Ginseng: There are several types of ginseng, two of which are Siberian ginseng, which is typically used as an aphrodisiac, and red Korean or Asian ginseng, which is used in Chinese traditional medicine and has slightly more research behind it, Saigal says.

Ginseng, like a lot of herbs, is thought to work by helping the body make more nitric oxide — as does Viagra. A couple of good studies showed some effect from ginseng, so people can look at this as an alternative to Viagra. But it’s not going to be as effective as Viagra or Levitra or Cialis.

Ginseng appears to help women, too. Ginseng gives people energy and may improve mood, and you need energy and endurance for sex.

Black Cohosh: In the past, black cohosh has been used to treat arthritis and muscle pain and was traditionally used for “female” complaints. Today, it is marketed to treat hot flashes, night sweats, vaginal dryness, premenstrual syndrome, and other menopausal symptoms.

Black cohosh has estrogen-like properties, and increases blood flow to the pelvis — which increases arousal and response to sexual stimulation.  More blood flow means more lubrication, and that’s good for sex.  The National Institutes of Health (NIH) is funding studies of black cohosh as a treatment for menopausal symptoms.

Chasteberry (Vitex): Chasteberry is native to the Mediterranean region and western Asia — and is approved in Germany for premenstrual and menstrual problems. It is said to increase sexual desire by boosting the hormone progesterone and the brain chemical dopamine.

Chasteberry also decreases the brain chemical prolactin that interferes with sexual desire.  It works for some patients..

L-Arginine (Arginine): Arginine is an amino acid the body needs for many functions, like boosting immunity. The body also uses arginine to produce nitric oxide — an effect similar to the way Viagra works. Arginine has been found to improve blood flow to the penis.

One study showed improvements when L-arginine, glutamate, and yohimbine were combined. (Yohimbine is FDA approved as a drug therapy for ED, so how much of the effect was due to arginine is unknown.) Another study showed “significant improvement in sexual function” when L-arginine and pycnogenol were combined — but not when L-arginine was used alone.

Arginine is generally safe, although there may be drug interactions — especially with high blood pressure drugs. In addition, men taking Cialis, Levitra, or Viagra – or nitroglycerin (nitrates) for chest pain (angina) — should be cautious as combining them with L-arginine can cause a potentially serious drop in blood pressure.

It’s something to try. And if it works for those arteries, it could also help the heart arteries, too. Men with heart disease might benefit most from taking arginine.

Ginkgo: Ginkgo has been used in traditional Chinese medicine for thousands of years. Ginkgo leaf extract is used today to boost mental power, help Alzheimer’s, and treat tinnitus, asthma, fatigue, and sexual dysfunction. Some studies show that gingko enhances the effects of nitric oxide — which allows better blood flow to the penis.

Ginkgo is one of those herbs that are pretty popular. The thing is there’s no great data for sexual function on it.  Ginkgo is thought to help with sexual dysfunction related to antidepressant use. One study showed that ginkgo made no difference; the other showed some slight difference. There may be a large placebo effect, but there have been anecdotal reports that it helps some people.

Yohimbe: Yohimbe is derived from bark of the yohimbe tree, native to Africa — and traditionally used as an aphrodisiac. In current times, this extract has been shown to be moderately effective in treating ED. It may perhaps increase erections and libido, because it has some effect on the brain.

Some studies indicate that yohimbe may help ED in men taking antidepressants, although research in this area is limited. Caution: Some yohimbe bark extracts may not contain significant amounts of yohimbine, so they may not have these effects. There’s a buyer-beware issue.  A lot of supplements use names that sound like yohimbe but are basically worthless. Look at the content label. Make sure it’s from the yohimbe tree. Also, look for the name of the active ingredient — yohimbine or yohimbine hydrochloride.

Maca: Maca is a vegetable native to Peru that is traditionally used as an aphrodisiac,  There have been rat studies, but studies to support its use are very limited,  but because it’s a vegetable, maca won’t hurt you.

Pycnogenol: Pycnogenol is an extract of the bark from French maritime pine. It is believed that pycnogenol helps protect blood vessels and boost production of nitric oxide — similar to L-arginine, yohimbe, ginkgo, and ginseng.

Some studies show that taking L-arginine and pycnogenol together boosts nitric oxide production. Those weren’t randomized trials [meaning the combination wasn’t compared to placebo], but there was an effect. So there’s some effect in combining the two.

ArginMax: If female patients are interested in herbs, Hutcherson guides them to ArginMax (a combination of Panax ginseng, L-arginine, ginkgo biloba, damiana, multivitamins, and minerals).

Two large clinical studies found that ArginMax improved sexual function in menopausal and other women with low sexual desire.

Zestra for Women: Zestra, a blend of botanical oils and extracts, is designed to increase female sexual desire, arousal, pleasure, and satisfaction when applied to the female genitalia.  Zestra’s ingredients include: borage seed oil, evening primrose oil, angelica extract, coleus extract, vitamin C, and vitamin E.

In a preliminary study, Zestra was shown to increase sexual sensation, arousal, pleasure, and satisfaction in “normal women” and women with arousal problems. Zestra also helped with sexual side effects related to antidepressants.

You rub it on your clitoris, which is supposed to increase blood flow.

The NIH is launching a clinical study comparing Zestra to placebo in women with a variety of sexual dysfunctions, including problems with interest, desire, arousal, and orgasm.

Vitamin E: Vitamin E oil — when applied to the vagina — helps improve lubrication. It is very effective. .

Cautionary Notes About DHEA Supplements

DHEA (dehydroepiandrosterone) is a natural hormone that is converted into male and female sex hormones in the body. DHEA is sold as an antiaging supplement that improves energy, strength, and muscle, plus it increases immunity and burns fat.

However, the NIH says, “there is no conclusive evidence that DHEA supplements do any of these things,” and “there is little scientific evidence to support the use of DHEA as a ‘rejuvenating’ hormone.”

Long-term effects of DHEA supplements have not been studied — but there are “early signs that these supplements, even when taken briefly, may have detrimental effects on the body, including liver damage.”

Even if DHEA does rev your libido, it won’t help erections,  If the goal is a better erection, getting more testosterone won’t help.  We don’t know the long-term effects of DHEA

Keeping Your Libido Healthy

Pills aren’t the only answer. If flagging sexual desire is the problem, find something that adds spice. Find something interesting that stimulates your mind, since the brain is the largest sex organ.

Her libido-boosting suggestions:

• Sleep in the bedroom. Have sex anywhere else — the den, kitchen, or laundry room.
• Seize the moment wherever, whenever, it hits.
• Buy something new. New lingerie definitely qualifies.
• Send hot sizzling notes to each other during the day.
• Buy a sex toy. Read an erotic novel together. Watch an erotic video.

There are so many things, you can never run out of ideas. What helps most — the best aphrodisiac — is going on a field trip to an adult store together. Try different things, touch, giggle, have a good time. You find you can’t wait to get home to try them.

Protecting Your Sexual Desire

To keep your libido in prime form, you’ve got to walk, jog — do some kind of aerobic exercise — daily. Maybe it doesn’t sound sexy, but a two-mile walk every day keeps the blood flowing.

Losing weight (if you’re obese) and eating a low-fat diet also helps restore sexual function. You’ll feel better about yourself, and your partner will be more interested in you. You’ll also help your heart.  And that’s very sexy.