“Men
taking iron supplements are warned that taking Viagra may cause them to
spin around and point north… Then there was the man who got his Viagra
tablet stuck in his throat and suffered from a stiff neck.”
Everyone
knows the jokes about Pfizer’s little blue erection pill, and indeed,
the best-selling drug has entered the realm of popular culture. In
everyday mythology, Viagra not only cures impotence, but it turns men
into handsome, voracious sexual supermen.
In
the wake of Viagra’s success, attention has turned to women’s sexual
problems. Obviously it takes two to tango, and while Willy may be raring
to go, Mavis may not necessarily be ready – or interested.
Thus, as part of the race for “female Viagra”, medical, and
media, attention has become focused on “female sexual dysfunction”
or FSD.
FSD
is a nebulous description that currently encompasses four main sexual
problems: lack of desire, lack of arousal, lack of orgasm, and pain
during sex. According to Professor Marita McCabe, a lecturer and
psychologist from Deakin University, at least 50% of Australian women
experience some form of sexual problem in their lifetime. “It used to
be that anorgasmia – or difficulty in experiencing orgasm – was the
main complaint. Now I would say that the most common one would be lack
of interest in sex; that has been increasing gradually over the last few
years.”
Clearly,
there are a lot of unhappy women out there, but it’s only recently
that the medical profession has tried to address FSD in any major way.
In the US, the FSD “movement” has been led by a Pfizer-funded
urologist called Dr. Irwin Goldstein from Boston University. Dr
Goldstein has written countless articles about women’s sexual
problems, as well as organised and headed two high-powered conferences
on the topic in 1999 and 2000. The first conference, at which half the
attendees were “industry” (read: drug company) people, focused
heavily on the purely physical problems encountered by women with FSD.
One delegate gave a speech entitled: “Psychologic Treatments: Are They
Effective and Do We Need Them?”, while others discussed rabbit
clitorises, blood flow and labial recovery after cancer.
Amidst
all this, Leonore Tiefer, a well-known feminist, clinical psychologist
and author from New York, gave a short speech entitled “The Selling of
FSD.” In it she argued that the drug companies and doctors were
combining to medicalise and simplify what were enormously complex
women’s issues. Tiefer berated doctors for ignoring the ground
breaking work of 70’s feminists in overcoming anorgasmia , and
advocated looking at the whole picture of women’s sexuality, as
opposed to a purely genital one.
“Most
people, including sex researchers, are afraid to look too closely at the
psychology of sexuality,” she said. “We protect ourselves with
questionnaires and standardized language… But our desires for
expression and affirmation are ultimately unique; our desire for an
orgasm, for example, is as often for a feeling of connectedness and
vitality as it is for release of pelvic tension.”
She
also urged them to “be alert to the insidious dangers of
commercialization of your research. Sex sells. If you didn't know it
before Viagra, you know it now.”
Tiefer
was something of a “lone voice in the wilderness” at the conference,
however she feels she succeeded in making a point. She relishes her work
as a watchdog in an increasingly drug-driven field.
“Too
much of the research about women's sexual problems is funded by drug
companies and narrowly conforms to their interests,” she told Salon
magazine. “There's just too much emphasis on claiming things are
physical and then selling products. The pharmaceutical companies want
products they can market, which I distinguish from products that will
help women with their sexuality.”
But
what’s so wrong with a doctor trying to help a woman to have an
orgasm. If a pill works, why not just take it?
“You
make it sound like doctors are just kind-hearted qualified professionals
desperately eager to help sexually unhappy women,” she told AWF,
“and what could be wrong with that? On the contrary, doctors are
largely uninformed about sexuality, unprepared and uncomfortable finding
out in any depth or detail why women have sexual problems, and unwilling
to provide any help other than prescriptions. Keep in mind no drug is
yet proven to be of help to women. Sex therapists and videos and books
can teach women to have orgasms, isn't that right? We're mostly talking
about women going to doctors for help with lost or absent sexual desire,
a much more complex matter, and more likely to be due to relational and
sociocultural factors.”
In
line with this, Tiefer and her feminist colleagues presented “A New
View of Women’s Sexual Problems” at the 2000 conference. They
advocated viewing FSD in broader terms of women’s dissatisfaction, as
opposed to comparing women to a sexual norm (orgasm versus non orgasm).
They
also suggested dividing sexual problems into four areas. First is the
social, cultural, political or economic category. This is where a woman
may have sexual problems due to lack of sex education, or cultural
differences. The second category looks at relationships, such as whether
there is abuse, a lack of communication, or low compatibility. The third
takes psychological problems into account, such as child abuse, or lack
of self esteem. And finally the fourth category focuses on purely
physical problems, such as STDs or circulatory problems. This category
can only be applied after all the other factors have been ruled out.
This
“new view” has been put forward to get doctors thinking about what
other factors may be involved in a problem, apart from a purely physical
one.
The
medical profession may be starting to pay attention as it becomes
apparent that drugs aren’t the “quick fix” they were supposed to
be. In March 1999, the medical journal Urology revealed
that 30 post-menopausal women reported no increase in sexual desire
after taking Viagra. And the 2000 FSD conference gave more time to those
covering the psychological factors behind women’s sexual problems.
Professor
McCabe believes the search for a “female Viagra” may not be the best
approach. “I think that female sexuality is more complex than what
would be addressed with a drug. Even if there is a physiological base to
some women’s problems, there is undoubtedly a psychological overlay,
because the woman will start becoming anxious about whether she’ll
become aroused or experience orgasm, she will start feeling not as
feminine, start losing confidence in her sexuality and so on.
“Female
sexuality is a combination of the physical and the psychological
component of engagement with the other person, of feeling good about
themselves and the situation. Indeed, research has shown that women who
present with sexual dysfunction have the same level of physiological
arousal as those who are quite functional. The difference is that the
dysfunctional women aren’t tuning in to their physical arousal due to
their psychological problems.”
Professor
McCabe says the main treatments for FSD in Australia at present were
psychologically based, and that there were no officially sanctioned drug
treatments available here.
Interestingly,
the only “treatment” approved in the US is the Eros-CTD clitoris
pump, a smaller version of the Austin-Powers-type Swedish penis
enlarger (but they’re really not my bag, baby!). The small suction cup
works by creating a vacuum and drawing blood into the clitoris, making
it enlarged and sensitive to the touch. It is only available on
prescription, and costs almost US$400.
Meanwhile,
the search for female Viagra goes on. Trials are still being held, and
results have not been released to the public. Leonore Tiefer’s crusade
continues. AWF asked what she thought was the best method of treating
FSD.
“’Treating’?
How about preventing problems with comprehensive sex education and equal
social status and opportunities? Women's knowledge in and pride about
their own bodies is a key factor - and is difficult to sustain as you
get older.
Women
need to feel safety and respect to maintain their initial sexual
attraction, they need to feel the burdens of life are shared (for
example, child care, elder care, and domestic chores), and they need to
feel their partner is interested in them as a human being - that's the
part that's often missing.”
Drugs,
Pumps, Herbs: What’s available?
Viagra (sildenafil
citrate).
Viagra works by increasing blood flow to the penis. The benefits for
women, if any, are yet to be proven. There is anecdotal evidence from
women who’ve tried their husband’s prescription and reported an
increase in desire, but this may be the placebo effect. Overseas trials
have only involved small groups of women, with no control groups or
placebos, and results have not been terribly positive.
Hormone
therapy
Both
testosterone, androgen and estrogen play a role in the levels of female
libido, and increasing the levels of these hormones can assist women to
regain desire. Hormone replacement therapy (HRT) has been proven to help
post-menopausal women regain their sex lives. Testosterone and androgen,
however, present a slightly murkier solution. There are conflicting
reports that these do actually work, and they often create side effects
such as increased facial hair and high cholesterol levels.
Sprays,
Creams and Gels
Most of these
contain L-Arganine, which is an amino-acid that assists in the
relaxation of smooth muscle. While it has not been tested on women in
clinical trials, it is an ingredient in a number of external creams and
gels available on the market. Viacreme, which is advertised on the
internet, is formulated using L-Arganine and Menthol. It supposedly
works by creating a “vigorous tingle” described by some women as a
“cool burning sensation”. This increased sensation in the genitals
is meant to facilitate better sex. Whether it works is a matter of
personal opinion.
“Herbal
Viagra”
Vigorex Femme has
recently been released on the market. It contains the herbs Avena Sativa
(green oats) and Saw Palmetto, and claims to “increase sexual
thoughts, desire and enjoyment”, as well as boosting overall energy
levels. While Avena Sativa was shown to produce some positive effect on
men, women did not generally respond to the herb. Whether Saw Palmetto
makes a difference has yet to be demonstrated.
Wellbutrin
(bupropion hydrochloride)
This is an
antidepressant. 33% of women in a study of this drug reported increases
in arousal and sexual fantasy, and 40% said they felt more sexually
satisfied than before they started to take the drug.
Eros-CTD
Clitoris Pump
Works by creating
a vacuum around the clitoris, drawing blood into the erectile tissue.
The US federal drug administration says it works. Feminists say it’s
not nearly as good as a vibrator.
Apomorphine
This anti-Parkinsons
drug has been shown to increase erectile response in men and assists
with increased desire by changing dopamine levels in the brain.
Apomorphine has not been tested on women.
Caring,
nurturing, supportive partner who knows where the clitoris is
Cost: Priceless.
Not available on prescription.
This
article also appears at For The
Girls Ezine and Erotica for Women
© Karen Jackson All rights reserved
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