The market analysis was equally encouraging. As a late entrant in the market for erectile-dysfunction treatments, PT-141 stood a decent chance of mopping up the floor. By this stage in Viagra’s life cycle, for instance, it was clear that the drug solves nothing for perhaps 50 percent of impotent patients, either because their general health is too poor to risk Viagra’s side effects or because it simply doesn’t work for them. But existing Viagra users weren’t exactly out of play either: PT-141 had a potential edge not just in ease of use but in quality of, well, results. (“On the five-point scale,” said patient 041, “I would rate the erection I had as a six.”) And there was a final and especially intriguing possibility: Since PT-141 affects arousal through a different, more brain-centric mechanism than Viagra, might it not boldly go where Viagra had failed to penetrate—into the female sexual-dysfunction market?
It was in pursuit of the women’s market that Shadiack approached Concordia University behavioral-neurobiology researcher Jim Pfaus, whose work with sexual response in female rats had caught her attention. Where the bulk of research into female-rat sexual behavior has focused on lordosis—that reflexive arching of the lower back that signifies the female is as ready as she’ll ever be—Pfaus has taken what might be called a more feminist approach. Instead of lordosis’s almost climactic spasm, he prefers to look at foreplay: the wiggling of ears, kicking of faces, and other acts of solicitation with which female rats reveal their desire to the partner of their choice.
Pfaus discovered that PT-141 significantly increases the incidence of these behaviors. He even detected an increase in the rarer phenomenon in which a female rat will throw coyness to the winds and, in a performance worthy of Kim Cattrall, mount the chosen male herself.
"You have the urge and the desire. You get this humming feeling; you're ready to take your pants off and go."
And thus the case was cinched. Pfaus’s results were powerful evidence not only of PT-141’s potential as a treatment for women but of its ability to do more than just move blood around. Granted, a male rat’s hard-on has a nice, solid objectivity to it, but on its own it doesn’t say much about the rat’s state of mind. A female rat’s coquetry, on the other hand, says all we need to know about her intentions and desires—and says it, moreover, with an invaluable honesty. Rats aren’t people, to be sure, and as test subjects they suffer from an often frustrating inability to tell us, in words, how they experience what they’re subjected to. But that has an upside too, Pfaus explains. “The bad thing about animals is they don’t talk. The good thing is they don’t lie.” They don’t get all weird about sex the way humans do when asked to talk frankly about it. They don’t try to guess what their examiners hope to hear, or shape their answers to their parents’ expectations, or their mate’s, or their own. They don’t tweak, warp, and violate the truth about sex in all the many ways, great and small, knowing and unknowing, that humans do.
So the testimony of rats—notwithstanding the 900 articulate, full-grown human subjects who have since reported enhanced arousal and desire from taking PT-141—remains the most objective evaluation the drug has yet received, or ever will.
I see a lot of couples in my practice—lawyer couples, banker couples—who don’t know how to relax,” says Leonore Tiefer, a professor of psychiatry at New York University School of Medicine. “That’s fine—it’s a big asset to them in their corporate lifestyle, where they can work 80 hours a week—but then I have to shut off two BlackBerrys in my office in order to keep the noise down. They’re trained to multitask. Well, it doesn’t seem that that is really doable when it comes to sex. And they’re angry about that: It should be doable. And they need it to be doable because they only have five minutes.”
The five-minute meaningful sexual encounter: If ever there was a holy grail for the age of the tight-wired global economy—with its time-strapped labor force and its glut of bright, shiny distractions—that is it. And if ever there was a reason to be leery of the pharmaceutical industry’s designs on the market for sexual healing, say critics like Tiefer, it’s the attractiveness of that simpleminded ideal.
Tiefer is one of the leading figures in a movement of academic researchers, sex therapists, and women’s-health activists contesting the increasing medicalization of women’s sexual problems, and when Procter & Gamble sought FDA approval last December for its “female sexual-desire disorder” treatment—a testosterone patch called Intrinsa—her testimony helped sway the agency to deny the request. Unlike the counting of erections, assessing subjective phenomena such as desire and satisfaction is, she testified, “subtle, complex—and arbitrary.” P&G’s findings were thus too inconclusive to hold their own against the established risks of long-term testosterone use. “Intrinsa is not a glass of Chardonnay,” she remarked, “and yet we have already seen that it may well be promoted with a giggle and a wink as ‘the female Viagra.’ ”