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Erectile Dysfunction

Ginkgo May Beat SSRI Sexual Dysfunction
By e Internal Medicine News by Nancy Walsh
Nov 15, 2002, 10:57pm

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SOUTHAMPTON, BERMUDA — The ancient Chinese herb Ginkgo biloba may provide a solution to the modern problem of antidepressant-induced sexual dysfunction.

The herb alone, or particularly in certain combination products, helps many patients taking selective serotonin reuptake inhibitors (SSRIs) or venlafaxine who experience side effects such as decreased libido, delayed orgasm, anorgasmia, or genital sensory impairment, Dr. Andrew L. Stoll said at a seminar on treating mood and anxiety disorders.

Ginkgo has multiple systemic effects. It acts as a free-radical scavenger, inhibits platelet aggregation, causes vasodilation, and allows more efficient cellular uptake of oxygen and glucose. The effects of ginkgo on sexual arousal are thought to result from increased blood circulation to the genital area.

The proprietary multi-ingredient ginkgo preparation ArginMax (Daily Wellness Co.) is “one of the best things I've ever seen for SSRI sexual dysfunction,” said Dr. Stoll, director of the psychopharmacology research laboratory at McLean Hospital and Harvard Medical School, Boston.

This supplement, which is sold over the counter, also contains L-arginine, an amino acid precursor to nitric oxide, which plays a central role in sexual arousal in part through increasing smooth muscle relaxation. ArginMax “has actions similar to Viagra,” Dr. Stoll said at the meeting, sponsored by Harvard Medical School. It also contains Korean ginseng; vitamins A, C, and E; and minerals in different formulations for men and women.

In a double-blind study of the women's formulation, 77 participants were randomized to receive the supplement or a placebo for 4 weeks. Improvements in overall sexual satisfaction were reported by 73% of women taking the supplement, compared with 37% of those receiving placebo (J. Sex Marital Ther. 27[5]:541-49, 2001).

Ginkgo alone also works for some patients, but a high dosage often is required. When taken in doses of 60-120 mg twice daily, ginkgo may increase genital blood flow, but also may cause bleeding because of its anticoagulant effects, he said.

In an open trial of ginkgo extract that included 30 men and 33 women with SSRI-related sexual dysfunction, 91% of the women and 76% of the men reported that the herb in doses ranging from 60 mg/day to 120 mg/day had “enhancing” effects on all phases of the sexual response cycle (J. Sex Marital Ther. 24[2]:139-43, 1998).

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