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Natural Sex Boosters: Can You Rev Up Your
Got bedroom troubles? Waning sexual desire or erection problems are very common. Maybe you've been tempted to try ginseng, gingko, and similar supplements. There's no lack of products out there.
What are these supplements? Do they live up to their promises? Are there any studies showing they work? Do they have bad side effects? Are they worth the cash? Is a romantic bath for two a better solution?
Getting Sex Supplement Advice
For advice on women's supplements, we turned to Hilda Hutcherson, MD, clinical professor of obstetrics and gynecology at Columbia University Medical Center, and author of the book Sex and Pleasure: A Woman's Guide to Getting the Sex You Want and Need and Deserve.
The supplements are generally harmless, she tells WebMD. She has found that herbal oils and supplements do seem to help some women having trouble with sexual desire and vaginal dryness. Yet she always advises talking to your doctor before taking any supplements -- as some have dangerous side effects.
We also spoke with Christopher Saigal, MD, assistant professor of urology at UCLA School of Medicine, about men's supplements -- mostly for erectile dysfunction (ED). He's got an open mind about supplements that mimic Viagra, but he's also got definite opinions.
If you're buying an off-the-shelf supplement, the quality is worth questioning, Saigal says. "There is so much fraud in this industry," Saigal tells WebMD. "Go to a site that evaluates the contents, like Consumerlab.com. One evaluation of ginseng showed that half the brands had contaminants like pesticides. So buyer beware. Look for high-quality products."
Sexual Desire, Supplements and the Science
Ginseng: There are two kinds of ginseng -- Siberian ginseng, which is typically used as an aphrodisiac, and red Korean ginseng, which is used in Chinese traditional medicine and is better studied, explains Saigal.
"Ginseng, like a lot of herbs, is thought to work by helping the body make more nitric oxide -- as does Viagra," he says. "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, says Hutcherson. "Ginseng gives people energy, and you need energy and endurance for sex, right?"
Black Cohosh: In the past, black cohosh has been used to treat arthritis and muscle pain. 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," Hutcherson says. "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.
Some swear a supplement or two can get sexual desire sizzling again -- but what do the studies show?(continued)
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," Hutcherson says.
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 Viagra. 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," says Saigal.
Gingko: Gingko has been used in traditional Chinese medicine for thousands of years. Gingko leaf extract is used today to boost mental power, treat asthma, fatigue, and sexual dysfunction. Some studies show that gingko enhances the effects of nitric oxide -- which allows better blood flow to the penis.
"Gingko is one of those herbs that's pretty popular," says Saigal. "The thing is, there's no great data on it." Gingko is thought to help with sexual dysfunction related to antidepressant use, he notes. "One study showed that gingko 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," says Saigal. "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," Saigal adds. "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 -- and is traditionally used as an aphrodisiac, says Saigal. "There have been rat studies, but studies to support its use are very limited," he adds. "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, gingko, and ginseng.
"Some studies show that taking L-arginine and pycnogenol together boosts nitric oxide production," says Saigal. "Those weren't randomized trials [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, Hutcherson explains.
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, says Hutcherson. Zestras 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," Hutcherson explains. But "I don't know whether it's the Zestra that works or because they're rubbing the clitoris."
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," Hutcherson says.
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, Saigal says. "If the goal is a better erection, getting more testosterone won't help. I advise using a pharmaceutical instead. I would say, start with [Viagra, Cialis, or Levitra] first -- especially since 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," Hutcherson says. "Find something interesting that stimulates your mind, since the brain is the largest sex organ."
Her libido-boosting suggestions:
"There are so many things, you can never run out of ideas," Hutcherson says. "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, Saigal says.
Losing weight (if you're obese) and eating a low-fat diet also
helps restore sexual function, he adds. "You'll feel better about
yourself, and your partner will be more interested in you. You'll
also help your heart." And thats very sexy.
Source: By Jeanie Lerche Davis, www.webmd.com/diet/vitamins-supplements-8/natural-sex-boosters-can-you-rev-up-your-libido?ecd=wnl_sxr_071908&spon=912345_0
States Implementing Laws that Provide Immunity from Prostitution Charges for Minor Victims
Since the development of state protective response laws is an emerging area fraught with implementation challenges, many state statutory responses have been built on earlier models, with each state identifying an approach that works for that state and adapting it to its unique policy and resource landscape. Within the range of state responses, four general categories of protective system responses have emerged10:
1. Immunity without referral provides immunity from prostitution-related charges to direct juvenile sex trafficking victims away from a punitive response but does not statutorily direct them into an alternative system or specialized response for access to services.
2. Immunity with referral provides immunity from prostitution-related charges and directs juvenile sex trafficking victims to an alternative system or specialized response for access to services.
3. Law enforcement referral to a protective system response does not make minors immune from prostitution charges but directs or allows law enforcement to refer minors suspected of prostitution offenses to child welfare or other system-based services instead of arrest.
4. Diversion process does not make minors immune from prostitution charges but allows or requires juvenile sex trafficking victims to be directed into a diversion program through which victims can access specialized services and avoid a delinquency adjudication.
States that do not fit into these statutory categories may still be implementing components of a JuST Response. Based on existing research and knowledge gained from the experiences of states that have been implementing protective response laws, three basic elements have emerged as critical to a complete juvenile sex trafficking (JuST) response: statutory protective provisions, multidisciplinary interagency state system protocols, and access to an array of funded service options. Georgia and Maryland for example each have protocols for connecting youth to services or avoiding a punitive response. No doubt there are other non-punitive service responses beyond these statutory categories that have not yet been explored or developed.
To explore the methods and challenges of deploying protective responses that integrate the critical elements of statutes, systems and services, the JuST Response Mapping Report merges Shared Hopes research and policy analysis to provide a national overview of existing state juvenile sex trafficking responses and an in-depth analysis of responses in example states that represent each of the four statutory frameworks most commonly found under existing state laws. While this report goes beyond those frameworks and explores the implementation of system responses and access to services, there are two reasons for organizing state JuST responses according to their statutory frameworks:
(1) The states statutory framework is a prerequisite to statewide change: By mandating a fundamental shift in how the state views juvenile sex trafficking victimsfrom criminals to victims of exploitationthe statutory framework can survive shifts in power that informal policies and executive-led initiatives are less likely to survive. The stability provided by a framework of law makes it less difficult to commit resources and energy to the hard work of implementing a protective rather than a punitive response.
(2) Since four approaches to enacting a statutory framework implementing this paradigm shift have arisen over the past several years, comparing implementation of these responses allows for a more structured analysis, i.e., comparing one states immunity response with another states immunity response provides a more accurate reflection of how similar laws can play out very differently depending on each states policy and resource landscape. Comparing immunity with diversion, for example, illustrates how the different laws play out, but comparing immunity with immunity illustrates how the different approaches to implementation play out.
It should be noted that the division by statutory category is meant to help guide the reader through a comparison of approaches and is not meant to minimize the concurrent importance of system protocols and available services. In addition, a states political climate, resources and advocate personalities invariably influences the implementation of its protective response for juvenile sex trafficked victim. Comparing the implementation of immunity laws in Tennessee and Minnesota provides an excellent narrative of these differences. For instance, Minnesota has one of the best funded state governments in the country11 while Tennessee is more resource limited. While their statutes are similar in terms of providing immunity to minors, implementation of their laws has been very different.12
Two approaches to protecting victims that are not included here are an affirmative defense for sex trafficking victims or definitional changes intended to direct victims to an alternative system process, such as the person or child in need of services (PINS or CHINS). These approaches do not amount to a protective response in most cases because these lawswhile important in helping to lay a foundation for such lack a procedure to affirmatively direct minors out of the punitive system response and into services and/or place the burden on the victim to seek protection and services.
This report is a first step in ongoing research and is not inclusive of all promising state protective responses since over half of the states in the country have enacted some form of protective response law. For example, the responses of states such as Georgia13 that have developed strong agency or community protocols in lieu of supportive statutes are not covered herein.
11 Kiernan, John S.. States Most and Least Dependent on the Federal Government.,WalletHub. Evolution Finance, Inc., 2014., http://wallethub. com/edu/states-most-least-dependent-on-the-federal-government/2700/. Accessed February 24, 2015.
12 These approaches are further explored in the following chapters,
13 The Georgia Care Connection, recently established by the
Governors Office for Children and Families, identifies
commercially sexually exploited children and links them to services
without subjecting them to arrest. The Georgia Care Connection office
serves as the single point of entry and care coordination entity for
these commercially sexually exploited girls, ages 11-17. Learn more
States Implementing Laws that Provide Immunity
from Prostitution Charges for Minor Victims
By ensuring that all juvenile sex trafficking victims are directed away from a punitive court process that can re-traumatize victims and reinforce mistrust of the system, immunity from delinquency charges for prostitution and status offenses related to juvenile sex trafficking is a critical component of a protective response. However, enacting an immunity statute does not come without challenges. A common concern raised by advocates in states that have passed immunity laws is that youth may still be charged with status offenses that mask the intent to arrest victims for prostitution. This is especially prevalent in areas where law enforcement feel there is a lack of safe placement alternatives or a particularly high risk of re-exploitation. States that enact immunity laws in the absence of a statutory procedure to ensure youth receive a specialized service response may face a situation where child serving agencies are unable to adequately respond to a trafficking situation, leaving exploited youth with limited service options. First line responders such as law enforcement and social workers are thus faced with the heart wrenching decision to return a victim to a situation where there is risk of re-exploitation.
Even in states that have passed immunity laws that mandate law enforcement referral of juvenile sex trafficking victims to child serving agencies, factors such as lack of training or implementable protocols within child serving agencies or a lack of appropriately equipped service providers may still leave victims vulnerable to re-traumatization and exploitation. At the JuST Response Congressional Briefing, panelists from two states, Minnesota and Tennessee, discussed their strategies for enacting immunity statutes as the core of their states protective response. Despite the similarity in their laws, which both lack a statutory procedure that specifically mandates a child welfare or alternative system response, the challenges and successes encountered in implementing their laws vary greatly. In Tennessee, immunity laws were enacted prior to identifying funding procedures and protocols to connect youth to services. This progressive law codified thestatus of juvenile sex trafficking as victims of trafficking and created a sense of urgency that has motivated state agencies to come to the table to create a state-wide protocol for identifying and responding to juvenile sex trafficking victims. In Minnesota, amendments to the state delinquency laws established a three-year deadline for the legislature to fund service protocols for responding to juvenile sex trafficking victims before the law establishing immunity for minors became effective. As a result, Minnesotas No Wrong Door14 campaign was able to secure government funding to establish a comprehensive, multidisciplinary plan to ensure communities across the state have the knowledge to identify and the skills and resources to serve juvenile sex trafficking victims.
Another approach to immunity laws is represented by Illinois and Kentucky, both of which combined immunity with a mandatory referral to child welfare for services. While Illinois enacted its law much earlier, enabling Kentucky to build upon Illinois model, similar challenges to implementation have arisen in both states. Such challenges, though similar, provide important learning as solutions are shaped by the policy and resource landscape peculiar to each state.
Oregon - State law establishes a protective response for DMST victims through existing systems1 - no
Type of protective system response: Immunity without referral to
alternative system / Immunity with referral to alternative system No
immunity, law enforcement referral to protective system / No
immunity, diversion n/a