The author says Viagra’s physical effect in women does not translate to arousal.

Question: What does Viagra do for women?

Mary Roach: The Viagra is...You know, it affects the vascular system so that...And that... They try...They were very eager to test that out on women, hoping that they could, you know, sell the drug to the other half of the planet. And it... it doesn't work. It does actually increase genital blood flow in women but it doesn't create a change that the women, then, interpret as I'm really aroused, I want to have sex, I feel really sexy. It doesn't... It doesn't do that. They don't even notice. It's a small enough change that it's not... it's not something that they would pay for. It's not really doing anything. So they then looked at...

Well, there's the other approach to libido in women is hormonal. And there was... There actually is a patch, testosterone patch, which was all set to go, called Intrinsa. And the FDA, then, wanted longer term safety data, I think, because of hormone replacement therapy. Remember there was a big... You know, we thought that hormone replacement therapy was the next greatest thing since whatever, sliced bread. Then, they came up with this, you know, long-term findings, sort of saying that, you know, they were actually increasing risk of stroke. There was that big study that scared everyone off so the FDA kind of backed off hormones.

So now, the only thing left is central nervous system, you know, affecting the brain. And I think that that's going to be tricky because I think that the FDA... The FDA considers sex a lifestyle issue, not really a medical issue. So in order to pass something for what is considered... a pass to get a drug approved for something as considered a lifestyle issue, it's... you know, they're going to be pretty squeamish about affecting your, you know, your brain for that purpose. So they may have, maybe, a bit of a long road to get something approved.

Question: Do herbal medications work?

Mary Roach: Well, for the most part, it's the placebo effect. One researcher told me about... She actually took a few of these... bought a few of these just to see what was going on. And there was... They were for... There was one for women. And she said, it had in it sort of... like a topical, almost like a capsicum, like a red hot pepper substance. And she said, you know, it did generate a little heat. But she said, in the directions, there was this line that says, you know, apply to vulva. Rub really well. Rub really, really, really well.

And they're like... So they got people that go, "hey, that really works." So I... My sense is that there's not... other than the placebo effect. I don't mean to knock the placebo effect because it's really... it works, you know. You tell somebody something works and they make it work. And if it works, it works, I don't care how it works so I don't want to dismiss everything. You know, I don't want to tell people don't even try it because if it's harmless and it's a harmless placebo and it works, then more power to it. But I don't know. You know, the safety of... I wouldn't feel comfortable purchasing a drug online, from a supplier that I didn't know. I don't know. Whether they're coming out of China, a lot of these things...

Question: What about aphrodisiacs?

Mary Roach: I was in Taiwan with a researcher. And he took me to a traditional pharmacy. And there's just... The guy kept coming out from the back with these boxes. It was like, you know, shoe salesman guy when I was young, with these big stack of boxes. Here, will be old dinosaur bones. And that was supposed to be, you know... And the researcher would go, "just because they're hard," You know, and anything shape like a penis, that was a treatment for erectile dysfunction. Just one after another, bringing out all of these herbal and other sort of natural things from the natural world that were supposedly cures for... But as for something, being... Things that work well, testosterone, small amounts of testosterone for women are pretty reliably effective and you don't have to... the patch, which is sold in Europe, isn't sold here but you can go to any compounder and say, look, you know... or just get a prescription for your... from your physician, saying I want a very low dose of testosterone for libido. And people... doctors prescribed that all the time and it's fairly effective, from what I understand. But outside of that, I think it's, again, a question if you... if you think it'll work, maybe it'll work, so give it a try.

Recorded on: April 6, 2009