Hi Sandra, I am a happily married man in my early 50's. I've always had a healthy libido but after a long period of intense stress I'm now struggling with this for the first time. My wife has been great but I'm really keen to recover this important aspect of my life, along with my energy levels, which have plummeted. Please help, John.

Hi John, I'm so glad that you asked this question. Whilst a lost libido is one of the most common outcomes of unrelenting stress, it's often the one we're the least comfortable talking about.

It's important to understand that a low to non-existent libido is one of the most common results of stress for both men and women. Our adrenal glands respond to stress with the release of adrenalin and cortisol, stress hormones that help our bodies respond to challenge. However, the body produces these hormones at the expense of reproductive hormones such as testosterone and estrogen. This helps us respond to life-threatening situations by focusing hormone production for survival rather than procreation, shutting down our sex drive in the process.

Traditional medicine can and does help in this area, but perhaps not in the way that you might have been led to believe on a late-night advertisement for a herbal product. Plant-based medicine works very differently to restore libido than pharmaceutical medicines; they work best to restore sex drive when taken regularly over a period of weeks, sometimes months, depending on the severity of the situation and the extent of stress. Because plant medicines work to restore the optimal functioning of the body, it's also normal to see a return of vitality, energy, endurance and an improved mood.

Key medicinal plants for restoring libido are:
St John's Wort (Hypericum perforatum) - St John's Wort has been used throughout the ages to lift the mood and energy levels of those who felt weighed down by daily stresses and strains. This well-known natural antidepressant and anti-anxiety medicine is also an important fertility herb that can help restore libido in those who have been affected by stress. Classed as a "tonic" herb, it works on all body systems to help restore optimal functioning and its action intensifies the longer it is used. It also calms the brain, helping to reduce the anxiety that can come with a lost libido. Certain concentrated extracts of St Johns Wort can interact with certain prescription medications so seek the advice of a qualified Medical Herbalist if wanting to combine non-traditional St Johns Wort preparations and prescription drugs.

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One of the most sought after and revered plants of Eastern and Western herbalists, Korean Ginseng (Panax ginseng) has been the subject of extensive scientific research. It is clinically proven to improve fertility markers including testosterone, sperm count and sperm motility in men. Trials on impotence in elderly men have yielded positive results. Other benefits include improved heart rate, aerobic capacity, energy levels, and enhanced sleep.

Korean Ginseng combines well with Withania (Withania somnifera), another tonic plant that helps the body adapt to stress by promoting normal physiologic function. Popular for over 3000 years, clinical research has shown it to increase energy, endurance, stamina and improve sexual function. Like St John's Wort and Korean Ginseng, its effect intensifies with regular daily use.

In addition to the longer-acting tonic plants, quicker acting herbs for restoring libido include Damiana (Turnera aphrodisiaca). The Latin name for this plant is revealing - it has been used as a sexual tonic for many centuries. Damiana is thought to mimic the action of testosterone, stimulating and enhancing reproductive system functions, particularly in men. In South America it was traditionally consumed as an uplifting beverage similar to coffee, since its benefits include alleviating fatigue and lifting a depressed mood.

A medical herbalist will usually select a combination of the above plants depending on the needs of the individual and combine them in an oral liquid to be taken twice daily for a period of weeks to months. I hope these suggestions have provided you with some ideas for recovering your energy, vitality and libido.

If the condition persists or does not improve, see your leading healthcare professional.

June is Men's Health Month, an international awareness month that aims to raise the awareness of preventable health problems and encourage early detection and treatment. Supported by the not-for-profit Men's Health Trust, the theme for men's health month 2017 is #MenStartTalking. Visit www.menshealthmonth.co.nz for more information.
References
Dongre, S., Langade, D., Bhattacharyya, S. (2015). Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study. BioMed Research International, Oct. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609357/

Jang, D., Lee, M., Shin, B., Lee, Y & Ernst, E. (2008). Red ginseng for treating erectile dysfunction: a systematic review. British Journal of Clinical Pharmacology, 66(4), 444-450. doi: 10.1111/j.1365-2125.2008.03236.x