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Revving Up Women's Sex Drive

Will there ever be a 'Viagra' for women?

Estratest

There is one FDA-approved androgen (male hormone) on the market for women. Estratest is a combination of oral estrogen and testosterone.

Although the product is only approved to treat estrogen-resistant hot flashes, it has been used "off-label" by doctors and patients. Off-label use means physicians prescribe drugs for a purpose other than what they are approved for.

Estratest has not been approved to improve sexual desire in menopausal women, but double-blind trials have shown it can do the job, says Shifren. "The nice thing is that it is a pharmacy-grade product designed for women. So there are a lot of data on safety and efficacy."

The drawback is that the drug is a fixed dose of a combination of estrogen and androgen. Women who may not need estrogen for hot flashes may not want to use the product.

"Estratest would be a very appropriate therapy for surgically menopausal women who, after surgery, notice hot flashes and a decrease in [sexual] desire," says Shifren.

Leiblum points out that Estratest and other drugs, while useful for some women, are not cure-alls for libido. "None of these [drugs] are probably going to be useful on their own," she says. "They all need to be seen as a multifaceted approach to both assessment and intervention."

Like all estrogens, the hormone may increase the risk of heart attack, stroke, breast cancer, endometrial cancer, and blood clots in the lungs or legs. Androgens can increase risk of liver cancer, and cause masculinizing effects in women.

Wellbutrin

There is some evidence that the antidepressant drug, Wellbutrin, may be able to boost women's libido.

In a 12-week preliminary study of 66 women most of who were not menopausal, 39% reported being satisfied with their levels of sexual desire. Harry Croft, MD, a psychiatrist and sex therapist based in San Antonio, reported the results of the study at the 2000 American Psychiatric Association meeting.

Experts say they are not aware of any large studies on Wellbutrin and sexual desire. But they aren't surprised that the drug may have some effect on women's libido.

"What happens sometimes is that people's sex drive goes up, because their depression is treated," says Koehler, noting that depression is often accompanied by lower sex drive. "So it may not be the Wellbutrin itself [that works]; it might be the feeling of being less depressed that is causing the increased sex drive."

None of the women in Croft's study was depressed when the trial began, but all had trouble becoming aroused or having orgasms.

Sometimes, a change in antidepressant drugs may help boost libido. SSRI-type medications such as Prozac and Zoloft are known to interfere with sexual desire. If a person switches from SSRI-type antidepressants to Wellbutrin, there may be an increase in sexual desire, because the others may be diminishing it, says Carol Rinkleib Ellison, PhD, a psychologist and author of Women's Sexualities.

On the other hand, Ellison says Wellbutrin could have the opposite effect of dampening desire. "People are really individual in how they respond to these medications," she says.

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