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Finding Viagra for...

Finding Viagra for Women: The Science of Sex

We’ve all heard about Viagra and how it affects men — but is there a Viagra for women? Here is what you need to know about female arousal, plus the details on how close scientists are to developing a female-equivalent to Viagra.

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One of the strangest jobs I ever had was interviewing women about their sex lives for a market research company. I was pretty sure the research was being done for a large pharmaceutical company — which could have been developing a Viagra for women — but I was fresh out of graduate school and extremely broke. The job paid well and was simple. Women were recruited to take a sex survey at seven different research centers around the country. After they took the survey, I would call and ask them about the survey questions. The company was trying to validate a sexual enhancement questionnaire, and this validation required me to ask questions about questions, the majority of them pertaining to wetness, orgasm, lubrication, arousal, and relationships. At first, asking things like “what does the phrase feeling anxious about sex mean to you?” or “what does the phrase easy for me to get lubricated (or wet) mean to you?” was somewhat awkward, but after the fifteenth or so interview, I got used to it.

I walked away from that job knowing two things. One was an assurance that I never wanted to do market research. The other was something I knew in my gut, but corroboration helped to make it obvious: on average, feeling comfortable, relaxed, self-confident, and emotionally connected were integral components of a woman’s sexual enjoyment. This might come as a “no duh” to any woman that’s ever had an orgasm or anyone that’s every tried to arouse her into one, but for scientists trying to crack the female sexual code, this is tough stuff. Ever since the development of male impotence drugs, there’s been a clamor to find an equivalent for women. If a little pill could turn a dud into a stud, certainly there must be a chemical to make Sandy randy.

But the story of Viagra’s failure highlights the fact that arousal and desire aren’t so simple in the womenfolk. Pfizer spent almost a decade trying to prove Viagra could enhance sexual function in women, and in 2004, it finally gave up. Though the drug increased blood flow to the clitoris—just as it increases blood flow to the penis causing erection—there was no evidence indicating that women’s lack of arousal was due to lack of blood flow. Turns out, we’re a bit more complex than that.

Though arousal and desire are intricately linked in men (see naked woman, get aroused, want to have sex), the two things are not always connected in women. Though Viagra and drugs like it might cause the telltale signs of arousal in women (blood-engorged genitalia), it does nothing to actually make us want or desire sex. For men it’s a hardware problem that needs a mechanical fix; for women it’s a software issue that could require the reprogramming of emotions, mental state, psychology, or physiology. Good luck finding a pill to help that.

But the search for a female Viagra equivalent has not been in vain. For one thing, it’s highlighted the fact that research into women’s sexual pleasure lags woefully behind men’s. Methods are archaic or nonexistent. Basic questions have yet to be answered. Funding is hard or impossible to come by. As much as researchers struggle to piece together cohesive theories of women’s sexuality, they have uncovered some basic differences between the sexes when it comes to arousal and desire. A team at Emory University found that when presented with visual stimuli, men and women have different brain functions. The researchers had men and women look at erotic photographs while an MRI documented brain activity. An interesting thing occurred in the amygdala, the region of our brain concerned with emotion and motivation. Men’s amygdala lit up, while women’s weren’t as active, even though both groups reported being aroused.

While men’s amygdala may show exactly what their below-the-belt brains are thinking, women may experience a disconnect between these two things. A study conducted at Northwestern University measured genital arousal in subjects while they looked at pornography. Heterosexual men were aroused by footage of men and women having sex, homosexual men were aroused by two men having sex, and women, regardless of sexual orientation, were aroused by everything. Sometimes women reported feeling no sexual arousal, even though the device said otherwise.

In her book, The Female Brain, Louann Brizendine says that for female sexuality to turn on, our brains, in a way, need to turn off. “The impulses can rush to the pleasure centers and trigger an orgasm only if the amygdala has been deactivated.” A woman has to be comfortable, relaxed, and secure around her partner before the arousal and desire start to align. Perhaps, suggests Dr Brizendine, this is one reason why women may have an easier time reaching orgasm with masturbation or with a vibrator—there’s no pressure, no worrying about the other person, and they have the ability to shut off the stress center.

But not all of our sexual appetite is controlled by the brain; a large part is due to hormones. Testosterone is the main trigger for sexual excitement for men and women, and estrogen is essential for vaginal lubrication. Because of the important role of hormones in sexual activity, many gynecologists use testosterone to treat people with low libidos. However, Intrinsa, a testosterone patch produced by Proctor and Gamble, was denied approval by the FDA in 2005 because its medical risks and side effects did not outweigh whatever benefits it imparted.

Although some women experience sexual dysfunction that can be treated with a chemical—lubrication problems due to postmenopausal estrogen drops, for example—for most women, lack of desire is more complex. And this is not necessarily a problem. A 2003 paper by researchers at the Kinsey Institute states “inhibition of sexual interest or response occurs as an appropriate or at least understandable reaction to certain circumstances,” and that this is “not necessarily evidence of malfunction of the sexual response system.”

Though there is no doubt in my mind the pharmaceutical companies will look for a drug that can work on the central nervous system to stimulate desire, I’m not so sure we need one. If psychology plays a larger role in our sexuality than in men’s, and if this is due to hard-wiring in our brains, there is an evolutionary purpose behind it. It’s a smart defense mechanism. Not being able to summon the desire to match your mate’s may be your body’s way of telling you what your wise girlfriends probably already know—he’s not right, the relationship isn’t working, something is amiss in my life. I don’t want any drug telling me otherwise.

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