The New York Times knows how to get your attention. The eye-catching headline "A Female Counterpart to Viagra" was enough to make me read a section of the paper I usually refer to only to check the ever-decreasing value of my 401K.
The story was about a patent that New Jersey pharmaceutical and medical technology firm NexMed Inc. had recently landed for a cream based on a drug now used to treat erectile dysfunction. According to NexMed, its cream would successfully treat a condition it calls "female sexual arousal disorder" (FSAD). The Times article reads in part as if it had been written by the company's public relations department: "Viagra, the drug that used professional athletes and a retired senator to become a household word, may soon have a counterpart for women," it promised. It's not hard to see why companies are interested in this potential market. In 1999, the Journal of the American Medical Association reported that 43 percent of women between 18 and 54 had experienced some kind of sexual dysfunction. That's a big market. Pharmaceutical companies dream of huge profits -- some estimates are upward of $6 billion -- in promising women steady orgasms and stimulation.
That's about all I needed to wake up the researcher in me. A trip to the library, a few phone calls to doctors and medical researchers, and a couple of hours on the Net later, my first surprise is that there isn't any agreement in the medical community on what constitutes female sexual dysfunction. The American Psychiatric Association says that "FSAD is a persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement." Boy, those psychiatrists really have a way with words. I've never really thought I might be diagnosed with a disorder if some professional arbiter of the "lubrication-swelling response" thinks mine is inadequate.
One psychiatric tome I consulted says, "Some evidence suggests that relationship issues and/or sexual trauma in childhood may play a role in the development of this disorder." Hmmm, why doesn't anyone say this about men who can't get it up and have to resort to Viagra? No one I know ever accuses the flaccid man of failing to perform because of a "relationship issue."
And the more I read, the more I wondered if FSAD should encompass women whose sex drive had dropped because of post-menopausal hormone imbalances, or those whose antidepressants or heart medications have given them the common side effects of reduced libido? What about the dryness that many women experience with menopause, a condition so uncomfortable for some that merely having sex is a painful, not pleasurable, experience? And what if the "dysfunction" is the result of finding yourself sharing a bed with an overweight husband, with beer- and pizza-breath, whose no-foreplay, frenzied attack is timed so he won't miss the second half of the football game blaring in the adjoining room?
One book admitted that FSAD was merely a fancier name for what used to be dubbed "frigidity." A couple of years ago, the medical wizards had come up with Eros, a soft funnel connected to a battery-controlled vacuum that pulled blood into the clitoris. At $359 each, and available by prescription only, the Eros sold even fewer tickets than Madonna did for "Swept Away."
But now the medical profiteers are taking a different tack. If Viagra worked for men, imagine what a variation could do for us ladies? The patented cream uses the same active ingredient that's in the male pills, a chemical called prostaglandin. The women's cream is designed to increase the flow of blood to our sex organs, implying that with the right dosage, even listening to Barry Manilow records could get us excited.
Dr. James L. Yeager, the NexMed senior vice president for scientific affairs, said the target audience is "women [who] say they can have intercourse, but nothing happens, they don't get aroused. We don't know why. We think it has something to do with the action of vasodilation, or blood vessel dilation, gone awry. It's not psychological."
Says who? Has this man ever talked to a woman about what it takes to really turn her on? But Yeager, and the medical boys, think they have the answer: "In female anatomy, it [the medication] dilates the blood vessels that feed the labia, and these are highly proliferated with secretory cells, and you need increased blood flow for increased secretion and increased engorgement."
Already getting you kind of warm and excited all over, right, girls? Don't the researchers in white lab coats understand that there's more to making us enjoy wonderful sex than an organ stimulator? I thought that's what masturbation was for. Anybody at NexMed ever hear of foreplay or a little tenderness? Let me suggest a more direct cure for many cases of FSAD -- thoughtful male lovers who know how to slowly arouse a woman. And some women don't accept that we essentially have to give ourselves orgasms. We have to be in the right frame of mind, have to want the sex, let our inhibitions go, and then really go for it.
For me, what is as important as sex itself is what happens before. My husband and I have been together for 22 years, so I know about creativity. I find it arousing to be spontaneous, adventurous and diverse. Get out of bed and be innovative, dress up, meet at a hotel with great sheets and room service, make a date as if it were the first time. And remember, men -- we need patience and tenderness. Spend time kissing, caressing and cuddling, not just focusing on our sex organs.
That's the problem, it seems to me, with the new wonder drug from NexMed. It focuses on the physical to the exclusion of everything else that arouses us. Sometimes it works, and sometimes it doesn't. But on those occasions when I just wasn't in the right mood, or couldn't quite get there, I never started to fret that I might have a sexual disorder. And no group of psychiatrists or medical researchers is going to convince me otherwise.
"We want to keep the dose low for safety," Dr. Yeager said, "but we want rapid penetration into the tissue, because if you want to apply it, you don't want to wait forever for it to work." Women, he noted, should need to wait only five or 10 minutes for a dab of the cream to take effect. "Of course, they'll need to engage in some sexual activity," he added.
Thanks for the advice, Doc.
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