Reclaiming Desire

By Andrew Goldstein, M.D., and Marianne Brandon, Ph.D.
Published by Rodale
May 2004; $23.95US/$32.95CAN; 1-57954-683-8

Anyone who has stood in a supermarket checkout line has seen all the sexy headlines on women's magazines, touting exciting new ways for readers to drive their men wild in bed or to heighten their own sexual pleasure. These are tantalizing promises, to be sure. But they sorely miss the mark.

The fact is, many women aren't interested in more sex or better sex. They aren't interested in sex at all. They used to be, of course. Over months or even years, their sexual desire all but disappeared. And they can't understand why.

Through years of clinical practice, Andrew Goldstein, M.D., and Marianne Brandon, Ph.D., have worked with scores of clients who aren't satisfied with their sex drives. They've seen how women struggle to open up about this very personal and painful problem. And they've seen how it can erode women's self-esteem and strain intimate relationships.

In Reclaiming Desire, Dr. Goldstein and Dr. Brandon present a self-care version of their highly effective holistic approach to treating low libido. Inside you'll find:

• An exclusive self-test to assess physical, emotional, intellectual, and spiritual health -- the four cornerstones of a healthy sex drive


• Essential information on how major life events like pregnancy, menopause, and divorce can affect a woman's sexual health


• A range of practical measures, from conventional and herbal medicines to mind-body techniques and lifestyle strategies, that can help rekindle sexual desire


• Personal stories that draw upon the real-life experiences of women who once struggled with low libido -- and emerged with a greater understanding of their sexual selves

Reclaiming Desire also offers a healthy dose of reassurance and encouragement as an antidote to all of the misconceptions about low libido. As you'll learn, a decline in sex drive doesn't automatically happen with age. And while hormones influence sexual desire and response, they don't determine a woman's sexual destiny. Just as important, low libido doesn't necessarily point to a problem in a woman's relationship with her partner. More than likely, she simply has lost touch with her sexual self.

Unlike those magazine headlines, Reclaiming Desire will more than live up to its promise. With this book, you can reclaim your desire -- and make your sex life better than ever.

***

A woman's sexuality is vital to her self-image and self-esteem. So if her sex drive should falter, the consequences can reach far beyond the bedroom -- to her sense of value as a person, her perception of her relationship with her partner, and her satisfaction with life in general.

Yet many women are reluctant to seek help for low libido, because it's such a deeply personal problem. Those who do may not get effective treatment. Too often doctors attempt to pigeonhole a diminished sex drive as purely physical or psychological. It's much more complicated than that.

Reclaiming Desire is the only book to address low libido by considering the whole woman -- her physical health, her emotional resilience, her intellectual fulfillment, and her spiritual beliefs. At last women can get a complete, accurate picture of their sexuality by exploring the diverse factors that have helped shape it. Using an array of proven self-care techniques, they can determine what could be sabotaging their sex drives -- and what will help bring it back.

Authors

Andrew Goldstein, M.D., and Marianne Brandon, Ph.D., are cofounders of the Sexual Wellness Center in Annapolis, Maryland, where they specialize in treating women's sexual health problems. Dr. Goldstein divides his time between Annapolis and New York City; Dr. Brandon resides in Annapolis.

Reviews

"A wonderfully up-to-date and comprehensive summary of the myriad psychological and biological factors that contribute to a woman's sexual desire."

--Cindy M. Meston, Ph.D., 2003 president of the International Society for the Study of Women's Sexual Health and associate professor of clinical psychology at the University of Texas at Austin

"Readers who embrace Reclaiming Desire as their guide to a healthier sex drive are likely to emerge more content -- not only with their libidos, but with life in general."

--Annette Owens, M.D., Ph.D., AASECT-certified sex counselor at the Charlottesville Sexual Health and Wellness Clinic

"Dr. Goldstein and Dr. Brandon have set a new standard in the understanding and treatment of a problem often regarded as one of the most difficult to treat in the field of woman's sexuality."

--David B. Fogel, M.D., medical director of the Human Sexuality Institute, a division of the Fogel Foundation, Washington, D.C.

"Any woman who has experienced low libido can benefit from reading Reclaiming Desire. I would heartily recommend this book to my students and clients."

--Barbara Keesling, Ph.D., author of The Good Girl's Guide to Bad Girl Sex

Excerpt

The following is an excerpt from the book Reclaiming Desire: 4 Keys to Finding Your Lost Libido

by Andrew Goldstein, M.D., and Marianne Brandon, Ph.D.

Published by Rodale; May 2004; $23.95US/$32.95CAN; 1-57954-683-8

Copyright © 2004 Andrew Goldstein, M.D., and Marianne Brandon, Ph.D.

From Mother Nature's Medicine Chest

As pharmaceutical companies continue their quest for the perfect synthetic aphrodisiac, more and more people are experimenting with natural alternatives to enhance their sexual experiences. Much of their interest has focused on herbs, though some cultures prize animal parts for their suspected aphrodisiac powers. (Tragically, this pursuit has contributed to the near extinction of several animal species -- including the black rhinoceros, whose horn is believed to enhance sexual prowess.)

Plants in general are a rich source of compounds that can after our physiological and psychological states. In fact, an estimated 60 percent of conventional medications come from plants. And that's after scientific study of just a relative fraction of the world's plant population. Realistically, then, many more herbs than the ones presented here may possess potent aphrodisiac powers. They just haven't been discovered yet.

A number of our clients at the Sexual Wellness Center have tried herbs to improve their libidos, with excellent results. But as we always remind them, herbs are medicines. Like conventional pharmaceuticals, they can cause serious side effects if they are not used according to directions or if they're taken with preexisting medical conditions such as hypertension.

In addition, the herbal industry -- like the supplement industry -- isn't subject to FDA regulation. This means the quality, safety, and effectiveness of herbal products is not guaranteed. As we mentioned in our discussion of DHEA in chapter 7, what is on the label is not necessarily what is in the bottle. And DHEA, which is synthesized, is much easier to control than herbal preparations, which are grown.

The potency and quality of an herbal preparation depends on the same variables that affect all crops, such as rain, sun, temperature, and soil conditions. As an analogy, consider wine. Some years, the weather cooperates and the grapes grow well, so the wine is full-bodied and robust. Other years, too much rain, or not enough, takes a toll on the grape crop, producing a thin and not especially tasty vintage. Herbs are just as vulnerable to environmental factors, if not more so.

Keep in mind, too, that we do not intend for this section to be an authoritative text on herbal aphrodisiacs. Dozens, if not hundreds, of herbs can claim prosexual properties. We have chosen to recommend only a handful at the Sexual Wellness Center, because they have been scientifically studied, their side effects are well-known, and they are widely available.

As you'll see, we've not included specific dosage information here. Your best bet is to consult a qualified herbalist or a physician who specializes in herbal medicine, who can recommend an appropriate dosage for you.

Yohimbe: A Proven "Love Potion"

Manzambi and her husband, Remmy, moved from their native Zaire to the United States 7 years ago. At first, they lived with Remmy's brother and his family in a cramped, dark Brooklyn apartment. Remmy worked 12 hours a day, 6 days a week driving a cab. It certainly was not paradise, but it was a much safer place to raise their daughter than in their war-torn country.

Like generations of immigrants before them, Manzambi and Remmy stayed in New York for a few years to get acclimated to the wonders and fast-paced life of their new country. Then they moved to Cleveland, where another relative had settled some years before. There Manzambi made many friends, who openly admired the relationship between Manzambi and her husband. While their husbands often went out to bars after work, Remmy headed straight home and showered affection on his wife.

Her new friends wanted the same type of relationship with their husbands that Manzambi had with Remmy. So they asked her advice. "The secret," she told them, "is to keep your man happy in bed." She continued. "Every night we drink a tea that we have sent from back home in Africa. The tea causes a pleasant fire in my vagina, and Remmy can make love like a man 15 years younger. Good sex keeps my husband home."

A traditional herbal remedy in West Africa, yohimbe has a centuries-old reputation for its libido-enhancing properties. The herb, which comes from the bark of the corynanthe yohimbe tree, plays a role in tribal fertility celebrations, marriage ceremonies, and mating rituals. Spurred by yohimbe's effects, some of these ceremonies involve sexual activity that may go on for days, or even weeks.

Since the late 1930s, researchers have been studying yohimbe to substantiate the prosexual claims for the herb. No less than 30 scientific articles have shown that the active ingredient in yohimbe, the alkaloid yohimbine, increases blood flow to the genitals and stimulates the central nervous system as well as the nerves of the genitals. Together, these physical changes set the stage for sexual arousal.

Researchers at Valparaiso University in Indiana confirmed that yohimbine increases the frequency of sexual activity and heightens sexual arousal. In fact, the FDA already has approved the compound as a treatment for erectile dysfunction in men. Further studies have shown that yohimbine can counteract the negative sexual side effects of the widely prescribed SSRI antidepressants.

As yohimbine works to stimulate the nervous system, it can enhance blood flow, metabolism, and alertness. On the downside, it can raise blood pressure and heart rate and cause heart palpitations, restlessness, and insomnia. For these reasons, we do not recommend yohimbe or yohimbine for anyone with a history of coronary artery disease, stroke, heart arrhythmias, high blood pressure, migraines, panic attacks, schizophrenia, or bipolar disorder. Even if you don't have one of these conditions, we advise trying yohimbe only after a thorough physical exam.

You have several options for using yohimbe. You can brew yohimbe bark to make a tea -- we suggest adding honey to mellow the slightly bitter taste -- or buy the powdered form in capsules. Yohimbine also is available as a concentrated tincture.

Damiana: Fights Low Libido On Many Fronts

Damiana is a wild shrub that grows in parts of Mexico, Central and South America, and the West Indies. Recently, it has been cultivated in Texas and California. Its botanical name, Turnera diffusa aphrodisiaca, hints at its reputation as a libido-enhancing plant. The ancient Mayans used damiana for its prosexual properties. And for centuries, Mexican women have been brewing tea from the plant's leaves to improve their sexual satisfaction.

Though much less studied than yohimbe, damiana has been the subject of some research that's worth discussing here. In one trial, researchers gave a damiana extract to impotent or sexually sluggish male rats, which showed marked improvement in their sexual activity. In another, an herbal preparation called ArginMax for Women -- which combines damiana with other reputed sex-enhancing herbs -- boosted sexual desire, reduced vaginal dryness, increased the frequency of sexual intercourse and the frequency and intensity of orgasm, and improved clitoral sensation in women who took it.

In fact, almost three-quarters of the women in the study showed positive changes in these sexual variables, compared with only slightly more than one-third of the women who took a placebo. The results are all the more significant because they come from a double-blind placebo-controlled study, considered the gold standard in clinical research.

Damiana leaves can be brewed as a tea or taken in powdered form in capsules. You also can buy Damiana Liqueur, a light herbal-based liqueur that is made from damiana grown in Baja California. It comes in a bottle with the shape of a pregnant woman, modeled after the Incan goddess of fertility. According to Mexican folklore, the very first Margarita was made with Damiana Liqueur. The Damiana Margarita remains popular in the Los Cabos area of Mexico.

Ginkgo: Slowly But Surely, It Works

Chinese culture is rich in the study and use of aphrodisiacs and sex-enhancing herbs. For centuries, the Chinese people have relied on the nuts and leaves of the ginkgo tree to help improve their sexual vigor, as well as their mental acuity.

Though limited, recent scientific research suggests that ginkgo may benefit sexual function by increasing blood flow. Two separate studies involving men with erectile dysfunction found that the herb helps to restore erections without side effects. In a study involving women, a preparation of ginkgo mixed with other herbs improved orgasms and overall sexual satisfaction.

Most herbalists agree that the effects of ginkgo are gradual. A woman who's taking ginkgo may notice increased genital sensation and more vivid orgasms, along with sharper memory, over a period of several months. Ginkgo can be found in most health food stores in extract form or as a powder in capsules.

Ginseng: Good For Mind And Body

Perhaps the best known of the Chinese herbs is ginseng. It has been used in Asia for more than 5,000 years to boost energy and alertness. It also is known for improving sexual response, increasing sexual energy, and reviving libido.

There are three different types of ginseng: Asian, or "red," ginseng (Panax ginseng); American, or "white," ginseng (Panax quinquefolius); and Siberian ginseng (Eleutherococcus senticosus). The herb is considered an adaptogen. In other words, it helps restore normal function to the human body by increasing all-around resistance to stress.

Ginseng contains ginsenosides, compounds that stimulate the hypothalamus to invigorate sex drive. It also acts locally on the vagina and clitoris to increase genital blood flow, which enhances lubrication, sensation, and arousal.

In randomized placebo-controlled trials, Asian ginseng has improved sexual response in men with erectile dysfunction. And in combination with ginkgo and damiana, ginseng appears to boost sexual arousal and overall sexual satisfaction.

Look for ginseng in tincture, capsule, or tablet form. Some health food stores even carry soft drinks made with the herb.

Buyer Beware

Before concluding our discussion of herbal aphrodisiacs, we must mention Avlimil, an herbal formula that is aggressively marketed on radio and TV. The ads cleverly compare Avlimil with Viagra by saying that women now have their own "little blue pill," just as men do. They also urge potential customers to ask their doctors about Avlimil, which implies that the supplement is available only by prescription and, therefore, has been approved by the FDA. Unfortunately, neither is the case.

As an herbal supplement, Avlimil is not regulated by the FDA. And if it has been studied, the research has yet to appear in any peer-reviewed medical journal.

Avlimil contains a blend of sage, red raspberry leaf, kudzu root, red clover, capsicum pepper, licorice root, bayberry fruit, damiana, valerian root, ginger, and black cohosh. Though damiana may have aphrodisiac properties, there is no evidence that the combination of herbs enhances desire, arousal, or orgasm, as the manufacturers claim. And it's very expensive -- $55 for a 30-day supply!

Reprinted from: Reclaiming Desire: 4 Keys to Finding Your Lost Libido by Andrew Goldstein, M.D., and Marianne Brandon, Ph.D. © 2004 by Andrew Goldstein, M.D., and Marianne Brandon, Ph.D. Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling (800) 848-4735 or visit their website at www.rodalestore.com.

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