Self Magazine - December 1999

By Jennifer Conroy

Thanks to Viagra, the lagging libidos of countless aging dads and granddads across the nation have become a hot topic - and for many, a thing of the past. Yet, little attention has been paid to the group hardest hit by sexual problems: women.

According to a study published earlier this year in the Journal of the American Medical Association, four out of ten women experience some form of sexual dysfunction, compared with three out of ten men. Even more surprising: The researchers found that women in their twenties have the highest incidence of many sexual problems, from inability to achieve orgasm to lack of sexual desire. The study leaders theorize that younger women are likely to have high rates of "partner turnover" and "periodic spells of sexual inactivity," which may lead to stressful sexual encounters.

No doubt. But some experts have other ideas about young women's sexual malaise. Judy Kuriansky, Ph.D., a clinical psychologist and certified sex therapist in New York City, attributes the problem in part to increased use of antidepressants, which more than 4 million American women now take.

An estimated 30 to 75 percent of antidepressant users experience some form of sexual dysfunction, from lack of sex drive to vaginal dryness. Libido squelchers include selective serotonin reuptake inhibitors (such as Luvox, Paxil, Zoloft and Prozac) as well as older antidepressants (tricyclics and MAO inhibitors). Fortunately, a number of drugs are less likely to pose this problem. Mirtazapine (brand name Remeron), bupropion (Wellbutrin, Zyban) and nefazodone (Serzone) are all sex-friendly alternatives to earlier mood-improvement medications. If you currently take antidepressants, ask your doctor if it makes sense for you to switch.

And more help may soon be on the way. Researchers are now experimenting on women with Viagra and other drugs that enhance blood flow to the genitals. And so far, so good. "Anything that's going to enhance penile erection will enhance clitoral erection," says Jed C. Kaminetsky, M.D., a urologist in New York City who frequently treats women with sexual dysfunction. He is trying out two topical formulations he developed for his female patients: One cream made from the active ingredient in Viagra has shown an 80 percent success rate in enhancing arousal - and without the side effects of the pill form; the other contains two blood-flow enhancer, L-arginine and aminophylline, and looks to be just as effective, he says. Applied directly to the genitals, both preparations are designed to take effect in about 15 to 20 minutes and work by increasing blood flow to the clitoris. If the research goes well, these and other sex-enhancing medications designed specifically for women could be on the market within two years.