Vagifem

You got reamed at the office. The baby spit up on you. And you just spent the last two hours doing the kids' chores. All you want to do is go to bed, but your husband wants to do more than sleep.

If this situation could be rectified by an herbal supplement, would you snap it up?

That's what the makers of Avlimil are hoping with a flashy ad campaign that has some experts wondering whether there's any substance to back up the glitz. The pharmaceutical company is marketing the little purple pill as the female Viagra. In other words, you'll never have a headache again, dear.

But what works for men may not be right for women. While men sometimes can't have sex despite their desire, women sometimes don't want to have sex because they're stressed out, exhausted or want to be romanced.

"There are no prescriptions such as Viagra available for women today," says Avlimil spokeswoman Sue Cossman, who likens the product to a "sexual vitamin."

"Female sexuality is far more complex than males', and there is no magic bullet for women. [But] Avlimil is the leading non- prescription, once-a-day premium supplement containing a proprietary blend of ingredients that have been shown to improve female sexual function over time."

Some doctors actually do prescribe Viagra to women, but the drug has only been approved by the U.S. Food and Drug Administration for use by men.

Avlimil isn't the only product purporting to enhance a woman's libido. Vasoplex's Web site promises its botanical gel topical "can bring back that vibrant excitement for you with an orgasmic responsiveness almost immediately." And Zestra claims to increase blood flow and "nerve velocity."

OK, but as one high-profile sexpert pointed out, isn't something good bound to happen if you rub the requisite area long enough? With or without a gel or lotion?

"I would have no reason to recommend [Avlimil] with the current information I have, but I would be happy to revisit it when there are studies done on it," says Northwestern Memorial Hospital's Dr. Lauren F. Streicher. "I'm not suggesting this is a harmful product, but when physicians make recommendations we need two pieces of information -- does it work and is it harmful?

"We don't know that yet about this product because they're vague about the ingredients, other than it's an herbal thing. And they did their own study, but there have been no valid peer review studies done by unbiased physicians yet."

A woman's sexual function is a complicated thing. While male sexual dysfunction is often reduced to issues of erectile dysfunction, female sexuality is a complex issue that lies at the intersection of psychology and biology. Depression, stress, relationship issues, past sexual traumas and body image all affect desire and arousal in women. Many doctors say that ebbs and flows in women's sexual appetites are a natural reaction to circumstances and aging, and should not be classified as a dysfunction.

"I saw a woman earlier today who was complaining about her rotten sex life," Streicher says. "Eventually she told me her husband snores so she's sleeping on her daughter's floor. It's really important to take the time to talk to women about what's going on in their lives. Very often it'll be that a woman is depressed and the decreased libido is a manifestation of that. There also may be underlying anger with her husband, two or three kids to take care of, a job, cleaning - - there are all these components to deal with and one is not more important than the other."

So how is a woman's diminished libido "fixed"? For some, hormonal therapy will prove to be the cure. Dr. Shari Goldman, a Chicago gynecologist with a general practice, says she considers testosterone therapy for the roughly 10 percent of her patients who complain of low libido.

But there are some healthy women -- and men -- who simply have very low sex drives. There are different sexual peaks in everyone's lives.

"When I talked to my patients, I found that those who are having sex think about it more and those who can't for whatever reason actually stop thinking about it," Streicher says. "That's not across the board, of course, but it seems to be nature's way of protecting people who are unable to have sex.

"But I don't blame women for looking to the Internet to find solutions to this problem. They want help and the medical community hasn't been very helpful until recently. But women have to be very careful not to believe everything they see in an ad. Like I said, I wouldn't recommend any product to my patient until it has been proven to work and to not be harmful."

Although it may take some time for scientists to come up with the real equivalent of Viagra for women, even critics of the so-called herbal aphrodisiacs should be happy that more attention is being paid to women's sexual complaints.

Laura Berman, a Chicago sex therapist devoted to women's sexual health, says that instead of telling women to "go home and have a glass of wine, lose a few pounds or get some therapy, the medical community is finally coming on board."

Contributing: Wall Street Journal

Options for women

Doctors are increasingly suggesting prescription drugs and herbal remedies to treat women's sexual problems. Here's a look at some of them:

PRESCRIPTION DRUGS

*Testosterone (AndroGel, Testim and products mixed for women at specialty pharmacies)

Application: Known as the "hormone of desire," it's prescribed for women who complain of low sex drive. Not approved by the FDA for use by women.

Comment: Has many unpleasant side effects, including hair growth, muscle mass increase and deepening of the voice.

*Wellbutrin (Bupropion)

Application: An anti-depressant without the libido-dulling effects. It may also boost sexual thoughts in women who are not depressed.

Comment: The drug is currently being prescribed to replace or counteract other antidepressants.

*Viagra/Levitra

Application: Both drugs increase blood flow to the genital areas, which some doctors say could improve "engorgement" in women. Approved by the FDA only for men.

Comment: Initial studies of Levitra in women have been "disappointing" according to its maker.

*FemRing/Topical Estrogen

Application: A silicon ring that is inserted into the vagina and releases estrogen. Used to treat menopausal symptoms, including vaginal dryness.

Comment: Topical estrogen products, including Etrace and Vagifem, have similar effects.

NON-PRESCRIPTION REMEDIES

*Zestra

Application: A lotion containing ingredients such as borage seed oil, evening primrose oil and coleus extract that creates a tingling sensation. Claims to increase blood flow and "nerve velocity."

Comment: The treatment has been tested in a small clinical trial, and some doctors say the results stand up to scrutiny.

*ArginMax

Application: A pill that contains an amino acid that may increase blood flow to the genital area.

Comment: Has been proven effective in placebo controlled studies.

*Avlimil

Application: A daily supplement that claims to "restore your sensuality." The treatment has been widely advertised in a slick ad campaign as the female equivalent of Viagra.

Comment: Some doctors are skeptical about its efficacy and the clinical trial posted on its Web site.

Wall Street Journal

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