for libido. Exercise also makes you feel better about your body, and this could also have an influence on your libido. Excessive physical activity, such as training for marathons, could have a short term negative influence.

Q. Do penis enlargement pills work? Many of them have sex herbs in them.
   A. See penis enlargement for information. Sexual health may be improved, but not the size of the penis.

Q. A doctor at a women' s sexual health clinic told me that testosterone works well to enhance sexual health. Is there a natural alternative to testosterone?
     A. DHEA is a hormone considered the grandfather of testosterone and it is available over the counter, but caution is suggested if you plan to use it. Female sexual health can be temporarily improved using androgens such as testosterone or DHEA.

Q. What food would be helpful for better sexual health?
     A. Fish and vegetables, along with some culinary spices are likely to better sexual health. Don't expect a food to improve sexual health right away.
Q. I am a man with a sexual health problem, more specifically premature ejaculation. Do you have any thoughts on this sexual health issue?
     A. See premature ejaculation for sexual health information on this topic.
Q. I have a sexual health question. Does chocolate improve sexual health?
     A. Cocoa has flavonoids that could help dilate blood vessels, but I am not that impressed with chocolate as an aphrodisiac.

Q. I saw a women's sexual health product advertised in a magazine. It was actually a cream that promised better sexual enjoyment. Do these creams work?
     A. I don't have clinical experience with these creams, so I don't know.
Q. I need sexual health advice. Ever since I started on Paxil, I seem to have lost my sex drive. This actually makes me feel a little depressed.
     A. SSRIs are known to lower sexual desire. Perhaps your doctor can switch you to an antidepressant that does not have sexual side effects.
Q. What do you think of yohimbe as a sexual health supplement?
     A. Yohimbe is a powerful sexual health supplement for a man, and sometimes women appreciate it too. However, there is a narrow range of effectiveness. Too little does not work, too much causes side effects, and sometimes it is difficult to find the right amount that helps without causing the unpleasant effects.

I did an online search for a male sexual health supplement, and there are hundreds of them. How do I know which one works?
   Basically, you really can't tell till you try. You are right, there are literally hundreds of male and female sexual health supplements on the market, and I know for sure that many of them work since I have tried them and I have had positive feedback from countless people who have tried them.

Q. I enjoy researching items written by you and your team. I appreciate your objectivity and depth. I read the following at the Mayo Clinic website: I have a moderate case of pyronies and have started taking vitamin e. However, I noticed that the site said the following which seems to contradict some of the other materials that I have come across on the web: Vitamin E may cause allergic skin reactions (inflammation or itching), blurred vision, changes in cholesterol levels, changes in insulin resistance, diarrhea, dizziness, fatigue, flu-like symptoms, headache, heart conditions, increased risk of death, increased risk of fainting or falls, increased risk of heart failure, increased risk of high blood pressure in pregnancy, increased risk of stroke, increased risk of tuberculosis, kidney dysfunction, nausea, severe response to infection (in preterm babies), sexual dysfunction, stomach pain, vision loss, and weakness. This reference that Vitamin E may cause “sexual dysfunction” is the only place I have bumped into it and I can’t find why the Mayo clinic article would say that. Other articles and references on the web seem to speak to Vitamin E perhaps having a more positive benefit on sexual function. Is there any reason to believe that Vitamin E usage (topical to the site of the Peyronie's scar and oral ingestion) should raise concern that it will lead to or be a causative of sexual dysfunction as the article states?
   A. Not that I am aware of.

Is Vigorelle a good sexual health product, how many pills should be taken?
   We have not tested this product ourselves so we don't know if this product is helpful and what the right dosage would be.

I have a question about my sexual health. Due to the overusage of my sexual system in my teenage years through masturbation and porn, my body seems very unresponsive and insensitive to sexual stimulation. I cannot obtain a hard erection any more nor does orgasm give me much pleasure. I am in my early twenties and seem to have the sexual health of a 60 year old. What can I do?
   Taking a few days off from masturbation may help restore sensitivity. We also suggest reading the option available at the libido page.

I have tried Lexapro off and on, and hate being on it, sexual side effects and over all being numb. I gave bad PMS, and Anxiety starting about 2 weeks before my period, I have tried B vitamins and they seem to make me worse (unless this is all in my head-sometimes I wonder) What are some good things to try for these problems.
   You may wish to review the pages on PMS and Anxiety for natural supplement options.

What would be the best single supplement you recommend for a man to recover from sexual exhaustion and depletion?
   There are a number of single herbs that are of benefit and many herbal formulas. It is not possible to predict in any one individual which single herb or combination will work for them.

Radio interview
We’re very much looking forward to talking to you Tuesday April 6, 2010. We’re going to talk for one 5 to 7 minute segment about remedies for sexual dysfunction both natural and pharmeceutical. Casey Acevedo Producer - Your Time with Kim Iverson. Entercom Communications. Syndicated in 10 Major Markets.
   What are the advantages and disadvantages of natural sex herbs over Viagra and its cousins. What are some common over the counter aphrodisiac herbsAre single herbs better or combination formulas? Ray Sahelian, M.D. is the bestselling author of Natural Sex Boosters, a book that reviews the benefits of natural aphrodisiacs from around the world. He has also developed a popular sexual enhancing formula called Passion Rx.