For many couples, trouble in the bedroom is still a taboo topic. However, problems related to sex life are more common than we realize. Issues in one’s sex life or the inability to perform in bed, regardless of gender, take a toll on relationships and also affect an individual’s self-confidence. Be it premature ejaculation, erectile dysfunction, or vaginismus, there can be several impediments to having a fulfilling sex life. It is important to not lose hope and seek expert advice, without embarrassment, when one is facing any issue.

Before we discuss the problems that are prevalent, let us look at the main stages of sexual function in men and women.

What Are The Stages Of Sexual Response In Men?

In men, clinically speaking, the stages of sexual function are

• arousal or excitement
• the sexual act (this could be intercourse or stimulation of the sex organs)
• ejaculation upon experiencing orgasm, and a latency period

So, what exactly happens during these stages?

The initial phase of penile erection occurs in response to visual, olfactory, or imaginative stimulation, or genital stimulation. During an erection, there is increased blood flow to the erectile tissues in the penis. Ejaculation is dependent on the sympathetic nerves, which are the nerves that prepare our body to deal with stress. These nerves cause the muscles in the vas deferens, seminal vesicles, and prostrate to contract. This results in the emission of semen.^[1]deGROAT, WILLIAM C., and AUGUST M. BOOTH. “Physiology of male sexual function.” Annals of internal medicine 92, no. 2_Part_2 (1980): 329-331.

What Are The Stages Of Sexual Function In Women?

There are three principal stages of sexual function in women:

• desire
• arousal
• orgasm

During arousal, blood flow increases to the internal and external genitalia including the vagina labia minora, clitoris, pelvic floor, and uterus. This causes heightened sensations. The vaginal canal is moistened and lubricated. Finally, rhythmic contractions of the uterus and pelvic floor occur during orgasm. Like in men, the sexual activity in women also depends largely on the sympathetic nervous system. It is also important to note that several hormones play an important role in female sexual function.^[2]Marthol, H., and M. J. Hilz. “Female sexual dysfunction: a systematic overview of classification, pathophysiology, diagnosis and treatment.” Fortschritte der Neurologie-psychiatrie 72, … Continue reading

What Does Ayurveda Say About Sexual Function?

The ancient ayurvedic text, Charaka Samhita, states that the three cornerstones of a healthy life are: a well-balanced diet, proper sleep, and healthy sex life.^[3]Dalal, P. K., Adarsh Tripathi, and S. K. Gupta. “Vajikarana: Treatment of sexual dysfunctions based on Indian concepts.” Indian Journal of psychiatry 55, no. Suppl 2 (2013): S273. Ayurveda divides the sexual response cycle into the following stages:

• Sankalpa/Desire: this is the first stage where one develops the desire for sexual intimacy.
• Arousal: also known as the excitement phase. This is the stage in which one is aroused by physical touch, olfactory, visual, or imaginative stimuli. This results in penile erection in males and the lubrication of the vagina in females, along with flushed skin, erection of nipples.
• Plateau: the physiological changes that occur in the arousal stage are sustained in the plateau phase. This phase is marked by sexual tension; both blood pressure and heart rate increase.
• Orgasm: this is the shortest phase marked by muscular contractions and can last anywhere between 3 to 15 seconds. There is a sudden forceful release of sexual tension
• Resolution: in this phase the body returns to its unaroused state.^[4]Purohit, Dharitri, Ramadevi, Arpana Jain, “A Review on Shukra Dushti and Disorders of Different Phases of Sexual Response Cycle”, International Ayurvedic Medical Journal

What Is Sexual Dysfunction And How Prevalent Is It?

When exactly can one say that they are suffering from sexual dysfunction? Well, if there is a persistent problem that one faces in terms of sexual response or pleasure, one might be suffering from sexual dysfunction. Sexual dysfunction can occur at any stage of the sexual act. Here are a few common ones:

• Premature ejaculation
• Delayed ejaculation
• Erectile dysfunction
• Female orgasmic disorder
• Vaginismus
• Medication-induced sexual dysfunction

Since, even today, most people are guarded about their sexual problems and there is a lack of systematic surveillance of these disorders, it is rather difficult to gather data. However, studies conducted on a small scale suggest that only 2% of men between 40 and 50 years report erectile dysfunction; it is more common in older men between the ages of 60 and 70 years. The prevalence rates of disorders in women are currently unknown.^[5]Shepardson, R. and M. Carey, “Sexual Dysfunctions”, 2021.

What Is Sexual Dysfunction Caused By?

Sexual dysfunction can be caused by physical or psychological factors.

• Physical causes: The physical causes responsible for sexual dysfunction could include diabetes, hypertension, liver or kidney disease, poor cardiac health, neurological disorders, or hormonal imbalance. Moreover, at times, the medications people take also have side effects.

• Psychological causes: The psychological causes can range from stress, anxiety about sexual performance, marital discord, guilt, to body image issues and past sexual trauma.

What Are The Causes Of Sexual Dysfunction According To Ayurveda?

Ayurveda enlists several causes that could result in sexual disorders.

• Forced intercourse or bitter recollections
• Excessive consumption of items that are saline, acidic, or pungent, that is, items that generate heat, results in the loss of the saumya dhatu or the watery element
• Loss of semen due to excessive sexual pleasure
• Sahaja impotency or congenital sexual disorders. This form of sexual disorder, along with ones caused by injury, are mostly incurable
• Voluntary suppression of sexual desire

Ayurveda classifies erectile dysfunction or klaibya into several types:

• Dhajabhangaja Klaibya: caused by excessive indulgence in sex resulting in damaged tissues
• Shukra Kshayaja Klaibya: reduced semen and low sperm count
• Jaraja Klaibya: caused by a diet that is deficient in nutrients..

How Can One Treat Sexual Dysfunction Naturally?

Sexual response is a complex phenomenon that is influenced by physiological (comorbidities like diabetes or hypertension), psychological (performance anxiety), and social (marital relationship) factors. A disturbance in any one of these can cause sexual problems. To treat sexual dysfunction, one has to adopt a holistic approach. Sexual dysfunction cannot be treated in isolation. While assessing the problem, the first step is accepting the problem and not being ashamed of it. Destigmatizing discussions related to sexual health is crucial.

A healthy lifestyle is paramount for not only maintaining good health but also for sexual health. Comorbidities and stress play a huge role and these are lifestyle disorders that can be managed. Here are some areas to focus on, along with consulting an expert:

• Your diet should be well balanced. Stay away from junk food.
• Exercise regularly. Practice yoga for physical health and also to alleviate stress.
• Focus on building your relationships. Establish stronger ties with your partner so that acts of intimacy are not awkward.
• If you suffer from low self-esteem, body-image issues, or anxiety, consult a therapist.

What Are The Types Of Sexual Dysfunction?

Let us delve deeper into the various kinds of sexual disorders that one may face:

1. Desire Disorders

Desire disorders refer to the loss of libido. The dysfunction, in some cases, masks deeper issues such as relationship problems, exhaustion, or substance abuse. Other causes include a deficiency of the testosterone hormone or side effects of medication.

Treating sexual desire disorders: since often they are caused by psychological factors, here are a few ways in which this is treated:

• group or couple therapy. This may involve sexual intimacy exercises.
• cognitive behavioural therapy (CBT)
• women can undergo testosterone administration. However, be cautious as the risks and benefits of this are still unknown
• orgasm consistency training with focused masturbation and focusing exercises

2. Arousal Disorders

Erectile Dysfunction: Erectile dysfunction, or what was earlier called impotence, is the condition in which one is unable to maintain a rigid penile erection that is necessary for sexual pleasure and intercourse. Of course, a one-time incident cannot be termed as a dysfunction. However, if this condition persists for over six months, it can be categorized as such. This disorder is more common among older men and usually increases with comorbidities such as diabetes and hypertension. ^[6]Sooriyamoorthy, Thushanth, and Stephen W. Leslie. “Erectile Dysfunction.” StatPearls Internet.

According to ayurveda, the apana vayu is a kind of vayu (air) located in the testicles, urinary bladder, phallus, umbilicus, thighs, groin, anus, and colon. It helps in ejaculation, evacuating bowels, and urination. The condition of erectile dysfunction has been described as klaibya in ayurvedic texts.

Treating arousal disorders:
The following is usually recommended:

• Use of erotic resources
• Honing one’s attention-focusing skills
• Kegel exercises (voluntary tightening of pelvic floor muscles; try this for a few seconds to begin with and release)
• Therapy to alleviate anxiety

3. Orgasm Disorders

1. Premature Ejaculation: Premature ejaculation is defined as ejaculation that occurs before or within a minute of vaginal penetration. If one suffers from this, one is unable to defer ejaculation in one or more penetrations.^[7]Gillman, Nicholas, and Michael Gillman. “Premature ejaculation: Aetiology and treatment strategies.” Medical Sciences 7, no. 11 (2019): 102.
2. Retarded Ejaculation: Retarded ejaculation refers to one’s inability to ejaculate despite being aroused and stimulated and despite erection. The causes range from the use of certain drugs, the effect of surgical intervention, to psychological factors like stress, guilt, or fear.^[8]Munjack, Dennis J., and Pamela H. Kanno. “Retarded ejaculation: a review.” Archives of sexual behavior 8, no. 2 (1979): 139-150. (Retarded ejaculation: a review – PubMed (nih.gov))

Treatment of orgasm disorders:
This usually involves:

• Self-pleasuring activities
• Fantasy exercises
• Working on building a positive body image
• Kegel exercises

4. Disorders Related to Sexual Pain

• Dyspareunia: Dyspareunia is genital pain that one may experience before, during, or after intercourse. It can affect both men and women; however, it is more common in women.
  
  Treatment of dyspareunia: in women, vaginal dilation is a tested treatment. This includes physical therapy, relaxation, maintaining correct posture.^[9]Magnuson, Sandy and Senja Collins, “Collaboration between Couples, Counselors and Physical Therapists when Treating Dyspareunia: An Untapped Partnership,” 10, no. 1 (2002): 109-111.
• Vaginismus: Women who suffer from vaginismus experience an involuntary spasm in their vagina during intercourse, and this inhibits coitus and often causes distress.^[10]Harish, Thippeswamy, KrishnaPrasad Muliyala, and Pratima Murthy. “Successful management of vaginismus: an eclectic approach.” Indian journal of psychiatry 53, no. 2 (2011): 154.
  
  Treatment of vaginismus: Cognitive behavioural therapy (CBT) has been found to be useful in treating vaginismus. Graded vaginal dilation with a self-finger approach or with instruments also helps.^[11]Mezzich, Juan E., and Ruben Ed Hernandez-Serrano. Psychiatry and sexual health: An integrative approach. Jason Aronson, 2006.

How Does Ayurveda Approach Sexual Disorders?

Vajikaran is a special branch of ayurvedic rasayana (a category of herbs and deep rejuvenation practices) that promotes sexual health. It revitalizes all the seven dhatus (elements) in the body and restores balance. Vajikaran therapy targets the neuro-endocrine-immune system. In other words, it restores nerve health and hormonal balance. It also alleviates stress.

Ayurvedic aphrodisiacs with therapeutic properties have been used for ages. Here is how they can help promote sexual health:

• Arousing sexual desire
• Increasing the quantity of semen
• Purifying the quality of semen
• Improve ejaculatory functions
• Delaying the time of ejaculation

Which Ayurvedic Herbs Can Treat Sexual Dysfunction In Men?

1. Ashwagandha (Withania somnifera)

This herb is an adaptogen (one that helps the body handle stress) with aphrodisiac properties. It is particularly beneficial for treating stress-induced sexual disorders. It has proved effective in improving spermatogenesis (the process by which sperms are formed) and also has testosterone-like properties.^[12]Iuvone, Teresa, Giuseppe Esposito, Francesco Capasso, and Angelo A. Izzo. “Induction of nitric oxide synthase expression by Withania somnifera in macrophages.” Life sciences 72, no. 14 … Continue reading

How to use ashwagandha

Ashwagandha is available in the form of tablets and powder.

• You can mix Ashwagandha powder (5 grams) with water, honey, and ghee and consume it. Alternatively, take one to two ashwagandha capsules twice daily or as prescribed by the Ayurvedic expert.
• Consult a practitioner for exact duration and dosage.

Precaution: If consumed in large doses, one may experience vomiting and diarrhoea.

2. Shatavari (Asparagus racemosus)

Literally, shatavari means the woman with a hundred husbands. It symbolizes increased female fertility. It has also been found useful in treating sexual disorders in men. A study proved its efficacy in diabetic male rats. ^[13] Thakur, Mayank, Shilpi Bhargava, and V. K. Dixit. “Effect of Asparagus racemosus on sexual dysfunction in hyperglycemic male rats.” Pharmaceutical Biology 47, no. 5 (2009): 390-395.

How to consume shatavari

• Take two capsules of shatavari with milk. Consult a practitioner for exact duration and dosage.

Precaution: Incorrect dosage of shatavari may lead to kidney damage.

3. Safed Musli (Chlorophytum borivilianum)

Safed musli acts as an aphrodisiac and a sexual stimulant. Its effect on sexual behaviour and spermatogenesis was studied on albino rats. There was an increase in mount frequency and a heightened attractability towards females. It also increased sperm count significantly. ^[14]Kenjale, Rakesh, Riddhi Shah, and Sadhana Sathaye. “Effects of Chlorophytum borivilianum on sexual behaviour and sperm count in male rats.” Phytotherapy Research: An International Journal … Continue reading

How to consume Safed musli

• Safed musli is available in the form of juice. You can dilute this with water and consume twice daily.
• Consult a practitioner for exact duration and dosage.

Precautions: People suffering from digestive or liver disorders should consult an ayurvedic practitioner before consuming safed musli.

4. Shilajit

While there is little research to support its claims, shilajit has been traditionally used to increase vigour. Shilajit, when consumed by women, helps in inducing periods and regulating the menstrual cycle.

How to consume shilajit

• Take two tablets of shilajit with milk twice a day.
• Consult a practitioner for exact duration and dosage.

Precaution: It can increase the iron levels in your body.

Which Ayurvedic Herbs Can Treat Sexual Dysfunction In Women?

While sexual disorders in men are well defined and manifest in the form of erectile dysfunction or premature ejaculation, the dysfunctions in women are harder to define. In women, it is common to observe a loss in libido and often their sexual response is affected by hormones and stress. In addition to the herbs mentioned in the previous section, here are some that can help women in particular:

1. Moringa

Moringa is a great way to provide vital nutrients such as calcium, vitamins A, B2, and B3. This also helps in improving female fertility.

How to consume moringa

• Moringa is now easily available as juice, capsule, and powder. You can consume moringa after breakfast.

Precaution: If you are pregnant, consult a medical professional before consuming moringa.

2. Nutmeg or jaiphal

Nutmeg is often referred to as women’s “viagra” because of their sexual stimulating properties. It is also an antidepressant.

How to consume nutmeg

• Take a pinch of nutmeg powder and swallow it with honey after your main meals of the day.

Precaution: Do not consume in excess (more than 120 g) as it can cause hallucinations. Excess amounts can also cause pregnant women to miscarry.

Are There Any Side Effects Of Ayurvedic Treatments?

There isn’t any reason to worry if the herbal remedies are consumed as per the advised dosage and with the precautions kept in mind.

• These remedies are not recommended for men older than 70 years and boys younger than 16.
• Some ayurvedic medicines may contain mercury and lead, which could be toxic. Men with cardiac issues must consult an expert before undergoing any ayurvedic therapy for erectile dysfunction.

It is important to bear in mind that sexual function in every human being is a complex act that depends on not only certain organs of the body but also on the mind and one’s social relations. Any sexual disorder must be treated without stigma and by adopting a holistic approach.

In addition to specific herbs, lifestyle changes also go a long way in promoting sexual health. If you feel you can benefit from personal consultation, do not hesitate to reach out to an experienced ayurvedic practitioner and a medical professional specializing in this domain.