Arousal, Erection, and the Search for “Female Viagra”

When Viagra was first discovered as an erection-enhancing medication, it was an accident. It was originally formulated as a blood pressure medication and during clinical trials, they discovered what else it could do. Since then, the market for erection medications has grown tremendously and the competition is stiff. (OK, that was unnecessary, but I needed to get it out of my system.) So it isn’t a surprise that pharmaceutical companies are looking for an equivalent product for women. However, as the film Orgasm Inc. documents, the efforts to find a “pink Viagra” haven’t met with much success.

One of the main reasons is that the attempts to find a sex-enhancing medication for women are focusing on increasing arousal. But Viagra and other erection medications don’t enhance male arousal, just erection. Most people tend to equate men’s excitement with erection, but they’re not synonymous. One can be very turned on without erection and one can be rock-hard erect without being particularly excited. And some users find that having a med-enhanced erection without significant arousal can make sex feel really detached. While some people continue to believe that “it is undisputable [sic] that women’s sexual response is much more complex than men’s”, that idea really highlights the confusion that results from equating erection and arousal.

The equivalent of penile erection is clitoral engorgement and erection. The penis and the clitoris are made of pretty much the same types of tissues, but in different configurations. (Here’s a picture of how they develop from Gray’s Anatomy.) And there are some indications that Viagra increases clitoral engorgement,vaginal lubrication, and may increase clitoral and uterine blood flow in healthy postmenopausal women without any erotic stimulus. If these preliminary findings turn out to be accurate, it would suggest that there isn’t a “male Viagra” and a “female Viagra.” Instead, if would mean that we have medications that increase blood flow to whatever sexual organs someone has.

Sexual desire and pleasure, on the other hand, is much more complicated than how much blood your bits are getting. For that matter, our desire for food is a lot more complex than how much blood is flowing to your stomach or how much you salivate. Unfortunately, a lot of people think of male desire as an on/off switch and female desire as a dizzying array of complex factors. This is yet another version of gender essentialism, which ignores the incredible diversity of sexuality and gender and reinforces sex-negativity. I’m willing to bet that if the pharmaceutical companies started looking for a medication to enhance male arousal, they’d discover that it’s just as difficult to do as they’re finding a med for female arousal to be.

The phrase “female Viagra” is definitely attention-grabbing. But as is often the case with catchphrases, when we look a little deeper, we can see that it doesn’t make any sense at all. And it certainly doesn’t do anything to address the many reasons why sexual response isn’t always what people want. After all, 30% of men with erectile dysfunction stop using Viagra within a year and 50% stop within three years. While I don’t think it’s the only reason, I suspect that part of the explanation is that they’ve discovered that there’s more to enjoying sex that getting it up, in, and off.

So will there ever be a pill that increases arousal? Maybe, but until we have a better understanding of the many parts of the process, I’m guessing that it will continue to elude researchers. Unless they accidentally stumble upon it, like they did with Viagra.