Skip to main content
SpringerLink
Log in

Short- and Long-term Effects of Ginkgo Biloba Extract on Sexual Dysfunction in Women

Archives of Sexual Behavior Aims and scope Submit manuscript

Cite this article

Abstract

Ginkgo biloba extract (GBE) facilitates blood flow, influences nitric oxide systems, and has a relaxant effect on smooth muscle tissue. These processes are important to the sexual response in women and, hence, it is feasible that GBE may have a therapeutic effect. The present study was the first to provide an empirical examination of the effects of both short- and long-term GBE administration on subjective and physiological (vaginal photoplethysmography) measures of sexual function in women with Sexual Arousal Disorder. A single dose of 300 mg GBE had a small but significant facilitatory effect on physiological, but not subjective, sexual arousal compared to placebo in 99 sexually dysfunctional women. The long-term effects of GBE on sexual function were assessed in 68 sexually dysfunctional women who were randomly assigned to 8 weeks treatment of either (1) GBE (300 mg/daily), (2) placebo, (3) sex therapy which focused on training women to attend to genital sensations, or (4) sex therapy plus GBE. When combined with sex therapy, but not alone, long-term GBE treatment significantly increased sexual desire and contentment beyond placebo. Sex therapy alone significantly enhanced orgasm function compared with placebo. Long-term GBE administration did not significantly enhance arousal responses beyond placebo. It was concluded that (1) neither short- or long-term administration of GBE alone substantially impacts sexual function in women, (2) a substantial placebo effect on sexual function exists in women with sexual concerns, and (3) teaching women to focus on genital sensations during sex enhances certain aspects of women’s sexual functioning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Notes

  1. The therapist manual is available from the corresponding author upon request.

References

  • Auguet, M., & Clostre, F. (1983). Effects of an extract of ginkgo biloba and diverse substances on the phasic and tonic components of the contraction of an isolated rabbit aorta. General Pharmacology, 14, 277–280.

    PubMed  CAS  Google Scholar 

  • Auguet, M., DeFeudis, F. V., & Clostre, F. (1982). Effects of ginkgo biloba on arterial smooth muscle responses to vasoactive stimuli. General Pharmacology, 13, 169–171.

    PubMed  CAS  Google Scholar 

  • Azadzoi, K. M., Kim, N., Brown, M. L., Goldstein, I., Cohen, R. A., & Saenz de Tejada, I. (1992). Endothelium-derived nitric oxide and cyclooxygenase products modulate corpus cavernosum smooth muscle tone. Journal of Urology, 147, 220–225.

    PubMed  CAS  Google Scholar 

  • Basson, R., & Brotto, L. A. (2003). Sexual psychophysiology and effects of sildenafil citrate in oestrogenised women with acquired genital arousal disorder and impaired orgasm: A randomized controlled trial. British Journal of Obstetrics and Gynecology, 100, 1014–1024.

    Google Scholar 

  • Basson, R., McInnes, R., Smith, M. D., Hodgson, G., & Kippiker, N. (2002). Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with Female Sexual Arousal Disorder. Journal of Women’s Health & Gender-Based Medicine, 11, 367–377.

    Article  Google Scholar 

  • Boolell, M., Allen, M. J., Ballard, S. A., Gepi-Attee, S., Muirhead, G. J., Naylor, A. M., et al. (1996). Sildenafil: An orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. International Journal of Impotence Research, 8, 47–52.

    PubMed  CAS  Google Scholar 

  • Bryk, A. S., Raudenbush, S. W., & Congdon, R. T. (1996). Hierarchical linear and nonlinear modeling with the HLM/2L and HLM/3L programs (2nd ed.). Chicago: Scientific Software International Inc.

    Google Scholar 

  • Burnett, A. L. (1997). Nitric oxide in the penis: Physiology and pathology. Journal of Urology, 157, 320–324.

    Article  PubMed  CAS  Google Scholar 

  • Caruso, S., Intelisano, G., Lupo, L., & Agnello, C. (2001). Premenopausal women affected by sexual arousal disorder treated with sildenafil: A double-blind, cross-over, placebo-controlled study. British Journal of Obstetrics and Gynaecology, 108, 623–628.

    Article  PubMed  CAS  Google Scholar 

  • Chivers, M. L., Seto, M. C., Lalumiere, M. L., Laan, E., & Grimbos, T. (2005, July). The agreement of genital and subjective measures of sexual arousal: A meta-analysis. Poster presentation to the annual meeting of the International Academy of Sex Research, Ottawa, Canada.

  • Christen, Y., Courtois, Y., & Droy-Lefaix, M. T. (1995). Effects of ginkgo biloba extract (EGB 761) on aging and age-related disorders. Paris, France: Elsevier.

    Google Scholar 

  • Cohen, A. J., & Bartlik, B. (1998). Ginkgo biloba for antidepressant-induced sexual dysfunction. Journal of Sex and Marital Therapy, 24, 139–143.

    Article  PubMed  CAS  Google Scholar 

  • DeFeudis, F. V. (1991). Ginkgo biloba extract (GBE 761): Pharmacological activities and clinical applications. Paris, France: Elsevier.

    Google Scholar 

  • Dinsmore, W. W., Hodges, M., Hargreaves, C., Osterloh, I. H., Smith, M. D., & Rosen, R. C. (1999). Sildenafil citrate (Viagra) in erectile dysfunction: Near normalization in men with broad-spectrum erectile dysfunction compared with age-matched healthy control subjects. Urology, 53, 800–805. [Erratum in: Urology, 1999, 53, 1072].

    Article  PubMed  CAS  Google Scholar 

  • Dunlop, W. P., Cortina, J. M., Vaslow, J. B., & Burke, M. J. (1996). Meta-analysis of experiments with matched groups or repeated measures designs. Psychological Methods, 1, 170–177.

    Article  Google Scholar 

  • Ellison, J. M., & DeLuca, P. (1998). Fluoxetine-induced genital anesthesia relieved by ginkgo biloba extract. Journal of Clinical Psychiatry, 59, 199–200.

    PubMed  CAS  Google Scholar 

  • FDA Guidance document. (2000). Guidance for industry: Female sexual dysfunction: Clinical development of drug products for treatment. http://www.fda.gov/cder/guidance/3312dft.htm.

  • Foa, E. B., Hembree, E. A., Cahill, S. P., Rauch, S. A. M., Riggs, D. S., Feeny, N. C., et al. (2005). Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: Outcome at academic and community clinics. Journal of Consulting and Clinical Psychology, 73, 953–964.

    Article  PubMed  Google Scholar 

  • Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998) Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338, 1397–1404.

    Article  PubMed  CAS  Google Scholar 

  • Janssen, E. (2001). Psychophysiological measurement of sexual arousal. In M. W. Wiederman & B. E. Whitley (Eds.), Handbook for conducting research on human sexuality (pp. 139–171). Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Jung, F., Morowietz, C., Kiesewetter, H., & Wenzel, E. (1990). Effect of ginkgo-biloba on fluidity of blood an peripheral microcirculation in volunteers. Drug Research, 40, 589–593.

    PubMed  CAS  Google Scholar 

  • Kang, B., Lee, S., Kim, M., & Cho, M. (2002). A placebo-controlled, double-blind trial of ginkgo biloba for antidepressant-induced sexual dysfunction. Human Psychopharmacology, 17, 279–284.

    Article  PubMed  Google Scholar 

  • Kirsch, I. (1997). Specifying nonspecifics: Psychological mechanisms of placebo effects. In A. Harrington (Ed.), The placebo effect: An interdisciplinary exploration (pp. 166–186). Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Kleijnen, J., & Knipschild, P. (1992). Ginkgo biloba. Lancet, 340, 1136–1139.

    Article  PubMed  CAS  Google Scholar 

  • Koltringer, P., Eber, O., Lind, P., Langsteger, W., & Wakonig, P. (1989). Mikrozirkulation und Viskoelastizitat des Vollblutes unter Ginkgo-biloba-extrakt. Eine plazebokontrollierte, randomisierte Doppelblind-Studie. Perfusion, 1, 28–30.

    Google Scholar 

  • Maitra, I., Marcocci, L., Droy-Lefaix, M. T., & Packer, L. (1995). Peroxyl radical scavenging activity of ginkgo biloba extract EGB 761. Biochemical Pharmacology, 49, 1649–1655.

    Article  PubMed  CAS  Google Scholar 

  • Marcocci, L., Maguire, J. J., Droy-Lefaix, M. T., & Paker, L. (1994). The nitric oxide-scavenging properties of ginkgo biloba extract Egb 761. Biochemical and Biophysical Research Communications, 201, 748–755.

    Article  PubMed  CAS  Google Scholar 

  • Marks, L. S., Duda, C., Dorey, F. J., Macairan, M. L., & Santos, P. B. (1999). Treatment of erectile dysfunction with Sildenafil. Urology, 53, 19–24.

    Article  PubMed  CAS  Google Scholar 

  • Meston, C. M. (2003). Validation of the Female Sexual Function Index (FSFI) in women with female orgasmic disorder and in women with hypoactive sexual desire disorder. Journal of Sex & Marital Therapy, 29, 39–46.

    Article  Google Scholar 

  • Meston, C. M., & Gorzalka, B. B. (1992). Psychoactive drugs and human sexual behavior: The role of serotonergic activity. Journal of Psychoactive Drugs, 24, 1–40.

    PubMed  CAS  Google Scholar 

  • Meston, C. M., & Heiman, J. R. (1998). Ephedrine-activated physiological sexual arousal in women. Archives of General Psychiatry, 55, 652–656.

    Article  PubMed  CAS  Google Scholar 

  • Meston, C. M., Rellini, A. H., & McCall, K. M. (2005, October). The sensitivity of continuous laboratory measures of physiological and subjective sexual arousal for diagnosing women’s sexual dysfunction. Poster presentation to the annual meeting of the International Society for the Study of Women’s Sexual Health, Las Vegas, NV.

  • Meston, C. M., & Trapnell, P. D. (2005). Development and validation of a five factor` sexual satisfaction and distress scale: The Sexual Satisfaction Scale for Women (SSS-W). Journal of Sexual Medicine, 2, 66–81.

    Article  PubMed  Google Scholar 

  • Montorsi, F., McDermott, T. E., Morgan, R., Olsson, A., Schultz, A., Kirkeby, H. J., et al. (1999). Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies. Urology, 53, 1011–1018.

    Article  PubMed  CAS  Google Scholar 

  • Paick, J. S., & Lee, J. H. (1996). An experimental study of the effect of ginkgo biloba extract on the human and rabbit corpus cavernosum tissue. Journal of Urology, 156, 1876–1880.

    Article  PubMed  CAS  Google Scholar 

  • Park, K., Goldstein, I., Andry, C., Siroky, M., Krane, R. J., & Azadzoi, K. (1997). Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency. International Journal of Impotence Research, 9, 27–37.

    Article  PubMed  CAS  Google Scholar 

  • Park, K., Moreland, R. B., Goldstein, I., Atala, A., & Traish, A. (1998). Sildenafil inhibits phosphodiesterase type 5 in human clitoral corpus cavernosum smooth muscle. Biochemical and Biophysical Research Communications, 249, 612–617.

    Article  PubMed  CAS  Google Scholar 

  • Porsolt, R. D., Martin, P., Lenegere, A., Fromage, S., & Drieu, K. (1990). Effects of an extract of ginkgo biloba (GBE 761) on “learned helplessness” and other models of stress in rodents. Pharmacology, Biochemistry and Behavior, 36, 963–971.

    Article  CAS  Google Scholar 

  • Prause, N., & Janssen, E. (2005). Blood flow: Vaginal photoplethysmography. In I. Goldstein, C. M. Meston, S. R. Davis, & A. M. Traish (Eds.), Women’s sexual function and dysfunction: Study, diagnosis, and treatment (pp. 368–382). London: Taylor & Francis.

    Google Scholar 

  • Rapin, J. R., Lamproglou, I., Drieu, K., & DeFeudis, F. V. (1994). Demonstration of the “anti-stress” activity of an extract of ginkgo biloba (GBE 761) using a discrimination learning task. General Pharmacology, 25, 1009–1016.

    PubMed  CAS  Google Scholar 

  • Rellini, A. H., McCall, K. M., Randall, P. K., & Meston, C. M. (2005). The relationship between self-reported and physiological measures of female sexual arousal. Psychophysiology, 42, 116–124.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., & Meston, C. M. (2006). The sensitivity of events logs, self-administered questionnaires and photoplethysmography to detect treatment-induced changes in female sexual arousal disorder (FSAD) diagnosis. Journal of Sexual Medicine, 3, 283–291.

    Article  PubMed  Google Scholar 

  • Rosen, R., D’Agostino, R., Brown, C., Heiman, J., Leiblum, S., Meston, C. M., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26, 191–208.

    Article  PubMed  CAS  Google Scholar 

  • Rosen, R., Lane, R., & Menza, M. (1999). Effects of SSRIs on sexual function: A critical review. Journal of Clinical Pharmacology, 19, 67–85.

    CAS  Google Scholar 

  • Sintchak, G., & Geer, J. H. (1975). A vaginal plethysmograph system. Psychophysiology, 12, 113–115.

    Article  PubMed  CAS  Google Scholar 

  • Smith, P. F., Maclennan, K., & Darlington, C. L. (1996). The neuroprotective properties of the ginkgo biloba leaf: A review of the possible relationship to platelet-activating factor (PAF). Journal of Ethnopharmacology, 50, 131–139.

    Article  PubMed  CAS  Google Scholar 

  • Stimmel, G. L., Dopheide, J. A., & Stahl, S. M. (1997). Mirtazapine: An antidepressant with noradrenergic and specific serotonergic effects. Pharmacotherapy, 17, 10–21.

    PubMed  CAS  Google Scholar 

  • Straus, J., & von Ammon, C. (1996). Placebo effects: Issues for clinical practice in psychiatry and medicine. Psychosomatics, 37, 315–326.

    PubMed  CAS  Google Scholar 

  • Toesca, A., Stolfi, V. M., & Cocchia, D. (1996). Immunohistochemical study of the corpora cavernosa of the human clitoris. Journal of Anatomy, 188, 513–520.

    PubMed  Google Scholar 

  • Tyler, V. E. (1993). Ginkgo. In V. E. Tyler (Ed.), The honest herbal (pp. 149–151). New York: Pharmaceutical Products Press.

    Google Scholar 

  • van Beek, T. A., van Scheeren, H. A., Rantio, T., Melger, W. Ch., & Lelyveld, G. P. (1991). Determination of ginkgolides and bilobalide in ginkgo biloba leaves and phytopharmaceuticals. Journal of Chromatography, 543, 375–387.

    Article  Google Scholar 

  • Wiegel, M., Meston, C. M., & Rosen, R. C. (2005). The Female Sexual Function Index (FSFI): Cross-validation and development of clinical cutoff scores. Journal of Sex and Marital Therapy, 31, 1–20.

    Article  PubMed  Google Scholar 

  • Wiegel, M., Scepkowski, L. A., & Barlow, D. H. (2006). Cognitive and affective processes in female sexual dysfunction. In I. Goldstein, C. M. Meston, S. R. Davis, & A. M. Traish (Eds.), Women’s sexual function and dysfunction: Study, diagnosis, and treatment (pp. 85–92). London: Taylor & Francis.

    Google Scholar 

Download references

Acknowledgments

This publication was made possible by Grant Number 5 RO1 AT00224-02 from the National Center for Complementary and Alternative Medicine to Cindy Meston. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Complementary and Alternative Medicine. The authors wish to thank Jessica Davis for her assistance in all phases of this investigation.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Texas at Austin, One University Station A8000, Austin, TX, 78712, USA

    Cindy M. Meston, Alessandra H. Rellini & Michael J. Telch

Authors
  1. Cindy M. Meston
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandra H. Rellini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael J. Telch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cindy M. Meston.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Meston, C.M., Rellini, A.H. & Telch, M.J. Short- and Long-term Effects of Ginkgo Biloba Extract on Sexual Dysfunction in Women. Arch Sex Behav 37, 530–547 (2008). https://doi.org/10.1007/s10508-008-9316-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-008-9316-2

Keywords

search

Navigation