The Colorado Springs Gazette
July 12, 1998

Women's use of Viagra next project for research

Drug holds hope for those in menopause

The Boston Globe
BOSTON - Those little blue pills may hold promise for women, too.

This week, two Boston University researchers will begin the second phase of one of the first U.S. studies on the effects of Viagra on women.

Dr. Jennifer Berman, 34, a urologist, and her sister Laura, 29, a sex therapist, are conducting the two-year study of women and Viagra.

"This is not a cure-all pill that is going to make a marriage better, make someone happy or increase desire," Jennifer Berman said. "But what it does do is increase sensation."

Berman is a protege of Dr. Irwin Goldstein, a professor of urology at the Boston University School of Medicine and a leading expert, on male impotence.

Preliminary research, the Bennans say, indicates Viagra may increase the ability of many women to have pleasurable sex and reach orgasm. If that's right, Viagra could revolutionize the lives of millions of women.

"The early reports seem to indicate that a woman's sexual problems seem to get better with Viagra," said Dr. Robert Krane, chairman of the Boston University urology department. But, Krane cautions, "It obvious it needs to be studied to support that."

The second phase of the study, which will include about 100 women from across the nation, will include an evaluation at Boston University and end for many in a prescription for Viagra. The cost of participating ranges from $300 to $700. Women capable of bearing children generally are excluded, because it is not yet known how the drug affects fertility. Additionally, the women will be required to periodically complete surveys detailing their sexual behavior and response. Thus far, about 36 have been enrolled for the second phase, with others calling, writing and pleading for appointments in the coming months. The study is the first conducted by the new Women's Sexual Health Clinic at Boston University. Jennifer Berman, director of the new center, led the first phase of the study at the University of Maryland at Baltimore.

Mary R., a 54-year-old graphic designer from Wakefield, is hoping Viagra will allow her to experience orgasms again, four years after a hysterectomy.

"It's sort of like cutting off your arm," she said. "You are not the same person, you don't feel the same and you feel a little less of a woman because you can't respond enough to a physical relationship."

The drug's ability to increase blood flow to the penis and remedy erictile dysfunction in some men may hold particular implications for women, since the clitoris essentially is the female version of the penis and becomes engorged with blood during arousal. In addition, Viagra seems to help women become aroused by relaxing the smooth muscles of the vagina.

"For many years menopausal women have been written off, because you are not supposed to want sex at an older age," Laura Berman said. "Tbe reason they are not interested in sex is because sex is not pleasurable."

Sexual intercourse may be more painful, and the vagina more difficult to lubricate.

Viagra also has inadvertently opened the door to more medical interest and research into the mechanics of female arousal, a subject traditionally considered a province of psychology.

"Initially, we were met with resistance and jeers and snickers; people were horrified," said Jennifer Berman, who is financing the study in part through a grant from the American Foundation of Urological Disease, "Nobody understands female arousal. As long as you were able to have intercourse and it didn't hurt, everybody thought everything was OK."

One of the problems is that it is more difficult clinically to measure female sexual arousal. And dysfunction in women is harder to pinpoint, its causes trickier to define. Researchers are still grappling with a basic question: Which comes first, physical arousal or desire?

Since the Food and Drug Administration approved the use of sildenafil citrate, or Viagra, for male impotence last spring, doctors have been inundated with requests for the drug, manufactured by Pfizer Inc. Launched April 10, Viagra prescriptions through June 26 totaled 2.7 million, pushing U.S. sales of the drug to $409 million its first quarter in the market.

The pills, which are supposed to be swallowed 30 minutes to one hour before the desired effect, retail for between $7 and $10 apiece. Many health-insurance companies will not reimburse patients for costs associated with taking Viagra,

Side effects can include dizziness, flushing of the skin and digestive difficulties. Also, some heart medications can be deadly when combined with Viagra.

Pfizer has yet to conduct U.S. trials on the efficacy of the drug on women, though it is conducting a trial on several hundred women in Europe.

Until Pfizer has conclusive data supporting use of Viagra for women, it is not advising them to take the medication. But it seems women are obtaining Viagra through their doctors, or from husbands with prescriptions.



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