From The March 1999 Issue of Nutrition Science News
By Letha Hadady, D.Ac.
The newest prescription rageViagra®is bringing the issue of sexual potency and vitality into the limelight. This interest is also bringing to light some of the oldest natural remedies for both sexual dysfunction and enhancement. Traditional Chinese herbalists treat sexual imbalances such as impotence or reduced desire by improving adrenal energy, muscle strength and endurance with herbs that increase vitality and immunity. For improved sexuality, herbal adrenal tonics are often combined with moistening or blood-building herbs that reduce stress and increase sexual fluids. Harmonizing sexual drive and capacity with sexual fluids is said to bring happiness, compassion and love.
Sexual vitality can become blocked for a variety of reasons, including a lack of strength or energy, or a problem with circulation, any of which can be caused by fatigue and stress. Chinese medicine's tonifying herbal combinations are not aphrodisiacsthey do not directly arouse sexual desirerather, they make sexual activity and enthusiasm possible by fortifying natural vitality.
Sexual Strength and Energy
Traditional Chinese herbalists have for centuries recommended Chinese ginseng (Panax ginseng) or ren shen in Mandarin Chinese, to improve vitality and sexual wellness for both sexes. Panax, a well-known adaptogen, is said to reduce fatigue and stress as it strengthens the body. Sexual performance could be complicated by stress if it manifests as heart weakness, blood sugar imbalances or poor circulation.
In 1997 a professor at Yale University's School of Medicine in New Haven, Conn., reported that Chinese ginseng stimulates nitric oxide, a neurotransmitter that mediates a variety of bodily actions including blood vessel dilation, blood pressure regulation and blood clot prevention.
 Nitric oxide activates an enzyme that relaxes smooth muscles, allowing blood to flow. When this happens in the corpus cavernosum, an erection is possible. Viagra, the sexual potency drug, also allows nitric oxide to relax smooth muscles in the penis but the drug comes with side effects. While Viagra emphasizes sexual performance, ginseng is said to tone the entire endocrine system for a more holistic beneficial effect.
People with high blood pressure, chronic headaches, irritability or insomnia should avoid using panax on a regular basis to avoid the risk of fevers. However, panax can be combined with anti-inflammatory or moistening herbs such as Solomon's seal (Polygonum multiflorum) or he shou wu, to balance ginseng's stimulating effects. A typical side effect of panax is temporary facial flushing or short-lived dizziness. These effects are most likely in people who are overheated or who have a cold.
Cordyceps (Cordyceps sinensis) or tung chung hsia tsao, a fungus that has been used medicinally for centuries, is highly valued in China as a tonic for general health. Traditionally, cordyceps is simmered in a double boiler for several hours, and the liquid is drunk as a tea. It is categorized as a neutral (not heating or cooling), sweet-tasting restorative.
Often, sexual tonic herbs are combined for optimal effect. For example, I recommend combining panax with ginkgo (Ginkgo biloba) or yin guo and sarsaparilla (Smilax medica). This combination is said to be more effective for both men and women than any one of those herbs used alone for treating sexual vitality problems. Ginkgo increases peripheral blood circulation to all extremities. Sarsaparilla, a diuretic, is said to carry the enlivening action of ginseng and ginkgo to the sexual area so they can increase circulation and enhance sensation.
Lung Fu Chuang Yeung Dan is a traditional Chinese formula recommended to men and women who suffer fatigue from overwork, blood deficiency, illness, emotional upset and insomnia. It contains panax, epimedium (Epimedium grandiflorum) or yin yang huo, and herba cistanches (Cistanche salsa) or rou cong rongall sexually stimulating herbs that are also believed to treat impotence.
In men, epimedium is said to increase sperm production and stimulate the sensory nerves, thus increasing sexual desire and strength. The herb is used to treat impotence, frequent urination from weakness, poor memory due to adrenal insufficiency, timidity, and painful lower back and knees. Studies done at the General Hospital of Beijing show epimedium improves sexuality and quality of life in patients with chronic renal failure. 
As for general health, although research is preliminary, animal studies at Seoul National University in Korea indicate that icariin, a flavonol glycoside and major constituent of epimedium, may reduce liver toxins.  Two other laboratory animal studies at the Chengdu College of Traditional Chinese Medicine and the Department of Pharmacy at the University of Helsinki, Finland, indicate that epimedium may have immuno-enhancing properties. [4,5] Herbs such as epimedium, which may also reduce liver and heart stress while increasing adrenal energy, are said to be beneficial sexual tonics because they strengthen immunity to illness and fatigue.
Traditionally, a tea is made by simmering a handful of dried epimedium leaves for 15 minutes in a quart of springwater. Epimedium is not recommended for long-term use nor is it indicated for people who have fevers or a high sex drive. Overuse might lead to dizziness, dry mouth, thirst or nosebleed. This herb is often combined with (Schisandra chinensis) or wu wei zi, and either lycium fruit (Lycii chinensis), gou qi zi, or Solomon's seal to balance epimedium's drying effects.
Solomon's seal is a blood-building and moistening herb described as being capable of enriching nutrition, enforcing the spirit, generating bodily power, and preventing illness and aging. It reverses the damage that accumulates over time from stress and modern life.
Curculigo orchiodes (Rhizoma curculiginis) or xian mao, is another herb used in Chinese medicine for impotence, urinary incontinence and infertility caused by conditions of weakness. Customers can simmer a handful of the curculigo twigs in a quart of water for 15 minutes for a mild-tasting tea. To begin, they should drink no more than one cup per day.
Circulation and Sex
Not all sexual problems are related to weakness and exhaustion. Inflammation and pain can build up, making sex uncomfortable. By holding in stress and anxiety, poor circulation can manifest as discomfort in the groin. Even in the absence of problems, increasing circulation in the sexual area improves vitality, particularly for those who may have stagnant lifestyles or who may hold in their emotions.
One of the best traditional Chinese remedies for prostate and lower abdomen discomfort is called Kai Kit Wan, which contains cow soapwort (Vaccaria seqetalis) or wang bu liu xing; peony bark (Paeonia suffruticosa and P. moutan) or mu dan pi; astragalus (Astragalus spp.) or huang qi; patrinia herb (Patrinia villoea) or bei jiang; hogfennel root (Peucedanum praeruptorum) or qian hu; licorice (Glycyrrhiza glabra) or gan cao; costus root (Saussurea lappa) or mu xiang; and akebia (Akebia trifoliata) or mu tong.
Chinese herbalists say the formula works because the two forms of peony increase circulation to break apart congestion pain, astragalus reduces water retention and builds strength, and hogfennel root and licorice relax smooth muscles to redirect the action of the other herbs to the sexual area. This combination is said to condition and promote prostate function and to increase blood circulation in the genital area, lower abdomen and inner thighs, creating a sense of opening, ease and healthy circulation. Such a combination has traditionally been used long-term to correct chronic prostatitis, painful or bloody urination, and testes pain. An herbal combination such as this, which allows blood to flow freely again, can release constriction and reduce discomfort. I recommend taking it with zinc for prostate conditions.
A Women's Medicine Chest
Women's sexual problems are often related to fatigue, lack of sexual interest or menstrual and hormonal irregularities. Several adrenal tonics are useful for a variety of energy-related problems. Nettle (Urtica dioica), an adrenal tonic, has traditionally worked well for those weakened by autoimmune imbalances, allergies, liver problems and long-term exhaustion. Clove (Syzygium aromaticum), fenugreek (Trigonella foenumgraecum) and sage (Salvia officinalis) are all heating spices that have been used for centuries to create energy and sexual desire in both women and men. People with low backaches, frequent light-colored urine or pale tongues, which indicate slow metabolism, should use a pinch in hot water as tea.
If lubrication is an issue, avoid clove, fenugreek and sage because these heating herbs are too inflammatory and drying; instead take polygonum. Cherries, berries, leafy greens, prunes, plums and peaches are cooling, moistening foods said to reduce inflammation and nervousness while improving menstrual regularity.
If a woman's sexual fatigue is complicated by hormonal factors, typified by symptoms such as fevers, night sweats, hot flashes and facial flushing, Chinese herbalists recommend a formula combining cooling herbs with aphrodisiacs. For example, anemarrhena (Anemarrhena asphodeloides) or zhi zi, which treats fever, irritability, thirst, rapid pulse and dry cough with thick yellow sputum, is often combined with herba cistanches, which treats impotence, urinary incontinence, and pain and chills in the lower back and knees. To make a substitute from garden herbs and kitchen spices, combine cooling skullcap (Scutellaria lateriflora) and cumin (Cuminum cyminum) with cloves. The result is a warming adrenal stimulant.
A natural, holistic approach to sexual remedies frees sex from a disease category and puts it in the context of vitality and health. This collection of Chinese sexual potency foods and herbs can make sex possible for men and women both now and into old age.
Letha Hadady, D.Ac., author of Asian Health Secrets (Three Rivers, 1998) and Personal Renewal (Harmony, 1999), is an acupuncturist and herbalist living in New York.
Panax ginseng pharmacology: a nitric oxide link?
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