I am a 53-year-old woman who has been married to the same man for over 25 years. Our sex life is nonexistent. What do you recommend?

Trust, communication, and getting out of comfort zones are important factors for restoring libido. But traditional Chinese medicine (TCM) is an approach that has addressed these issues for centuries.

TCM, a 2,000-year-old system that uses a mind-body approach to illness and disease, recognizes that decreasing vitality—including sexual energy—is part of aging. But there are certain TCM protocols that any couple can follow to help get physical forms of affection back on the schedule.

1. Discomfort during or after sex.

If a woman’s hormone levels are low, which is typically what happens when she gets older, sex doesn't feel good. In fact, dryness in the vagina and vulva—some women describe it as feeling akin to sandpaper—can be downright painful, even causing a burning sensation. TCM defines dryness as a yin deficiency, also known as lack of moisture. The tissues of the vagina and vulva depend on estrogen for nourishment. As early as perimenopause, when estrogen levels slowly begin to decline, most women begin to experience some form of genital dryness. By the time they’ve completed menopause, a lack of estrogen may have made their vaginal lining extremely thin, delicate, and sensitive.

Solution: To supply estrogen to these tissues and plump them up with moisture, women can use a natural low-dose estrogen vaginal cream or suppository. The best form of estrogen to use is estriol, an estrogen that’s much weaker than estradiol and other estrogens typically used in hormone replacement therapy. For women concerned about taking hormones, a hydrating aloe vera lotion or vitamin E applied locally may help.

As part of an herbal program, women can also take Chinese ginseng (also called Panax ginseng or Korean ginseng). Chinese ginseng, which is warming and promotes circulation in the entire pelvic region, is often used to treat or prevent vaginal dryness and tissue atrophy.

2. Lack of energy and libido.

Being tired is one of the most common reasons older people don’t have sex. TCM refers to fatigue as lack of chi or vital force. Although getting more sleep can help, an herbal program can also assist in restoring libido.

Solution: One of the best herbal aphrodisiacs is reishi, “the mushroom of immortality.” (Reishi is the Japanese word: it is known in TCM as lingzhi.) Reishi taken daily can gradually intensify one’s sexual chi. Extensive research shows this mushroom will help build up the adrenal glands—exhausted adrenals are usually tied to burnout—and enhance immunity. Cordyceps is another Chinese herb, often paired with other ingredients, to elevate libido and strengthen chi.

3. Lack of time and an imbalanced lifestyle.

Even older people can sublimate their sexual energy into other activities. But because sex is healing, comforting, and pleasurable, it’s important to fit it into the schedule.

Why does sex get shortchanged? Blame it on putting work and achievement before physical gratification. In my clinical practice, I’ve observed that women don’t allow themselves quality time to bond with their mates.

Solution: For a woman to experience satisfying sex, feeling relaxed and safe is important. If those qualities are in short supply at home, it’s important to restore them.

The best way is balancing female yang energy—passion and activity—with the quiet of yin. Getting acquainted with your yin is basically taking time to smell the flowers. Indeed, a TCM practitioner would advise frazzled older patients to head to the country and be part of nature. It’s no wonder why gardening is so popular—it’s an activity that naturally puts you in a yin mood.


Laurie Steelsmith ND, LAc, is a licensed naturopathic physician and acupuncturist with a 20-year private practice in Honolulu. She and her husband, Alex Steelsmith, are coauthors of Great Sex, Naturally: Every Woman's Guide To Enhancing Her Sexuality Through The Secrets Of Natural Medicine. Learn more at drlauriesteelsmith.com.