Can Maca Root Restore Sexual Health in Women on Antidepressants?

A Closer Look at the First Controlled Trial on Antidepressant-Induced Sexual Dysfunction

Antidepressant-induced sexual dysfunction (AISD) affects over half of patients using SSRIs or SNRIs, often persisting despite remission of depressive symptoms. The condition not only diminishes quality of life but also drives treatment discontinuation, risking relapse in underlying mood disorders. With limited therapeutic options—especially for postmenopausal women—natural alternatives like maca root (Lepidium meyenii) are gaining attention.

A study led by Dording et al. explored whether maca could improve sexual function in women experiencing AISD. This double-blind, placebo-controlled trial is the first of its kind to assess maca’s effects in this population.

Study Design and Participants

• Duration: 12-week double-blind, placebo-controlled trial
• Participants: 45 female outpatients (mean age 41.5 years) in remission from depression but reporting AISD
• Groups: Randomized to either 3g/day maca root or placebo

Assessment Tools:

• Arizona Sexual Experience Scale (ASEX)
• Massachusetts General Hospital Sexual Function Questionnaire (MGH-SFQ)
• Clinical Global Impression scales (CGI-S, CGI-I)
• Hormonal blood assays for testosterone, estradiol, progesterone, and prolactin

Key Results

1. Overall Efficacy

Remission Rates were consistently higher in the maca group:

• ASEX ≤10: 9.5% (maca) vs. 4.8% (placebo)
• MGH-SFQ ≤12: 30.0% (maca) vs. 20.0% (placebo)
• MGH-SFQ ≤8: 9.5% (maca) vs. 5.0% (placebo)

While differences were not statistically significant in the full cohort, subgroup analyses revealed important distinctions.

2. Menopausal Status

Postmenopausal women experienced stronger improvements:

• MGH-SFQ remission (≤12): 57.1% in maca group vs. 20.0% placebo
• Orgasm improvement was significantly higher in this group (MGH-SFQ item 3)

Premenopausal women reported enhanced arousal (MGH-SFQ item 2) with maca, but no difference in orgasm or satisfaction compared to placebo

3. Hormonal Insights

Testosterone levels in the maca group correlated significantly with improved sexual function (ASEX score improvements):

• Change in testosterone: r = 0.834, P = 0.042
• Endpoint testosterone level: r = 0.720, P = 0.008

These findings suggest maca’s potential androgenic mechanism may involve indirect stimulation through a feedback loop involving luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Tolerability and Safety

• Maca was well tolerated, with only three participants withdrawing due to mild adverse effects (e.g., nausea, flu-like symptoms)
• No liver function tests were conducted; future studies should address this potential oversight given concerns about herbal supplement safety

Limitations

• Small sample size, particularly among postmenopausal participants
• Self-report measures for orgasm and satisfaction may introduce bias
• Lack of sensitive testosterone assays limits mechanistic conclusions
• Findings require replication in larger, more diverse populations

Conclusion

This study provides early evidence that maca root may alleviate antidepressant-induced sexual dysfunction in women, especially in older and postmenopausal subgroups. The potential androgenic effects—correlated with improved sexual response—warrant further research using more precise hormonal assays.

A larger-scale trial is currently in development, aiming to further explore maca’s clinical utility in AISD, with improved endocrinological measurement tools and expanded dosing strategies.

Source:
Dording CM, Schettler PJ, Dalton ED, et al. A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women. Evid Based Complement Alternat Med. 2015;2015:949036. doi: 10.1155/2015/949036 (https://pmc.ncbi.nlm.nih.gov/articles/PMC4411442/).