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February 2005»

Sex, romance and a patch

There's more focus on women's sexual dysfunction, although treatment options still lag behind those available for men

By Lisa Marshall

SCRIPPS HOWARD NEWS SERVICE
published: February 7, 2005 6:00 am

Mary Shackelton hears stories like it almost every day. In the privacy of her Boulder, Colo., office, women anywhere from their 20s to their 60s quietly confess that their sex drive just isn't what it once was, and shrug their shoulders as if that's just the way it has to be.

"When I ask about it, they kind of laugh like, 'What libido?'" says Shackelton, a naturopathic doctor at the Boulder Women's Center for Natural Medicine. "They really think that there's nothing that can be done about it."

As recently as a decade ago, that was largely true. But thanks to an increased openness about female sexual dysfunction, a growing body of research about what causes it, and a flurry of new products aimed at treating it, that's beginning to change, medical experts say.

Late last year, a Food and Drug Administration advisory panel voted against Procter & Gamble's Intrinsa, a slow-release testosterone patch that, if approved, would have been the first prescription drug designed specifically to increase female sex drive.

But several over-the-counter products are already on the market, including Zestra, a topical cream, and Avlimil, an herbal supplement. And many more are in the pipeline, as pharmaceutical companies race to capitalize on what is estimated to be a $3 billion sales opportunity in treating what they have dubbed female sexual dysfunction (FSD) or hypoactive sexual desire disorder (HSDD).

Many women's health care providers say they welcome the increased attention to the long-hushed topic. But they believe the burgeoning market of pills, potions and lotions should be approached with caution.

"I'm troubled by the tendency that there is to pathologize things and look for a chemical remedy," says Susan Hubbard, a licensed clinical social worker in Boulder. "There are times when chemical remedies are marvelous, and we need them, but sometimes people are encouraged to turn to them before they can realize what is really going on with their psyches and their bodies."

According to a study published in the Journal of the American Medical Association, more than 43 percent of women from 18 to 59 experience sexual dysfunction, making the problem more prevalent among females than males (31 percent).

Because emotional problems often follow, the report said, it should be treated as an "important health concern."

Yet the focus has been on men. Since the 1998 release of the anti-impotence drug Viagra - which works by increasing blood flow to the penis - no company has found a successful equivalent for women.

That's because women are far more complex than men when it comes to sex drive and sexual response, says Boulder nurse practitioner Carol Dalton.

As women age and estrogen levels decrease, the blood flow to the genital area also slows and nerves there start to degenerate, diminishing sexual response.

"Some women can be thinking about it, and be turned on, but physiologically, nothing happens," Dalton says.

But then there is that other critical sexual organ - the brain.

A lack of testosterone can keep the brain from responding to romantic movies or nibbles on the ear the way it used to. But so can a host of other less-measurable problems, like stress and fatigue, which can hinder adrenal gland function, or relationship problems which can overshadow a healthy hormonal system.

While women approaching menopause are more likely to lose their sex drive because of expected hormonal dips, it is by no means a problem exclusive to those in their 40s and 50s.

Oral contraceptives have been shown to flatten out the rising estrogen curve in the middle of the month, dampening a woman's libido at the time when it is typically at its peak.

"I think there are about five women in my practice with an intact libido," says Shackelton.

One of the first questions Dalton asks women struggling with fading libido is "What are you eating?"

Protein is a critical building block for libido-boosting hormones, yet it is one of the first things to go as women start watching their weight.

"They start eating salads for lunch and fruit for breakfast," and often as the weight goes, the sex drive goes with it.

source:-http://www.citizen-times.com

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