Healthy Life

HerDrugs may not cure female sexual dysfunction

NEW YORK, Aug 02 (Reuters Health) - Addressing only the physical component of female sexual dysfunction with drugs like Viagra (sildenafil citrate) is likely to fail if psychological issues are not also addressed, according to a researcher.

Her commentary in the August issue of Obstetrics & Gynaecology points out that drugs like Viagra enhance blood flow to the genitals. But for many women with sexual arousal problems, genital engorgement is not the problem.

"For men, their sexual enjoyment and sense of being aroused and wanting to continue the experience is influenced directly by awareness of their genital congestion," said Dr. Rosemary Basson of the University of British Columbia in Vancouver, Canada. "Women have much less of that direct feedback," she explained.

If a woman has sustained damage to the nerves connected to tissue in the vulva, she may have only a partial sexual response, for instance.

"When the area is massaged, it does not feel very good because it's not filling with blood. So certainly we would expect Viagra-like compounds to help women in this situation," Basson said.

Other factors such as depression, medication side effects, hormonal and other medical problems could also interfere with sexual arousal. Likewise, "past negative experiences, low sexual self-image, lack of safety (re: birth control, sexually transmitted disease or emotional safety), feelings of naivety, or negative emotions in response to physical arousal (sometimes related to past abuse) may be relevant," Basson writes.

But even if the initial problem is biological, it can develop into an emotional barrier as a woman loses confidence or begins to avoid stimuli that would excite her. Over time, she may become distant from her partner. By the time she seeks help, the problem may be more than a medical one.

"Just giving a little bit of hormone or drug that enhances the neurotransmitter won't be enough...because her experience is so composite," Basson said.

She suggests that physicians encourage female patients with sexual dysfunction to recreate the context in which sex used to be enjoyable, since recent memories may be less positive.

SOURCE: Obstetrics & Gynaecology 2001;98:350-353.

bal anti-impotence Web sites stretch the truth

By Jonathan Landreth

NEW YORK, Aug 27 (Reuters) - "Be the biggest man your lover has ever had!" urges the animated Web site for an herbal pill called LONGitude, created by a "former Viagra pharmacist" to increase penis size, or your money back, guaranteed.

But companies selling herbal pills for enhanced sexual performance may soon be facing the wrath of US regulators, as well as possible legal action from the legitimate maker of Viagra, the world's largest drug maker, Pfizer Inc.

"We have arrested and charged people claiming a new product will change the structure or function of your body in a way that only approved drugs can," said Laura Bradbard of the US Food and Drug Administration (FDA).

The Internet pitch artists are taking aim at the anti-impotence drug Viagra's nearly US$2 billion annual sales, making dubious claims that their drug is safer than Viagra and even adds an extra dimension.

The Web site for LONGitude, which is registered to Scottsdale, Arizona-based company CP Nutritionals Direct, tells visitors that 67% of women are unhappy with their partner's penis size--a problem for which they claim to have a remedy.

Wild claims are nothing new with herbal medicines. They are regulated less strictly than drugs in the United States and are allowed to go to market without FDA approval as long as they carry a disclaimer on their label that reads: "This product is not intended to diagnose, treat, cure or prevent any disease."

But in recent years, the FDA has stepped up investigations of the mushrooming number of herbal medicines being marketed online and recommends that consumers avoid doing business with Web sites that offer no access to a registered pharmacist to answer questions.

With no pharmacist contact number on its site and no prescription required, LONGitude is nonetheless billed as "clinically analyzed." It is offered with a 30-day money-back guarantee that two pills a day for 3 to 4 months will increase the size of a user's penis by 26%, according to the Web site.

Made from a blend of ingredients including zinc, pumpkin seed and oat straw, LONGitude also includes the more exotic muira pauma, yohimbine, nettle leaf, and oyster meat, the Web site states.

Before the introduction of Viagra, the root extract yohimbine, which acts as a stimulant, was among the few FDA-approved medications for treating impotence.

Between March and July 1998, a total of 69 people in the US died after having taken Viagra. Of these, the cause of death was unmentioned or unknown for 21, two patients had strokes, and 46 suffered cardiac arrest. Yohimbine, though herbal, can be equally dangerous if taken in high enough doses, experts say.

"These companies are playing on the fear of cardiac arrest that scared Viagra patients for a time. But those fears have been disproved time and again and these companies are going to sell their herbal pills, take your money, then close up shop." said Dr. Andrew McCullough, director of Male Sexual Health & Fertility at the New York University Department of Urology.

"This stuff is bogus. There is no scientific evidence that it works," McCullough said.

CP Nutritionals was not available by telephone for comment.

Another herbal anti-impotence pill, Biogen 14 from Cincinnati-based Lifekey, offers a 100% money-back guarantee if for US$49.95 it fails to "enhance your sex drive, give you stronger erections and increase your semen output by 581%," a company saleswoman who declined to be named said in a telephone interview.

The company is currently offering two bottles for free for each customer who buys three.

Pfizer said it will vigorously defend the use of its trademarked brand on the LONGitude Web site and will look into CP Nutritional's claim that LONGitude was created by a pharmacist who had worked on Viagra. Consumers, in the meantime, should think twice before buying herbal alternatives, said Pfizer spokesman Geoffrey Cook.

"It's a situation of 'buyer beware,' and the best route has always been to see your physician," Cook said, adding that Viagra costs about US$9 for an effect that lasts about 4 to 6 hours.

"Folks who are going to look for pharmaceutical products on the Internet need to make sure that the pharmacy they're going to is a licensed pharmacy in their state," Cook said.