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Q: Several female patients who I see for a urinary concerns complain about a lack of sexual desire. Many feel a uneasy about taking hormones to increase desire, but they've asked me about "natural" products that might enhance their sexual interest level. Can you comment on this?
A: Many of my patients voice similar questions. Most of the prosexual agents in the "natural" category are available over the counter (OTC). I agree with you that it is important for nurses and practitioners to know about these products and to be able to suggest or discourage the use of specific ones. These include ArginMax, yohimbe, DHEA, EROS-CTD, exercise, and phytoestrogens.
'Natural' Products
ArginMax. This is an oral dietary supplement that contains several "natural" substances. One ingredient is L-arginine, an amino acid which is the precursor to nitric oxide. Nitric oxide mediates relaxation of vascular and nonvascular smooth muscle in the clitoris and vagina; damiana, an African shrub that is considered by some to be a powerful aphrodisiac for women because of speculation that it enhances dopamine levels in the brain; and ginseng, an herb that has no direct prosexual effects, but has been associated with increased energy and stamina.
Preliminary double-blind, placebo-controlled studies of oral supplements containing L-arginine and damiana have demonstrated that up to 70% of pre and postmenopausal women experience significant improvement in desire and sexual responsiveness after 4 to 6 weeks of daily use (Trant & Polan, 2000). This supplement is widely available in general...