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While they don’t fully understand the swing, the unique female response likely provides more evidence that sexual function is more complex in females, says Dr. R. Clinton Webb, chair of the MCG Department of Physiology and a study author. Scientists define female sexual dysfunction as a multifaceted disorder that includes anatomical, psychological, physiological and social-interpersonal aspects.

MCG researchers have shown part of that complexity may be the smooth muscle cells in the internal pudendal arteries of females communicate, agreeing to contract and relax, while male smooth muscle cells make independent decisions to just relax.

They found one other distinction: females were more sensitive to Viagra, or sildenafil, while males were most sensitive to Levitra, or vardenafil.

Previous studies on the effectiveness of these drugs focused on the cavernosal tissue, or penis. The internal pudendal artery actually feeds the penile artery which is buried deep in the penis where numerous caverns enable it to be flaccid when not engorged with blood. Physical stimulation of the area causes the tissue, endothelial cells and nerves to release nitric oxide, a powerful dilator of blood vessels. The system works pretty much the same way in the vagina and clitoris.

New studies indicate the three drugs used to treat male impotence also appear to work in females, albeit a little differently, and should give the scientific community pause to take a second look at their potential in the 40 percent of women who report sexual dysfunction, researchers say.

In one of the first studies of the effect of phosphodiesterase Type 5 inhibitors - Viagra, Levitra and Cialis - on the pudendal arteries that supply the penis, vagina and clitoris the blood needed to produce a satisfying sexual experience, Medical College of Georgia researchers showed the drugs relax the artery in male and female rats.

“It shows the drugs need to be investigated more for women and small alterations could make these compounds more effective for women living with these disorders,” says Dr. Kyan J. Allahdadi, postdoctoral fellow in physiology at MCG. He’s presenting the findings during the 122nd Annual Meeting of the American Physiological Society held in New Orleans April 18-22 as part of the Experimental Biology 2009 scientific conference.

Although there was talk years ago of a pink pill for women to parallel the blue Viagra for men, early clinical trials found essentially no response in women.

MCG researchers decided to look again, first giving a drug to constrict the internal pudendal arteries in male and female rats - as they would be in a non-erect state - then giving doses of each impotency drug to see the impact. The arteries from male rats displayed a relatively standard concentration-dependent relaxation - the more drug they got, the more they relaxed - while in females arteries, there was an initial relaxation then an odd oscillation between relaxation and contraction with subsequent dosing.

A new report issued today by HHS’ Agency for Healthcare Research and Quality found that there isn’t enough evidence to determine which drugs work best to treat erectile dysfunction and which cause the least harm. Erectile dysfunction is a common sexual disorder that prevents men from getting or keeping an erection. It affects between 15 million and 30 million men in the United States.

The authors found that men who took oral phosphodiesterase type 5 inhibitors (also known as PDE-5 inhibitors) had improved erectile function as compared to men who didn’t take the medication. However, head-to-head trials comparing three erectile function medications - sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) — were inconclusive as to which medication worked best.

The most common short-term side effects in men taking PDE-5 inhibitors were headache, flushing, abdominal pain, and runny nose, and although the types of reactions varied with the drugs studied, there were no significant differences in side effects associated with either Viagra, Levitra, or Cialis.

According to Alexander Tsertsvadze, M.D. of the AHRQ-supported University of Ottawa Evidence-based Practice Center, who led the review, more studies are needed to clarify the best treatment management options for different groups of patients as well as more clinical trials to compare PDE-5 inhibitors to hormonal, injection, and creams or other topical treatments for erectile dysfunction.

Please don’t misinterpret my remarks. Medical science has come a long way. We are well beyond the time when we took mentally disturbed patients and locked them up. Thank goodness we have appropriate antibiotics to eradicate infections. In the United States killers such as tuberculosis and polio are rare. There are wonderful drugs for hypertension, cholesterol management, and diabetes; though, perhaps, many of our afflictions are related to lifestyle issues such as obesity, cigarette smoking and lack of exercise, not to mention the stresses of life in the 21st Century. Most certainly the pharmaceutical industry has made wonderful positive contributions to improving our health.

Do be advised: When you go to the doctor and ask, “Is this pill right for me?”, beware.

Jeff Hilb, a retired Louisville physician, is a Forum Fellow.

Most of you, even with the simplest knowledge of medicine, have heard of such diseases as diabetes, high blood pressure, arthritis and pneumonia. But if you have turned on the TV lately or picked up any magazine, you have also become acquainted with such entities as restless leg syndrome, insomnia and depression as legitimate medical diseases you thought were just part of getting through the stresses of living. Somehow, feeling “blue” got to be depression, which evolved into a mood disorder, which is now a chemical imbalance, requiring a doctor’s prescription for Prozac or one of its cousins. What we used to call “heartburn” when you ate one too many spicy meatballs, and was often relieved by a swallow of Maalox, may now be classified as “acid reflux disease” and demands the purple pill costing as much as $5.50 a pill. That child who lives next door and goes to school with your son cannot just be a brat who could use some more responsible parenting. No, I am afraid he must be labeled with the honorable designation of having an “attention deficit disorder,” and be appropriately medicated for the benefit of the student, the parent and the teacher. Even before all this TV advertising, there was a need for “mother’s little helpers,” but the consumer demand for pills to take away the stresses of getting through the day seems to be rising all the time. And speaking of rising, Viagra, Cialis and Generic Levitra are on the air waves constantly, even during the children’s hour, available to elevate more than just your mood.  Now when you make an appointment to see the doctor, take off time from work, make your co-payment and wait your turn to see the man in the white coat, more likely than not, you will not be satisfied unless you walk out the door with a prescription, or even better some free samples. You have had this bad cold for several days and you know you need an antibiotic. You developed an outbreak of zits a week before the prom, and you absolutely have to be cleared up by Friday. You have your first real date since your divorce, are hoping to get lucky, and maybe one of those blue pills wouldn’t be a bad idea.

In a recent issue of American Medical News  it was noted that in a university medical clinic when branded drug samples were not available, doctors wrote prescriptions for as many as 40 percent of less expensive generic drugs, but when samples were handed out, this was more in the 10 percent range. Thus, patients who received “free” samples actually had greater out of pocket costs for their prescriptions. Does this seem a little like that nefarious guy in dark glasses giving a kid a free trial of some crack, knowing he will be back with some money for more?