WASHINGTON — Elizabeth Belt remembers holding the two pale-blue, diamond-shaped pills in the palm of her hand before swallowing them and thinking: "Please God, let this work."
The 35-year-old Richmond, Ind., woman has been desperately unhappy for years over the sexual problems she has suffered since undergoing routine gynecological surgery when she was 19.
Belt now pins her hopes on Viagra, the hot-selling impotence pill for men. Although the first published study of Viagra in women proved less dramatic than anticipated, the sizzling market it created among men has sent researchers and drug companies racing to find its female equivalent.
"The world is finally coming around for women," said Dr. Jennifer Berman, a urologist who runs the Women's Sexual Health Clinic at Boston University with her sister, Laura Berman, a psychotherapist.
But the search for a female Viagra has led researchers to an important conclusion: The key to improving sexual function in women may lie in stimulating the libido. For women, scientists are finding, the most important organ for sexual function may be the brain.
"Viagra is really, literally, a functionally acting drug--it does something mechanically," said Roland Gerritsen van der Hoop, vice president of clinical operations for Solvay Pharmaceuticals in Atlanta, one of the companies testing a libido-enhancing drug for women. "It won't work if desire isn't there."
Dr. Steven A. Kaplan, a urologist at New York Presbyterian Hospital who conducted the first published study of Viagra in women, agreed that enhancing desire could be more important for women than increasing blood flow to the primary sex organs.
"Many women define sexual pleasure as arousal without orgasm and some disassociate desire and arousal from the act of intercourse," Kaplan said.
The winning drug could produce an enormous windfall. Viagra, which Pfizer Pharmaceuticals put on the market last spring, enjoyed $788 million in sales last year. The market for women may be even more promising. A recently released study found that four of every 10 American women are having problems in the bedroom.
One libido-enhancing drug currently being tested in clinical trials among women is a chemical called apomorphine, which stimulates the brain.
It is a pill that will be sold under the name Uprima and it has already been studied--and judged effective--for increasing men's sexual desire. The company plans to seek Food and Drug Administration approval for men later this year. It could take several additional years before it is approved for women.
