Sexual health for women

Nutraceutical products for men’s sexual health have significantly more than their fair share of representation, with sales estimations to be in the range of $517 million, and recent annual increases of 5.4 percent, according to 2012 figures from Nutrition Business Journal. Likewise, articles and books on the topic abound.

The same, however, cannot be said for women’s sexual health. This is problematic since research1 suggests that sexual dysfunctions affect 20 percent to even more than 40 percent of all women. The reason for this may be there are a greater number of factors influencing the female libido.

According to the Mayo Clinic: A woman’s desire for sex is based on a complex interaction of many components affecting intimacy, including physical well-being, emotional well-being, experiences, beliefs, lifestyle and current relationship. If you’re experiencing a problem in any of these areas, it can affect your sexual desire.2

With this article I will focus on two issues that probably account for a significant percentage of sexual health issues for women: stress and menopause.


It is well established that female sexual dysfunctions and low desire, in particular, are frequently associated with an elevated level of psychological stress.3,4 Consequently, anything that can be done to promote relaxation and reduce the effects of stress may be able to help. The amino acid L-theanine fits this description.


Asian cultures have often used teas for relaxation effects. The relaxing effect is, at least in part, caused by the presence of a neurologically active amino acid, L-theanine (gamma-ethyl-amino- L-glutamic acid). In the brain, L-theanine increases both serotonin and dopamine production5, and possibly GABA as well.6 Evidence from human electroencephalograph (EEG) studies show that it also significantly increases brain activity in the alpha frequency band which indicates that it relaxes the mind without inducing drowsiness.7

According to Mason, two small human studies8 showed that within 30-40 minutes of consuming 50 or 200 mg of L-theanine there is an increase of alpha wave activity/electrical signals produced by the brain. The perceived relaxation effect in the subjects coincided with the detection of alpha waves. This shows that L-theanine fosters a state of alert relaxation, which is consistent with the fact that anxious people have fewer or smaller alpha waves. Other studies have shown similar benefits.6,9,10


Most authors agree that female sexual dysfunctions are age-related.1 Research suggests that some sexual functions are significantly impaired in postmenopausal compared to perimenopausal women11, and other research suggest that sexual dysfunctions affect about 50 percent of postmenopausal women.12 While the reasons for this may be multifactorial, there is at least one physiological reason: the lining of the vagina changes around menopause. It usually becomes thinner and drier, so sex can be uncomfortable, especially if the vagina is not lubricated well enough through arousal.13 Of course, other menopausal symptoms such as hot flashes are not particularly conducive to feelings of intimacy either. Maca root extract, black cohosh root extract and hop cone extract may help.

Maca root extract

The herbal medicine maca has a history of use for women’s sexual function. Maca’s fertility-enhancing properties and also its stimulant effect were first described in 1653.14 Field researchers have since reported that, in Peru, maca has been used for medicinal purposes and as a source for energy, stamina and endurance, and has been used as an aphrodisiac and tonic for postmenopausal problems.15 In 1964, Leon16 reported that Maca was currently eaten by Indian and white women who want to have children, and is sold in the market for this purpose.

In addition, modern, human clinical research has also shown benefits. In a randomized, double-blind, placebo-controlled, crossover study17, postmenopausal women received 3.5g of powdered maca root or placebo daily for six weeks. The results were that maca supplementation reduced psychological symptoms, including anxiety and depression, and lowered measures of sexual dysfunction.

Another randomized, double-blind, parallel group dose-finding study18 examined the effect of maca supplementation on sexual dysfunction caused by SSRI (anti-depressant) drugs. Doses of 1.5g and 3g per day were compared. The results were that libido improved significantly (P<0.05) in the group receiving 3g of maca. Other placebo-controlled studies have shown similar benefits in sexual interest and function when maca was supplemented to postmenopausal women.19,20

Note: Since 3-3.5g is probably a significant amount of maca root to supplement with for many women, the use of 270 mg of maca root extract standardized for 0.6 percent macamides and macaenes will provide equivalent activity in a more manageable daily dose.21-24

Black cohosh root extract

While many are aware that black cohosh is well established as an effective herb for the treatment of menopausal symptoms, not everyone is also aware that those symptoms include menopause-related sexual disorders. For example, a recent randomized, double-blind, placebo-controlled, multicenter, clinical study25 demonstrated that black cohosh extract was significantly more effective than placebo in improving the menopause rating scale subscore (P=0.012) associated with vaginal dryness, sexual disorders and urinary complaints.

Earlier randomized, multicenter, double-blind, clinical studies26,27 with black cohosh extract demonstrated virtually identical results. In addition, a prospective observational study28 demonstrated that black cohosh extract significantly improved quality of life in the sexuality domain among postmenopausal women. The daily doses typically used were 40-80 mg of black cohosh root extract standardized to 2.5 percent triterpene glycosides.

Furthermore, numerous studies have demonstrated that black cohosh root extract significantly reduces menopause-related hot flashes, night sweats, nervousness, moodiness, sleeplessness.25-27,29-39 It would seem logical that a reduction of these symptoms would also play a positive role in helping to remove additional roadblocks to healthy sexual activity.

Hop cone extract

Although best known for its role in brewing beer, the hop cone has also been studied for its effect in relieving hot flashes during menopause. In a 16-week, randomized, double-blind, placebo-controlled, cross-over study,40 a daily dose of 85 mg hop cone extract (standardized for 100 mcg 8-prenylnaringenin) or placebo was given to menopausal women. The results were that the hop cone extract was superior in reducing hot flashes.

In another 12-week, prospective, randomized, double- blind, placebo-controlled study41, menopausal women received 80 mg of hop cone extract (standardized for 100 mcg 8-prenylnaringenin) or a placebo. The results were that the hop cone extract exerted favorable effects on hot flashes and other menopausal discomforts.

Note: Hop extract contains plant estrogens that may bind to primary estrogen receptors in the female reproductive system, and may help smooth out some of the rough spots as estrogen declines during menopausal years.42,43 Black cohosh does not contain plant estrogens that bind to primary estrogen receptors44, but rather works with neurotransmitters or by other support mechanisms.45,46 Given these distinctly different mechanisms, I like to recommend the use of both herbs concurrently for the relief of menopausal symptoms.


As previously indicated, there are a number of factors influencing the female libido, and the nutraceuticals discussed in this article do not address all of them. Nevertheless, there is a good chance that they will help address two of the most frequent contributors to sexual health issues for women: stress and menopause.


Field researchers have since reported that, in Peru, maca has been used for medicinal purposes and as a source for energy, stamina and endurance, and has been used as an aphrodisiac and tonic for postmenopausal problems.


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