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If you have an email address, you've heard of the major libido-boosting drugs aimed at men: Viagra, Cialis and more all come crashing against your spam filter on a daily basis. What about women, though?

The fairly easy availability of Viagra has highlighted an equally pressing problem: low sexual desire in women. While you can hardly escape from suggestions that you might like to take Viagra, if you're a woman, options for improving sexual desire are more limited.

How Widespread Is The Problem?

Well, in 2006 a German study found that four years into a relationship, less than half of 30-year-old women wanted regular sex. And after 20 years, the study found that same number had fallen to just 20 percent.

By contrast, men's sexual appetites remained the same however long they had been in a relationship.

This figure held steady at between 60 percent and 80 percent. The researchers attributed the difference to evolutionary differences in male and female physiology and psychology, though the real cause or causes isn't known and could well be social. 

There Are Two Big Problems In The Area Of The 'Hunt For Pink Viagra'

These are the nature of female sexual dysfunction, and the nature of female sexual desire - but the close financial links between researchers in the field and pharmaceutical companies seems to suggest that the medicalization of low female libido, currently known as Hypoactive Sexual Desire Disorder, or HSDD) might be a question of profit for some.

In the case of female sexual dysfunction, there's always going to be the question of whether this is a complaint by women that their sexual desires aren't functioning as they wish, or whether the complaint is coming from men who see lack of female desire as a condition to be medicated, treating women's sexualities as their reproductive and mental lives were treated in the nineteenth century.

The evidence does suggest that a lot of the impetus is coming from women themselves.

A low sex drive is the most common complaint made by women about sexual matters, with between 30 percent and 40 percent of complaints having to do with this, according to Sandra Lieblum, PhD, director for the Center for Sexual and Relationship Health at the Robert Wood Johnson Medical School in New Jersey. 

The other problem is female sexual desire itself. Viagra is essentially a drug for filling the penis with blood, but that's not always going to cut it for women. In the case of many men who find Viagra helpful, the spirit is willing but the flesh is weak, while others suffer from performance anxiety, a paradoxical condition that means men are more likely to suffer from erectile dysfunction because they are afraid that they will. Meanwhile male lack of enjoyment of sex is referred to under different terms, as a symptom of anhedonia (failure to find pleasure in normally enjoyable activities). In other words, male sexual dysfunction is divided between a physical side and a psychological side, while female sexual dysfunction isn't.

Female sexual desire is widely seen as being more complex than male sexuality.

As Bella Ellwood-Claytonwrites in the Huffington Post, many women see their sexual desire as complex and essentially located in the brain, involved with 'how we feel, our mood, the context' - less to do with physical desire than men's sexuality.

If that's true, how do researchers rise to the challenge of a medication that can work on both erectile tissue, and the brain?

The Hunt For Pink Viagra

The sex-drugs-for-women market is largely made up of products that have to be sold with weasel words because there's no real evidence that they work as medications. Google the term 'sex drugs for women libido' and you get a few products describing themselves in terms like 'works to increase your vitality and provide enhanced enjoyment of sex,' and 'age old remedy,' followed by a slew of articles about how complex and difficult the matter is.

The Main Three Approaches

Actual drugs, as opposed to 'age-old remedies' like horny goat weed, that are aimed at improving female sexual desire are usually grouped by whether they affect blood flow to the genitals, the hormonal system or the central nervous system.

Blood Flow Drugs

Starting with the blood flow drugs, these are basically Viagra and Viagra-like drugs like Cialis and Levitra. They function by increasing blood flow, especially to erectile tissue.

Since there's little essential difference in the nature of a man's penile erectile tissue and a woman's clitoral erectile tissue, these drugs might be expected to have some positive effects on female libido too.

In both men and women, these substances work by raising the levels of nitric oxide in the blood, and there is some limited research that shows that women who take one of these nitric oxide vasodilators experience an increase in the flow of blood to their vaginas and clitorises. There's also some evidence that taking Viagra-tye drugs can help reduce the negative sexual consequences associated with SSRI-type antidepressants. The trouble is that women don't seem as willing, or as able, as men to equate physical effects with mental ones. Viagra might make women present the physical signs of arousal but it doesn't actually make them want to have sex.

Drugs That Target The Hormonal System

Some sex drugs aimed at women work by targeting the hormonal system, and the prospects for theses seem better than those for the Viagra-type drugs. Oddly, many of these center around 'androgen therapy' - essentially, increasing serum testosterone levels. These drugs do work, but they're currently available in some locations only on prescription for women with a medically diagnosed sexual problem, or who are experiencing a problem after surgery, and in other locations they're not approved by regional drug authorities because of unkonwn safety risks. Known risks include fears of masculinization - basically, the effects you'd expect to see in female bodybuilders taking steroids - as well as exposure risks to kids and pets. 

Another hormonal drug therapy is HRT, which is usually given to menopausal women but has some effects on reducing vaginal dryness and other signs of sexual dysfunction in women. HRT might have a future as a female sex drive drug.

The most likely candidate for the immediate future is a variant on HRT: bioidentical hormone replacement therapy. This means taking blood tests to determine blood hormone levels and then using those data to offer an individualized prescription to women based on their own body chemistry.

Central Nervous System Drugs

Drugs aimed at the central nervous system include a drug intended for smoking cessation, which is often used by women without prescription for increasing libido. Known as Bupropion, this has some anecdotal evidence to support it and even some studies, but it's not about to enter the mainstream officially. There's also a sunless tanning drug, Bremelanotide, which is being tested in the US for low libido and has shown some positive results in rats.

So actually we have plenty of sex drive drugs for women, they're just not very effective.

We know how to increase the physical manifestations of desire but that isn't currently enough for women.

The discussion as to why that is will probably continue at least as long as the search for an effective drug therapy for a condition that many women would happily take a pill to 'cure.'

If you think I've said something great, or something you really disagree with, let me know in the comments section below and we'll talk it through.

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