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Since then, Viagra has become a part of the popular culture, a topic for comedians, serious articles, and much discussion. According to Pfizer, the drug's manufacturer, as many as 10 million men worldwide use Viagra to improve their sexual performance.

Not surprisingly, women's sexual and reproductive health remains in the back of the cultural bus. While many insurers don't cover the cost of contraceptives that women use to prevent pregnancy--methods that have been available for decades--most insurance companies have rushed to subsidize men's manly ability to get us that way.

I'm not sure if it's good news or not, but pharmaceutical help for women's sexual dysfunction is on the way, as drug companies compete to tap into a potentially multimillion-dollar market. According to studies, women consult doctors twice as often as men and spend three out of four health-care dollars, so drugs that combat female sexual dysfunction (FSD) represent enormous possibilities for profit. But what exactly is FSD? Who suffers from it--and why--and what are appropriate remedies?

The Food and Drug Administration defines FSD as decreased sexual desire, decreased sexual arousal, pain during intercourse, or inability to achieve orgasm. Drug manufacturers are currently working overtime to create creams, sprays, gels, and whatever devices they can come up with--including a "clitoral vacuum pump," already available by prescription, that retails for $359--to alleviate these conditions. Such products will, theoretically, open up a world of increased sexual pleasure for women, but that's just speculation. What they'll definitely do is create new, profitable avenues for the drug manufacturers.

While I'm sure that there are some women whose inability to have pleasurable sexual relations is a cause for medical concern and attention, it seems to me that more often, the reasons for women's sexual dissatisfaction stem from our role in society, and the cultural expectations--or sometimes the lack of them--that come with that role.

Let's face it: For women, it's either sex vixen or mammy. We're sexualized for the first 40 years of our lives, and then desexualized thereafter. Not to mention that we're expected to work both outside and in the home, raise children, care for extended family, and then function as eager seductress. Menopause, a natural part of our lives, is treated as something to be denied and fought as a loss of womanhood, as opposed to accepted and embraced as simply another, vibrant stage of it.

Even though a 1999 article in the Journal of the American Medical Association reported that 43 percent of women suffered from FSD, I was skeptical. So I did an informal survey of some women I know, and according to them, boy, is the AMA wrong.

"Bad sex" was the number one reason my respondents gave for manifesting the decreased sexual desire, decreased sexual arousal, pain during intercourse, and inability to achieve orgasm that are the symptoms of FSD. These women argued that lack of foreplay, perfunctory foreplay, and men who seemed oblivious to women's sexual needs and simply hurriedly ejaculated and passed out were the primary reasons for their sexual "dysfunction."

"Listen, I have two children, work 10 hours a day, then come home and deal with the kids and the house while my husband watches ESPN," explained one woman when asked about decreased sexual desire. "So yeah, when I fall into bed I'm tired, and when I'm not exhausted, I'm annoyed that my husband hasn't done anything to help. So why would I want to have sex with him?" she snapped rhetorically. Other survey participants had a similar response when asked about decreased sexual desire, although most said this was an occasional, not chronic, problem.

"You know how men are--watching a beer commercial turns them on," said a sister, laughing, in response to a question about decreased sexual arousal. "It's not that easy for women. Instead of drugs for women, there should be mandatory classes for brothers on how to turn a woman on, including intensives on oral sex, kissing, and foreplay in general," she concluded, sucking her teeth in disgust.

"Girl, please. When the sex is good, I never have pain during intercourse," another woman, who proudly identified herself as postmenopausal, cackled wickedly. "But if the sex is terrible, all those lubricating gels they sell at the drugstore aren't gonna help."

On the subject of FSD, the consensus from women--we who don't have to worry about getting an erection to experience sexual pleasure--seems to be this: There's no reason to rush out and buy any drugs, unless all other possibilities have been exhausted. "With a sensitive lover, who's as interested in your pleasure as his own, most of these problems can be fixed without drugs," says one experienced woman. "A woman should get to know her own body, find out what arouses her, and have a dialogue with her man about how her needs could be better met. If that doesn't work, there are all sorts of other possibilities that don't necessitate a man," she adds, laughing.

Jill Nelson is the editor of Police Brutality: An Anthology (Norton; $24.95). On the Verge, her exclusive column for NiaOnline, appears semimonthly

Published on: 08/20/2001

Jill Nelson's column on MSNBC.com  






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