Virtually all antidepressant medications are associated with a high incidence of adverse sexual side effects. In women, the side effects most commonly reported include decreased sexual arousal with decreased lubrication, delayed or inhibited orgasm, and decreased sexual desire. To date, there are no effective pharmacological antidotes for treating these sexual side effects. Gingko biloba extract (GBE), a naturally occurring substance from the ancient Chinese Gingko tree, has properties proven to increase peripheral blood flow and to facilitate the relaxation of smooth muscle tissue. Its effectiveness in this regard has been demonstrated in numerous clinical trials that show gingko biloba to be highly efficient in treating peripheral vascular disorders. Female sexual arousal involves a complex interplay of these very actions - the relaxation of smooth muscle tissue and the inflow of blood to the genital region. Hence, pharmacologically, it is feasible that GBE may be effective in enhancing female sexual arousal. Moreover, given that the mechanisms hypothesized to facilitate female sexual function are operative at a peripheral rather than a central (i.e., neurotransmitter) level, it is unlikely that GBE would adversely impact the mood-alleviating therapeutic effects of antidepressant medications that are believed to be centrally mediated. Limited, uncontrolled studies lend support to this hypothesis. The purpose of the present study is to provide the first empirical examination of the effects of both acute and chronic GBE on subjective and physiological measures of sexual function in women who are experiencing clinically diagnosable hypoactive sexual desire disorder, female sexual arousal disorder, and/or inhibited female orgasm secondary to either to fluoxetine, sertraline, or paroxetine use. Women (N = 110) stabilized on antidepressant medication and free of a current Axis I disorder will be randomized to 8 weeks of daily treatment with either GBE (200 mg) or placebo. Sexual functioning will be assessed through (a) daily patient diary recordings, (b) patient-rating scales completed each week, and (c) blind independent evaluator ratings. The acute effects of GBE will also be assessed using vaginal photoplethysmograph techniques to assess genital blood flow, both prior to and following chronic GBE treatment. The findings from the present study will (a) help determine whether chronic and/or acute GBE facilitates sexual function in women with antidepressant-induced sexual dysfunction and, (b) examine whether acute GBE influences vaginal measures of sexual arousal. If effective, GBE could play a significant adjunctive role in the treatment of clinical depression and other psychological disorders commonly treated with antidepressant medications.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Research Project (R01)
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Special Emphasis Panel (ZAT1-C (09))
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Hopp, Craig
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University of Texas Austin
Schools of Arts and Sciences
United States
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Stephenson, Kyle R; Rellini, Alessandra H; Meston, Cindy M (2013) Relationship satisfaction as a predictor of treatment response during cognitive behavioral sex therapy. Arch Sex Behav 42:143-52
Harte, C B; Meston, C M (2013) Association between cigarette smoking and erectile tumescence: the mediating role of heart rate variability. Int J Impot Res 25:155-9
Stephenson, Kyle Richard; Meston, Cindy M (2012) The young and the restless? Age as a moderator of the association between sexual desire and sexual distress in women. J Sex Marital Ther 38:445-57
Harte, Christopher B; Meston, Cindy M (2011) Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors. Arch Sex Behav 40:597-606
Stephenson, Kyle R; Meston, Cindy M (2010) Differentiating components of sexual well-being in women: are sexual satisfaction and sexual distress independent constructs? J Sex Med 7:2458-68
Ahrold, Tierney K; Meston, Cindy M (2009) Effects of SNS activation on SSRI-induced sexual side effects differ by SSRI. J Sex Marital Ther 35:311-9
Meston, Cindy M; Rellini, Alessandra H; Telch, Michael J (2008) Short- and long-term effects of Ginkgo biloba extract on sexual dysfunction in women. Arch Sex Behav 37:530-47
Harte, Christopher B; Meston, Cindy M (2008) Acute effects of nicotine on physiological and subjective sexual arousal in nonsmoking men: a randomized, double-blind, placebo-controlled trial. J Sex Med 5:110-21
Harte, Christopher B; Meston, Cindy M (2008) The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: results from a randomized, double-blind, placebo-controlled, cross-over trial. J Sex Med 5:1184-97
Farmer, Melissa A; Meston, Cindy M (2007) Predictors of genital pain in young women. Arch Sex Behav 36:831-43

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