When Sex Pales, Women May Need More Than Viagra
Louann Brizendine, director of the program in sexual health at the University of California-San Francisco, treated one couple that "had a wonderful sex life for 30 years," she says. When the woman lost interest, the husband was alarmed. "He really thought she didn't love him anymore," says Brizendine. She found the woman had very low levels of testosterone. "As soon as I saw them sitting in the waiting room after treatment, the husband looked at me and gave me two thumbs up."
Another 41-year-old from New Hampshire says she spent decades regretting her lack of sex drive. Just a year ago she learned about the hormone that makes her feel like an adolescent. "Suddenly my head and body work in sync," she says.
So far, testosterone replacement products are all designed for men and contain doses much higher than women need. Because the hormone can cause acne, foster hair growth, and deepen the voice, doctors have to prescribe small doses. An estrogen/testosterone product for women called Estratest is now in clinical trials for sexual dysfunction. And Unimed, which sells AndroGel, a testosterone gel for men that came on the market last week, is developing a product for women. (Pregnant women should avoid testosterone altogether, as it can harm a fetus.)
Other drugs would work differently. The antidepressant Wellbutrin looked promising in a pilot study of women who weren't depressed but had a low sex drive. And although Viagra failed to help women with low libido, it and other erectile-dysfunction drugs under development may still aid women who have trouble becoming physically aroused.
Mommy mode. But for most women, pills and creams alone will not be the answer. Desire often takes a holiday when life is full of other demands. "A woman in her 30s coming into my office is typically juggling a full-time career, young children, and is basically overwhelmed," says Sheryl Kingsberg, assistant professor of reproductive biology and psychiatry at Case Western Reserve University. "It is virtually impossible for her to switch gears from mommy mode to lover mode just by walking from one room to the next."
A loss of interest can also be a red flag that a woman is feeling angry. "In many relationships, the woman feels like her partner is only attentive to her when he has a sexual urge," says Dorothy Strauss, a sex therapist in Brooklyn, N.Y. "[That] is a terrible turnoff." She and others say that women need a supportive emotional context for sex, which a partner can provide by helping with chores and expressing feelings. As Zoldbrod puts it: "For some women, foreplay is everything that happened in the last 24 hours."
Women should not try to mask a flagging libido by having sex for harmony's sake, says Kingsberg. "When sex becomes an obligation or is always about someone else's needs, it creates a lot of problems." Instead, women should talk to their partners about their concerns, says Linda Banner, a sex therapist in San Jose, Calif. But "make the conversation less emotional or personalized" by keeping it out of the bedroom.
You should also discuss concerns with your doctor, even though it can be awkward. "Many physicians are not trained in how to talk about sexuality," says Margaret Nusbaum, codirector of the family practice residency program at the University of North Carolina-Chapel Hill School of Medicine. But she urges women to broach the subject.
Hendy Lund is glad she took action. Now, she says, when her husband turns to her in bed, "I'm very receptive."
Women and sexual problems
Women in the United States report different sex-related problems at different ages.
[Data for chart are not available]
[Chart labels]: Lack of desire; Trouble reaching orgasm; Pain during sex; Low physical arousal; Age: 18-29, 30-39, 40-49, 50-59
Source: National Health and Social Life Survey
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