Male Herbs for Impotence
Christopher Hobbs L.Ac., A.H.G.

"I can't make love, I have a terrible headache." This phrase has become well-recognized, and even a subject of humor to epitomize a popular belief that women may often need an excuse to avoid love-making with a man whose sexual appetite is much more insistent that hers. In recent years, however, we have been hearing increasingly about men who are intimidated by women, or for one reason or another, cannot perform--"performance anxiety." Do women or men have a higher incidence of inhibited sexual desire to the point where it becomes a problem in their life? Perhaps it is much more equal than is popularly thought, but men are more reticent to talk about it. It's no joke to many men when it comes to what is called in the Merck Manual (14th ed.) abnormal fear of the vagina. Other intrapsychic (it's all in the mind) causes in men for "inhibited sexual excitement" (impotence) are listed as sexual guilt, fear of intimacy, depression, and some recreational drugs (see sidebar).

In no other area of human health does the mind enter in more thoroughly than in human sexuality--an ironic statement, because most of us realize that this is precisely one area of human activity where the mind can often do more harm than good. But in fact, statistics show that for both men and women, up to 80% of sexual dysfunction and inhibited sexual desire are of mental or emotional origin.

According to the Merck Manual, impotence in men is of two types: primary, which is rare, and "generally indicates severe psychopathology;" and secondary, "in which erectile dysfunction prohibits completion of successful sexual intercourse in about 25% (or more) of opportunities." As mentioned, a full 80% of the secondary impotence is directly attributable to mental and emotional factors and only 20% to disease and functional abnormalities such as diabetes, cardiovascular diseases, surgery, and disorders of the hypothalamic-pituitary-gonadal hormone processes, which might lead to lowered levels of testosterone. Although low levels of testosterone might even be found in a majority of men with impotence, it is difficult to know whether psychological factors inhibiting sexual contact leads to lowered testosterone levels, or visa versa.

Drugs and their effect on Sexual Performance

Drugs, such as alcohol, can also be a factor. I recently read a study that was carried out in the 60s in San Francisco with a group of volunteers, which clearly showed that while cocaine (which is considered the 'cadillac' of sexual stimulants) and marijuana led to increased sexual interest and improved performance, drugs such as heroin, alcohol, and a variety of downers (such as reds and quaaludes) and amphetamines actually led to a mild to strong decrease in these areas. Common prescription drugs can also lead to impotence as a side-effect. This is especially notable with hypertensives, sedatives, and tranquilizers.

A common myth in this culture is that older people loose their sexual desire and ability to have satisfactory intercourse. Statistics and studies do not support this, however. According to the Merck Manual again, "Aging is not an inevitable cause of impotence, even into the 70s and 80s." Of course, the desire to have sex will cool off somewhat as we get older. I've often felt how fortunate I am to not have the same desire in my 40s as I did when I was 19!

The most common prescription for functional impotence is yohimbine hydrochloride. The drug originated from a West African tree, Pausinystalia johimbe, which has been sold for years on the herb markets of countries world-wide, including the U.S. The alkaloid is an -adrenergic blocker, increases parasympathetic tone and decreases sympathetic tone, as well as a central nervous system (CNS) stimulant. There are a few modern studies showing that it is effective for some types of impotence, especially ones of vascular, diabetic, or psychogenic origins, and it can improve the quality and staying power of erections, usually without increasing sexual excitement. However, the drug should be used cautiously, because it is a CNS stimulant and can lead to side-effects such as dizziness nervousness and anxiety (Physicians Desk Reference, 43rd edition). Yohimbe is also available in some products sold in health food stores, but again, it should be used with caution.

Because many cases of impotence are associated with our mind and emotions, it is appropriate to seek the services of a qualified psychologist, marriage and family counselor or social worker. I prefer to work with practitioners who do not view such problems as pathological, but as a process of self-discovery and personal growth. It is important to clearly understand the root causes of impotence, and often doing so, the problem will disappear on its own.

As an herbalist, and Traditional Chinese Medicine practitioner, I use herbs as a major part of my "bag of tricks" in a clinical situation, as well as personally and with friends and acquaintances. Besides herbal therapies, I recommend proper exercise and deep breathing daily, to make sure the circulation is moving. Hydrotherapy (cool showers, for instance) can also be effective for this, and it is essential to eat a strong diet that avoids foods rich in saturated fats, refined sugars, and processed foods in general, and emphasizes high-fiber foods such as grains and legumes, fresh lightly cooked vegetables, and a variety of fruits in season. Following this diet and the other recommendations will often lead to improvement within a few weeks.

Herbal Programs

I would organize herbal treatments and programs under the following categories, depending on the needs of the individual.

Relaxing herbs (when anxiety, tension and poor sleep is a root cause)
Aphrodisiacs (to increase sexual desire)
Testosterone enhancers (where testosterone levels are low)
Circulatory stimulants (when circulation is poor, a person is often cold)
Adaptogens (when a person is under a lot of stress)
Tonics (blood, vital energy and vital essence, when a person is deficient or weak)

Relaxing Herbs
Because nervousness, tension and even anxiety may play a major role in impotence, relaxing herbs can be of benefit. Herbs such as valerian, passion flower (I like the name), California poppy, lavendar and wild oats can relax without lowering sexual desire. The relaxing herb hops should be avoided, however. Modern studies show that it is estrogenic, and has a long history of use as an anaphrodisiac (lowers sexual desire).

Valerian should be used as a fresh plant liquid extract (1-2 droppers/3 times daily, or as needed). Passion flower is mild, but effective, and is usually combined with other relaxing herbs to enhance their activity. California poppy is one of the best muscle relaxers and scientifici studies show that it can help relieve mild anxiety. In my experience, valerian and California poppy are very effective together. Wild oats is well-known as a mild sexual enhancer and relaxing herb. Use it in liquid extract form (2-3 droppers, made from the fresh spikelets) or as a powdered extract.

Aphrodisiacs
Since time immemorial, people have been looking for that magic herb that can strongly increase sexual desire and potency. Unfortunately, there is no one herb that can do miracles, rather there are several that can help build up sexual energy and vitality. Ginseng is probably the best-known aphrodisiac. Although there are many types of ginseng, look for either "red Korean," or "red Chinese" (Kirin) ginsengs. In my experience, these are stronger than white, unprocessed types. Ginseng is especially effective for people over 40 who have weak digestive systems, are not getting enough nourishment and are deficient, and have little or no sexual desire. It should be taken daily (10-15 grams), in combination with some ginger as a tea, liquid extract or powdered extract. To my knowledge, ginseng is one of the only herbs known to stimulate the production or testosterone in the body. In my experience, the following herbs are also worth trying for their aphrodisiacal (is it a word?) properties.

Turmeric (powdered extract, liquid extract--1 ddropper 2-3 x daily)
Damiana (won't work unless it's very fresh--liquid extract only, 40 drops 3 x daily)
Mira puama (German researchers have found some activity, popular in Europe)
Ginger (warming, stimulating to the circulation and is mildly aphrodisiac--use it on a regular basis as a tea or liquid extract in a little water)
Chocolate (contains the alkaloids theobromine, and small amounts of caffeine)--use the liquid extract, or the unsweetened powder.

Testosterone Enhancers
After a thorough search of the available literature, and from personal experience, I feel that herbs such as sarsaparilla and wild yam, which are often sold in body-building formulas as a testosterone source are highly overrated. Both herbs contain plant sterols, but there is no solid evidence that they either stimulate or supply testosterone in the body. However there is one Mexican study, which I can't confirm, that suggests that sarsaparilla extracts can have this activity. It may be fun to experiment--it isn't bad-tasting, but I'm not giving the story much creedence.

Red Panax ginsengs may be the best bet in this category, and there is one animal study that shows that ginseng extracts can increase blood testosterone levels.

Other herbs that may be helpful in a total herbal program can include circulatory stimulants (ginger, prickly ash bark, turmeric, motherwort), and adaptogens, which also can help support adrenal function (eleuthero, American ginseng, ashwaganda, schisandra).

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