Good Sex Is Vital to a Good Relationship

You're Not Alone

It happens to just about everyone: Your sex life ebbs and flows. Your age, health, and how you feel about your relationship can all have an impact.

In some situations, supplements might help. But you need to look at the big picture first. Don’t be shy about telling your doctor what’s going on.

“Before trying an herb or a supplement, think about what you can add or subtract from your life: exercise, weight loss, treating a condition, or changing a medication. These can all help,” says Adriane Fugh-Berman, MD, an associate professor of pharmacology at Georgetown University.

Most of the attention about sex and supplements focuses on men. But what might work for a man doesn’t necessarily work for a woman, Fugh-Berman says. Both sexes have options.

For Women

Iron: If you are low in iron, it might dim your libido. This includes desire, arousal, lubrication, and ability to have an orgasm.

In one study, women noticed improvements after they took iron to correct a shortfall of that nutrient.

Too much iron is bad for you. More than 20 milligrams of iron a day can cause constipation and other kinds of stomach upset. More than 60 milligrams at once can be life-threatening.

Tribulus terrestris is a fruit-producing Mediterranean plant that's covered with spines. It's also called puncture vine.

People use the fruit, leaf, or root of the tribulus plant as medicine. Some formulations also include other ingredients.

In a small study, women with low sexual desire disorder took 7.5 milligrams of Tribulus terrestris every day for 4 weeks. They said they were doing better with their desire, arousal, lubrication, orgasm, and satisfaction, and they had less pain during sex.

Maca, also known as Peruvian ginseng, is a South American root vegetable. If you are taking an antidepressant that makes you lose your sex drive, maca may help, according to one small study.

“Because it’s a food, it’s probably safe to try,” Fugh-Berman says. But they recommend you skip it if you have an estrogen-sensitive cancer or condition because it could raise your estrogen levels. If you have sexual side effects from antidepressants or any other medication, ask your doctor if you can change your medication before you turn to a supplement.

For Men

Supplements often target erection problems, which can happen for many medical reasons, including some medications for high blood pressure or depression.

“The solution is probably a discussion with your physician about whether there are alternatives to your medication that will help,” says Josephine Briggs, MD, director of the National Center for Complementary and Integrative Health.

Your doctor can also let you know if it would help to work on your diet, exercise, and weight.

If you want to give supplements a try, ask your doctor if these would be OK for you.

L-arginine is an amino acid, which are the building blocks of protein. In your body, it turns into nitric oxide. In one study, about one-third of men who took 5 grams of it per day for 6 weeks had improved erections.

“Erectile dysfunction is caused in part by [poor] penile circulation. Nitric oxide causes blood vessels to dilate [widen], so there’s some rationale for L-arginine perhaps having some effect,” Briggs says.

The supplement can cause belly pain, bloating, diarrhea, and other side effects. It can also cause a serious allergic reaction or worsen symptoms for people with asthma.

Propionyl-L-carnitine: Your body makes this amino acid. It’s important for metabolism. As a supplement, it might help make sildenafil (Viagra) more effective for men with diabetes and erectile dysfunction. One study tested that idea in men who had tried sildenafil at least eight times with no luck. When they added 2 grams of propionyl-L-carnitine per day to their plan, they got results.

“Carnitine does improve blood flow,” Fugh-Berman says. “It’s also been tested in men with Peyronie’s disease, which is a bent penis disease. L-carnitine reduced pain and seemed to make the disease progress more slowly.”

Side effects can include chest pain, nausea, vomiting, and stomach upset. It can also make your sweat and urine smell fishy.

Niacin is a B vitamin that raises your "good" cholesterol level. In one study, men with high cholesterol and moderate to severe ED who took 1,500 milligrams of niacin for 12 weeks saw improvements.

Be careful, though. Very high doses can harm your liver and cause heart, blood pressure, and urinary problems.

SAM-e: Depression can hurt your sex life. Treatment (therapy, exercise, and, for some people, medication) can help. But some antidepressants may lower your libido, too.

SAM-e (S-adenosyl methionine) is a chemical that your body makes. Some studies show that it can help mild to moderate depression without sexual side effects. It might also boost the effects of some prescription antidepressants.

Don’t mix SAM-e with your antidepressants without your doctor’s supervision. Taking the supplement along with some antidepressants can cause serious side effects. High doses might upset your stomach and cause insomnia, dizziness, and headache.

Yohimbine: This herbal supplement comes from the bark of a tree native to Central Africa. It can improve ED. But it’s not all good news.

“It’s the most effective [supplement for erectile dysfunction] and the most problematic,” Fugh-Berman says.

“Yohimbine can cause high blood pressure, heart palpitations, headache, anxiety, and dizziness. It’s a problem in people with psychiatric issues, and it interacts with a lot of drugs,” Fugh-Berman says. “I don’t recommend it.”

For Women and Men

Panax ginseng (Asian ginseng) might raise sexual desire in women going through menopause. In a small study, women saw improvements after taking three 1-gram capsules every day for 2 weeks. It may help improve erectile function in men, too. Studies typically use doses of 900 to 1,000 milligrams two to three times a day.

It can cause insomnia. So don’t take ginseng if you have trouble sleeping. Less common side effects include painful periods for women and diarrhea.

If you are low on sexual energy, talk to your doctor about your concerns. There can be many different causes, and they are treated differently. Sex enhancers can have side effects. Discuss your specific situation with your doctor first.

Remember that the FDA does not require supplements to prove that they are safe, effective, or contain what they say on the label. You may want to look for a seal of approval from groups that check on supplement ingredients. These include the United States Pharmacopeial Convention (USP) and NSF International.

Also, follow the dose exactly. “The bottle says take one tablet, and people take four,” Briggs says. “Any product of this sort should be used with caution, and the labeling should be taken very seriously.”

Always let your doctor know what you are thinking of taking, in case it could affect your health or any medications that you take.

Here are two supplements that work together well. Get a great night's sleep and wake up with morning wood!