Huge new excitement has been stirred up over Viagra, the pill that was originally billed as the answer to the misery of male impotence. There was feverish speculation from the start as to what else it might do. Clubbers were said to be buying the blue, diamond-shaped pills on the black market, hoping to be able to make love all night. And of course Pfizer, the manufacturers, were not slow to hint that Viagra might help women too.
Now they have got the evidence they wanted, it seems. The British Journal of Obstetrics and Gynaecology published a report of a small study, involving 53 Italian women, the other day. All the women were in their 20s and 30s and were experiencing sexual problems in long-term heterosexual relationships. What apparently happened to them on Viagra was a story to thrill the heart of any woman's magazine editor. One woman was said to have found the effects of the drug so powerful that she took a second lover, while another embarked on a lesbian relationship. Both had to be removed from the trial.
The women on Viagra said they were having sex more frequently - three times a week instead of once a week - and enjoyed more orgasms. When the trial ended, 70% of them asked if they could carry on with the drug.
The drug works in men by stimulating blood flow to the penis, allowing it to become aroused. It is believed to work in the same way for women - increasing the blood flow to the lips of the vagina and the clitoris. But, says Julia Cole, a Relate-trained psychosexual therapist, the physical effect of the drug may not necessarily translate into a real increase in desire among women, whatever this small Italian study appears to suggest.
"What Viagra doesn't do is change the desire mechanism in the brain," she says. "It doesn't have a chemical effect on the brain." The flow of blood to a woman's genitals might give her a feeling of mild arousal or perhaps even intense arousal, but that does not necessarily translate to what she is experiencing in her head.
"What's interesting about women is that where they are stimulated to full physical arousal, many will still say, 'Yes, I'm aware I'm aroused - but in my head it's kind of, "So what?" ' In men, physical arousal seems to trigger desire, but in women it doesn't. There is research to demonstrate that.
"I think a woman could take a Viagra pill, could have increased blood flow and be more aroused, but there is a cutoff between head and genitals which seems to come into play for women but not for men." She points out that women can admire a good-looking man in the street without feeling in the least bit aroused. "A lot of research seems to suggest that the context of the relationship seems to be more important than for men. It would be nice to think that men and women were on an equal footing, but it seems as if either nature or nurture has caused a difference."
Interestingly, in spite of the bonk-busting results of the study by Professor Salvatore Caruso of the University of Catania, Pfizer is not showing too much excitement. Caruso's results would have to be amalgamated with the results of other trials in Europe and the USA, and they have not all shown the same positive trend. "To date, Pfizer's female sexual dysfunction studies demonstrate that, while Viagra has been well-tolerated, it has not shown a significant increase in reported sexual arousal," says a Pfizer spokesman.
One in five women is said to have lost all interest in sex; this is how half of the women who go to Relate for psychosexual counselling describe their problem. It would be nice if the answer were as simple as a pill, and many women will try it to find out. But sexual problems are not just sexual problems, in Cole's view - they are sexual problems in a relationship. "It is quite hard to have a sexual problem on your own - even if it is not achieving orgasm," she says. What does work, however, is counselling. She says 80% of the women in long-term relationships who come to Relate with sexual problems say the advice they and their partners receive has worked for them.
