Sex Therapy New York

The Hot New Sex Potion

Seven couples road test a Viagra cream – for women.

By Nancy Wartik, Redbook Magazine, December 1999

“You want to try WHAT?” asked my significant other, with a distinct lack of enthusiasm for the erotic experiment I had just proposed. Okay, so things weren’t exactly off to an amorous start. Still, I understood why my loved one was a bit taken aback. The innovation I’d mentioned was a topical drug, as yet in the research stage, containing pulverized Viagra, the wildly popular impotence treatment. This form of Viagra, however, was designed with my pleasure in mind, not his, and it represents a trend. The medical world has suddenly awakened to the potentially lucrative market for meeting women’s sexual needs; Viagra cream is one of several products now in the pipeline. Earlier this year, Michael Wysor, M.D., the developer of a similar kind of cream, also in the experimental stages, told The New York Times that rubbing this product on the clitoris could induce multiple orgasms, “basically eliminat[ing], the need for foreplay.”

So when Redbook asked me to check out this phenomenon-obviously one of global significance-my curiosity was piqued. And now here was my bedmate grumpily suggesting he didn’t want foreplay eliminated from our repertoire. But in the spirit of scientific inquiry, he was persuaded to help test the new Viagra product and another similar cream; six couples from around the country also volunteered to try them. Motivations varied: Some women, myself included, were basically satisfied with our sex lives but curious to see if Viagra cream would give us effortless multiorgasmic bliss. One woman found it hard to have orgasms through intercourse alone. Two had more serious concerns: Psychological or physical problems had wreaked havoc on their sex lives, and they feared the potential relationship fallout.

Not just for MIDDLE-AGED MEN

Their situation isn’t uncommon: Earlier this year, the journal of the American Medical Association reported that more than 40 percent of women age 18 to 59 can’t get erotic satisfaction. They’re uninterested in sex, don’t have orgasms, or find sex painful, unpleasant, or anxiety-provoking. It was these sorts of problems that New York City urologist Jed C. Kaminetsky, M.D., wanted to address when he developed the new Viagra cream. “I’ve had women tell me, ‘I feel as if I know what it’s like to be impotent-I feel like my vagina has been injected with Novocaine,'” Kaminetsky says. “I see women who’ve never had an orgasm. For the most part, we haven’t had much to offer these women.” Several years before Viagra was introduced, Kaminetsky began prescribing male impotency medications to some of his sexually dysfunctional women patients. (Although the drugs are not FDA-approved for treating female sexual dysfunction, such off-label prescribing is common-and legal-for the majority of drugs.) He also experimented-and had a measure of success-with putting some of the drugs in ointments to penetrate the vaginal walls. When Viagra hit the market, Kaminetsky began experimenting with that, too. Working with a pharmacist, he devised a way to crush Viagra pills into a water-soluble cream. He also developed a second product, dubbed Dream Cream, which combines two other promising impotency treatments (an asthma medication called aminophylline, which is being tested as a male impotency drug, and an amino acid, I-arginine). Both creams are meant to work by dilating blood vessels in the genitals, thereby upping the intensity of arousal and orgasm. About 50 women so far have tried the two products (which are only available to Kaminetsky’s patients). “Over 90 percent say the creams make sex feel a lot better,” he says. “They have more sensation, lubrication, arousal.”

Let the TRIALS BEGIN!

Kaminetsky sent each of our intrepid testers a tube of Viagra cream and a tube of Dream Cream. Using either cream is simple: A woman applies about a teaspoonful just inside the vagina, as well as to the clitoris, 20 to 30 minutes before she plans to have intercourse. (Unfortunately, this rules out one particular warm-up diversion, since the creams are inedible.)

Brooke, 32, of New York City, was hoping to make sex more passionate. Her husband, Christopher, 33, is a medical resident who works grueling hours. “Our time together is so short,” she says. “If one of us isn’t tired, the other is. It’s not like sex is bad when we have it. But I can usually imagine it might be a little better.’ The couple only found time to test the Viagra cream and saved the Dream Cream for a rainy day. “We planned a little date,’ she says. “We saw Eyes Wide Shut, which was kind of sexy. Then we came home, I put on the cream, and we had a drink.” The cream gave her a warm, tingling sensation and extra lubrication. “Sex was much more intense than usual,” she says. “Everything was heightened. What’s normally good felt really good. What’s normally great felt fabulous. I had much more stamina than usual. I didn’t want to stop.” Agrees Christopher “We definitely had fun. I had briefly worried that the cream might make Brooke want to keep going after I was ready to go to sleep, but that wasn’t the case. Things went on for a long time, despite some debate about the wisdom of proceeding, given that I had to get up at 5 the next morning!” Would they use the cream regularly? “Every so often, like you buy a bottle of champagne or go out for a nice dinner,” says Brooke. “I think good sex begets good sex. This seems to me like a totally positive thing that will carry over.”

Marion, 28, and her husband, Duane, 30, of the Austin, TX, area, tried both creams in hopes of rekindling a nearly extinguished sexual glow. When the couple met five years ago, their sexual relationship was satisfyingly intense. But before they married, Marion’s birth control failed twice; not ready for motherhood, she had an abortion each time. “It was very traumatic. Afterward, sex wasn’t as much fun,” Marion says. “I’d literally tighten up, and intercourse would hurt. I started associating sex with pain.” A stressful, work-heavy schedule also took its toll on Marion. During the past two years, the couple’s infrequent sexual encounters have usually ended with her in tears. “It’s awful,” she says. “I love this man, and I feel like I can’t be close to him and satisfy him.” Counseling, along with estrogen cream to counteract Marion’s vaginal pain, helped only minimally. “We’re a strong couple,” says Duane. “But it’s been frustrating for both of us.” The creams – especially the Viagra cream, says Marion catapulted them back to the kinds of sexual encounters they used to have. “I was very wet and completely aroused,” Marion says. “The cream made me feel as if I was oozing warmth. I know some of it was mental, but the cream empowered that mentality. I felt utterly relaxed, liquid. I had several orgasms. After two years of problems, we had sex four times in a week. It’s been great.” Not surprisingly, Duane agrees: “I don’t know if the effects of the cream were more psychological or more physical,” he says. “Either way, it’s been a very good week.”

Were these couples responding mainly to chemicals — or more to psychological factors? “I’d guess the increased warmth or tingling gets women focused on their sexual sensations,” Ursula Ofman, Psy.D., a New York City sex therapist, speculates. “It connects their brains and their bodies. Women can learn to get to the same point by deliberately tuning in to their sexual sensations. But the creams may be a good first step.”

Tougher CUSTOMERS

Not everyone loved the drugs. Tamara, 32, and her husband, Nelson, 36, of Jersey City, NJ, tested both creams, partly to combat an ongoing sense of battle fatigue that leaks into the bedroom. “It’s hard to come to bed feeling fabulous when it seems like I’m always so tired,” Tamara says. “I was curious to see if the creams would help overcome the feeling of always being in a fog, if they would go ‘Zing!’ and wake me up.” The Viagra cream did increase her lubrication, but she didn’t feel the fireworks she’d hoped for. She pronounced herself “disappointed but not devastated.” Both she and Nelson agree that the problems in their sex life go beyond fatigue. “I’m not a very sentimental guy,” he admits. “I know she sometimes feels like she can’t feel me emotionally.” Adds Tamara, “We don’t always communicate clearly in bed.” Angela, 47, of Orange County, CA, also learned that the creams aren’t a cure-all. At 25, Angela was diagnosed with cancer and had heavy doses of chemotherapy and radiation. The harsh treatments dulled her capacity for sensual feeling. “In my 20s and 30s, I worked like crazy trying to make sex feel good –and sometimes it did,” she says. “But it was never as good as before I got sick.” Married for 20 years to Noel, 52, Angela has found it harder in recent years to experience any feelings of desire or arousal. “Some men couldn’t care less if women enjoy sex, but Noel isn’t like that,” she says. “When it’s unsatisfying for me, it’s very disappointing to him. So I feel pressure to enjoy myself. I love my husband, and our marriage is good. But he’s a very sexual man, and I don’t want him to feel like he has to go elsewhere.” Though she has consulted physicians, nothing has helped. When Angela heard about Kaminetsky’s creams, she couldn’t wait to try them. “The Dream Cream did nothing for me,” she says. “The Viagra made me feel warm and very lubricated, so it made sex less uncomfortable and definitely more enjoyable for my husband. But it didn’t help in terms of desire or orgasm. That was disappointing for both of us.” She’d use Viagra cream again for lubrication, she says, but will keep searching for something else to restore her lost sensuality. Does this less-than-100-percent success rate shake Kaminetsky’s faith? Not at all: “If a patient has a partial response, like lubrication, I’d say it’s a good start. Now, how can we improve on it. I’d ask the woman, “Which cream do you like best? We’ll make sure you’re using it properly. We’ll increase the dose,” he says. “I wouldn’t say, “That’s it. It doesn’t work. Bye.”

the THRILL-SEEKERS

Okay, I’ll buy his reasoning (though it’s not something he’d mentioned when first touting his 90-percent success rates). But what of the remaining orgasm-cream pioneers, who weren’t looking so much for sexual solutions as a little added thrill? Evelyn, 38, of Berkeley, CA, wanted to see if the creams would help her have orgasms through intercourse alone. “It’s not a real problem, because I’m basically happy with our sex life,” says Evelyn, who lives with boyfriend Terry, 41. “On the other hand, I’m always up for easy sexual experiments.”

Although neither cream worked miracles, the Viagra cream intensified her sensations. “It was less effort to have an orgasm, and it felt stronger,” Evelyn says. That added to Terry’s pleasure. “I could see she was getting a charge from it, which was gratifying to me,” he says. Adele, 41, of Silver Spring, MD, tried both creams with her husband, Jon, 46, out of curiosity. “I have orgasms easily,” she says. “But they vary in intensity. I wondered if the creams could make my orgasms reliably like the best ones I’ve had. But they didn’t make a difference.” As for me, I’d love to tell you the creams skyrocketed me to heights of bliss, but as George Washington said in a rather different situation, I cannot tell a lie. Using Dream Cream, I felt a localized sensation of warmth, which my partner (who, for the record, overcame his initial skepticism to perform brilliantly) and I enjoyed. But overall, the encounter was no better than interludes we’ve had without prescription drugs. There was one happy side effect: Waiting for the creams to kick in, we talked about our sexual sensations, and my significant other later told me that the increased communication heightened his pleasure. If orgasm cream didn’t do it for us, then maybe conversation will. When I summed up the results for Kaminetsky, he was typically optimistic. “If two women were really happy and it improved their sex lives, and a couple of them found things a little better, and if the creams didn’t harm anyone, that’s not bad,” be said. “This research is still in its embryonic stages. There’s a lot we’re still learning.” The next step is a trial in which some women try the medication while others unknowingly apply a placebo; only then will it be clear whether the effects are more physical than psychological and whether the drugs have any long-term side effects. Kaminetsky says he hopes to do such studies and win FDA approval to market these new variations on already-approved drugs.

At this stage, though, the fate of a specific drug matters less than that researchers have had a stunning revelation: Women’s sexual pleasure deserves as much study as men’s! “It’s been a long time in coming, and this is just the beginning,” says Laura Berman, Ph.D., co-director of the Women’s Sexual Health Clinic at the Boston University Medical Center. “In the next few years, all kinds of options will become available; until they go through formal trials, each one needs to be taken with a grain of salt. But it’s encouraging and exciting. It’s wonderful that women are getting the means to reach their full sexual potential.”