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Discovering the cause or causes of a woman's sexual difficulties will help her to resolve them. Many of the problems are reversible or treatable. The question uppermost in her mind might be: Can erectile dysfunction drugs orginally designed for men -- such as Viagra, Levitra, or Cialis -- be of help?
At the moment, the answer is maybe.
Studies have been inconclusive, although some results have shown that Viagra may increase lubrication for women. At $10 or so a pill, however, the price is pretty steep compared with the price of a tube of K-Y Jelly, Dr. Renshaw points out.
However, some researchers are hopeful. Myron Murdoch, M.D., a urologist and past director of the Impotence Institute of America, noting that a woman's clitoris is made of tissue similar to that in a man's penis, speculated that an oral medication could make it easier for a woman to become aroused.
Similarly, Dr. Goldstein, who initially was mentioned on the second page of this article, has said his research indicates the problem for women may be the same as for men: not enough blood flowing to the sex organs, perhaps due to vascular disease and aging. The clitoris, after all, is the female equivalent of the penis and becomes engorged with blood during arousal. And Goldstein also found that the women in his study who were more likely to have sexual problems had similar medical profiles to the men with erectile dysfunction.
In theory, at least, perhaps an oral medication could help women, too, if arousal depends on clitoral stimulation. (It's important to note that Dr. Goldstein is a paid consultant to many companies developing drugs to treat erectile dysfunction, including Pfizer, the maker of Viagra.) At this point, the FDA has not approved Viagra, Levitra, or Cialis for treatment of female sexual dysfunction.
The difficulty is measuring arousal in women. Not enough is known yet about women's sexual function, say some physicians, who believe it's therefore premature to test a drug's effects. But the findings about Viagra certainly have opened the door to the study of female sexual function.
The question of testing such a drug runs up against the same obstacles often found in research about women's health.
Until the last 20 years or so, most clinical trials included only white men, and effects on women and different ethnic groups were extrapolated from those study results. Now, as studies begin to establish gender differences in, for instance, how drugs are metabolized, researchers are beginning to spread their nets wider. However, some gender differences, such as the ability to get pregnant, still make it difficult to include women in some trials.
Recent studies underscore the importance of knowing some basics about how men's and women's bodies work. One, at the University of Georgia in Athens, found men's veins are more likely to contract and cause blood-flow problems than are women's. This difference alone could have huge implications for research into drug therapy.
Hope springs eternal and dies hard, though, and many women with sexual problems are just as eager for a magic bullet as the men who swamped the phone lines with calls about Viagra and other such drugs. Time will tell whether they will get an equal opportunity.
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