Women and Sex Drive

Sexual Enhancement
with Arginine, DHEA, Ginkgo, and Choline,
for Women Who Want to Be in the Driver's Seat

e are driving into the third millennium in vehicles that have been revolutionized by technology. These "vehicles" - cars, computers, communications networks, entertainment systems, etc. - must be constantly upgraded or replaced, lest we fall behind and lose the ability to connect with those around us. How quickly things become obsolete, as new systems yield to yet newer ones. Our bodies are vehicles too, and they benefit from "upgrades and restorations" that become especially important as we age and no longer operate as efficiently as we once did. In the realm of that special "entertainment system" known as sex, Viagra® has "paved the road" by providing a new driving force that can empower our vehicle and take us where we want to go. But Viagra is a "male" product - or so we are led to believe. When do women get to drive?

Viagra causes the smooth-muscle fibers in the walls of arteries to relax via a mechanism involving nitric oxide (NO), a gaseous molecule produced in your body from the nutrient amino acid arginine. Nitric oxide (not to be confused with nitrous oxide, or laughing gas) leads to the production of another chemical, cyclic GMP, which causes muscles in the spongy erectile tissue of the penis to relax. This, in turn, allows the penile arteries to expand during sexual stimulation. Thus, blood engorges the penis, and an erection results when the blood is trapped there by a constriction of the penile veins.

Oddly, research on sildenafil (the generic name for Viagra) was not originally intended for the treatment of impotence, but for angina pectoris (chest pain associated with poor blood supply to the heart muscle). But because sildenafil didn't turn out to be particularly effective for that purpose, the manufacturer (Pfizer) was about to abandon it. Then reports came to light that some test subjects who had been sexually dysfunctional were getting better erections. Once the mechanism of sildenafil's action in this arena was explained,1 the drug gained a new lease on life . . . as have, since then, a great many men.

Because the amino acid arginine is the precursor to nitric oxide, its ingestion and concomitant elevation in the serum accomplish much the same goal as Viagra, as several studies have borne out.

In the first of these studies, 15 impotent men first took a placebo for 2 weeks, but none improved.2 Then, unbeknownst to them, they were switched to 2.8 g of L-arginine daily for 2 weeks. Six of the 15 men (40%) reported they had improved erections while taking the arginine supplement. The improvements were of three general types:

  • Firmer erections
  • Return of vaginal penetration
  • Ability to distinguish placebo from arginine

As a group, the men who responded to the treatment reported increased libido and enhanced potency. Significantly, however, their mean age was 18 years less than that of the men who did not respond. The researchers wondered whether the age-dependent response signified a shortage of arginine.3 The more that arteries are damaged by plaque buildup, the less NOS is created and released. Fortunately this deficit may be reversed through the use of Ginkgo biloba.

In another study, 25 men (ages 40-77) with mild to moderate erectile dysfunction were given a formulation, the principal element of which was arginine at a level of 2.8 grams.4 The subjects took the formulation for four weeks, during which time they were evaluated. Four of them dropped out, but of the remaining 21, 18 reported improved ability to maintain an erection during sexual intercourse, and 15 reported improved satisfaction in their overall sex lives. No significant side effects were noted. One of the other ingredients in the formulation was Ginkgo biloba, an herb that has been shown to increase the releasability of NOS, which may have allowed enough additional NO to be produced to make a difference for some of the older men. The authors stated that arginine provided the principal mechanism of the formula's ability to increase potency.

All else being equal, arginine goes beyond Viagra's capability because it improves cardiovascular function, thereby enabling restoration of arterial health, upon which an important mechanism for sex is based. In addition, arginine acts as a growth hormone releaser. It enhances muscle mass and tone, as well as memory and immune function. Unlike the drug Viagra, arginine is a natural nutrient that is safe and essential, without side effects.

Women suffer from the same type of insufficient genital blood flow that causes impotence in men.

While it seems unfair that men should be the primary beneficiaries of sexual enhancement research, there is a reason for this. It has to do with the reluctance of scientists to use women, who are presumed capable of becoming pregnant at any time and thus, during the term of a study, susceptible to fetal damage - or so the argument goes. There may be other reasons too, alas, having to do with scientific paternalism or male dominance of the profession.

In national surveys, one-third of all women report a lack of interest in sex, and one-quarter confess that they are unable to achieve orgasm. These problems may very well result from insufficient arousability. Thus they may be treatable in much the same way that men's are, because women suffer from the same type of insufficient genital blood flow that causes impotence in men.

Since Viagra first became available, many women have reported that it works as well for them as for their male partners. Anecdotally as well, many women have said the same about arginine (see sidebar). Reports claim greater lubrication, more sensitivity, and increased ease, frequency, and intensity of orgasm.

Nitric Oxide Replacement in Women 

So how does arginine work in women? NO has been found by Burnett and associates to be produced in clitoral tissue.22 This means that the same kind of hampered blood flow that causes erectile difficulties in men may be the cause of many cases of impaired female sexual response. Moreover, levels of nitric oxide have been found to decline rapidly in women as they age. Thus, women may need to boost NO levels, which they can do by supplementing with arginine naturally. Viagra cannot make NO. Furthermore, the prescription drug Viagra is foreign to the body and has a spectrum of significant side effects, some of which have been reported to be associated with numerous deaths. Viagra is also considerably more costly than arginine.

Sexual responsiveness requires adequate blood flow to the vagina and especially the clitoris. It follows that when women are unable to achieve orgasm or have delayed orgasms or suffer from vaginal dryness, these problems are likely to be due to insufficient or poor blood flow to the genital area. A variety of factors can cause poor circulation, such as heart disease, diabetes, or too much cholesterol. Smoking, a bad diet, lack of exercise, and a wide variety of drugs can also cause circulatory problems.

Unfortunately, there are far fewer answers to questions about sexual dysfunction in women than in men, because they are not as frequently the subjects of studies. Although there may be as many as 60 million American men with erectile problems ranging from occasional to complete dysfunction, comparable figures have not been compiled for women.

Undoubtedly, however, answers are on the way. But rather than wait for the needlessly gloomy finding, women will not settle for second-class responsiveness. Given a clear choice, women will progress beyond drugs like Viagra, which are not long-term solutions for the restoration of their sexual health. Whatever they choose, the chances are good that they will take NO for their answer.

But unlike Viagra, arginine is reported to increase sexual desire (libido). This is probably because NO, also made from arginine in the brain, operates as a neurotransmitter involved in the creation of long-term memory. Indeed, studies have shown that memory and libido are connected. In women, they decline with age, but when sex hormones such as testosterone are replaced, both memory and libido increase.5 At least one study has reported that testosterone maintains the erectile response by alternate pathways, including one that is independent of NO.6 Alternatively, when NO is abundant, it may be that more testosterone is available for increasing libido. Other research indicates that NO enhances the ability to remember sex scents (pheromones), which are intimately related to libido.7,8

The hormone dehydroepiandrosterone (DHEA) has been studied extensively and found to improve various aspects of the quality of life in both men and women.9 In men and women, e.g., higher levels of DHEA have been associated with enhanced sexuality.10 With this knowledge, researchers decided to test women who had abnormally low levels of DHEA owing to diagnosed adrenal insufficiency. In a double-blind, placebo-controlled study, 24 such women were given 50 mg of DHEA orally each morning for four months. Then, following a washout period of one month (i.e., nothing for one month), they and the placebo group were switched to opposite regimens.11

The results were dramatic: The women using DHEA had significantly increased frequency of sexual thoughts, sexual interest, and satisfaction with both the mental and physical aspects of sexuality. In addition, the restoration of normal serum levels of DHEA resulted in a significantly improved overall sense of well-being, as indicated by far lower levels of  depression and anxiety.

At the University of California, San Francisco, an open trial was conducted with 63 subjects (33 of them women) to see if the cerebral enhancer Ginkgo biloba could help treat antidepressant-induced sexual dysfunction caused predominantly by SSRIs (selective serotonin reuptake inhibitors, such as Prozac®).12 The subjects received 60 mg of ginkgo four times daily, or 120 mg twice daily. Women responded to the sexually enhancing effects of ginkgo more than men, with success rates of 91% and 76%, respectively.

Ginkgo generally had a positive effect on all four phases of the sexual response cycle: desire, excitement (erection or lubrication), orgasm, and resolution (afterglow). Curiously, the idea for the study originated when it was observed that a geriatric patient taking ginkgo for memory enhancement had improved erections.

Ginkgo increased desire, excitement, orgasm, and afterglow.

The nutrient choline is now recognized to be important for memory, muscle control, and the cardiovascular system. Studies on sexuality have found that the neurotransmitter acetylcholine (ACh) - made in the body from choline and pantothenic acid - plays a vital role in orgasm in women as well as men.13 ACh helps transfer the brain's sexual arousal messages via neurons to the genital arteries.14 In women, the uterine and vaginal arteries are provided with rich cholinergic innervation.15

The first measurable sign of sexual arousal in a woman's vagina is an increase in the blood flow, which leads to engorgement and increased tension.16 This, in turn, stimulates the production of vaginal lubrication, allowing for painless penile penetration and coital movements. Although it probably does not participate directly in this mechanism, ACh is necessary to initiate the process of arousal in the first place.

ACh is also known to help release nitric oxide, which, as we know from men, permits localized sexual excitation and response.17 The same spongy tissue, the corpus cavernosum, is the erectile tissue in both the penis and the clitoris. In a recent study, NO was found to operate the same way to induce erection in both of these organs.18

Acetylcholine, made in the body from choline, plays a vital role in orgasm.

When it comes to muscular control, choline and pantothenic acid are especially important for women, because their byproduct, acetylcholine, is the primary biochemical used by the body to transmit signals from nerves to skeletal muscles. Without sufficient ACh, muscle movement would be tenuous, and sexual activity would be sluggish instead of energetic. Therefore, in order to enhance the energy and stamina needed for prolonged lovemaking, supplementing with choline and pantothenic acid is a good insurance policy. In female rats, lordosis (sexual arching) and other positive sexual attitudes have been shown to be dependent on sufficient cholinergic function.19 In other words, high levels of ACh are strongly associated with robust sexual activity in laboratory animals.

As women are becoming everything they can be, sexually speaking, they are taking command of their body-vehicles and driving them in ways that give them more options, more control, and more pleasure - things that men have long taken for granted. Fortunately, nutritional supplements are beginning to grant women the same advantages for "upgrading and restoration" that men have known, and for traveling to places they might never have gone before. It's never been any fun to be in the rear seat; now it's time for women to sit in the driver's seat, shift the gears of their sexuality, and take the wheel and drive.


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