Natural Aphrodisiacs

Sexual Attraction

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Sexual Attraction Summary


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I started using this book straight away after buying it. This is a guide like no other; it is friendly, direct and full of proven practical tips to develop your skills.

As a whole, this book contains everything you need to know about this subject. I would recommend it as a guide for beginners as well as experts and everyone in between.

Fenugreek Seed And Leaf

Called in Sanskrit methika, fenugreek was cultivated in Egypt as early as 1000 BC. It was prized throughout the Middle East and in India as a flavoring, medicine, and fumigant, while in Europe mainly for medicinal use. The Egyptians and Indians soaked the seeds in water until they swelled and then used them to reduce fevers and aid digestion. By AD 1050, fenugreek had spread as far as China. The name fenugreek is derived from the Latin word foenum graecum, which translates to Greek hay (strong haylike aroma of dried leaves) it was never used as a spice in Greek cooking. Today, North Indians and Middle Easterners enjoy fenugreek (both seeds and leaves) in their cooking, but many Westerners do not like its strong bitter taste. Origin and Varieties native to the eastern Mediterranean, fenugreek is now cultivated in India, Pakistan, France, Morocco, Greece, Lebanon, Germany, Argentina, and the United States. Common Names fenugreek was called Greek hay and goat's horn or cow's horn in...

Sexual Desire Disorders

The DSM-IV-TR (6) category of Sexual and Gender Disorders is divided into three parts, one of which is Sexual Dysfunctions. One of the group of sexual dysfunctions is Sexual Desire Disorders (SDD) of which there are two kinds (A) hypoactive sexual desire disorder (HSDD) and (B) sexual aversion disorder (SAD). No distinction is made between SDDs that affect men and those affecting women. The assumption is evidently made that sexual desire and desire problems are the same in both gender groups a concept that is debatable. According to DSM-IV-TR (6), the principal distinguishing feature of SAD is a persistent or recurrent aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner. The diagnosis is somewhat controversial in that some observers think that sexual desire problems exist on a continuum, rather than in separate categories. As the diagnosis of SAD is rarely made in men, and because a Pubmed search failed to reveal any articles with this...

Ginseng And Aphrodisiac Activity

The reported occurrence of oestrone, oestradiol and oestriol in liposoluble fractions of ginseng extracts, based on TLC results, was not confirmed. Some workers likened tail erection produced in test animals to aphrodisiac agent effect. 0ther workers suggested that increased deoxyribonucleic acid (DNA), ribonucleic acid (RNA) and protein formation due to ginsenoside administration offered an explanation. The hormone-like phenomenon was also related to the superficial structural resemblance of steroid hormones and digitalis cardioactive glycosides to the ginsenosides, but closer investigation of the spatial conformations of such compounds clearly shows that the ginsenosides are quite different and would not interfere with the steroid hormone receptors and, under physiological conditions in human subjects, the ginsenosides do not interfere with the progesterone receptors. Thus, despite the many reports of the use of ginseng in the treatment of impotence and penile dysfunction, no simple...

Closer Look At The Biological Basis Of Womens Sexual Desire And Arousability Including The Role Of Androgens

The neuroendocrine basis of sexual desire interest is poorly understood. The effects on sexuality of medications with known or partially known mechanisms of action suggest that more than 30 neurotransmitters, peptides, and hormones are involved in the sexual response. Currently, the most clinically important include noradrenaline, dopamine, oxytocin, and serotonin via 5HT1A and 5HT2C receptors all considered to be prosexual. Serotonin acting via most 5HT receptor sites, prolactin, and GABA, are considered sexually negative. The role of dopamine has been investigated particularly in rodents. Dopamin-ergic input from the ventral tegmental area, particularly to the nucleus accumbens and forebrain is important for cognitive and reward processes. Dopamine administration into the nuclear accumbens has been found to stimulate the anticipatory phase (or appetitive phase) of a sexual activity (54). The paraventricular nucleus and the medial preoptic area of the hypothalamus regulate the...

Traditional Markers Of Sexual Desire

Fantasies, which are a marker of sexual desire in DSM-IV-TR may, in fact, serve as a deliberate means of creating arousal and reinforcing desire. Data confirm the clinical experience that women fantasize to deliberately focus on their sexual feelings and avoid the distractions that are interfering with their sexual response (47). Awareness of sexual desire is not the most frequent reason women accept or initiate sexual activity (1 -6).

Normal Sexual Desire For

If one accepts the notion that sexuality generally and sexual desire in particular may be different in men and women, another question quickly follows when considering sexual desire, what is 'normal' for men A corollary to this question is since there is a general understanding that sexual activity changes with age, what represents normal sexual desire for men as they get older An exceptional source of information on men and sexuality (including sexual desire) is the Massachusetts Male Aging Study (MMAS), a survey that involved a random sample of men in the general population aged 40-70, and one in which questions were asked about sexual issues from the viewpoint of both behavior and subjective thinking (9). A total of 1709 men participated in the study. A self-administered questionnaire included 23 items on such sex-related subjects as satisfaction frequency of activity frequency of desire frequency of thoughts, fantasies, or erotic dreams frequency of erections and erectile...


Historical note Fenugreek's seeds and leaves are used not only as food but also as an ingredient in traditional medicine. It is indigenous to Western Asia and Southern Europe, but is now mainly cultivated in India, Pakistan, France, Argentina and North African countries. In ancient times it was used as an aphrodisiac by the Egyptians and, together with honey, for the treatment of rickets, diabetes, dyspepsia, rheumatism, anaemia and constipation. It has also been described in early Greek and Latin pharmacopoeias for hyperglycaemia and was used by Yemenite Jews for type 2 diabetes (Yeh et al 2003). In India and China it is still widely used as a therapeutic agent. In the United States, it has been used since the 1 9th century for postmenopausal vaginal dryness and dysmenorrhea (Ulbricht & Basch 2005).

Spice Use In The West

In the West, precious Eastern spices were collected and treated like jewels, given as gifts, or used for ransom or for currency when purchasing cows, goats, or sheep. From the Bible, we know that King Solomon counted spices among the valuables in his treasury. Ancient Egyptian rulers used spices such as sesame, fenugreek, cinnamon, anise, cardamom, saffron, caraway, and mustard for embalming, as body ointments, and as fumigants in their homes. Many of the spices described in ancient western texts and writings are not grown in the West but are native to India and other eastern countries. The great desire for these spices became a driving force in transcontinental trade between the East and the West.

Assessment Of Low Desireinterest And The Associated Low Arousability To Identify Therapeutic Options

The DSM-IV-TR definition of hypoactive sexual desire disorder is problematic because its only focus is on initial desire, does not acknowledge the many reasons that motivate the woman towards sexual activity, and ignores the broad range of frequency of fantasies among sexually healthy women. An international group has recently proposed the following definition for women's sexual interest desire disorder

Significance to humans

All species are hunted and trapped for their meat, which is often a favorite delicacy of indigenous people, and for their skins and scales, which are involved in international trade. Their scales are often used for adornment and good-luck charms for example, they are made into rings and used as charms against rheumatic fever. In Asia, powdered scales are believed to be of medicinal value. The Chinese people have extensively hunted pangolins because the animal's scales are traditionally thought to contain medicinal attributes, such as an antiseptic in fighting fever and skin disease. Its skin is thought to be an aphrodisiac by some hill tribes.

Reported Therapeutic Effects of Spices

Is a wonder medicine and has been used and researched for its many healing properties. Curcumin and curcumene in turmeric are the active compounds. Turmeric has protection against free radical damage and cancer prevention possesses anti-inflammatory properties by lowering histamine levels protects the liver against toxic compounds reduces platelets from clumping together thereby improving circulation and protecting against arteriosclerosis prevents cancer acts as an antipeptic ulcer and antidyspepsia agent and heals wounds. Researchers at UCLA (University of California at Los Angeles) have shown curcumin to slow the formation of, and even destroy, accumulated plaque deposits that play a key role in development of Alzheimer's disease. Allicin in garlic lowers cholesterol, capsaicin in chile peppers prevents blood clotting, trigonelline in fenugreek seeds prevents rise in blood sugar, and gingerol in ginger aids digestion. Research is being conducted on many more spices. Fenugreek Seed...

Xiisexual Dysfunctions And Paraphilias

Should be considered during the assessment of Sexual Dysfunctions. These cultural variations may affect sexual desire, expectations, and attitudes about performance. In some societies, a female sexual desire is not considered very relevant particularly when fertility is the primary concern (Castillo, 1997 DSM-IV, 1994, p. 495). In the case of the paraphilias, the DSM-IV (1994, p. 524) only suggests that these disorders might be appropriate in one culture and, at the same time, they may be seen as inappropriate in other cultures this makes the diagnosis of paraphilias across cultures and religions a complicated task for the clinician.

Survivorship Issues And Hrql

To understand the magnitude of HRQL issues among cancer survivors, we have classified these concepts into discrete domains, however it is understood that they represent a highly interrelated and dynamic system. Adhering to this model of self-reported health, the late effects of cancer can have wide spread ramifications. For example, many of the late physical effects (e.g., pain, fatigue, urinary incontinence, infertility) can also have significant emotional and social consequences. Since those with increasing age also represent a large segment of cancer survivors, it is sometimes difficult to determine whether physical changes are predominantly age or cancer related (e.g., fatigue, decreased libido, weakness). Apart from the observed physical changes, the psychosocial and existential issues acknowledged by survivors

Voyeurism Exhibitionism and Frotteurism

Exhibitionism must be distinguished from nudist interests, such as enjoyment of vacationing at nude beaches and resorts, and from prank behaviors, such as flashing and mooning. While sometimes offensive or illegal, these do not involve sexual arousal. Fedoroff has stated that exhibitionists have no interest in experiences such as nude beaches, where social norms are intolerant of overt expressions of sexual arousal (34). However, in the authors' research, a small number of diagnosed exhibitionists have reported such overlapping interests and behaviors. A exhibitionistic variant that reflects this overlap is the seeking of approval or validation, such as in the form of applause, as the exhibitionist perceives his victims more as an audience, as does the flasher, than as individuals upon whom he perpetrates harm. Frotteurism is a paraphilic preference for rubbing one's genitals against an unsuspecting person. This paraphilia most often occurs in crowded public places where the frotteur...

Fetishism and Transvestic Fetishism

Fetishism was first described in 1886 by Richard von Krafft-Ebing and in 1887 by French psychologist Alfred Binet (41-43). The essential feature is the necessity for an inanimate object to achieve or maintain sexual arousal, either in fantasy or in actual behavior. The fetish is often preferred or required for arousal, egosyn-tonic, and rarely the cause of personal distress. Individuals may experience sexual dysfunction when engaging sexually without use of the fetishistic object or fantasy. Transvestic fetishists report a spectrum of behaviors and cognitions. It is important to note that for some, the need for erotic arousal abates over time. As the erotic cross-dresser ages, his cross-dressing may be used more to reduce anxiety than to produce sexual arousal (54).

The Behavioristic View

An often used method to gain control of the vaginal muscles was described by Luyens (34). According to this author, a woman can become conscious of her vaginal muscles by looking at her genitals using a hand-mirror and then making squeezing and bearing-down motions with the vagina. Often, first attempts are unsuccessful, because many women are unable to localize these muscle groups and pull in their stomach instead. However, this can be learned by means of pelvic floor muscle exercises. An additional advantage of pelvic floor muscle exercises is that these exercises have a positive effect on the intensity with which genital sensations are experienced during sexual arousal.

Causes and symptoms

HSDD may be a primary condition in which the patient has never felt much sexual desire or interest, or it may have occurred secondarily when the patient formerly had sexual desire, but no longer has interest. If lifelong or primary, HSDD may be the consequence of sexual trauma such as incest, sexual abuse, or rape. In the absence of sexual trauma, there is often a repressive family attitude concerning sex that is sometimes enhanced by rigid religious training. A third possibility is that initial attempts at sexual intercourse resulted in pain or sexual failure. Rarely, HSDD in both males and females may result from insufficient levels of the male sex hormone, testosterone. and eventually is absent, often resulting in serious marital discord. HSDD may be selective and focused against a specific sexual partner. When boredom with the usual sexual partner is the cause and frequency of sex with the usual partner decreases, real or fantasized sexual desire toward others may be...

Vulvar Vestibulitis Syndrome

Vulvar Vestibulitis Treatment

Factors such as psychological distress, anxiety, depression, low sexual self-esteem, harm avoidance, somatization, shyness, and pain catastrophization (41,55,56,60,68,69) have been found in women with vulvar vestibulitis. Whether they precede or develop subsequent to the pain remains to be elucidated however, it is crucial to investigate the role of these factors in the maintenance of dyspareunia as negative affect has been shown to modulate pain intensity (70). Negative affect is also associated with an increase in attention towards pain stimuli, otherwise known as hypervigilance (71), which in turn can increase perceived pain intensity (72). In a recent study (73), hypervigilance for pain stimuli was examined in women with vestibulitis and matched control women. Results indicated that women with vulvar vestibulitis syndrome reported hypervigilance to coital pain and exhibited a selective attentional bias towards pain stimuli, an effect mediated by anxiety and fear of pain. These...

Mints Spearmint And Peppermint

Spearmint was the symbol of hospitality in traditional Europe, where it was crushed and used in baths and other leisure places. It was called Herba Santa Maria in Italy and Our Lady's mint in France. The Greeks used it as an aphrodisiac, while the Romans used its aroma as an appetite stimulant. Today, spearmint is commonly used in chutneys, curries, and sauces in India and Southeast Asia. It is also a popular flavor for teas around the world.

Model Of Sexual Response Showing Various Incentives And Motivations To Be Sexual And Arousal Triggering And

For one or more of the earlier mentioned reasons, a woman choosing to be receptive to sexual stimuli (or to provide them) can subsequently become sexually aroused. The degree of emotional intimacy with her partner that may have even been the major motivating force, is also a very important influence on her arousability to the sexual stimuli. Various other psychological and biological factors will influence this arousability such that the processing of the sexual information in her mind may or may not lead to subjective arousal (27-31). On those occasions she becomes subjectively aroused, providing the arousal remains enjoyable, and the stimulation continues sufficiently long, and she remains focused, then the arousal can become more intense and an urge or sexual desire for more of the sexual sensations and emotions is triggered. This accessed or triggered sexual desire and the subjective arousal continue together, each reinforcing the other (32,33). A positive outcome, emotionally and...

Doshas and Respective Personalities

For example, fenugreek seed provides a bitter taste as well as astringency, and fennel seed has sweet and cooling tastes. Thus, there is more than one taste contributed by a spice (see Table 10). With regard to rasas, other spices can be explored to provide more variety. Understanding these rasas is essential to understanding and applying Ayurvedic medicine. They affect our digestion, disposition, and health. Cardamom, fennel, anise, tamarind Sweet, bitter, astringent Asafetida, ginger, cardamom, cinnamon, fenugreek Pungent, bitter, astringent Turmeric, fenugreek, mint, mustard, clove astringent Ginger, asafetida Chilies, fenugreek Pungent, sour, salty Chilies, salt, tamarind Garlic

Pharmacological Treatment of the Paraphilias

Some individuals with a paraphilia experience distressingly high drive and hyperarousability. Pharmacological interventions to lower libidinal urges are not only sometimes useful, but frequently essential, particularly the offending disorders such as pedophilia (136). The side-effect of diminished sexual desire, Methoxyprogesterone acetate (MPA) is the most commonly used hormonal agent for the reduction of sex drive in the United States (140,146,154,155). It does not compete with androgens at the receptor level but blocks levels of testosterone by inducing hepatic testosterone reductase. The goal of this strategy is to reduce baseline testosterone to 50 of initial values. Common dosages are 50-300 mg orally or 300-400 weekly via intramuscular injections with reduction to 100 mg weekly for a maintenance program. Depot preparations of methoxyprogesterone are also available. Side-effects include weight gain, hyper-glycemia due to an exaggerated insulin response to a glucose load,...

Sexual aversion disorder

There are a number of reasons that people lose interest in sexual intercourse. It is normal to experience a loss of desire during menopause directly after the birth of a child before or during menstruation during recovery from an illness or surgery and during such major or stressful life changes as death of a loved one, job loss, retirement, or divorce. These are considered normal causes for fluctuations in sexual desire and are generally temporary. Changing roles, such as becoming a parent for the Sexual aversion disorder and hypoactive sexual disorder are both considered to be caused mainly by psychological factors and to manifest psychological symptoms. Another disorder that can have some similar symptoms is female sexual arousal disorder (FSAD). FSAD refers to a woman's recurrent inability to achieve or maintain an adequate lubrication-swelling response during sexual activity. Lack of lubrication is a physical problem that may have either physical or psychological causes. Women...

Zyprexa see Olanzapine

Hypoactive sexual desire disorder sexual aversion disorder Avoidance personality disorder schizotypal personality disorder of sex hypoactive sexual desire disorder schizoid personality disorder sexual aversion disorder of social situations avoidant personality disorder seasonal affective disorder separation anxiety disorder may occur with tic disorders of specific feared situations social phobia

Coriander Seed Leaf Cilantro

Since ancient times, coriander has been enjoyed by many cultures for its culinary and medicinal values. Coriander is mentioned in Sanskrit literature as far back as 5000 BC and in Greek Eber Papyrus as early as 1550 BC. About 400 BC, Hippocrates, the Greek physician, recommended coriander for its medicinal value. Coriander was found in Egyptian tombs dating from 1090 BC. As early as fourth century BC, the Chinese ate it to attain immortality. The Arabs used it as an aphrodisiac, while the Romans used it as a seasoning. Therapeutic Uses and Folklore coriander seed is an ancient spice eaten by the Chinese, Indians, and Arabs for longevity and as an aphrodisiac. Early Egyptians and European monks used coriander as a medicine for stomach ailments and to perfume cosmetics and flavor liqueurs. The Greeks flavored their wines and tonics with coriander seeds.

Cognitive Behavioral Approaches

Anxiety could feasibly impair orgasmic function in women via several cognitive processes. Anxiety can serve as a distraction that disrupts the processing of erotic cues by causing the woman to focus instead on performance related concerns, embarrassment, and or guilt. It can lead the woman to engage in self-monitoring during sexual activity, an experience Masters and Johnson (78) referred to as spectatoring . Physiologically, for many years it was assumed that the increased sympathetic activation that accompanies an anxiety state may impair sexual arousal necessary for orgasm via inhibition of parasympathetic nervous system activity. Meston and Gorzalka (79-81), however, have noted that activation of the sympathetic nervous system, induced via means such as 20 min of intense stationary cycling or running on a treadmill actually facilitates genital engorgement under conditions of erotic stimulation.

Anatomy and Physiology

The clitoris contains two stripes of erectile tissue (corpora cavernosum) that diverge into the crura inside the labia majora. On the basis of recent anatomical studies, O'Connell et al. (24) proposed to rename these structures as bulbs of the clitoris. They found that there is erectile tissue connected to the clitoris and extending backwards, surrounding the perineal part of the urethra. However, most anatomical facts have been known for a long time (25). The clitoris' parasympathetic innervation comes from lumbosacral segments L2-S2, while its sympathetic supply is from the hypogastric superior plexus. The pudendal and hypogastric nerves serve its sensory innervation. It responds with increased blood flow and tumescence on being stimulated through sexual arousal. Nitric oxide synthase (NOS), among many other neuropeptides, has been identified in the complex network of nerves in the clitoral tissue (26). Apparently, coitus alone is not a very effective stimulus for orgasm in women....

Is Absent or Impaired Genital Responsiveness a Valid Diagnostic Criterion

In a recent study we investigated whether pre- and postmenopausal women with sexual arousal disorder are less genitally responsive to visual sexual stimuli than pre- and postmenopausal women without sexual problems (42). Twenty-nine women with sexual arousal disorder (15 premenopausal and 14 postmenopausal), without any somatic or mental comorbidity, diagnosed using strict DSM-IV criteria, and 30 age-matched women without sexual problems (16 premenopausal and 14 postmenopausal) were shown sexual stimuli depicting cunnilingus and intercourse. Genital arousal was assessed as vaginal pulse amplitude (VPA) using vaginal photoplethysmography. We found no significant differences in mean and maximum genital response between the women with and without sexual arousal disorder, nor in latency of genital response. The women with sexual arousal disorder were no less genitally responsive to visual sexual stimuli than age- and menopausal status-matched women without such problems, even though they...

Models For Treating Sexual Dysfunction Sex Therapy

Experience supported efficacy in treating hypoactive sexual desire, sexual aversions, dyspareunia, and delayed orgasm in men (9). Despite its potency, there were and are drawbacks to this approach, particularly from a cost-benefit standpoint. Although considered as a brief treatment within a mental health context, it typically required many appointments with a trained specialist and a high degree of motivation on the part of the patient. Historically, healthcare systems have discarded labor intensive, expensive approaches once easier and more rapid alternatives were available. Sex therapy receded as a treatment of choice during the 1990s, as medical and surgical approaches performed by urologists established hegemony over the treatment of ED, in particular. The pinnacle of this transition was reached during 1998, with the launch of sildenafil.

Psychoanalytic Models of Etiology

Stoller described sexual masochism as the neurotic eroticization of maternal hatred, a narcissistic solution to early life trauma (74), although in later writings, after observing many higher functioning individuals and couples who engaged in recreational S&M practices, he questioned his earlier assumptions (77,78). Kernberg suggested that masochists experience narcissistic gratification in the grandiose view of the self associated with high tolerance for pain (79). Waska described the masochist as alternating between compulsion toward servitude and rage at the internalized possessive, rejecting, or neglectful maternal object (80). The masochist suffers a core incapacity to self-soothe and, therefore, deep cravings to be soothed by others. The cravings, and accompanying rage, explain the masochist's inherently ambivalent position, in which self-suffering disguises feelings of anger and yearning for maternal soothing. Ultimately, his compensatory style is one of the expecting to be...

Reproductive biology

As with porcupines, people are curious how crocodilians manage to mate without causing each other grief In reality, it is a gentle affair (once the competition has been dispensed with, that is). To copulate successfully, males must court females to gain their consent. Males of some species, such as es-tuarine crocodiles, establish territories that contain a number of females, others, such as American alligators, display competitively to attract females. Courtship may be elaborate or subtle, involving mutual signaling on a visual, olfactory, auditory, and tactile level. Alligators combine rumbling bellows with infrasonic vibrations, the water dancing across their backs proving a potent aphrodisiac for females. Gular musk glands are rubbed across the head and neck in mutual appeasement, and several minutes of head- and tail-raising postures are necessary for consent. Once she consents, the female allows the male to press her underwater. To align his vent with hers, the male rolls the...

Summary And Conclusions

Some may see it as a truism that men and women are sexually different, but in the latter half of the 20th century there has been a strong effort to view the two as functionally symmetrical. In spite of this attempt at equation, evidence about just how men and women differ, especially in the crucial area of sexual desire, is rapidly accumulating. Although doubtlessly unintentional, investigations of sexual desire in women have shed light on the same in men. These observations have insinuated that the pattern of sexual desire resulting in arousal is more true of men than women (where desire might follow arousal), and that sexual desire tends to be quantitatively greater in men. According to several different studies, at any one time 16 of men experience HSDD. However, sexual desire manifests in different ways (both psychologically and behaviorally), and it is far from clear just who is included in this 16 . Does it represent, for example, men who have sexual thoughts but do not act on...

Biological Theories of the Paraphilias

Understanding of the neurobiology of sexual functioning, both normal and deviant, is incomplete. Nevertheless, it is clear that sexual interest and function derive from both the central nervous system and endocrine factors. In normal sexual arousal, central nervous system involvement includes a cascade of connections from the neocortex to the limbic system and the hypothalamus, particularly the preoptic area and the brainstem (113). Sexual arousal begins via either sensory input, such as tactile, visual or olfactory stimulation, or via fantasy in the neocortex. This cortical arousal propagates through the limbic system and hypothalamus to enable a progression of physiologic events that promote sexual behaviors and orgasm. Subcortical brain areas are important for sexual functioning and include the limbic system and the preoptic nuclei in the hypothalamus. Both peptides, such as beta endorphin and oxytocin, and LHRH modulate sexual behavior in animals. The role of monoamines is also...

Medical Letter In Reference To Erical Dysfunction

Simultaneous monitoring of human vaginal haemo-dynamics by three independent methods during sexual arousal. In Hoch Z, Lief HI, eds. Sexology. Amsterdam Elsevier Publishing Co, 1981 114-120. 15. Levin RJ. Sexual desire and the deconstruction and reconstruction of the human female sexual response model of Masters & Johnson. In Everaerd W, Laan E, Both S, eds. Sexual Appetite, Desire and Motivation Energetics of the Sexual System. Amsterdam Royal Netherlands Academy of Arts and Sciences, 2001 63-93. 17. Levin RJ. The mechanisms of human female sexual arousal. Annu Rev Sex Res 1992 3 1 -48. 18. Fisher C, Cohen HD, Schiavi RC, Davis D, Furman B, Ward K, Edwards A, Cunningham J. Patterns of female sexual arousal during sleep and waking vaginal thermo-conductance studies. Arch Sex Behav 1983 12 97-122. 29. Levin RJ. The physiology of sexual arousal in the human female a recreational and procreational synthesis. Arch Sex Behav 2002 31 405-411. 43. Caruso S,...

The Asian Spice Emporium

Turmeric had erotic significance for Indians and played an important role in wedding ceremonies of Hindus and Muslims. During the nuptial bath called Nalangu, the heads of the bride and groom were rubbed with sesame oil, and the exposed parts of their bodies were smeared with turmeric. In some communities, sweets made of nutmeg and saffron were also given to the newlyweds as aphrodisiacs, while perfumes of saffron, white sandalwood, cardamom, nutmeg, and mace were poured on the sacrificial wedding fire. The exquisite golden complexion of Naga women of North India was reputedly obtained through their constant use of turmeric.

Postmenopausal Dyspareunia

As women approach middle-age and menopause, physiological aging, psychosocial factors, and declining levels of endogenously produced sex hormones caused by ovarian senescence can exert significant effects on their sexual response cycle. As such, comprehensive enquiry of dyspareunic pain characteristics and history, climacteric symptoms, as well as changes in sexual functioning, urogenital anatomy, marital partner relations that have occurred are essential in the assessment of post-menopausal dyspareunia. The many anatomical changes, within but not limited to the urogenital region, experienced by aging women (e.g., reduced vaginal and or clitoral size, loss of fat and subcutaneous tissue from the mons pubis, arteriosclerosis) can result in decreased sexual arousal, vaginal dryness, and dyspareunia (23). Dyspareunia may also result from iatrogenic efforts, including pelvic or cervical surgery and radiotherapy, and pharmacotherapy (24). Moreover, it is considered a secondary symptom of...

Why Do Women Have Orgasms

An essential feature of sexual arousal of the female genitalia is to create the expansion of the vagina (vaginal tenting) and elevation of the uterocervix from the posterior vaginal wall. This reduces the possibility of the rapid entry of ejaculated spermatozoa into the uterus and gives time for the initiation of the decoagulation of semen and the capacitation of the spermatozoa to begin, decreasing the chance of incompetent sperm being transported too rapidly into

Terminology and Definitions

The term andropause indicates a particular type of hypogonadism that is related to aging in men and is said to consist of the following diminished sexual desire and erectile function, decrease in intellectual activity, fatigue, depression, decrease in lean body mass, skin alterations, decrease in body hair, decrease in bone mineral density resulting in osteoporosis, and increase in visceral fat and obesity (24). The word andropause is an attempt to draw a parallel in men to

Identifying Psychosocial Barriers to Success

There are a variety of bio-psychosocial obstacles to be recovered that contribute to treatment complexity. All of these variables impact compliance and sex lives substantially, in addition to the role of organic etiology (20). There are multiple sources of patient and partner psychological resistance, which may converge to sabotage treatment (i) What is the mental status of both the patient and the partner and how will this impact treatment, regardless of the approach utilized What is the nature and degree of patient and partner psychopathology (such as depression) What are the attitudinal distortions causing unrealistic expectations, as well as endpoint performance anxiety (ii) What is the nature of patient and partner readiness for treatment When and how should treatment begin, and be introduced into the couple's sex life What is his approach to treatment seeking What should be the pacing of intimacy resumption The average man with ED waits 2-3 years, before seeking...

Nonhormonal Pharmacological Treatment of Low Desire Interest

The place of pharmacological management for women's complaints of low desire interest is undecided. This is because of broad normative range of women's appreciation of sexual desire, especially in the long-term relationship and because of the importance of women's subjective arousal in influencing and triggering their desire and the minimal focus until now on the whole entity of subjective arousal. Thus, the appropriate outcome criteria for a desire drug are unclear. Studies with bupropion hydrochloride have suggested benefit over placebo. Of 30 women with active drug, 19 improved during a 12-week double blind placebo-controlled study for nondepressed women having a spectrum of sexual complaints, including low desire interest (91). A more recent study, again of nondepressed women, this time diagnosed with hypoactive sexual desire, were treated in a single blinded manner and 29 responded to the active drug and none had responded to the initial 4-week placebo phase (14). The entity of...

Case Study Jon and Linda

Three years ago, Jon started SSRI treatment for depression, secondary to work stress. His depression exacerbated his insecurity about his intelligence and abilities. He developed ED and could not erect, but his sexual desire was still strong. Medication helped his moodiness and reduced his depression. They both wanted Jon on the antidepressant medications, yet their marital conflict increased. His psychopharmacologist tried reducing the SSRI and augmenting with bupropion. This did not help If anything, it uncharacteristically, worsened his sex life. They tried switching him from paroxetine to bupropion to escitalopram. During this time, he lost his job, and money problems became worse. He needed to move to a different city in order to find work, uprooting Linda and the kids. He also used a low dose, blood pressure (BP) medication, which had not caused ED, although it was a risk factor. Possibly, the BP medication exacerbated the anti-sexual impact of the SSRI, culminating in his...

Activation And Regulation Of Sexual Response Processing of Sexual Information

A surprising finding from our studies was the ease with which healthy women become genitally aroused in response to erotic film stimuli. When watching an erotic film depicting explicit sexual activity, most women respond with increased vaginal vasocongestion. This increase occurs within seconds after the onset of the stimulus, which suggests a relatively automatized response mechanism for which conscious cognitive processes are not necessary. Even when these explicit sexual stimuli are negatively evaluated, or induce little or no feelings of sexual arousal, genital responses are elicited. Genital arousal intensity was found to covary consistently with stimulus explicitness, defined as the extent to which sexual organs and sexual behaviors are exposed (66). This automatized response occurs not only in young women without sexual problems, but also in women with a testosterone deficiency (67), in postmenopausal women (68,69), and in women with sexual arousal disorder (42). Such responses...

Newborn Testing and Conditional Probability

The actual number of disease cases relative to the number of false positives is an important consideration when deciding whether to screen the general population. Another example of this is maple syrup (or fenugreek) urine disease. This is a metabolic genetic disease that can be easily treated with vitamins and dietary control. This disease is quite rare in the general population, and the estimated frequency is about 1 in 300,000. In several years of testing newborns in Iowa, all babies that tested positive turned out to be false positives. Therefore, testing for this disease was discontinued in Iowa in 1995. There are populations that have unusually high rates of this disease, for whom testing is advised. For example, a Mennonite community in eastern Pennsylvania has a rate of 1 in less than 200 We discuss possible reasons for such differences in disease frequency in the next chapter.

Why Is it Important to Study and Treat Dyspareunia

In addition to problems encountered in the health care system, women with dyspareunia suffer negative impacts in both sexual and nonsexual areas of their lives. In terms of sexuality, women with dyspareunia report lower frequencies of intercourse, lower levels of sexual desire, arousal, and pleasure, and less orgasmic success than non-affected women (10-12). It is therefore not surprising that women with dyspareunia also report difficulties with relationship adjustment and psychological distress, including depression and anxiety (10). Outside of sexuality and intimate relationships, activities such as gynecological examinations, bicycle riding, or sitting for long periods of time may also be affected (10,11,13,14). Given the significant negative impact dyspareunia can have on multiple aspects of life, it is crucial to provide women suffering from this condition with information, validation of their pain, and appropriate treatment. However, the classification of dyspareunia has...

Treatment Psychological Treatments

(101), sexual problems were seen as consequences of (nonsexual) psychological conflicts, immaturity, and relational conflicts. Masters and Johnson proposed to directly attempt to reverse the sexual dysfunction by a kind of graded practice and focus on sexual feelings (sensate focus). If sexual arousal depends directly on sexual stimulation, that very stimulation should be the topic of discussion (masturbation training). A sexual dysfunction was no longer something pertaining to the individual, rather, it was regarded as a dysfunction of the couple. It was assumed that the couple did not communicate in a way that allowed sexual arousal to occur when they intended to produce it. Treatment goals were associated with the couple concept the treatment goal was for orgasm through coital stimulation. This connection between treatment format and goals was lost once Masters and Johnson's concept was used in common therapeutic practice. People came in for treatment as individuals. Intercourse...

Diagnostic Procedures

An ideal protocol for the assessment of FSAD should be constructed following theoretical and factual knowledge of the physiological, psychophysiological, and psychological mechanisms involved. The protocol then describes the most parsimonious route from presentation of complaints to effective therapy. Unfortunately, we are at present far from a consensus on the most probable causes of FSAD. Despite this disagreement, at least two diagnostic procedures should be considered. Firstly, assessment of sexual dysfunction in a biopsychosocial context should start with a verification of the chief complaints in a clinical interview. The aim of the clinical interview is to gather information concerning current sexual functioning, onset of the sexual complaint, the context in which the difficulties occur, and psychological issues that may serve as etiological or maintaining factors for the sexal problems, such as depression, anxiety, personality factors, negative self- and body image, and...

Use of Questionnaires

The use of questionnaires, such as the International Inventory of Erectile Function (IIEF), are sometimes of relevance, and are a useful way of measuring improvement over time (18). The IIEF is a self-report tool that has been used in the clinical trials to assess the response of a subject to oral treatments for ED. It comprises 15 questions which cover five key areas of sexual function in men erectile function intercourse satisfaction orgasmic function sexual desire and overall satisfaction. The two key questions in relation to the studies on ED are question 3 which asks about the ability to achieve an erection sufficient for penetration When you attempted intercourse, how often were you able to penetrate (enter) your partner and question 4 which asks about the ability to

Acquired Delayed Ejaculation

The onset of ejaculation delay may be sudden or gradual and deteriorates progressively to global unremitting ejaculatory inhibition. A rather normal delay of ejaculation occurs during aging. Androgen deficiency or hypogonadism may be accompanied by loss of sexual desire and delay of ejaculation. Any neurological disease, injury, or surgical procedure that traumatizes the lumbar sympathetic ganglia and the connecting nerves (multiple sclerosis, diabetic neuropathy, abdo-minoperineal resection, lumbar sympathectomy) may lead to a delay or failure of ejaculation. A wide range of drugs (SSRIs, tricyclic antidepressants, antipsychotics, alpha-sympathicolytics) can impair the ejaculatory process through central and peripheral mechanisms. Alcohol can delay or abolish ejaculation by a direct effect after acute abuse and indirectly by neurological or hormonal disturbances during chronic abuse.

The Psychoanalytical View

More recent research revealed that women with vaginismus have significantly increased comorbid anxiety disorders, whereas depression rates are not found to be increased (4,19,20). The role of childhood sexual trauma is unclear, since different frequency rates are found (3,4), and the presence of increased rates of posttraumatic stress disorder has not been investigated as yet. Psychological characteristics, measured with self-report instruments, do not unequivocally corroborate the presence of anxiety disorders. Personality traits found to be more often present in this group suggest the presence of self-focused attention and negative self-evaluation in the etiology or maintenance of vaginismus (3,20). Sexual functioning may be impaired with regard to sexual desire and arousal response during sexual activity. Psychopathology and impaired psychological functioning may be caused as well as effect of vaginismus. Experimental evidence thus far documented the role of experienced threat in...

Theoretical Perspectives Biological Psychological and Social

Others look at sexuality and see the absence of intimacy as being crucial to understanding the psychological origins of many sexual difficulties (11,32). One can particularly appreciate (and learn from) the implications of the absence of intimacy for sexual relationships generally, and sexual desire in particular, when considering the plight of those with a serious mental illness who, by the very nature of the disorder, also have substantial intimacy difficulties (33). The roots of intimacy difficulties are in the patient's past this needs to be thoroughly explored because it may well have included turmoil in his or her family-of-origin, as well as a dearth of love and nurturing connections which are so often a rehearsal for love relationships later in life. Likewise, the patient's past may not have included the experimental love and sexual relationships of adolescence in which so much learning takes place about oneself and others.

Former Reader in Pharmacognosy University of Bradford UK

According to the old Doctrine of Signatures or Similitudes, a theory apparently derived independently in many parts of the world, a plant would by its colour, shape and characteristics indicate its potential medicinal uses (Court, 1985). Thus ginseng with its man-like appearance was quickly accepted as a tonic, a cure-all with particular value as an aphrodisiac and a treatment for impotence and loss of sexual drive. The more anthropomorphic the better and the price rose accordingly.

Organ Systems Affected By Low T Levels

T also appears to be essential for development and maintenance of libido or sexual desire. Males with congenital hypogonadotropic hypogonadism have minimal libido. This is increased by therapy that increases their T levels. Reduced libido also is observed in men with acquired hypogonadism, and clinical trials with replacement doses of T in young and middle-aged men usually show improved libido.

Psychiatric Disorders

Sexuality is commonly affected by mood disorders. Specifically, diminished sexual desire is often seen as a feature of depression (42). Schreiner-Engel and Schiavi looked at the relationship between HSDD and depression using an unconventional strategy (35). They examined couples where one partner reported generalized HSDD (22 of the men and 24 of the women all of whom were euthymic at the time) and compared them to a control group. Interestingly, they found that those with sexual desire difficulties had a significantly higher lifetime rate of affective disorder almost twice as high as the control group. Furthermore, the authors theorized that there may be a common biological etiology to the two disorders, or, that affective psychopathology may contribute to the pathogenesis of the desire disorder. There is little information on sexual dysfunctions in untreated euthymic patients who have a bipolar disorder. However, manic patients are often described as hypersexual but the meaning is...

Female orgasmic disorder

Female orgasmic disorder (FOD) is the persistent or m recurrent inability of a woman to have an orgasm (climax or sexual release) after adequate sexual arousal and sex- i ual stimulation. According to the handbook used by men- o tal health professionals to diagnose mental disorders, the e Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (also known as the DSM-IV-TR), this lack of response can be primary (a woman has never had an orgasm) or secondary (acquired after trauma), and can be either general or situation-specific. There are both physiological and psychological causes for a woman's inability to have an orgasm. To receive the diagnosis of FOD, the inability to have an orgasm must not be caused only by physiological problems or be a symptom of another major mental health problem. FOD may be diagnosed when the disorder is caused by a combination of physiological and psychological difficulties. To be considered FOD, the condition must cause personal...

Gulls Terns Relatives And People

In the 1800s, gull and tern feathers, and sometimes even whole birds, were used to decorate women's hats. The eggs of certain species have been, and continue to be, collected for food. Some eggs are considered aphrodisiacs (aff-roh-DEE-zee-acks), substances that enhance sexual desire, in parts of the world. Adult gulls and terns are also sometimes hunted for food. Gulls and terns were sometimes used as a sign that land was nearby by sailors, and terns are still used to locate schools of fish. Because of their more remote tundra habitats, skuas and jaegers have interacted less with human beings.

Antiinflammatory And Antipyretic Activity

Single-dose and ch ronic-dose applications of a dried leaf decoction of fenugreek Fenugreek 408 relatively equal to 300 mg kg sodium salicylate for single dosing however, chronic administration was more effective than sodium salicylate. Additionally, the fenugreek decoction demonstrated stronger antipyretic activity than that of sodium salicylate.

Sexual Sadism and Sexual Masochism

Sexual sadism denotes sexual arousal and excitement in response to the psychological or physical suffering of another, whereas sexual masochism denotes a preferred fantasy of selfsuffering. The term sexual sadism derives from the name of the 18th century French aristocrat and pornographic author, Marquis de Sade,

Behavioral Models of Etiology

Clinical work in the Internet era provides observational support for the role of conditioning in the paraphilias. Exposure to Internet-based sexually explicit material and accompanying high levels of sexual arousal appear to, in some individuals, profoundly influence the development of conditioned sexual fantasy and arousal responses. However, there is a wide range of responses to comparable levels of exposure. Therefore, caution must be exercised in drawing conclusions about any direct causative effects of exposure Internet or otherwise on the development or latensification of psychosexual pathology. Fisher and Barak have presented eloquent reviews on the effects of exposure to pornography, concluding that it is difficult to distinguish between the effects of exposure and the effects of pre-existing underlying personality factors in individuals who seek such exposure (97). Junginger pointed out the possible relevance of the two-process learning theory, which has earned acceptance as...

Gender Differences in Sexual Feelings

Our hypothesis is that in women other (stimulus or situational) information beyond stimulus explicitness determines sexual feelings, whereas for men peripheral feedback from genital arousal (and thus stimulus explicitness) is the most important determinant of experience of sexual arousal. This hypothesis fits well with the observed gender difference in response concordance. It coincides with Baumeister's assertion that women evidence greater erotic plasticity than men (90). After reviewing the available evidence on sexual behavior and attitudinal data of men and women, he concluded that women's sexual responses and sexual behaviors are shaped by cultural, social, and situational factors to a greater extent than men's. Both women's and men's sexuality are likely to be driven by an interaction of biological and sociocultural factors. Evolutionary arguments often invoke differential reproductive goals for men and women (91). The minimal reproductive investment for females is higher than...

Ejaculation Threshold Hypothesis

In the case of a low setpoint of the threshold, men can only sustain a small amount of sexual arousal prior to ejaculation. Whatever these men do or fantasize during intercourse, any control of ejaculation remains marginal and these men ejaculate easily even when they are not fully aroused. The low threshold is assumed to be associated with a low 5-HT neurotransmission and probably a hypofunction of the 5-HT2C receptor and or a hyperfunction of the 5-HT1A receptor, as mentioned earlier. In the case of a higher setpoint, men will experience more control over their ejaculation time. They can sustain more sexual arousal before ejaculating. In these men, 5-HT neurotransmission varies around a normal or averaged level and the 5-HT2C receptor functions normally. The mean and range values of the setpoints that are considered to be normal or averaged are not known. These men have the neurobiological ability to voluntarily decide to get an ejaculation quickly or after a longer duration of...

What is a Sexual Dysfunction

The experimental evidence and theoretical notions presented earlier strongly suggest that for women, sexual dysfunction is not about genital response. The women in our study who were diagnosed with FSAD according to strict DSM-IV criteria (42) turned out not to be sexually dysfunctional according to these same criteria because their genital response was not impaired. This study demonstrated that it is difficult to be sure that sexual arousal problems are not caused by a lack of adequate sexual stimulation, and that impaired genital response cannot be assessed on the basis of an anamnestic interview. This implies that the current DSM-IV criteria for sexual arousal disorder, which states that genital (lubrication swelling) response is strongly impaired or absent, is unworkable. For most women, even those without sexual problems, it is difficult to accurately assess genital cues of sexual arousal, but this is exactly what the DSM-IV definition of sexual arousal disorder requires. The...

The Maiden Must Be Kissed Into A Woman

Most pharmacological treatments that are currently being developed for women with sexual arousal disorder are aimed at remedying a vasculogenic deficit. In a study we did in the late 1990s we compared pre- and postmenopausal women with and without sexual arousal disorder, diagnosed according to strict DSM-IV criteria (1). Women with any somatic or mental comorbidity were excluded. This study investigated whether pre- and postmenopausal women with sexual arousal disorder were less genitally responsive to visual sexual stimuli than pre- and postmenopausal women without sexual problems. From the findings of this study we concluded that in such women, sexual arousal disorder is unrelated to organic etiology. In other words, we are convinced, from this and other studies to be reviewed, that in women without any somatic or mental comorbidity, impaired genital responsiveness is not a valid diagnostic criterion. The sexual problems of women with sexual arousal disorder are not related to...

Positron Emission Tomography Scan Studies in Humans

All the activations of these various cortical areas is not yet clear. Further studies need to clarify whether associated sensations of orgasm are mediated by these cortical areas. Unexpectedly, a very strong activation was found in parts of the cerebellum, the meaning of it remaining unclear. Decreased blood flow, and thus less activity was found in the amygdala during sexual arousal, erection, and ejaculation. This may perhaps indicate that the brain looses a state of anxiety or fear during sexual activity. Hypothalamic involvement, as has been demonstrated in animal sexual behavior, has not been found in these male volunteers. Obviously, further PET-scan studies are needed to unravel this human and animal dichotomy.

Proposed Sexual Aversion Criteria Revision

Given the difficulties inherent in the current classification systems for sexual aversion disorder (DSM-IV-TR and the 1999 Consensus Classification), we have proposed (11) a revised classification system that is based on a modification of these taxonomies. This proposed classification maintains the distinction between primary and secondary sexual aversion. However, this distinction will only be useful for the diagnostic differentiation of the acquisition of aversion early in life and the lifelong presence of hypoactive sexual desire (Table 5.3).

Elevated Lipid Levels

Several clinical studies conducted in people with and without diabetes have identified significant lipid-lowering activity with different fenugreek preparations, such as defatted fenugreek, germinated seed and hydro-alcoholic extracts (Bordia et al 1997, Gupta et al 2001, Sharma et al 1990, Sowmya & Rajyalakshmi 1999). As can be expected, the dose used and type of preparation tested has an influence over results. An open study using a daily dose of 18.0 g germinated fenugreek seed in healthy volunteers demonstrated significant reductions in total cholesterol and LDL-choles-terol levels. A placebo-controlled study found no effect after 3 months with a lower dose of 5 g seed daily (Bordia et al 1997, Sowmya & Rajyalakshmi 1999), suggesting that higher intakes may be required for lipid-lowering activity to become significant.

Psychological Treatments

Psychological therapy is the mainstay of the management of low sexual desire interest. Given the mandatory blending of mind and body, making deliberate changes in thoughts, attitudes behavior, leads not only to changed feelings and emotions but altered sexual physiology. Under the term sex therapy typically the woman's negative thoughts and attitudes to sex, her distractions during sexual stimulation, the need for more varied, more prolonged, or simply different sexual stimuli, the need for the couple to guide each other and the usual needs of safety, privacy, and optimal timing of sexual interaction will be addressed. Sensate focus techniques whereby there is a graded transition from touching and caressing that is not specifically sexual to that which is sensual to that which is frankly sexual, may sometimes be included. The approach is one of systematic desensitization common to other behavioral therapies. Cognitive behavioral therapy (CBT) focuses on the restructuring of myths or...

Treatment General Considerations

Treatment follows diagnostic subtyping (Fig. 1). (A) If HSDD is acquired and generalized, the clinician must make substantial efforts towards finding the explanation(s) for the change. HSDD is sometimes (the frequency appears to be unknown) accompanied by another sexual dysfunction, especially ED, and when both occur together, it may be revealing and useful to find out which came first and to act accordingly. One might envision how a lack of sexual desire can cause erectile problems. However, the opposite is not so clear. The extent to which the presence of ED can result in a generalized lack of sexual desire appears to be entirely unknown. (B) If HSDD is lifelong but situational, a biogenic explanation is unlikely and individual psychotherapy undertaken by a mental health professional seems preferred. (C) If HSDD is acquired but situa-tional, a biogenic explanation is, again, unlikely (with the possibly exception of hyperprolactinemia). In this circumstance, psychotherapy seems...

Gender and the Paraphilias

As far as is known, the paraphilias occur predominantly in males, with the exception of sexual masochism, which is also commonly observed in females, although still with less frequency than in males. Exceptions have been reported, including single case reports of female genital exhibitionism and female fetishism (11-13). Two recent reports described, collectively, five cases of accidental autoerotic death in females, with evidence strongly suggesting the presence of the paraphilia asphyxiophilia, in which cerebral hypoxia is induced for the purpose of generating or intensifying sexual arousal (14,15). Gosink reported that autoerotic deaths occur differentially in males and females at a ratio of more than 50 1. It is not known to what extent this figure reflects gender differences in the prevalence of other paraphilias. Another recent report described multiple paraphilias in a female, including fetishistic arousal to men in diapers as well as sexual sadism characterized by extreme...

Spices as Antimicrobials

Spices have also been used for bactericidal and health reasons. During the Middle Ages, spices such as cinnamon, garlic, and oregano were used to treat cholera and other infectious diseases. In the late nineteenth century, clove, mustard, and cinnamon were shown to have antimicrobial activity. In the twentieth century, new research on spices, including ginger, garlic, fenugreek, coriander, turmeric, and clove, as potential natural antimicrobials, continued. Today this research continues.

Family Dysfunction Models of Etiology

A study of five adolescent males who practiced autoerotic asphyxia revealed early histories of physical abuse, sexual abuse, and, more specifically, choking in each of the five boys. The investigators hypothesized that choking had become paired with sexual arousal and that the pairing, along with the abusive early experiences, were etiologically relevant to the development of a paraphilia in four of the five boys (95).

Detection and Assessment

There are no reliable and empirically derived criteria for recognition of depression in PD. Therefore, it is not surprising that depression remains under-detected and under-treated in the PD population (15,71). In a clinic-based study, nearly two-thirds of patients with clinically significant depressive symptomatology were not receiving antidepressant therapy (11). Older individuals often underreport depressive symptoms and are likely to focus on somatic or vegetative complaints (e.g., fatigue or loss of energy, reduced sexual desire or functioning, pain, sleep changes, or appetite changes), which are the prominent features of mood disorders as well as PD (102). Patients may simply attribute any mood symptoms to their PD, even when their PD has been relatively stable and the mood changes are relatively acute. In one study, over half the patients who had clinically significant depressive symptoms did not consider themselves depressed (11).

Recommendations For Clinical Practice

The second question refers to the sensitivity of the sexual system. As we have seen, in healthy women problems related to genital unresponsiveness are unlikely. For clinicians who need to rule out that organic etiology is underlying sexual arousal difficulties, or who question genital responsiveness for other reasons, a psychophysiological assessment will provide indispensable additional information.


The diagnosis of MDD involves a constellation of symptoms in addition to depressed mood. After taking a careful history, including asking the patient about his or her sleeping patterns, appetite, sex drive, and mood, the doctor will give the patient a physical examination to rule out other possible causes of the symptoms. Certain other disorders may resemble MDD, including cognitive dysfunction caused by the direct effects of a substance (drug of abuse, medication, or toxic chemical) various medical conditions (i.e., an underactive thyroid gland strokes or early stages of dementia), or other mental disorders. Such stressful life events as normal bereavement may also produce behaviors similar to those associated with MDD while a bereaved person may appear to have many of the characteristics of MDD, the disorder would not be diagnosed unless the symptoms continued for more than two months or were extreme in some way. As part of the diagnostic interview, the doctor may give the patient a...


Sexual desire in men manifests in three ways (i) psychologically through thoughts, fantasies, and dreams (ii) behaviorally in sexual activity with a partner and (iii) behaviorally in sexual activity with oneself through masturbation or self-stimulation. Topics in Table 4.1 form the basis of the following suggested questions that one might ask when faced with a man who says that he is not sexually interested. 1. Has a feeling of low sexual desire always been a part of your life or was there a time when you were more interested Sexual desire is a feeling which usually (but not always) manifests in sexual behavior. Extrapolating from sexual behavior to determine someone's sexual desire (the third question in 2) can be problematic since there are many reasons for someone engaging in sexual activity

Medical Disorders

Medical conditions in which all sexual dysfunctions occur, and more specifically loss of sexual desire, result from biological, psychological and or social, or interpersonal factors, and most often from a combination of these elements (40). Examples of biological factors include direct physiological effects of the Of all types of epilepsy, that which affects the temporal lobe (TLE) has been the most frequently studied in relation to sexual consequences. TLE is particularly linked with low sexual desire in patients undergoing temporal lobe surgery (an admittedly unrepresentative group afflicted with this disorder) (41). The association between other kinds of epilepsy and low sexual desire is unclear.


Nevertheless, some of what does exist in the literature on the psychotherapy of HSDD in men will be reviewed. Heiman et al. considered studies on the treatment of sexual desire disorders in couples (51). None of the studies involved only men most referred to the treatment of HSDD in women only, or included reports that referred to both men and women as the identified patient. Of the three studies that included men with sexual desire difficulties, only one included information concerning diagnostic subtyping (52). The latter investigation reported on a 3-month follow-up of 152 couples in which at least one person had a desire difficulty as part of the presenting complaint. Fifty-eight (38 ) of the men had a diagnosis of low sexual desire. Seventeen percent were lifelong and 40 were global. Numbers of patients were not given in the report. In comparing couples in which either the man or the woman presented with a desire difficulty, the authors concluded that initially there was a lower...

Diagnostic Criteria

Second, the panel specifically distinguished between psychogenic and organically based disorders. This revised classification system includes sexual aversion under the category of sexual desire disorders along with hypoactive sexual desire disorders (Table 5.2). The consensus panel developed a very detailed document to describe and justify their new classification system. Sexual aversion disorder, however, was given little attention and by virtue of being placed in the category of sexual desire disorders, is likely to be overlooked. I. Sexual desire disorders A. Hypoactive sexual desire disorder B. Sexual aversion disorder II. Sexual arousal disorder It is further possible that this secondary descriptor has been maintained in the taxonomies because sexual aversion has been confounded with hypoactive sexual desire. Hypoactive sexual desire may legitimately be either a biologic or a learned condition. The biologic contribution could well have been present since birth or early...

Sexual Feelings

Recently, functional imaging studies showed that the subjective experience of various emotions such as anger, disgust, anxiety, and sexual arousal is associated with activation of the insula and the orbitofrontal cortex (83-86). It has been suggested that the insula is involved in the representation of peripheral autonomic and somatic arousal that provides input to conscious awareness of emotional states. It appears that the feedback of autonomic and somatic responses are integrated in a so-called meta-representation in the right anterior insula, and this meta-representation seems to provide the basis for the subjective image of the material self as a feeling entity, that is emotional awareness (83).

Disease Specific

Adjustments may need to be made in the patient's medication if a woman chooses to pursue pregnancy in order to eliminate drugs that may be teratogenic. Treatments and medications can also cause decreased libido and sexual dysfunction. Some patients may lose the desire for sexual relations as a result of fatigue, tumor location, treatment, medication, depression, or body image changes. Patients should be asked about this important aspect of their life so that adjustments can be made whenever possible to improve sexual function.

What Causes Orgasm

Only very recently have investigators examined the brain areas activated during orgasm in women (21). Compared to preorgasm levels of sexual arousal, the brain areas activated during orgasm in women included the paraven-tricular nucleus of the hypothalamus, the periaqueductal gray of the midbrain, the hippocampus, and the cerebellum. Other areas shown to be activated during sexual arousal include the amygdala, the anterior basal ganglia, and several regions of the cortex including the anterior cingulated, frontal, parietal, temporal, and insular cortices (22-24). Some of these areas may be more involved in the perception of sexual stimuli than with the actual triggering of orgasm. Further studies that compare brain imaging during sexual arousal without orgasm with brain imaging at orgasm are needed to determine whether there are any areas of the brain specifically involved in generating orgasm.

Sexual masochism

The essential feature of sexual masochism is the feeling of sexual arousal or excitement resulting from receiving pain, suffering, or humiliation. The pain, suffering, or humiliation is real and not imagined and can be physical or psychological in nature. A person with a diagnosis of sexual masochism is sometimes called a masochist. The DSM lists one particularly dangerous and deadly form of sexual masochism called hypoxyphilia. People with hypoxyphilia experience sexual arousal by being deprived of oxygen. The deprivation can be caused by chest compression, noose, plastic bag, mask, or other means and can be administered by another person or be self-inflicted. Sexual masochism must be differentiated from normal sexual arousal, behavior, and experimentation. It should also be differentiated from sadomasochistic behavior involving mild pain and or the simulation of more dangerous pain. When this is the case, a diagnosis of sexual masochism is not necessarily warranted. Sexual masochism...

Sexual Functioning

Other findings suggest that impaired sexual functioning among survivors of testicular cancer may not be a permanent condition. For example, the findings from a prospective analysis suggest that while patients are significantly less satisfied with their status of sexual functioning 6 months after completion of treatment, this dissatisfaction is not observed at either 12 or 36 months after the completion of treatment.44 Similarly, a significant decrease in sexual desire and increased erectile problems were reported at 6 and 12 months after treatment when compared to baseline (prior to diagnosis). However, by 36 months post treatment, sexual desire and frequency of erectile problems were not significantly different from baseline.44 More recently published findings by van Basten and colleagues45 also appear to suggest that sexual functioning does recover following treatment. Their results, also from a prospective study, indicate that considerable sexual morbidity occurs during treatment...

Case Study

Jim, 32 years old, and Rebecca (not their real names), 31 years old, were referred to a psychiatrist because of lack of sexual desire on Jim's part. They had been married for 5 years and did not have children. Actually, Rebecca initiated the referral through their family doctor. In tears, she told the doctor of her longing to have children and hearing the ticking of the biological clock. In the course of asking detailed fertility-related questions, the doctor discovered that intercourse was taking place only about once in 2 months. No other couple-related sexual activity occurred in the interval. The idea of including separate chapters on sexual desire problems in men and women in this book is unusual. The editors evidently considered that such problems in the two gender groups were not identical. However, apart from disorders, is sexual desire itself different for men and women health professionals who care for people with sexual difficulties suggest that there may be major...

Erectile Dysfunction

A significant improvement in erectile function, sexual desire, and intercourse satisfaction was demonstrated in 45 subjects following 8 weeks' oral administration of Korean red ginseng (900 mg three times daily) in a double-blind, placebo-controlled, crossover trial. Subjects demonstrated significant improvement in mean International Index of Erectile Function scores compared with placebo (baseline, 28 16.7 Korean red ginseng, 38.1 16.6 placebo, 30.9 15.7) (Hong etal 2003).


Therapeutic Uses and Folklore traditionally, nutmeg has been used to treat digestive disorders, such as nausea and diarrhea, and kidney ailments. Southeast Asians also treat fevers, headaches, and bronchial problems with nutmeg. The Chinese consider it to be an aphrodisiac.


The species once was considered to be a source for a medicinal pharmaceutical against many ailments as well as an aphrodisiac. Dried specimens wrapped in wormwood (Artemesia) were imported into Europe via Cairo until the last century. The belief in their medicinal effects seems to have been based on the fact that they feed on wormwood, which is known to have medicinal properties. They are eaten by locals.

Diagnosing FSAD

Classification of sexual disorders has been derived from phases of the sexual response cycle, on the basis of the work of Masters and Johnson (10) and Kaplan (33). This model depicts a sexual desire phase and a subsequent sexual arousal phase, characterized by genital vasocongestion, followed by a plateau phase of higher arousal, resulting in orgasm and subsequent resolution. It is assumed in this model that women's sexual response is similar to men's, such that women's sexual dysfunction in DSM-IV mirrors categories of men's sexual dysfunction. In contrast to the third edition of the DSM manual, subjective sexual experience is no longer part of the definition, possibly in a further attempt to match norms and criteria for men's and women's sexual dysfunctions (34). There are a number of serious problems with the current DSM-IV classification criteria. Firstly, although the DSM-IV explicitly requires the clinician to assess the adequacy of sexual stimulation only when considering the...

Subtypes of HSDD

Thyroid Sexual Dysfunction

Clinicians are directed to subtype the diagnosis of HSDD, that is, to say if the pattern has been (A) lifelong or acquired (i.e., always existed since puberty or followed a period of normal sexual desire), (B) situational or generalized (i.e., has existed only in some sexual circumstances or all) and (C) due to psychological or combined factors. Maurice (12 pp. 54-55) considers diagnostic subtyping to be clinically useful in helping to point towards the etiology and thus assessment and treatment for example, acquired problems would require a more diligent search for the explanation of change than those which are lifelong. Likewise, if a man has a situational difficulty, for example, not sexually active with his partner but masturbating several times each week, there is little PRL prolactin T testosterone TSH thyroid-stimulating hormone Figure 4.1 Assessment of low sexual desire disorder in men. PRL prolactin T testosterone TSH thyroid-stimulating hormone Figure 4.1 Assessment of low...

Spice Preparation

Smoking, tarkaring, tumising, or bagharing jalapeno, mustard seeds, ground coriander, or cumin seeds, creates many desirable flavors. In India, spices are tarkared or bargared to obtain a broad spectrum of flavor profiles that enhance, intensify, or simply change flavors. For example, when preparing South Indian dals and sambars, cumin and fenugreek seeds are dry roasted, while mustard seeds are cooked in hot oil until they pop. Saute-ing a whole spice in oil and adding this spice oil mixture to the food, called tarkaring, is a common cooking feature in the Indian kitchen. In bargharing, ground spice is cooked in oil or coated with oil, vinegar, wine, or any other liquid from recipe, to make a thick paste, which is then cooked till fragrant. Then other ingredients are added to create the unique, balanced flavors that characterize South Asian dishes. Some spices are more stable to heat while others are added at the end of cooking. Adding different spices at appropriate times or stages...

Dill And Dillweed

In the southern Mediterranean region, as early as 3000 BC, dill was popular for its medicinal properties. Dill promoted digestion and soothed the stomachs of Assyrians and later Egyptians, Romans, and Greeks, and eventually northern Europeans. Dill's name comes from the Old Norse word dilla, meaning to soothe because Norse parents used it to ease the stomach pains of crying babies and to lull them to sleep. Dill was also believed to have magical properties and was valued as an ingredient in love potions and aphrodisiacs.

Promoting Lactation

Although fenugreek has been used traditionally for centuries to increase milk production and improve lactation, no controlled studies are available to confirm effectiveness. Commission E approves the external use of fenugreek as a poultice for local inflammation (Blumenthal et al 2000).


Along with a drop in testosterone in approximately half of all meno-pausal women, the aforementioned changes presumably contribute to a decline in the sex drive reported by 30 or so women after menopause (Sheehy, 1993). Perhaps an even more important factor in the reduced sexual activity of widows, however, are social mores that view sex as something that older women should not be interested in. Despite the decline in sexual activity for most older women, the increased independence and assertiveness experienced by many postmenopausal women are often accompanied by a renewed interest in sex.


Savory was introduced to England by the Romans, and it was named by the Anglo-Saxons for its strong spicy taste. Europeans used savory as a substitute for black pepper and so it came to be called pepper herb. It is a popular ingredient for vegetable and legume dishes as it helps with their digestion. In ancient times, it was added with vinegar and used as a seasoning, as well as an aphrodisiac and cough medicine.

What Is Orgasm

Orgasm is a transient peak sensation of intense pleasure that is accompanied by a number of physiological body changes. In men, orgasm is normally accompanied by ejaculation, which makes the event easily identifiable. In women, however, the achievement of orgasm appears to be less facile than for males and recognizing that it has occurred is often difficult for some women. Objective indicators that orgasm has occurred have been sought for many years. Kinsey et al. (1) proposed the abrupt cessation of the ofttimes strenuous movements and extreme tensions of the previous sexual activity and the peace of the resulting state as the most obvious evidence that orgasm had occurred in women. Masters and Johnson (2) described the onset of orgasm as a sensation of suspension or stoppage. In order to serve as a clear marker of orgasm, however, the indicator must involve a bodily change that is unique to orgasm. This necessarily rules out simple measures like peaks of blood pressure, heart and...


In Europe, marjoram was a traditional symbol of youth and romantic love. Used by Romans as an aphrodisiac, it was used to cast love spells and was worn at weddings as a sign of happiness during the Middle Ages. Greeks who wore marjoram wreaths at weddings called it joy of the mountains. It was used to brew beer before hops was discovered, and flavored a wine called hippocras. A cousin of the oregano family, marjoram originated in Mediterranean regions and is now a commonly used spice in many parts of Europe. Called za'tar in the Middle East and often mistaken for oregano, it is also a popular spicing in eastern Europe.


Therapeutic Uses and Folklore Indians chew cardamom pods to sweeten and clean their breaths after meals and also after dinner to help settle their stomachs and aid in digestion. Cardamom also prevents nausea and vomiting. It soothes colicky babies, induces sweating, and cools the body during summer months. Arabs traditionally used cardamom as an aphrodisiac. In Scandinavia, it is used to mask the smell of alcohol, fish, and garlic.


South Indians use it in sambar podi, a spice blend added to legume dishes to enhance their flavor and to prevent flatulence. Jains, a religious group in India, do not eat root vegetables or root spices such as garlic, onion, ginger, or turmeric, for fear of killing living organisms. Therefore, they rely on asafoetida as an alternative flavoring. The Brahmins, who will not eat garlic or onions because they consider them aphrodisiacs, also use asafoetida as a substitute flavoring. Therapeutic Uses and Folklore Romans used asafoetida to aid digestion and as an aphrodisiac. In India and Iran, it is used to treat hysteria and taken as an antispasmodic, anticoagulant, and sedative. Asafoetida is also used to reduce flatulence and to treat nervous disorders. In India, singers take asafoetida before singing because it supposedly mellows their voices and produces a sensation of warmth.


There are a number of cogent criticisms of the current nomenclature system. The system developed to diagnose psychosexual disorders has been adopted to classify disorders presumed to be organic in etiology (44). Duration and severity criteria for diagnosis are unclear. Many of the diagnoses overlap, and the criteria for diagnosing female sexual disorders have been criticized. To put all of this in perspective, a brief description of the history of the diagnostic system will follow. The Diagnostic and Statistical Manual of Mental Disorders (DSM) was developed in the United States although it is employed by professional in other countries as well. The DSM is supposed to correspond to the International Classification of Diseases (ICD). The DSM-I was developed in 1952. The DSM-II was developed to correspond with the ICD-8. Psychosexual disorders in the DSM-II were grouped under one diagnostic entity, genitourinary disorders. The DSM-III was developed to reflect changes in diagnosis and...

Ill Partner

Severe medical and psychiatric illness can alter partner-related sexual desire. Case Study Tanya and Phillip (not their real names) were each 27 years old and married for the first time for 3 years. They did not have children, did not smoke or use street drugs, and neither had had major health problems in the past. They described themselves as Christian and although they did not have intercourse before marriage, they could not keep their hands off each other during that time and enthusiastically engaged in a variety ofsexual activities. Their sexual experiences in the early years of their marriage were uncomplicated and highly pleasurable to both. In the second year of their marriage Tanya developed an episode of mania. When they were initially referred (because of lack of sexual desire on Phillip's part), she had been taking maintenance medication for the previous 12 months. When Phillip was seen alone (they were initially seen together), he professed his continuing love for Tanya...

Future Directions

Further research is needed to further examine the pain component of dyspareunia using standardized tools in an effort to more fully understand the mechanisms involved in the development and maintenance of this painful and disruptive condition. Currently, we are investigating the effects of sexual arousal on genital and nongenital sensation, baseline measures of vestibular blood flow through thermal and laser Doppler imaging techniques, and sensitivity to body-wide pressure in women with vulvar vestibulitis syndrome. We hope to extend these research avenues to include the examination of women suffering from vulvodynia and postmenopausal dyspareunia in the near future. In addition, our research group is presently conducting a randomized treatment outcome study of women with vestibulitis, examining the effects of pain relief therapy compared with typical medical treatment. Future treatment outcome studies will include the investigation of the effects of physical therapy, as well as...

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