Dudley S. Danoff, MD, FACS
Nearly every culture in every period of history has a record of substances alleged to stimulate sexual desire and improve virility. Medical science has found no evidence that these aphrodisiacs work, but that has not stopped people from using them. If you’ve been looking for a substance to boost your sexual performance this Valentine’s Day, make sure you have all the facts before you ingest, apply, or otherwise try anything advertised as an aphrodisiac, including these five items:
- Plant- and Animal-Based Herbal Remedies
Spanish fly, L-arginine, gingko, ashwagandha or “Indian ginseng,” the Mexican herb damiana, the plant extract called pygeum, and complex combinations of Chinese herbs have all been purported to act as aphrodisiacs. Sadly, nearly an entire species of magnificent white rhinos has been slaughtered just to macerate their horns because of a belief that the resulting powder can enhance sexual experiences. Medical science has found no evidence that these aphrodisiacs work. Perhaps they have a placebo effect. In my clinical experience, I have found no ingestible animal part or herbal substance that will cure any sexual problems.
- Yohimbine
Of all the herbal substances believed to have aphrodisiac powers, yohimbine seems to be the most promising. Derived from the bark of the yohimbine tree, it has been considered an aphrodisiac by native cultures for hundreds of years. Initial studies have substantiated the claim. Dr. Christiaan Barnard, the eminent heart surgeon who pioneered human heart transplantation, used yohimbine on patients who developed impotence after surgery. He reported satisfactory results in 75 percent of his cases. However, mainstream medicine does not embrace yohimbine therapy. Yohimbine’s biochemical action is not understood. The original research was contaminated because yohimbine was used in combination with other drugs, primarily testosterone. So far, there is little reason for me to think that the bark of a tree can foster significant improvement in men with impotence.
- Nitroglycerin Paste and Minoxidil
One of my patients, in a dicey self-experiment, applied a nitroglycerin paste to his penile shaft. Because of its “vasoactive” profile, he concluded that it could increase blood flow. He eventually had to stop using it. During sex, the substance was absorbed by his wife’s vaginal mucosa, giving her severe headaches. The same might be true of the off-label use of minoxidil, which is marketed as an aid to hair growth in balding men. Because it also is a vasoactive substance, some have suggested that its use might produce better erections (or even hair!). I urge you to refrain from self-experiments with such products. There are plenty of proven alternatives.
- Alcohol and Drugs
Some substances create the illusion of enhanced sexuality and may be considered aphrodisiacs because they seem to take the edge off, calm you down, lower inhibitions, and produce a heightened sensitivity. To paraphrase one of Shakespeare’s wisest observations: drugs might add to desire, but they just as equally take away from performance. Drug and alcohol abuse and addiction can cause everything from a temporary failure to achieve erection to long-term impotence.
- “The Pills” (Viagra, Cialis, and Levitra)
No single development over the past thirty years has changed the landscape of men’s health as dramatically as the recent widespread use of erectile dysfunction medication, but it is important that men and women understand that Viagra, Cialis, and Levitra are not aphrodisiacs. They are not sexual cure-alls. They do not create desire; more accurately, these medications give a man the capacity to exercise his sexual potential. These drugs seem to be remarkably effective in patients who have an organic (biological) reason for their impotence. However, these drugs seem to have very little impact on men who are getting adequate erections, but who hope to make sex better (those men who use them as “performance-enhancing” drugs).
From my clinical experience, I long ago concluded that the greatest aphrodisiac ever invented is love itself. Just as love is an aphrodisiac, the opposite is also true: the biggest enemy of sexual desire is hate. For men in intimate relationships, nothing will diminish desire as quickly as anger, hostility, or resentment toward a partner. If men fail to express their feelings and resolve their conflicts, the situation just gets worse.
My clinical studies have proven that diminished desire caused by anger will lead to sexual difficulties. Of all the extenuating circumstances that can affect a man’s sexuality, the single most powerful factor is the nature of his relationship. If you are harboring animosity toward your partner, if you are rehashing angry feelings in your head without expressing them, if resentment has been accumulating in your heart so much that it obscures the love that brought you together, then how can it not affect what happens when you get into bed? This is why a man who aspires to a great sex life should learn to deal effectively with his feelings and not let them contaminate his relationships.
As time goes by, as the fires of passion diminish, and as the novelty of sex becomes routine, emotions guide the course of sexuality more than anything else. It is beyond the scope of my professional expertise to advise you on all the complexities of romantic and sexual relationships and the nuances of subtle emotions. What I can do is tell you what I tell my patients: remove all the anger and resentment from your relationship and your love life will be strong and long lasting. Keep the love and affection alive. Do not take your partner for granted. Do not let your appreciation wane. Do not let petty animosities overshadow the qualities that have kept you together.
Two mature people with a strong commitment have the greatest potential for mutually satisfying sex. This does not mean that problems will not arise. Every relationship has conflicts: sex, money, children, in-laws, and the thousand annoyances that make up everyday life. You must be aware that every conflict affects your sexuality. You also have to be aware that the most effective response to a conflict is to work things out in a healthy and effective way. Do everything in your power to resolve those difficulties in a forthright and honest manner.
Communicate. If you cannot do it on your own, then by all means find a counselor or a friend who can help you. Get your feelings out in the open. That does not just mean venting your emotions or allowing your feelings to come out in negative and hurtful ways. It means truly discussing the issues in an atmosphere of fairness and mutual respect where each party listens, as well as speaks.
Don’t be afraid to show vulnerability. If you are angry, express your negative feelings rather than holding them in and exploding at some inopportune moment. If your relationship is built on a solid foundation, then your partner will respond with equally genuine feelings. When that happens, the love you have buried beneath your anger has a good chance of rising to the surface, and your sexual desire is likely to rise with it. If you can do this, you won’t need to search far and wide for concoctions to improve your sex life.
Dudley Seth Danoff, MD, FACS, is president and founder of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, a Diplomate of the American Board of Urology, a Fellow of the American College of Surgeons, and author of The Ultimate Guide to Male Sexual Health.