This is a great article that I found on an excellent web site for women, The Women's Sexual Health Foundation (http://www.twshf.org/). It's a well written article on the subject that seems "to wax and wane" to paraphrase Julia Heiman, Director of the Kinsey Institute in Bloomington, Indiana
No Fem a gra
A decade after Viagra, there's no equivalent for women, but treatments for sexual problems are promising.
By Shari Rudavsky
shari.rudavsky@indystar.com
T en years ago, American found themselves talking about sex. A new HBO show, "Sex and the City," instantly sparked controversy for the I- can't-believe-they-said-that girl talks among its leading ladies. And a little blue pill called Viagra landed on U.S. shelves, with pitchman Bob Dole helping to usher the phrase "erectile dysfunction" into common parlance.
Fast forward a decade. Turns out "Sex and the City," a movie version of which arrives in theaters on Friday, made a lot of real-life women feel OK about discussing sexual issues. And while no pink pill has emerged from the laboratories to play the role for women that Viagra played for men, that doesn't mean the drug hasn't had an effect for women, experts say.
"That's opened the door for women feeling and believing that they really have a right to a satisfying, intimate life with their partner," says Lisa Martinez, executive director of The Women's Sexual Health Foundation. "What we've heard is, 'Men have Viagra and Cialis and penile implants, and what do we women have?' "
Interest in women's sexuality "seems to wax and wane," says Julia Heiman, director of the Kinsey Institute in Bloomington. "For now, it seems to be coming back some."
The data varies widely, but studies suggest that about 40 percent of women will have a problem with sexual function at some time in their lives, says Martinez, whose nonprofit organization aims to educate doctors and women about sexual health.
Decreased desire is women's most common complaint. Finding a remedy, however, may not be as simple as developing Viagra, originally developed for angina, not male sexual dysfunction.
In the flurry of interest after Viagra hit the market, scientists wondered whether it might also work for women. But after initial trials in this area failed, efforts to find such a drug waned.
One of the challenges is that men and women are completely different when it comes to sexual arousal. For men, arousal is a biological phenomenon. For women, sexual arousal is tied more to their emotional and mental state.
Women, who often have multiple responsibilities, may have other priorities that push sex lower on their to-do list.
"Women's sexual functioning is by and large above the neck," says Dr. Lynda Smirz, a gynecologist with Women's Health Alliance in Carmel. "Therefore, to find a medication that is able to produce the same results that Viagra does in a male is going to be virtually impossible."
There's one proven thing to improve a woman's libido, Smirz says: a new partner. While she's not advocating adultery, this offers proof of the power of women's minds.
Studies have also shown that women respond to placebos, testifying further to the link between the mind and sexual satisfaction, Smirz says.
"The guys can take a pill and immediately they're ready for sexual activity," she says. "Well, we're not ever going to have something like that for women."
Not that the drug companies aren't trying to find the female Viagra equivalent.
In many European countries, Intrinsa, a patch that dispenses testosterone and aims to increase sexual desire in surgically menopausal women, is already on the market.
Products being tested
LibiGel, a testosterone gel, is in trials here. If approved, this product could become the first on the market to treat all women with a low sexual drive. BioSante Pharmaceuticals says it hopes to have LibiGel approved and launched by 2011.
One nonhormonal product in the pipeline, flibanserin, is, like Viagra, a drug that was originally tested for one purpose (as an antidepressant) and is now being tested for its effect on sexual desire. But unlike Viagra, flibanserin would need to be taken regularly, not just when one planned on sexual intercourse.
Such a product might prove useful for women whose libido has dropped and who have a history of some cancers, such as breast cancer, that would make taking hormones risky for them, Martinez says. "Certainly we're headed in the right direction with options."
And some options already exist, such as Zestra, an over-the-counter topical product made of natural oils that's billed as a female arousal fluid.
But drugs or topical applications are not the only answer for women with low sexual desire, experts agree. Because so much of sex is mental for women, those who lack desire may benefit from either couples or relationship therapy, they say.
"Sex is not just a medication-treatable problem," the Kinsey Institute's Heiman says. "It's something that also responds to other kinds of intervention."
When love hurts
Some women, however, suffer from a decreased interest in sex because they find it painful.
About 6 million women of reproductive age suffer vulvodynia, pain that lasts at least three months without any known cause. Some women may experience it just upon penetration, even with a tampon. For some, the pain comes on suddenly; for others, it's gradual.
"Women describe the pain as sitting on shards of glass," says Christin Veasley, associate executive director of the National Vulvodynia Association.
While the cause of vulvodynia is unknown, there are some treatments available. Topical estrogen creams may help, as may antidepressants to control the pain. Alternative techniques such as biofeedback or acupuncture may also ease the pain.
For some women, a surgical procedure similar to an episiotomy that removes excess nerve fibers in the region will address the condition. Women with this condition have about 10 times as many nerve fibers in this area as women who are not affected.
Diagnosing this condition can be tricky, Veasley says. Many women are told they have recurrent yeast infections. Others are told it's psychological. Even once it's diagnosed and treated, however, vulvodynia can have a dramatic effect on a woman's sexuality.
"There's this loop that takes place. Women start to avoid sexuality," Veasley says. "When you have pain when you're having sex, that can be very difficult to reverse even once the pain has gone away."
With another rare condition, vaginismus, the woman's muscles contract involuntarily whenever penetration is attempted. Often associated with past trauma or pain, this condition can be addressed with treatment, which may include pelvic floor exercises and the use of insertable dilators.
Far more common, and more easily treated, is vaginal dryness, which can make sex more painful than enjoyable. Problems with lubrication affect about 70 percent of all women at some point in their sexual lives, according to statistics from Trigg Laboratories, which makes a range of lubricant products. While it's a common problem among menopausal women, dryness also can stem from other hormonal changes, dehydration, alcohol or certain medications and childbirth.
Despite signs that women are now more comfortable talking about their sexuality, too many who suffer do not raise the issue with their physicians, says Martinez. Nor are doctors asking their patients about their sex lives, but that is slowly changing, she adds.
"If you have a concern, you absolutely must raise it," Martinez says. "There's more help out there than there was five or eight years ago."
No Fem a gra
A decade after Viagra, there's no equivalent for women, but treatments for sexual problems are promising.
By Shari Rudavsky
shari.rudavsky@indystar.com
T en years ago, American found themselves talking about sex. A new HBO show, "Sex and the City," instantly sparked controversy for the I- can't-believe-they-said-that girl talks among its leading ladies. And a little blue pill called Viagra landed on U.S. shelves, with pitchman Bob Dole helping to usher the phrase "erectile dysfunction" into common parlance.
Fast forward a decade. Turns out "Sex and the City," a movie version of which arrives in theaters on Friday, made a lot of real-life women feel OK about discussing sexual issues. And while no pink pill has emerged from the laboratories to play the role for women that Viagra played for men, that doesn't mean the drug hasn't had an effect for women, experts say.
"That's opened the door for women feeling and believing that they really have a right to a satisfying, intimate life with their partner," says Lisa Martinez, executive director of The Women's Sexual Health Foundation. "What we've heard is, 'Men have Viagra and Cialis and penile implants, and what do we women have?' "
Interest in women's sexuality "seems to wax and wane," says Julia Heiman, director of the Kinsey Institute in Bloomington. "For now, it seems to be coming back some."
The data varies widely, but studies suggest that about 40 percent of women will have a problem with sexual function at some time in their lives, says Martinez, whose nonprofit organization aims to educate doctors and women about sexual health.
Decreased desire is women's most common complaint. Finding a remedy, however, may not be as simple as developing Viagra, originally developed for angina, not male sexual dysfunction.
In the flurry of interest after Viagra hit the market, scientists wondered whether it might also work for women. But after initial trials in this area failed, efforts to find such a drug waned.
One of the challenges is that men and women are completely different when it comes to sexual arousal. For men, arousal is a biological phenomenon. For women, sexual arousal is tied more to their emotional and mental state.
Women, who often have multiple responsibilities, may have other priorities that push sex lower on their to-do list.
"Women's sexual functioning is by and large above the neck," says Dr. Lynda Smirz, a gynecologist with Women's Health Alliance in Carmel. "Therefore, to find a medication that is able to produce the same results that Viagra does in a male is going to be virtually impossible."
There's one proven thing to improve a woman's libido, Smirz says: a new partner. While she's not advocating adultery, this offers proof of the power of women's minds.
Studies have also shown that women respond to placebos, testifying further to the link between the mind and sexual satisfaction, Smirz says.
"The guys can take a pill and immediately they're ready for sexual activity," she says. "Well, we're not ever going to have something like that for women."
Not that the drug companies aren't trying to find the female Viagra equivalent.
In many European countries, Intrinsa, a patch that dispenses testosterone and aims to increase sexual desire in surgically menopausal women, is already on the market.
Products being tested
LibiGel, a testosterone gel, is in trials here. If approved, this product could become the first on the market to treat all women with a low sexual drive. BioSante Pharmaceuticals says it hopes to have LibiGel approved and launched by 2011.
One nonhormonal product in the pipeline, flibanserin, is, like Viagra, a drug that was originally tested for one purpose (as an antidepressant) and is now being tested for its effect on sexual desire. But unlike Viagra, flibanserin would need to be taken regularly, not just when one planned on sexual intercourse.
Such a product might prove useful for women whose libido has dropped and who have a history of some cancers, such as breast cancer, that would make taking hormones risky for them, Martinez says. "Certainly we're headed in the right direction with options."
And some options already exist, such as Zestra, an over-the-counter topical product made of natural oils that's billed as a female arousal fluid.
But drugs or topical applications are not the only answer for women with low sexual desire, experts agree. Because so much of sex is mental for women, those who lack desire may benefit from either couples or relationship therapy, they say.
"Sex is not just a medication-treatable problem," the Kinsey Institute's Heiman says. "It's something that also responds to other kinds of intervention."
When love hurts
Some women, however, suffer from a decreased interest in sex because they find it painful.
About 6 million women of reproductive age suffer vulvodynia, pain that lasts at least three months without any known cause. Some women may experience it just upon penetration, even with a tampon. For some, the pain comes on suddenly; for others, it's gradual.
"Women describe the pain as sitting on shards of glass," says Christin Veasley, associate executive director of the National Vulvodynia Association.
While the cause of vulvodynia is unknown, there are some treatments available. Topical estrogen creams may help, as may antidepressants to control the pain. Alternative techniques such as biofeedback or acupuncture may also ease the pain.
For some women, a surgical procedure similar to an episiotomy that removes excess nerve fibers in the region will address the condition. Women with this condition have about 10 times as many nerve fibers in this area as women who are not affected.
Diagnosing this condition can be tricky, Veasley says. Many women are told they have recurrent yeast infections. Others are told it's psychological. Even once it's diagnosed and treated, however, vulvodynia can have a dramatic effect on a woman's sexuality.
"There's this loop that takes place. Women start to avoid sexuality," Veasley says. "When you have pain when you're having sex, that can be very difficult to reverse even once the pain has gone away."
With another rare condition, vaginismus, the woman's muscles contract involuntarily whenever penetration is attempted. Often associated with past trauma or pain, this condition can be addressed with treatment, which may include pelvic floor exercises and the use of insertable dilators.
Far more common, and more easily treated, is vaginal dryness, which can make sex more painful than enjoyable. Problems with lubrication affect about 70 percent of all women at some point in their sexual lives, according to statistics from Trigg Laboratories, which makes a range of lubricant products. While it's a common problem among menopausal women, dryness also can stem from other hormonal changes, dehydration, alcohol or certain medications and childbirth.
Despite signs that women are now more comfortable talking about their sexuality, too many who suffer do not raise the issue with their physicians, says Martinez. Nor are doctors asking their patients about their sex lives, but that is slowly changing, she adds.
"If you have a concern, you absolutely must raise it," Martinez says. "There's more help out there than there was five or eight years ago."
