The Search for a Female Viagra

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Two years after Viagra stormed the market and revived erections for millions of men, many women are asking if a women's Viagra exists as a solution to their sex life. Is there a Viagra for women?

The short answer is no — at least not yet. But that could change within the next two or three years as drug companies and researchers race to develop a libido enhancer for a very large — and underserved — market.

Just how large? Some 43 percent of women suffer with sexual dysfunction, compared to 31 percent of men, according to University of Chicago researcher Dr. Edward Laumann. And some $2 to $3 billion will be spent within the next ten years on products aimed at improving the sex lives of these women.

The Drivers of Female Sexual Dysfunction
Female sexual dysfunction is characterized by a lack of desire, arousal and orgasm. Lack of desire is the chief complaint among women, affecting about one-third of them at some point in their lives, says Cindy Meston, assistant professor of clinical psychology at the University of Texas at Austin.

The Cause?
A woman's lack of sexual interest is often tied to her relationship with her partner, says Sandra Lieblum, director for sexual and marital health at the UMDNJ Robert Wood Johnson Medical School in Piscataway, N.J. "The important sex organ [for women] is between the ears. Men need a place for having sex — women need a purpose," she says. But it can also be triggered by family concerns, illness or death, financial or job worries, childcare responsibilities, managing a career and children, previous or current physical and emotional abuse, fatigue and depression.

Indeed, female sexual dysfunction seems to be psychologically — rather than physically — rooted. "What the genitals are doing may play a less important role in how a woman defines her sexual arousal," says Meston. "I don't think there will ever be an aphrodisiac that will make [women] want to have sex all the time."

That's not to say its causes aren't physical, Lieblum says. Hypertension, heart disease, cancer, diabetes, thyroid disorders, neurological diseases and autoimmune disorders like lupus can all contribute to a woman's lack of sexual desire. Other factors include prescriptions drugs, particularly anti-hypertensives and depression medication, as well as over-the-counter medications and illegal drugs and alcohol abuse.

Why Not Viagra?
Viagra is designed to increase blood flow to the genitals. Viagra works well for many men who suffer with impotence — or erectile dysfunction — because it's considered a physical — rather than an emotional — problem. That's not to say that Viagra can't "restore function" for women, says Dr. Myron Murdoch, clinical instructor of urology at George Washington Medical School. It can, but it's not for all women.

While Viagra-like drugs may help the 20 percent of women reported to have difficulties with lubrication (blood flow to the female genitals increase lubrication), it's unknown to what degree such drugs would help the 43 percent of women with sexual dysfunction who either say they're uninterested in sex or that sex provides little pleasure.

Cure in a Pill?
Even so, drug companies — banking on the success of Viagra — hope to find its female equivalent. At the moment, they are focused on developing a drug that increases blood flow to the female genitals, resulting in vaginal lubrication and relaxing vaginal muscles.

The concept is similar to Viagra, which increases blood flow to the penis, resulting in an erection. So far, there are some promising drugs on the horizon. These include prostaglandin, already approved for men, apomorphine and phentolamine, both of which are being tested for arousal disorder in women.

Whether drug companies succeed, the good news is that women needn't wait for a sex pill. They have options. Research shows that exercise, counseling, vaginal lubrication products and sex videos all can help put spur a woman's libido.

What's more, the three following options — while scientifically unproven — are readily available and also hold the promise for improving a woman's sex life.

• L-arginine amino acid cream
  The same amino acid that has been used by athletes to promote muscle development is purported to increase blood flow to the female genitals, thus sparking sexual urges. "Our informal studies on 500 patients showed that 70 percent of women who applied this cream to the clitoris and labia a half hour before sex reported more arousal and stronger orgasms," says Dr. Jed Kaminetsky, clinical assistant professor of urology at the New York School of Medicine.
• DHEA
  Dehydroepiandrosterone is a male hormone produced by the adrenal gland and ovaries and converted to testosterone and estrogen. DHEA, which depletes with age, can be purchased over the counter in supplement form.In one small study published in the New England Journal of Medicine (Sept. 30, 1999), women who took 50 mg of DHEA daily noticed a significant increase in sexual interest. Other preliminary findings report encouraging results. However, most DHEA products lining the store shelves recommend taking only 25 mg per day. Because of its potential for heart attacks and breast cancer and masculating side-effects such as facial hair, DHEA is best used under a doctor's supervision.
• Testosterone therapy
  For women who have undergone oophorectomy (the removal of one or both ovaries) and hysterectomy, testosterone treatment has shown to improve sexual function and psychological well being, according to recent research from Boston's Massachusetts General Hospital.

  However, women looking to boost testosterone levels should work with their physician closely so the hormone can be monitored. Too much of it can cause, among other things, facial hair and change a women's voice, which is irreversible. Meanwhile, a study looking at the combination of L-arginine glutamate and yohimbine — a natural extract from tree bark that excites part of the central nervous system — has shown that postmenopausal women were more than twice as aroused after taking the combination drug and viewing an erotic film than women who took a placebo.