One Pill / Makes You Larger / And The Other / Makes You Small...
Petra Boynton takes a look at the recent story about Viagra possibly working for women on anti-depressants. I actually thought the press handled the press release relatively well compared to earlier stories that semen alleviates depression or this not-even-meant-as-a-prank fellatio/breast-cancer-prevention story from last year. That's actually *not* a vote of confidence though. While most of the articles have been surprisingly clear that the viagra thing worked for only a very small subset of women with sexual side-effects from anti-depressants Boynton has other concerns.
The media coverage has been predictably uncritical. It has tended to suggest that Viagra is a wonder drug that will save depressed women, and as a subtext suggested it could also help the sex lives who weren’t depressed too.
If you are a woman or the partner of a woman with depression there are several things you need to know about this research before you go asking your doctor for a Viagra script.
The study does rightly state that some anti depressants can lead to sexual problems (usually the inability to have an orgasm through intercourse or masturbation, taking longer than usual to reach orgasm, and/or a lack of lubrication). In order to be an issue, however, women can’t just have these symptoms - they have to be bothered by them too. Meaning if a woman finds it difficult to reach orgasm but isn’t distressed by this then it is not an issue requiring clinical intervention. It’s worth noting that depression can lead to women finding it difficult to reach orgasm or have any desire for sex. It can be worrying for a depressive patient who recieves pharmacological treatment and expects to feel better to discover their sex life hasn’t returned in the way they wanted.
While research subjects were chosen from women who didn't have orgasmic difficulty until they began taking anti-depressants Boynton points out that care givers nor patients (nor, perhaps, patient's partners) might not be so discriminating.
[T]his is not always just down to the side-effects of medication - the underlying causes of the depression may not have gone away and could easily still be contributing to a woman’s sexual problems. For example problems within a relationship, family difficulties, work problems, economic or housing difficulties, issues with childcare, isolation or a lack of support could all be contributing to a woman’s sexual difficulties.
And that gets to a point *I* think about a lot when I think about men and Viagra. And depression. And consent.
I don't have erectile dysfunction, or at least not yet -- I'm only in my 50s -- but I do have mild bouts of... I'll call it "physical" depression because while I still feel optimistic, cheerful, even playful mood-wise I get loss of energy, shyness or withdrawal, sleeping a *lot* more than usual, oh, and two other symptoms that I think of a sure-fire indicators: resumption of nicotine cravings (even though I quit years ago) and diminished libido. I'm in the middle of one of those slumps this summer, which partly explains my slow posting rate, my horrible personal-correspondence rate. (This doesn't count as the apology to everyone who's map I've seemingly dropped myself off of.) As in Boynton's last paragraph external factors such as having children and partner home for the summer, a busy travel season, various elderly but fairly distant relatives passing away, a ton of projects around the house, and an extended allergy season are seriously contributing factors.
I actually think I'm starting to come out of the slump a bit -- as is often the case we only notice these things when things start to improve, and I'm pretty sure I wouldn't have posted about it in the first place if I wasn't perking up a bit. But I digress... if only slightly.
Anyway, I was already sort of thinking about in my earlier pink-is-for-girls/blue-is-for-boys pill post but it seems like some of the consequences of the Viagra for Women story illuminates similar problems for men.
For instance while my partner and I are pretty compatible when it comes to conflict resolution in the past I've been involved with people who loved both to argue and to then have make-up sex. I'm not sure if I'm just sensitive (I once slept, literally slept slept, on a mattress made entirely of sacks of dried peas so I can't be *too* sensitive) but after an argument all I want is a lot of time, alone, to process. The *last* think I want is physical contact, let alone *sexual* contact! Which with one partner in particular was cause for further acrimony as she was pretty insistent that make-up sex was important in relationships.
Had Viagra been available at the time I might have felt it was a good solution to "my problem" with sexual interest after arguments. Instead the solution I eventually found was to end our relationship -- which was probably for the best for both of us considering our, well, other considerable incompatibilities.
Anyway, just to be clear this isn't a "what about the menz, we getz pressher too" post. Instead it's just an observation that some of the concerns anticipated in the event a "female libido" pill is developed might be examined among depressed or alienated Viagra users.
Because (as I mentioned in that pink/blue post) while Viagra has certainly been trumpeted as a "get back the feeling" drug for men it's also been an "it's about time" drug for their partners. Who, after all, are often healthy and generally younger humans and therefore as likely to desire sex and intimacy as... men in similar situations who despair of *their* partner's libido.
So... I'm a little rattled today (believe me that didn't help although a lot of unbidden tears throughout the day hasn't hurt either!) Anyway, I'm not sure any of this makes sense.
I'm just saying that from my own *situational,* post-argument disinterest in sex, and my experience of pressure to meet a partner's expectations in those situations, I'm just saying that an enterprising young student of psychology or relationship therapy might get a nice paper out of studying some of the perhaps less obvious reasons men might take Viagra... with it's possible insights into potential consequences of "Viagra for women."
Anyway, I'm not sure any of this makes sense.
It makes a lot of sense, figleaf.
To assume that one's libido should be a constant is unrealistic. It would be rare for a man or woman to have a level of sexual desire unchanged by hormonal fluctuations, emotions and/or health.
Even when sex is not the cause of the problems in a relationship, sex is where unresolved conflicts, anger and resentment are manifested.
It is not unusual for people with partners who have lower levels of sexual desire to find that their own interest in sex will diminish. The higher libido partner, after repeated refusals, may feel that the cause of the problem is his or her own physical appearance, which is a false assumption based on the false belief that everyone is having more sex. Which they are not.
So Viagra is a cure for a specific physical symptom, which may be very distinct from the underlying disorder.
I'll call it "physical" depression because while I still feel optimistic, cheerful, even playful mood-wise I get loss of energy, shyness or withdrawal, sleeping a *lot* more than usual, oh, and two other symptoms that I think of a sure-fire indicators: resumption of nicotine cravings (even though I quit years ago) and diminished libido.
This observation is really important because that loss of energy can make it so difficult to work, write, or even listen patiently to our partners. Lack of energy is not necessarily a result of hidden anger. It could be mitochondrial dysfunction, sleep apnea, or poor distribution of neurotransmitters (rather than a lack of neurotransmitters, which is why anti-depressants will not always alleviate these symptoms.) It can take so long before you find the real cause of that constant tiredness.
Glad you're starting to feel better.
[Thank you so much, Kochanie. I really appreciate it. --fl]
Here's the thing about Viagra or Cialis. You could take a whole bottle of them and all you'd get would be a stuffy nose and a headache - unless you've also got some lovely stimulation, physical or mental (or ideally, both). By themselves, they can't create desire or raise your libido. (I'm actually sure you know this, figleaf, but this post doesn't draw this distinction.)
This is why it makes sense that some women might orgasm more easily on Viagra (once they were happily stimulated), but Pfizer still can't find a way to package it for women with "low desire." Which, as I wrote a few months ago, is only partly a creation of Big Pharma; it's also an issue that some women feel very acutely as a loss.
Anyway, if you'd had Viagra with that ex-partner, you still wouldn't have wanted make-up sex (which, BTW, I agree with you on - I usually need at least a day's time and some prior peacemaking). Viagra wouldn't have changed your desires. Of course, if a drug did exist to boost libido (there was a promising contender that failed trials a year or two ago), the low-desire partner might well resent be expected to take it under the circumstances you described.
And no amount of Viagra is going to address your current situation, either. Otherwise I'd swipe some and send it to you! :-) Seriously, I *really* hope that your slump is on its way out.
[That's very interesting,Sungold. Also good to know. Having never really seen Viagra I assumed it was more direct, like maybe the old Caverject that (unless I'm mistaken about that) just constricted blood flow out of the penis. Also, in a way, a relief to know it wouldn't have helped with my former situation. And no, what I probably need for my current slump is for school to go back in session. (I've stolen two whole hours this afternoon with everyone out from underfoot... and wound up spending most of it at the hardware store and prepping and painting! Doh!) Thanks for your very kind thoughts. --fl]
It's semi-tangential to the main point of your posting, but thank you for writing this: I'm not sure if I'm just sensitive [...] but after an argument all I want is a lot of time, alone, to process. The *last* thing I want is physical contact, let alone *sexual* contact!
I too am like that, and have been in relationships mostly with people not like that, which has caused similar acrimony, which usually makes me question whether I'm reacting reasonably or not. I always end up deciding that I have a right to have my own feelings, but it's affirming to read that I'm not the only one who reacts that way.
[I don't think it's necessarily reasonable or unreasonable to like makeup sex, or not. It's just the way each of us turns out. Which is sort of why we need to be sensitive rather than demanding about each other's inclinations. Especially when it comes to sex. That doesn't mean I can't learn to come out of my mood, nor that someone else can't learn to take a shower or a long walk. But if its' *demanded* of me, or if I put you on the defensive for asking, then we're going to have problems. Speaking only for myself it's nice to hear arguing puts others off their feed as well. Thanks, DN. --fl]