Experts Debate Treatment: Psychotherapy Or Gadgets And Pills?(for treatment of "female sexual dysfunction")

2001 APR 12 - (NewsRx.com & NewsRx.net) -- Ever since Pfizer unleashed the little blue diamond (Viagra) in 1998 and revamped the male sexual landscape, doctors and researchers, not to mention pharmaceuticals companies, have set their sights on finding physical causes for women's sexual problems.

So-called "female sexual dysfunction" (FSD), they say, is a physical disorder that is measurable, diagnosable, and ultimately treatable with drugs, gadgets, or surgery.

The more traditional sex therapists, however, are defending their hard-won ground, says an article in the March 17, 2001, issue of New Scientist. The quick physical fix is doomed to fail, they say, because it ignores a grim reality: in their view, most women's sex problems stem not from physical or medical problems but from their social or cultural situation, poor relationships, and emotional factors.

Even the term FSD is contentious. When, in late 1998, a consensus panel set up by the American Foundation for Urologic Disease met to thrash out definitions for different types of FSD, they included an addendum that was widely interpreted as a bid to placate traditional sex therapists. They conceded that a woman only has FSD when her problems cause her personal distress.

What everyone does agree is that there is a big problem. In 1999, the most definitive study of sexual practices in the U.S. to date reported that an alarming 43% of women, young and old, had problems with their sex lives (Journal of the American Medical Association, 1999;28 1:537).

In women with female arousal disorder, the clitoris and vagina fail to engorge with blood. The result is that sex, let alone orgasm, can be impossible. Viagra works in men by slowing the breakdown of nitric oxide, the substance that relaxes smooth muscles in the penis so that erectile tissue can fill up with blood. Since nitric oxide is also present in female genital tissues, doctors reasoned that the drug should help women, too.

The early prognosis for Viagra for women, though, is less than thrilling. In one study, roughly half of 577 women tested reported an increase in genital sensation, lubrication, and overall arousal. But the successes were equally split between the women taking Viagra and the control group.