A More Zest(ra)-y Sex Life for Women?

Gratuitous flowers for a sex post: Cascading morning glories captured by me, Sungold, in October, back before the frost bit ‘em.

The Denver Post ran an article today asking why an arousal-booster for women called Zestra can’t find TV stations willing to run their ads, even as Viagra ads are literally driving in circles around us. Historiann took the article to task for its casual disavowal of feminism, and I’ve got nothin’ to add to her critique except a vigorous nod of approval. Figleaf chimed in to say that the stations’ ad policies spotlight the illegitimacy of autonomous female desire.

What most struck me about the article, though, was its conflation of libido and arousal, which is endemic in “science writing” that reports on “pink viagra.” Here’s how reporter Mary Winter framed it:

Now, you would not know it from the $300-million annual ad campaign for erection-enhancing ads for Viagra, Cialis and Levitra, but women suffer more sexual dysfunction than men do — 43 percent to 31 percent, according to the Journal of the American Medical Association.

In other words, the potential market for flagging female libidos is huge. But here’s the irony: When the makers of Zestra went to 100 television networks and stations to buy ads, the vast majority refused them. The few stations that did take their money would run the ads only after midnight or during the daytime.

The stations “told us they were not comfortable airing the ads,” Zestra co-founder Mary Jaensch told “Nightline.” The double-standard here — men, you deserve sexual pleasure, and women, what’s wrong with you hussies? — is breathtaking.

So how about this ad: a Camaro, a woman, and a vibrating driver’s seat?

(This is just the end of the article; read the whole thing here. Winter is very sharp and witty on the Viagra ads!)

In a way, it’s unfair to pick on Winter, because most writing about female sexual dysfunction fails to draw basic distinctions between arousal, orgasm, desire, and libido. It also tends to ignore the reality of the physical pain some women experience (which K has explored eloquently at Feminists with Female Sexual Dysfunction.) In practice, women can of course have issues with any or all of the above, and problems in one area can easily spill into another. A woman  suffering from vulvodynia, for instance, might be able to orgasm, but if sexual activity hurts, that’s likely to dampen her libido. Another woman might have a generally low libido (meaning she doesn’t crave sex very often) but develop desire responsively to her partner, at least in certain situations. There are probably as many variations as there are women.

Now, getting back to Zestra and the Denver Post: Winter’s article refers mainly to libido. She’s partly on the right track, insofar as that “42 percent” figure refers mainly to women who complain about low libido. (Some feminists have criticized that figure as too high, but let’s set that debate aside for today.) Winter does hint at the primary issue here – arousal – in that apparent throwaway line about a vibrating driver seat in the Camaro. Why yes, I think quite a few of us gals might enjoy such a ride! But if we got a good buzz per gallon, that wouldn’t mean our libido was revving – only that our engine was purring smoothly.

Libido is not the primary target for Zestra, though Zestra’s website refers to a whole host of potential benefits: stronger libido, greater satisfaction, more earth-shaking orgasms, and a more harmonious relationship with one’s partner. (That last point comes up only in testimonials; the overall tone of the website is “try this for yourself,” not “use this to please your long-suffering husband.”) It’s being marketed to women who suffer from sexual problems of any sort due to illness (including cancer), postpartum changes, menopause, antidepressants, stress, and even widowhood. But what does it really do?

Zestra’s primary mechanism, as far as I understand it, is to enhance arousal and response during sexual activity. As far as I can see without having tried it myself, it looks like it might increase engorgement and/or creaste prickling sensations in a nice way. In the best case, yummy sensations start a cascade of increasing desire during lovemaking. As a topical agent applied directly to one’s ladyparts, Zestra doesn’t act directly on libido, which is regulated by the brain and a complex dance of different hormones and neurotransmitters (including estrogen and testosterone, but also thyroid hormone, stress hormones, dopamine and lots of other nifty “messenger” chemicals). A topical gel won’t directly influence that chemical brew. It’s only logical, though, that if sex is more pleasurable, some women might want it more. Biological anthropologist Helen Fisher has written about how hot sex with a new partner gives us a dopamine high akin to cocaine (quick summary of her ideas here). Maybe hot sex with in a newly reinvigorated relationship can give us the same buzz?

Also, the testing for Zestra relied on women who committed to have sex eight times in a month, so it’s unlikely many of them had a super low libido. (For more details on the testing, check out the clinical study.) These women were already open to regular sex. As a group they sound to me more like women who basically like sex but were frustrated by difficulty getting aroused. They don’t sound like the subset of women who’ve given up on sex – a group that constitutes about 15% of American marriages, by the way. (This according to Tara Parker-Pope in the New York Times, where “sexless” was defined as no sex at all with one’s spouse during the previous six to twelve months.)

In other words, the mechanism behind Zestra appears to be entirely different than flibanserin, an orally-administered drug recently rejected by the FDA for ineffectiveness. Flibanserin was supposed to increase libido directly by changing one’s brain chemistry. It too was compared to Viagra, and quite wrongly so: Viagra targets a mans plumbing, so to speak. It produces an erection (though it almost always requires mental and/or physical stimulation to be effective). Flibanserin left physical arousal untouched while aiming to increase psychological arousal and desire.

Calling flib a “pink viagra” was just misleading. In the case of Zestra, the comparison appears more apples-to-apples, since both Viagra and Zestra appear to work by increasing engorgement.

I still think it’s too bad that flib flopped. Yes, the drug was intended to be a Big Pharma Bonanza. I don’t really give a shit. If it had really helped women live better, I’d be all for it. I trust women to make decisions about their bodies (though I also insist on our responsibility to understand our bodies. At any rate, flib failed to gain FDA approval because it didnt work.

As far as I know, there’s still nothing  on the market that specifically helps women who only desire sex once in a blue moon. For some women, hormone therapy (sometimes including testosterone as well as estrogen) delivers a libido boost. But hormones carry some risk. Women fear breast cancer if they take estrogen and they fear growing a beard and unibrow if they take T. But these are the choices, because there’s no drug that specifically targets libido.

Zestra interests me because it seems to be quite safe (worst side effect: transient burning sensations in some rather precious real estate). I’m skeptical to the extent that their studies are pretty small. Unavoidably, the very fact of running a study is an intervention in itself. This can have real effects on its findings. How many of the couples studied would have had sex at least eight times in a month? If most would’ve had less, that means Zestra wasn’t the only independent variable. Perhaps the twice-weekly commitment, combined with a new toy or just wall-to-wall pictures of George Clooney and Jon Hamm would fire their engines just as well. I’m pretty sure I’d be off and roaring on that program! (Where do I sign up?)

Seriously, I have been meaning to try Zestra just for the fun of it, since it sounds like its potential benefits might not be limited to people suffering from difficulty with arousal … and, y’know, anything for science! I’ve got a packet of it in a drawer but I’m not so sure what my lab partner would think.

As always, I’m very curious if any of you out there in bloglandia have given Zestra a whirl? And if so – are you willing to dish? Pretty please?