Viagra for women?

What do you think of Viagra for dryness in women past menopause?

A: No sooner had the news about Viagra as a magic pill for male impotence gotten out than the word started to spread that it may be helpful for women too. While the research isn't conclusive and the FDA hasn't approved it yet for women, what data there are look good, and I believe it will be only a matter of time before women start getting Viagra prescriptions for vaginal dryness.

In fact they already have. In the recent cover story in Time magazine about Viagra, one Seattle nurse who tried it without telling her husband reported " significantly more lubrication." But she also complained of a slight headache and major facial flushing during sex and afterward. For female baby boomers dealing with postmenopausal vaginal dryness, this is an exciting anecdote indeed. Unfortunately, that's about the only information available on Viagra use for women. Pfizer, the drug's manufacturer, does have a study under way in Europe to see how the pill affects blood flow to the female sexual organs, but no results are in yet. A lot of the unknown here is that while " sexual dysfunction" is fairly well understood in men, it's much less understood in women.

The basic question is that while the level of a man's sexual stimulation is visually obvious, by what measure do you gauge a woman's? By the blood flow to the clitoris, or by the level of vaginal lubrication? About 100 researchers met recently to discuss this very issue. One of them, Dr. Irwin Goldstein of Boston University School of Medicine, believes sexual problems for both men and women can be traced to restricted blood flow to the sex organs due to aging and vascular disease. His survey of 300 women found 58 percent of them had symptoms of sexual dysfunction (discomfort during sex, dryness, difficulty reaching orgasm, or diminished clitoral stimulation). He also discovered that the women more likely to have sexual problems had similar medical profiles to the men dealing with impotence. However, using that parallel as a basis for prescribing Viagra assumes that a lack of lubrication or sexual interest can be remedied by increasing blood flow to a woman's sexual organs. That assumption may not be valid.

Apparently many doctors aren't waiting to find out. According to the New York Times, Dr. Raymond Rosen of Robert Wood Johnson Medical School in New Brunswick, N.J., gave a Viagra-like drug to a handful of women and measured their responses while they watched pornographic movies. Blood flow to the women's vaginas increased, Rosen found, and they said they felt wet and had pleasant tingling sensations in their genitals -- responses they did not have without the drug.

If you want to try it, talk to your doctor. Doctors can write " off-label" prescriptions (giving out medicines for use other than manufacturers' recommendations) if they feel comfortable doing so. In the case of Viagra, that can be a tougher decision than it might seem.

In the meantime you might want to try a homeopathic remedy for vaginal dryness called NatMur (follow dosage on the label). The herb chasteberry (Vitex agnus-castus) has a good reputation for relieving menopausal symptoms, including vaginal dryness, and there is always topical application of over-the-counter products like Replens, which is not a drug at all.
Andrew Weil, M.D.