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Sadly, my Mojo remains a no-show.
I have Lupus, which I refer to as “Mr. Wolf,” because lupus is the Latin word for wolf, and because it has devastated my life sufficiently to have more than earned his own pronoun.
A recent insurance nightmare forced me off of a key medication because of cost. It’s an injectable bio-medication that alters my cells so that my immune system is less whacky. Eventually, the medication was restored but not until I’d gone off of it for about three months and gotten really, really sick. I was thrilled to have the medicine again but something unexpected and unpleasant – ’natch – happened. I suffered and am suffering from horrendous side-effects. It had never occurred to me that would happen simply by resuming the medication, since I’d used it for about 10 years.
I have endured the nausea, aches, hot flashes (I’m 54 – well past menopause) and fainting spells like a trooper. But, the worst side-effect totally blind sided me: In the twinkling of an eye, my libido disappeared without even the courtesy of an adieu!
Frankly, desire has never been a problem for me, at all. My sexual issues all related to being able to perform despite the physical limitations, disability, imposed by Mr. Wolf, which not only includes losing range of motion, a lot of pain, but also debilitating fatigue. So, I had no problem getting revved, but rather staying revved at certain...critical...times.
As regular readers know, sex has been saving my life – or more precisely, has helped me decide to hold onto it for as long as I can. When I’m having sex, I am no longer disabled. The pain and misery that has been Mr. Wolf’s calling card transcends into pleasure. Touch and intimacy has been my link to life, and to the divine. In those moments, I am my true self again. Not a disabled person on her way out, but a vibrant woman who was put on this planet for some purpose beyond her finite understanding. (I have always lived my life as a sex-positive person, but if I hadn’t, Mr. Wolf would have converted me at the very first orgasm!)
Now, desire seems a foreign concept. The doctor has said she does not know when my sexuality will reassert itself. I refused to accept that and launched Project Desire, in an attempt to rekindle the ’ole fire down below.
Thus far, re-igniting desire’s flame as been a very slippery – or in my case a very non-slippery – slope.
The usual suggestions to increase desire in women who have lost or lower libido don’t really apply to me, because I’ve lost it as a result of medication issues, not through poor self-image, or some other emotional factor.
What I have been doing is:
— Continuing my usual masturbation routine, making sure that I use plenty of vulva-friendly lube! I have been an enormous proponent of solo sex for decades. It allows women, who generally have little experience with it compared to men, to take charge of their own sexuality and needs. Masturbation can teach women how they like to be touched and what they don’t like. It also teaches how to accept and love our wondrous female bodies, especially if you’ve suffered abuse in the past (I was molested when I was a young girl.) I remain committed to masturbation, even if it doesn’t lead to orgasm, it is still a very erotic, sensual practice. FYI: Let me be very clear, masturbation is REAL sex!
— Reading erotica by my favorite authors including Alison Tyler, Alison's Wonderland
, and Radclyffe, Trauma Alert
. There are so many great women writers who pen erotica. If you’ve not taken time to read any of it, do yourself a favor and experiment. Read some reviews, then jump right in. There is something for everyone’s tastes, from mild romantic fare to hard-core, explicit, fetish, kink and everything in between. If you like to fantasize about BDSM but don’t want to actually try it, reading erotica with that theme might be the perfect solution.
— Watching female produced porn, including the fabulous Crash Pad series featuring the amazing Jiz Lee and others, and the erotic DVD’s by the Welcomed Consensus. Like masturbation, fewer women than men watch porn, but the number of adult women viewers is the largest growing demographic in the field. Just like reading erotica, there is porn for every person’s tastes.
(I’m bisexual, so I like erotica and porn that is either focused on straights, gays, or a combination of the two – isn’t that so cool!)
— Doing as much sensual touch, kissing and foreplay as possible. Receiving a massage can be both sensual and a pain-reliever for me. I love this, even if it doesn’t end up in bed.
The result of the above strategy? Thus far, my libido remains in very cold storage.
I hereby make the following promise: I refuse to just give up! Damn it to hell, Mr. Wolf can have my joints, and even my ability to walk, and eventually my life, but he will not take away my sexuality forever. He will not because I WILL NOT LET HIM! Period.
— The Curator
I’m old enough and motivated enough to be really good at sex.
I know the subtle, and not so subtle, nuances required to consistently give and receive enormous pleasure. I’m not bragging, it just happens when you age – and provided that you care to learn. I have always cared to learn. That’s why these last few weeks have been especially brutal.
As regular readers know, sex has been saving my life – or more precisely, has helped me decide to hold onto it for as long as I can.
I have Lupus, which I refer to as “Mr. Wolf,” because lupus is the Latin word for wolf. I have the most serious form of the disease, Systemic Lupus Erythematosus (pronounced: er-uh-thee-muh-toe-sus), also called SLE. (Visit the Lupus Foundation of America America for more information.)
SLE is an autoimmune disease. As such, it is characterized by a malfunction of the immune system. In these types of diseases, the immune system cannot distinguish between the body’s own cells and tissues and that of ‘foreign’ matter. So, rather than simply producing antibodies to attack invading viruses, bacteria or other similar foreign substances, my immune system creates auto-antibodies that attack my body’s own cells and/or tissues. It causes a great deal of pain, stiffness, and I’m losing my ability to walk, and to use the fingers. It also often makes me really exhausted, frequently feeling like I have the flu. And at the end of it all, is the end of it all, as it’s eventually fatal.
Recently, Mr. Wolf has been really having his way with me – and not in the good way, either. (Ironically, October is Lupus Awareness Month. I am soooo very aware – but others need to become aware, too. Research for this disease needs funding, duh!)
During the current onslaught, I blogged about having had a sudden, horrible realization: I could no longer truly remember what it felt like to be well. Oh, I had memories of being very active, athletic and whole, but they were no longer sense memories. It was as if that part of my life was so insubstantial it had been absorbed into the unreality of dreams.
That’s why sex has been so very important. When I’m having sex, I am no longer disabled. The pain and misery that has been Mr. Wolf’s calling card transcends into pleasure. Touch and intimacy has been my link to life, and to the divine. In those moments, I am my true self again. Not a disabled person on her way out, but a vibrant woman who was put on this planet for some purpose beyond her finite understanding. (I have always lived my life as a sex-positive person, but if I hadn’t, Mr. Wolf would have converted me at first orgasm!)
To say that it’s not easy, emotionally or physically, to have a consistently satisfying sex life when you’re disabled, suffering from an acute disease or illness, is an enormous understatement. I worked really hard at overcoming and/or coping with my physical limitations to be truly, satisfyingly active and intimate; to re-build my core sexuality from the ground up, as it were. I was convinced that by doing that, I would establish and be able to maintain a razor thin edge of stability. My goal was not to perform sexually as I had before since that would be impossible, but to re-invent my intimate life; to re-imagine myself and the glorious, rich possibilities that only sexuality offers.
— The Curator
A wonder drug hailed as a "Viagra for Women" has been discovered by accident — after it failed trials as an antidepressant.
The once-daily pill, developed by Boehringer Ingelheim GmbH, was said to increase female sex drive in late-stage trials, putting the biotechnical group in the lead to launch the first non-hormonal treatment for women with low libido.
The compound, known as flibanserin, was said to promote sexual desire and increase the number of "satisfying sexual events" in women suffering from abnormally low libido, Boehringer researchers claim. The company is hoping to market the pill in Great Britain in 18 months.
If the drug performs as advertized, it has the potential to revolutionize sexual medicine much as Pfizer Inc.’s blue pill (Viagra) did a decade ago. That would put family-owned Boehringer at the center of a debate about whether the medicine is a chemical shortcut around a complex dysfunction involving body and mind, or even if disinterest in sex is a legitimate medical condition in the first place.
Originally, flibanserin was developed as an anti-depressant, but turned out to be a poor one. Questionnaires given to patients helped discover the drug possessed libido-boosting side effects, and many of the women who participated in the trial seemed reluctant to give back the drug.
According to biotech BI researchers, one tester revealed: “It changed my life. It filled me with excitement and lust.”
One of the most interesting aspects of this announcement, is that it underscores the fundamental difference between the way sexual arousal works in men and women. The drug expected to be marketed to women works on their brains, while male impotency pills such as Viagra, Eli Lilly's Cialis and Bayer's Levitra, widen blood vessels to increase the blood flow to the penis needed for an erection. These same male impotence pills, have failed to show notable aphrodisiac effects in women.
Let’s see: Women=Brain; Men=Penis. Haven’t we always suspected that very equation, hmmmm?
Boehringer, based in the German town of Ingelheim on the Rhine’s west bank, was searching for a depression treatment in the 1990s when it stumbled on the compound. By 2002, Boehringer researchers found the drug wasn’t lifting patients’ mood, but were startled when test subjects rated one measure of well-being, sexual appetite, consistently higher than the others.
But Paula Hall, of Relate, urges caution. "Female loss of libido is a big problem and it is not going away. It can cause problems within a relationship and affect self-esteem.
"This research is really quite exciting for women with loving partners whose loss of libido is a physical thing. But it is not going to fix a broken relationship or help with looking after the kids or cleaning the house," Hall said.
For some women AND men, reduced sexual interest or response may be "normal," doctors say.
Nonetheless, the biotech company now says it is "putting the finishing touches on a pill designed to reawaken desire by blunting female inhibitions," hoping that their compound will rival the sales of Viagra, which has become the Holy Grail for drug manufacturers.
Men’s Viagra was originally meant to be a treatment for high blood pressure, and the heart condition angina. As with the women in this study, men taking part in early trials of the drug realized it had an interesting and unexpected side effect: Erections! Arriving in 1998, the drug has since been prescribed for over 25-million men.
Flibanserin is being developed as a non-hormonal treatment for low sexual desire in women, a market that's thought to be more financially lucrative than even the $2 billion dollar erectile dysfunction market.
The market to women is so potentially lucrative because research has shown that, depending on their age and whether they have undergone menopause, between 9 percent and a whopping 26 percent of adult women report experiencing low libido, or reduced sexual desire.
However, the new drug has proven controversial among sex researchers, with some arguing the pharmaceutical companies are exaggerating the number of women affected by low libidos, simply as a market expansion ploy by pushing a pill unable to deal with psychological issues responsible for putting someone off sex, e.g. poor body image, former abuse, or stress.
I find it even more interesting that the firestorm ‘erupting’ over this drug has far exceeded anything related to male impotency drugs. In fact, discussions focusing on the meaning of sexual desire were sadly, and noticeably missing when Viagra-type medications were on the horizon. It was the primarily the physical impact of those medications on patients that were discussed, not their psychological effects on users.
In comparison, little if any discussion of a woman’s safety has ‘arisen’ in discussions of this drug. Instead, the primary discussion has been whether or not the compound will, or even should, work. Apparently, women do not have the inherent intelligence to be able to choose to take a drug to increase desire, or decide they do not wish to. Sooooooo typical!
In 2003, a year after Boehringer researchers began the clinical trials, an article written by Ray Moynihan in the British Medical Journal called female sexual dysfunction, “the freshest, clearest example we have” of a disease created by pharmaceutical companies to make healthy people think they need medicine.
“This is for some an ideological battle,” said psychiatrist Michael Berner of the Freiburg University Clinic, who had patients in Boehringer’s studies. “One view is the multi-dimensional view you get from people like me. And then you have these people that say you should work only on relationship issues and that medication cannot have a place.”
Flibanserin reportedly works on the pleasure center of a woman's brain to restore flagging libido. Women who take flibanserin once a day make love more often and enjoy it more, large-scale trials have reportedly shown.
Researchers had abandoned previous efforts to develop a similar drug for women because it wasn't clear what constituted a normal sexual drive for women. A lack of sexual desire in women has often been linked to a woman's relationship with her partner. Apparently, what’s normal for men must be clear! Such stereotying is a great disservice to men.
"This drug has the potential to finally open the door to acceptance of the idea that decreased desire can be something that involves a dysfunctional way the brain works, and not only a bad partner," said Jim Pfaus, a neurologist at Concordia University in Montreal, who conducted early tests of the drug in rats. "Of course it's in your head."
“An erection is obvious, it’s easy,” Pfaus said. “But desire – how do you get at that?”
The explanation may be partly evolutionary, some scientists suggest. Male primates are driven by a need to spread their semen, while for females it’s important to be able to care for and rear the offspring.
Some researchers believe the social components of intercourse mean that sexual problems can’t be addressed in the same way as heart failure or cancer.
Sex is a “historical and cultural phenomenon,” said Leonore Tiefer, a psychiatry professor at New York University. There’s no baseline of normalcy by which to define a disorder, she contends.
It’s like dancing, or music, or piano-playing,” Tiefer said. “You do it with the body, but the part the body plays isn’t the largest part.”
Flibanserin works on the brain by putting “two feet on the brakes” to block the release of a chemical called serotonin, which regulates mood, appetite, sleep and memory, Pfaus said. In time, the process should trigger the production of dopamine, a chemical that, among other jobs, helps stimulate desire.
The drug differs from testosterone, a hormone that’s also been tested to reawaken women’s desire. Berner, interviewed at his study in Freiburg, sketched the picture of a wall to explain how flibanserin works.
“You’re standing here, sad, inhibited,” he said, drawing a stick figure next to the wall on a scrap of paper. “Testosterone would give you a little bit more excitement, so you’d climb over. Flibanserin would take away one of the stones.”
Boehringer researchers recruited women for clinical studies using print advertisements. The patients were largely professionals in their early 30’s to mid-40’s, and most chose to continue in the trial in a subsequent phase that ensured they would get the real drug instead of a placebo. Boehringer researchers have said it is recruiting older women for a follow-up study.
After what Pfaus described as an initial period of hesitation about developing a sex pill, Boehringer officials decided to move forward. The company needs new drugs because it faces the loss of 1 billion euros ($1.5 billion) in annual revenue when two older medicines, Mirapex for Parkinson’s disease and Flomax to treat enlarged prostate, lose patent protection next year.
Professor John Thorp, from the University of North Carolina in the US, led the research. He said Flibanserin was a “poor” antidepressant. “It’s essentially a Viagra-like drug for women in that diminished desire is the most common feminine sexual problem, like erectile dysfunction is in men,” he said.
The main criterion for the clinical trials, which the company named after flowers (give me a break!), was how many “satisfying sexual events” women said they had experienced after starting treatment. If the results are good, the so-called Bouquet studies, dubbed Violet, Daisy, Dahlia and Orchid, could form the basis for applications to U.S. and European regulators.
The German company is taking a page from Pfizer’s book. The U.S. drugmaker broadened the appeal of Viagra in 1998 by steering clear of the word “impotence” and saying the blue pill addressed a disease called erectile dysfunction. Boehringer is avoiding potentially offensive words such as frigidity and refers to the problem its pill cures by its clinical name, hypoactive sexual desire disorder, or HSDD.
“An increasing body of evidence shows that hypoactive sexual desire disorder causes substantial emotional distress,” said Heike Specht, a spokesman for the company. The drugmaker “has conducted late-stage clinical trials in over 5,000 women from which we hope will result the first available pharmaceutical treatment.”
In fact, the pill proved so popular in its trials that its manufacturers are poised to apply for permission to sell it across Europe, meaning it could be on UK bedside tables by 2011. A spokeswomen for Boehringer, Germany's second-largest drugmaker after Bayer, said the company was preparing regulatory filings in the U.S. and subsequently for Europe and other markets. She declined to provide a time-frame for filings and market launch and said Boehringer would not publish an assessment for the drug's annual peak sales potential.
Last week, biotech BI orchestrated several media releases, webcasts, and a presentation at a major sexual medicine conference in Europe, all to release data from its Phase III trials on the pre-menopausal women labeled with low sex drive, HSDD.
Unfortunately, all of this has everything to do with marketing and little to do with science. The data hasn't been released by the company, and no breakthroughs have been discovered. Nonetheless, it provides an opportunity to have a global conversation about female sexuality.
As any woman can attest, sexual desire is difficult to define, a fact that even the researchers involved in the flibanserin studies acknowledged. The following is the model, in three elements, presented by BI researchers that they used to measure that illusive zing that women feel:
• Drive: A finding that spontaneous sexual interest is somehow hardwired in a woman’s brain
• Belief and Values: Including social, cultural, ethnic, religious, and other factors that impact how often women might experience sexual desire, how intensely it is felt, and how comfortable women are with sexual desire
• Motivation: Considering the psychological and interpersonal factors that create a willingness for a woman to be sexual and experience sexual desire.
BI researchers claim that while effective treatments exist for women suffering from low sexual desire caused by beliefs, values, and motivation, there is nothing to treat the drive component (which they call the "biologic" component). According to the researchers, they allege that flibanserin effectively treats that “drive” component of sexual desire in women.
Here’s the BIG problem: These same researchers have no flipping clue how flibanserin actually does this! They know only that the drug reduces serotonin levels (FYI: Most antidepressants work by raising these levels.) As a result, their guess is that the drug impacts sexual desire by reducing inhibitory effects in women’s brains.
Thus, the researchers suspect that the drug works directly on the brain's pleasure zones, correcting levels of the chemicals involved in generating feelings of desire. Unlike Procter & Gamble's hormone patch Intrinsa, targeted at woman after the menopause, flibanserin apparently directly manipulates the chain of chemical reactions in the brain believed to trigger sexual desire.
"By modulating the neurotransmitter system, flibanserin may help to restore a balance between inhibitory and excitatory factors leading to a healthy sexual response," said Elaine Jolly, a Canadian gynecologist and medical researcher who helped oversee the trials.
However, unlike Viagra, it takes several weeks for the effect to build up, meaning it cannot simply be "popped" on demand, researchers said.
It also has side-effects, with up to one in eight of the women in the trials dropping out with dizziness, fatigue and sleep problems, researchers said.
In its release of partial findings, BI researchers said they conducted several studies in North America and Europe involving over 5,000 pre-menopausal women who had been diagnosed with HSDD. Researchers focused on the North American studies, which included just over 1,300 women. The average age of the women was 35, and most were married and the average length of their relationships were over 10 years.
Every day for six months, the women were asked to record their subjective evaluation of their own sexual desire, as well as their sexual activity, defined as “Satisfying Sexual Events (SSEs).” For the study, sexual events were not defined solely as intercourse or orgasm. An SSE was defined in the study as sexual intercourse, oral sex, masturbation or genital stimulation by the partner, but which was subjectively evaluated by the woman as satisfying (with prompts like gratifying, fulfilling, satisfactory and/or successful).
The company used personal “digital assistants” to check whether the pill was working. Participants were beeped once a day and asked to rate their level of desire, and say whether they had been sexually active and whether it was enjoyable.
Comparing the women in the North American study taking daily doses of flibanserin with women taking a placebo, the data revealed that women taking the drug increased their SSE’s by 1.7 per month, while women taking the placebo had one more satisfying sexual event per month.
Women taking flibanserin also allegedly reported an increase in sexual desire, and a reduction in distress about sexual desire. Women taking the placebo also reported increased desire, and decreased distress, but the difference between the two groups was statistically significant.
Thus, after taking the drug, the women in the North American study had sexual encounters 60 percent more often, and also found it more satisfying. They also felt less stressed about their sex lives, researchers alleged.
Very importantly, in the European study there was NOT significant increases in sexually satisfying events.
Researchers have offered no explanation for the geographic differences in the test results. The answer to that may be very, very problematic for the study and overall project. Researchers may not have performed the studies consistently regardless of cultural differences, or those cultural differences regarding sexual attitudes between continents may nullify the benefits of the pill. Whatever the reason, researchers will have to address this glaring problem at some point down the road to financial, if not physical, nirvana.
In addition, after the six month study had concluded, there were participants who reported that their sexual desire did not diminish after they stopped taking the drug. Whether this suggests that the drug may have a longer lasting effect on brain chemistry, or that brain chemistry is not as an important a factor in developing sexual desire as researches believe, also remains to be proven.
Even if the drug does perform as represented, women should be very cautious. Petra Boynton, a healthcare researcher at University College London warns the pill is not a 'magic bullet' and could prevent couples from thrashing out their underlying issues.
She said couples should pay attention and talk about their problems. She said: “It’s not going to make you feel better about your body and it won’t make your partner better in bed.”
Because there as so many unanswered questions regarding this drug, I believe it is premature at best to tout any potential benefits of flibanserin. The decision by the biotech company to release just enough information to make it appear that the drug will be effective to help women with sexual dysfunction may be an effective marketing strategy, but may end up hurting the very demographic they claim to care about.
Procter & Gamble's Intrinsa testosterone patches are licensed for use in Europe but not in the U.S., where regulators voted in 2004 against approving the patches that deliver the male hormone, citing lack of evidence for their long-term safety.
To date, the only female sexual dysfunction therapy approved in the U.S. is NOT a drug, it’s Eros-CTD, from NuGyn, Inc., a suction pump that fits over the clitoris much like the erection pumps that predated Viagra. The U.S. specialty drug company BioSante is developing a testosterone skin gel to treat a decline in libido in menopausal women.
It remains to be seen how much this new drug will cost if approved, but it is unlikely to be widely prescribed by Health Services in the UK already struggling to find cash to fund treatment of life-threatening illnesses.
The results from the flibanserin trials were presented last week at the congress of the European Society for Sexual Medicine in Lyon, France.
Researchers around the world will be watching Boehringer’s results carefully. “There are probably a lot of companies holding their breath,” Pfaus said.
— The Curator
