 The creation and promotion of female sexual dysfunction as a mental disorder seems like a textbook case of disease mongering by the pharmaceutical industry, harkening back to the first DSM, Psychiatry's Diagnosis Manual, which listed fragidity as a mental disorder, along, of course, with homosexuality. The latest manifestation is hypoactive sexual desire disorder, a disease invented by drug companies. It's like when Prozac was about to go off patent. The company sponsored the creation of a new mental illness to market a drug called serifem, which was simply Prozac repacked in a pink capsule. The condition previously known as shyness was branded as social anxiety disorder, so they could get kids on Paxil. There are certainly women who are troubled by low libido, but there's no reliable scientific evidence that hypoactive sexual desire disorder is a real medical condition, and women can get diagnosed with it even with a normal libido. A woman highly interested in sex, just not for whatever reason, with her current partner, can still qualify for the diagnosis and the drug. Even a woman who is perfectly satisfied with her sex life may still qualify if her partner isn't. Our story begins in 2009 when a drug company tried to get a failed anti-depressant called the Phlebancerin, approved to treat hypoactive sexual desire disorder. The only problem? It didn't work. It was resubmitted again after more study and was still rejected, as was the appeal. But in 2015, the FDA approved the drug. What changed? Nothing about its efficacy. It didn't work any better. What changed is that the drug company that bought it helped launch an astroturfake grassroots advocacy group, Even the Score, which lobbied for approval under a feminist rubric. Men have their drugs. Why don't women get any sex drugs? Which was exposed as kind of a bitter irony. But hey, within 48 hours of FDA approval, the drug was sold for a cool billion in cash, very satisfying for the drug company. But what about the women who take the drug? Now, sold as add-ye. Not much. The drug just doesn't work as advertised. Yes, it may stimulate monkeys to groom each other more, but when researchers dug up the unpublished data about the drug, any clinical benefit was found to be marginal, and the drug was found to have significant adverse side effects. Besides being ineffective, it can be dangerous. Combining it with alcohol can cause dangerous hypotension and fainting. A problem so serious that the FDA put a black box warning on it, its most serious safety alert on the label that, of course, no one reads. Even without alcohol, it can cause severe drops in blood pressure levels and cause sudden prolonged unconsciousness. Now, serious side effects might be acceptable in some kind of cancer wonder drug or something, but are entirely unacceptable in a drug given to healthy women for an invented condition. Are there any safe and natural solutions? Well, there's lots of studies on diet and men's sexual health, but what about women's? I've previously explored the evidence about women with high cholesterol levels, reporting diminished sexual function across a number of dimensions. This could explain why a more plant-based diet, rich in a variety of whole plant foods, might be effective in ameliorating sexual function issues in women, as it does in men. More whole grains, beans, vegetables, and fruit and less meat, dairy, and sugar associated with a reduced risk of erectile dysfunction. Because of the anatomy and physiology of sexual responses are actually quite similar between the two, it can have a similar effect. You can measure clitoral engorgement with fancy MRI techniques within minutes of exposure to an erotic video. And we know now that lubrication is all about blood flow, too. Within the sexually aroused vagina, it's the hydrostatic pressure from all the additional pelvic blood flow that forces fluid to leak out onto the surface as the vaginal lubrication. So how can we improve blood flow? Well, the flavonoid phytonutrients in cocoa can help open up arteries, using pulse wave amplitude from this set baseline to this, after drinking cocoa for four days, peaking at about 90 minutes after consumption. So can that Valentine's Day chocolate make a difference? Women who eat chocolate do tend to have higher female sexual function index scores, but the effect disappeared once age was taken into account. So despite all the potential biological mechanisms supporting a role for chocolate as an aphrodisiac food, the study failed to show a benefit. One would assume that chocolate could improve blood flow, but remember that was with cocoa powder, maybe the fat and sugar in chocolate is counteracting the benefits. What are some whole food sources of flavonoids? Well, onions have a lot, and indeed fresh onion juice enhances copulatory behavior in rats, but for those of us less interested in increasing the percentage of ejaculating rats and looking for something other than onion juice for a hot date, how about that apple? But there wasn't a study addressing the potential correlation between daily apple consumption and women's sexual function until now. The title kind of gives it away, but women were split into regular daily apple consumers versus those consuming less than an apple a day. And the hundreds of apple-eaters in the study scored significantly higher on the female sexual function index. Now, note they only included women eating unpeeled apples because the phytonutrients are concentrated in the peel, so we don't know if there's a link with peeled apples. And this was just an observational study, so further studies will be necessary to clarify the relationship between apple intake and female sexuality. However, the present data can allow the development of future research for identifying new compounds and food supplements to use in female sexuality recovery, or you can just try eating an apple.