Love is a drug, it's no use denying it

Blue for men, pink for women: Sue Woodman foresees a time when the answer to all of our sexual woes will be kept in a jar on our bedside tables

The scene: A middle-aged, middle-class couple's bedroom in Anytown, USA. A husband and wife are sitting in bed, each engrossed in reading. After a while, the husband reaches to his bedside table for a bottle of blue, diamond-shaped pills and takes one. The wife reaches for a similar bottle on her bedside table, and she takes a pink, heart-shaped pill. Within moments, they fall into intense, passionate lovemaking. Ten minutes later, it's all over, and the satisfied couple turn away from each other and settle down to sleep.

The scene: A middle-aged, middle-class couple's bedroom in Anytown, USA. A husband and wife are sitting in bed, each engrossed in reading. After a while, the husband reaches to his bedside table for a bottle of blue, diamond-shaped pills and takes one. The wife reaches for a similar bottle on her bedside table, and she takes a pink, heart-shaped pill. Within moments, they fall into intense, passionate lovemaking. Ten minutes later, it's all over, and the satisfied couple turn away from each other and settle down to sleep.

This scene is not from some postmodern remake of Barbarella, but rather, it's a vision of things to come. Thanks to the wonders of modern medicine, we are on the brink of discovering Love Potion Number Nine. And rumour has it, there'll be a lot of demand.

The accidental discovery in 1997 of Viagra, a heart drug that, as an unexpected side-effect, gave men powerful erections, has spawned some important developments for women too. It has jump-started a frantic race amongst pharmaceutical empires to find a female version of this blockbuster drug. (Latest sales figures: more than $1 billion in its first year, and counting.)

It has also fuelled an eager pursuit in the medical profession to treat sexual problems medically, rather than psychologically, and opened up an intense debate among health professionals about our future attitudes toward sex. Will a medical approach to our sexual problems cause us to re-evaluate this complex act, not as the indefinable chemistry between human bodies, but as chemistry of the scientific kind - measurable, quantifiable, fixable?

What Viagra showed us, first of all, was that a great many ageing men experience impotence and that there is a fortune to be made in finding a treatment.

In just two years, 17 million Americans have used Viagra, and almost 200,000 prescriptions are filled each week. Viagra may prove in time to be a primitive model, but it is the first time the medical establishment, which has been researching men's sexual function for decades, has had a scientifically proven cure. Ask the guys who take it what they think: they'll tell you that it sure beats Spanish Fly or penile implants, once the only options.

Now it is women's turn. And new research suggests that women are as eager as men for a magic bullet. Millions of female baby boomers are approachingmenopause, where libido and sexual satisfaction commonly drain away; and this is the generation that won't take that lying down. With such a potentially vast new market in mind, the medical profession is hard at work making sure they won't have to. In the process, they're creating a new sub-specialty of medicine: Female Sexual Dysfunction.

For almost a century, since the time Freud first wondered, "What do women want?", women's sexual problems have been seen principally as a matter for psychotherapy. Shockingly little is known about the physical facts of women's sexuality. Alfred Kinsey and Masters and Johnson pioneered some important physiological studies in the 1950s and 1960s, but there has been virtually no research in the United States since then. The conventional approach of sex therapy has been a psychological one, examining sexual problems within the context of the relationship as a whole.

That may be about to change. Today, sexual problems are increasingly likely to be diagnosed in a urology clinic rather than on a couch, and their diagnosis to be treated as a medical condition, treatable with a rapidly growing inventory of drugs. "Sexual dysfunction," says Irwin Goldstein MD, professor of urology at the Boston University Medical Center, "is in essence a vascular disease."

If it sounds serious, some doctors say it is. A major study, published last year in the Journal of the American Medical Association, said the level of sexual dysfunction it had uncovered in America's bedrooms was an important public health concern. It found 31 per cent of men, and as many as 43 per cent of women, weren't having much fun.

Science to the rescue then. In clinics and laboratories around the country, researchers are engaged in fierce and secretive competition to find a Viagra for women, or to discover whether Viagra itself will serve as an equal-opportunity aphrodisiac. Pfizer, Viagra's proud creator, is already far along with clinical trials involving hundreds of women taking either the drug itself or a placebo. (Viagra trials have also been taking place in Europe.)

Rival companies are racing to produce their own versions of sex-enhancing drugs, and all have enlisted "sex experts" from around the country - both physicians and psychologists - to run industry-financed studies in a breathless race to hit the jackpot first.

Among them are the Berman sisters, at the Women's Sexual Health Clinic at Boston University Medical Center. Priding themselves on the joint qualifications they bring to their clinic - the ability to apply both psychological and medical interpretations to a patient's complaints - the clinic co-director, Laura Berman, and her urologist sister, Jennifer, direct one of the country's most sophisticated sexual research centres, with perhaps the largest selection of modern aphrodisiacs. These include drugs (Viagra, of course, and Apomorphine, a medication for Parkinson's Disease, which has similar, vascularising effects), plus hormone-delivering patches, topical sprays, and a collection of scientific sex toys.

The sisters claim impressive results, and can produce happy volunteers to vouch for this. One is 61-year-old Katherine Taylor. She speaks of how, after a divorce and almost a decade of sexual abstinence, she found a new lover and discovered, to her distress, that her sexual enjoyment was not what it used to be.

"Our culture places such an emphasis on sex that when something is lacking, it can create a real problem," she says. It did for her. Then she met the Berman sisters, and their pharmacopia of hope.

In exchange for the promise of greater pleasure, the Bermans' patients must subject themselves to intimate scientific monitoring. They come into the busy hospital clinic, get shown into a small treatment room, where they are measured pre-arousal, then left alone in a room with an erotic movie. After showtime, the women get measured again. The instruments used have names like Biothesiometer and Anorectal Compliance Machine, yet women like Taylor think that monitoring themselves for science is a small price to pay for a spicier sex life. Taylor says, "This is a way of helping others as well as myself: how else can science find out the facts?"

After more extensive testing than her gynaecologist had ever performed, Taylor was prescribed a heady chemical cocktail: testosterone to increase her desire; Viagra to intensify her pleasure. Taylor swears that her custom-made love potion works well. "I don't use Viagra every time but when I do, I can feel right away that my sexual response is faster and stronger," she says.

Can good sex or the concept of desire, then, be boiled down to a chemical recipe - a dollop of this, a sprinkling of that? "I think a lot of women would be happy to find a drug to help, and I can understand why doctors are excited by these new treatments," says sexuality therapist Gina Ogden, author of Women Who Love Sex (Women's Spirit Press). "On the end of a pin, it is great work. But it shouldn't define all of human sexuality."

The argument over definitions is threatening to cause a rift among professionals. Ogden is one of those who fear that treating sexuality in an exclusively physical way will ultimately create wider dysfunction. "The medical definition of sex - a goal-driven act involving intercourse and orgasm - is a killer for everyone, but especially for women," Ogden says. "It's too narrow, and discounts all the million other ways there are of having sex and feeling satisfaction. People will feel dysfunctional, not because anything's wrong, but because they're not doing what the medical establishment tells them they should be doing."

Others worry that an increasingly medical view of sex will reintroduce the concept of frigidity - that it's a woman's fault if she's not responsive to sex. Even medical champions like Goldstein say that, if there's a pill available for women, the men in their lives might pressure them to take it.

Most of all, traditional sex therapists argue, you can't understand a couple's sexual dynamics without examining the relationship in which the sex happens.

As one put it succinctly: an angry couple with Viagra is an angry couple with an erection. Yet Ogden notes pragmatically that there's probably no turning back the clock. "Sex is the most complex of human acts, but that's probably why we seek to medicalise it, because it's not so complex when we do."