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(WOMENSENEWS)--Maura Kelly remembers the night the spark in her
marriage fizzled out.

"A month after I gave birth to my first child, my husband reached for
me in bed and started kissing my neck and caressing my thighs," says
Kelly, who is using a pseudonym to protect her privacy. "But while he was
lighting candles, I was staring at the ceiling and running through the
grocery list in my head."

Due to hormonal shifts during her pregnancy, Kelly, a mother of two in
South Kingstown, R.I., no longer felt a glimmer of interest in sex.
Tests showed that her body was low on testosterone--the hormone that fuels
sexual desire in both men and women. Kelly's doctor prescribed pills
containing DHEA (a precursor to testosterone) and a testosterone gel that
she applies to her skin once a day. "Now my husband and I are having
pull-the-buttons-off-your-shirt sex again," she says. "We can barely wait
until our kids drift off to sleep at night."

Following the tremendous success of Viagra, a pill that treats erectile
dysfunction in men, drug and supplement manufacturers are working to
address the needs of women like Maura Kelly.

This trend has accelerated since Pfizer, the New York-based company
that makes Viagra, announced in Feb. 2004 that its wonder drug does not
significantly improve sexual functioning in women. Now drug and
supplement makers are racing to create the first "Viagra for women"--a feat that
is proving difficult because women's sexual response is physiologically
and psychologically more complicated than that of men.

Though the Food and Drug Administration has yet to approve a single
drug for women's sexual functioning, off-label and over-the-counter
remedies abound. Some, like the drugs that Kelly took, are prescription
remedies still undergoing clinical trials. Others are over-the-counter,
nonprescription supplements. Amidst the hype surrounding these products,
it's hard for women to know which remedies might solve their sexual
problems--and whether these problems require treatment in the first place.
Health experts caution that many sex remedies are unregulated and may
pose risks to women's health.

Sexual Setbacks Affect Most Women at Some Stage

Studies show that at some point in their lives, most women will
experience a blip in sexual functioning such as loss of libido, diminished
arousal or difficulty achieving orgasm.

"In most cases, these aren't medical problems but instead have to do
with what's happening in a woman's relationship, career or family life,"
says Leonore Tiefer, a clinical associate professor of psychiatry at
the New York University School of Medicine. "Usually, the problem is just
a passing one."

If trouble persists, experts recommend seeking help from both a
counselor and a medical doctor. Psychological evaluation may reveal
communication problems in a romantic relationship or trauma stemming from a rape
or childhood sexual abuse. Medical tests may reveal hormonal imbalances
triggered by pregnancy or by taking prescription drugs. Doctors may
discover that a woman has pain during intercourse because birth control
pills don't mix well with her body chemistry. They may find that she has
lost sensation in her pelvis due to nerve damage suffered during
childbirth or a hysterectomy.

For most of these problems, there are effective solutions. Doctors may
suggest counseling or sex therapy. They may give a woman new
prescriptions that are less likely to affect her hormone levels. They may perform
surgery to repair nerve damage or recommend Kegel exercises to
strengthen the muscles of the pelvic floor.

Off-Label Drugs Address Sexual Complaints

In recent years, a growing number of doctors are not only turning to
these standard remedies, but to prescription drugs. In 1997, a group of
leading urologists met in Boston and coined the term "Female Sexual
Dysfunction" to describe women's problems with desire, arousal and orgasm.
In 1999, a study published in the Journal of the American Medical
Association found that sexual dysfunction affects more women than men--43
percent versus 31 percent. Since then, doctors have started diagnosing
women with sexual dysfunction and giving them drugs like those that Maura
Kelly took. Because the federal Food and Drug Administration has yet to
approve any sex drugs for women, all of these remedies are prescribed
"off-label," that is, administered in a way that is different from their
intended use.

Though these off-label applications are still under scientific study,
most health advocates approve of them because they are done with a
doctor's supervision. "Many women say off-label treatments have made a
terrific difference and literally helped them turn their sex lives around,"
says Lisa Martinez, director of the Cincinnati-based Women's Sexual
Health Foundation.

Non-Prescription Sex Pills Proliferate

If a woman doesn't feel comfortable confiding in her doctor about her
sexual problems, she may try one of over-the-counter remedies peddled in
magazines, on TV and on the Internet. From Viafem, Scream Kreem to
Zestra Feminine Arousal Fluid, these remedies have names corresponding to
every letter of the alphabet. From bull's testicles to ginseng, they
contain every ingredient believed to stir desire or ignite an orgasm.

Advertised with soft-focus photos and presented as if they were
prescription drugs, herbal remedies can rake in big profits. Avlimil, one of
the most popular sex supplements for women, has racked up $30 million in
annual sales since it was introduced in January 2003. But its ads lack
scientific data--a practice that is common with herbal remedies.

"Though some women swear by herbal remedies, these supplements can have
a placebo effect 30 to 40 percent of the time," says Julia R. Heiman,
director of The Kinsey Institute for Research in Sex, Gender and
Reproduction at Indiana University in Bloomington. "But is this an enduring
response? And, more important, is it safe?"

Because herbal supplements do not contain drugs, they do not require
federal approval and are pulled off the market only when users report
adverse affects. Some may contain ingredients that trigger adverse
reactions when taken with common medications. Some may contain potentially
hazardous substances such as ephedra, an herbal stimulant that has been
linked to several deaths.

"Unless there are appropriate, double-blind, placebo-controlled studies
for these products, I wouldn't use them and I wouldn't try them,"
asserts Dr. Irwin Goldstein, director of Boston University's Institute for
Sexual Medicine.

New Products on the Horizon

Since Viagra hit the market in 1998, it has racked up more than $5
billion in sales and garnered 23 million prescriptions. Two newer drugs for
erectile dysfunction--Levitra and Cialis--are also raking in big
profits.

Across the U.S., drug and supplement makers are scrambling to create
companion pills for women. In Cranberry, N.J., Palatin Technologies is
developing a pill that stimulates the area of the brain related to sexual
arousal. In Bothell, Wash., Nastech Pharmaceutical Company is testing a
nasal spray designed to improve lubricating secretions. In
Lincolnshire, Ill., BioSante Pharmaceutical Inc. is developing a testosterone gel
for the treatment of female sexual dysfunction. In Cincinatti, Proctor
and Gamble is testing Intrinsa, a testosterone patch designed to boost
libido in postmenopausal women. Sixty percent effective in clinical
trials, Intrinsa is slated to hit the market in 2005 and will likely be the
first drug the federal food and drug agency approves for sexual
dysfunction in women.

Though encouraged by this research, health advocates say it may be
years before science makes sense of women's sexual functioning.

"The development of Viagra and other drugs has kicked up a lot of
interest," says the Kinsey Institute's Heiman. "But it's going to take time
before we figure out what's really valuable and for whom."

Molly M. Ginty is a freelance writer based in New York City.

For more information:

FSD Alert: - http://www.fsd-alert.org/

Boston University School of Medicine - Institute for Sexual Medicine: -
http://www.bumc.bu.edu/Dept/Home.aspx?DepartmentID=371

The Women's Sexual Health Foundation: - http://www.twshf.org/

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