Julian Whitaker, MD
Joe’s friends decided to surprise him on his 80th birthday with a racy singing telegram. On the big day, he answered the door, and there was a sultry blonde in fishnet stockings, miniskirt, and a low-cut blouse. “Would you like some super sex?” she purred. Joe thought about it for a minute and replied, “What kind of soup?”
No doubt about it, sexual desire and function slow down as we get older. What doesn’t change, however, is our lifelong need for intimacy, and for many, that includes satisfying sexual relations. It’s important for men and women to understand the challenges they and their partners face during all stages of life—and to be aware of therapies that enhance libido and performance in both sexes.
Good Health = Good Sex
You can’t expect to have top-notch sexual function if you have poor overall health. Hypertension, cardiovascular disease, uncontrolled diabetes, and other disorders involving impaired circulation are commonly linked with sexual dysfunction. That’s because optimal blood flow is required to produce erections in men and clitoral engorgement in women. Other conditions that can affect interest in sex and the ability to act on that interest include anxiety, depression, hormonal imbalances, chronic pain, and neurological problems. Once these health issues are tackled, desire and function often return.
Problem is, some of the medications used to treat these diseases make things even worse. For example, psychotropic drugs are notorious for causing significant sexual dysfunction. Studies suggest that up to 60 percent of the men and women taking Prozac and related SSRI antidepressants have difficulty achieving orgasm. Also problematic are some blood pressure–lowering drugs (especially beta blockers), stimulants, narcotics, antihistamines, sleeping pills, and peptic ulcer and heart meds—more than 130 prescription drugs in all!
Recently, I heard from a subscriber whose husband had been taking a number of drugs that robbed him of his sex drive. It was very frustrating for both of them. He finally got so fed up with feeling lousy on all of his medications that he replaced them with CoQ10, L-arginine, and other nutritional supplements. Now his libido is back and their sex life is “fantastic.”
Then there are lifestyle issues. Harvard researchers have found that men who eat a good diet, exercise regularly, and maintain their optimal weight are able to delay age-associated erectile dysfunction by about 10 years! Among the bad habits that contribute to sexual problems are drinking too much alcohol, overeating (obesity), and smoking. As you can see, anything you can do to improve your overall health will also improve your sexual function.
HRT to the Rescue
A hallmark of getting older—and what many experts believe to be an underlying cause of aging—is declining levels of hormones. As a woman’s production of estrogen gears down and her monthly cycles cease, the vagina loses elasticity and becomes drier, which makes intercourse difficult and uncomfortable. No wonder some women lose interest in sex! Men, you’re not off the hook either. As testosterone levels fall, erections take longer and are less firm, and libido may take a hit as well.
Fortunately, there’s a solution: natural hormone replacement therapy. Estrogen can be a lifesaver for women during and after menopause. It relieves hot flashes, improves vaginal tone and dryness, and lifts mood, which often translates into better sexual function. Hormone replacement therapy—particularly with bioidentical hormones, which are exactly like those produced in your body—can be a godsend at this time of life.
If you’re not crazy about the idea of hormone replacement, you should still consider topical estrogen. When applied directly to the vagina, it doesn’t have the systemic effects of full-blown hormone replacement therapy. It only stimulates estrogen receptors in the vagina, which plumps up tissues and naturally restores lubrication. Though a variety of over-the-counter lubricants such as Replens and KY Jelly work fairly well, my patients report near-miraculous results with vaginal estrogen.
Women who want a libido booster should talk to their doctors about testosterone. Testosterone is the hormone of desire. A small amount of weak testosterone cream, applied to the skin daily, is the best therapy I know for restoring female sexual desire. Another option is DHEA, a hormone that converts into testosterone in the body. Results aren’t as predictable as those of topical testosterone, but DHEA doesn’t require a prescription.
Improving Male Sexual Function
I have one thing to say to men who are having sexual difficulties: Give supplemental testosterone a try. Although men don’t experience a defining “event” such as menopause, testosterone production tapers off throughout adulthood. This decline is linked not only with sexual problems but also with increased risk of obesity, loss of muscle and bone mass, heart disease, diabetes, and even death.
Supplemental testosterone is an amazing libido lifter. High levels of this hormone explain why young men think about sex so often. If lack of interest is your problem, I can almost guarantee it will work. But sexual desire isn’t the main problem for most men—it’s erectile dysfunction (ED). And testosterone can also improve function. Given its many benefits, I recommend it as a first-line therapy for this condition.
If testosterone doesn’t work, you can move on to alternatives such as Viagra and other ED drugs. No, they aren’t perfect—they interact with a number of medications and are tied to several cases of vision loss. But erectile dysfunction is a serious concern for many men, and these drugs work for the majority who use them. Many over-the-counter supplements claim to improve erectile function but, as far as I can tell, few live up to the hype. The most promising candidate is L-arginine, which works on the same principle as Viagra. If all else fails, I’d recommend either a vacuum pump or penile injections.
- Bioidentical hormone replacement therapy requires a prescription and must be ordered from a compounding pharmacy. To locate such a pharmacy, contact the International Academy of Compounding Pharmacists (IACP) at (800) 927-4227 or iacprx.org. Although supplemental testosterone does not cause prostate cancer, it should not be taken by men with this condition.
- A comprehensive natural hormone replacement therapy program requires physician supervision. To see a doctor at the Whitaker Wellness Institute, call (866) 944-8253or click here.
- Bacon CG, et al. Sexual function in men older than 50 years of age: results from the Health Professionals follow-up study. Ann Intern Med. 2003 Aug 5;139(3):161–188.
Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2008. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.