A new approach might be on the verge of producing an effective sex drug for women. Unlike Viagra, the male impotency pill which acts on the sexual organs, the drug given to women in this study acts on the brain.
Tests carried out by Ian Russell, a specialist nurse at Dumfries and Galloway NHS Trust, have produced promising results. His work is featured in the BBC Two Science programme Horizon.
Ten women suffering from reduced sexual desire were treated with a drug called apomorphine. Apomorphine is active in the brain where it mimics the effect of one of the brain's main chemical messengers, dopamine. Problems with desire are the most common complaint reported by women who seek help for sexual problems.
At the end of the 18 week study eight out of the ten women reported an overall improvement in their sexual response, including increased desire. "The results were astonishing" Russell told Horizon.
Ever since its launch in 1998, scientists have been investigating whether Viagra could work for women too. Viagra was the first oral treatment for male erection problems and has been used by more than 20 million men worldwide. Viagra works by blocking the action of a key enzyme in the pelvis. This increases the blood-flow to the penis following sexual stimulation and it is this extra blood-flow that makes patients with erectile dysfunction more likely to achieve and maintain an erection.
However, clinical trial results have revealed that apart from small subgroups of women, like those with very specific problems associated with vaginal blood-flow, Viagra will probably do nothing for the majority of women with sexual problems. The reason seems to be that, despite the physical similarities between male and female genitalia, there are crucial differences in our sexuality.
In men, blood-flow to the penis is at the heart of the sexual response. However, research has shown that for women, vaginal blood-flow can have little to do with feeling aroused. Experiments in Amsterdam by Clinical Psychologist Ellen Laan have shown that blood flow to the vagina increased while women watched pornographic material, despite the fact that many didn't report feeling 'turned on'. It seems that in women feelings of arousal and desire are much more to do with the response of the brain than that of the sexual organs - and this could explain why drugs that act on the brain may provide an effective treatment for female sexual problems, such as loss of desire.
Despite the encouraging initial results from Scotland, scientists remain cautious about Ian Russell's findings. "We will have to wait until we have controlled, double blind studies before we know" said Professor Julia Heimen, clinical psychologist at the University of Washington.
Russell agrees and has begun a much larger clinical trial to investigate. This should be completed next year.
Source: BBC News
The success of Viagra has companies racing to achieve a female equivalent, and one herbal product's claims of effectiveness are stirring debate on whether any one drug can be the answer for women. "They have Viagra. Now we have Avlimil," its makers boast in magazine and television advertisements. As an herbal treatment, Avlimil didn't require the extensive study and tests necessary for U.S. Food and Drug Administration approval. But that does not prevent it, and others like it, from promoting themselves as giving women what Viagra offers men.
Since the 1998 launch of Viagra, which racked up $1.7 billion in sales last year for New York-based Pfizer Inc. as a treatment for male sexual dysfunction, at least 10 pharmaceutical companies have undertaken development of a similar drug for women, according to market research firm Decision Resources. Their efforts were spurred on by a 1999 study said 43 per cent of women have difficulties with sex. Decision Resources estimates the global market for an effective treatment at between $2.7 billion to $3.2 billion by 2006. Avlimil's splashy promotion has helped intensify debate over how to help women with sexual problems, as has a January article in The British Medical Journal that accuses drug companies of exaggerating female sexual dysfunction to peddle medicine.
No one questions that many women have difficulties with libido, arousal and orgasm. But because women's sexuality is more complicated and psychologically driven than that of men, many question how key any drug would be to treatment. "For women, arousal and desire starts in the brain. Women's sexual dysfunction often has a psychological component," says Dr. Adelaide Nardone, a gynecologist and obstetrician who is also a consultant to Vagisil, a line of women's health products.
Nardone said drugs may help the women whose sexual difficulties are tied to physical conditions. But since the conditions are diverse, it is unlikely one drug will help all women. For example, desire problems could stem from low testosterone levels while arousal difficulties may be a result of low blood flow to the clitoris.
Avlimil claims it can help in all types of sexual problems. The assertion is based on a company-sponsored, three-month trial of 49 women. Trials for prescription drugs usually take years and often include thousands of patients. Since Avlimil's launch two months ago 30,000 people have purchased it, said Susan Cossman, vice president of marketing of Warner Health Care, a division of Wagner Pharmaceuticals. A month's supply of the pills costs $49.25
Wagner was founded a year ago by a private investor group to purchase the rights to Avlimil. Cossman declined to say how much Wagner paid for Avlimil or who developed it. Avlimil sales to hit $110 million in 12 months, Cossman said. Wagner is spending between $3 million to $5 million on ads in magazines such as Health and Ladies Home Journal and women-oriented cable television stations like Lifetime.
The polished campaign, which says that 50 million women suffer from sexual dysfunction, sets Avlimil apart from scores of other herbal remedies, many sold on the Internet, which have less visible - but often more steamy - marketing approaches. "It is intentional for us to use quality in the ads because we want women to look seriously at the issue of sexual dysfunction," said Cossman.
Not every one is buying the marketing. "Just what we need - more ads that try to appeal to a woman's fear that she isn't normal,' said Dr. Leonore Tiefer, an associate professor of psychiatry at the New York University School of Medicine. "Fifty million is a ludicrous number. There may be 50 million women dissatisfied with their sex lives, but it is probably for 50 million different reasons."
Cossman says the 50 million figure was derived from the 1999 study in the Journal of the American Medical Association, which said 43 per cent of women experience sexual dysfunction. Now even some in the drug industry believe the article overstated the problem.
Tiefer believes drug companies are trying to create medical problems out of the natural ebbs and flows of a women's sex life. She says as females age they may not have as much intercourse or as many orgasms, but enjoy other sensual pleasures. "Not having an orgasm is not a medical problem," said Tiefer, who started www.fsd-alert.org to highlight what she says in the hyping of the condition. "Sex isn't like a broken ankle or a gall bladder operation. It is arbitrary and is about what you do and what you like."
Other doctors say women with sexual problems deserve medical help. "Pfizer didn't create female sexual dysfunction," said Dr. Andrew Goldstein, director of the Sexual Wellness Center in Annapolis, Maryland. He is working on a testosterone patch, designed for women with low sexual desire, for Procter & Gamble. "There is a generation of women getting older who started the sexual revolution," he said. "They bought vibrators, read the Kama Sutra and when their sex lives aren't good they get pissed off about it."
"Osteoporosis is a natural part of aging but that doesn't mean we don't keep people from trying to break their hips," added Goldstein.
Procter & Gamble, and Pfizer, which is testing Viagra in women, are giants in the race to find a drug for female sexual dysfunction. Most of the others are smaller biotech firms.
Pfizer was singled out in the British Medical Journal article for funding conferences and research on female sexual dysfunction, including the JAMA study. The article alleges drug-funded studies are biased to conclude medicines are necessary. Pfizer spokesman Geoffrey Cook denies the company is trying to manufacture a disease to sell more Viagra, and is instead contributing to a better understanding of the condition. In fact, he says tests show Viagra won't work across the board for women with sexual problems. And comparisons to Viagra by herbal treatments aren't appreciated. "Herbal treatments aren't tested like pharmaceutical problems so patients should be careful," said Cook.
Source: The Canadian Press 2003