Paula, a 50-year-old patient of Romanzi's, experienced a loss of libido after menopause. "I didn't feel passionate," she says. "My 22-year-old daughter is so passionate, and I was feeling so blah. I used to have that passion." Paula began taking testosterone and says her libido is back in action. "The blues definitely subsided. I needed to take something to get back to being me." Paula says the testosterone has also helped her relationship with her husband. "He knew that it was my hormones, but you can't help but take it personally. So it was hard for him. Plus it's a big part of our relationship, because the more intimate we are, the closer we are."

Sarah, a patient at the Hartford clinic, lost her interest in sex a few years ago. "It was just like, things weren't happening," says the happily married 47-year-old. "It never bothered me to participate, but I wasn't starting sexual activity. It became not part of my life. I just didn't know what was going on."

"It wasn't the same, but I accepted it," says her husband, "thinking, that's how it is, I'm not gonna leave her for some younger woman just because the sex isn't as good as it used to be. I just figured this is what happens to women, her hormones change, that's life."

After undergoing testing, Sarah learned she had low testosterone, and began taking a nutritional supplement called DHEA, which breaks down into usable testosterone, as well as Viagra for a "good, immediate fix" until the testosterone took effect. She also began a low dosage of Wellbutrin. Now, she says, the sex is better than ever. "I feel like I have my life back. My reason for being is back again. The zing is back."

Testosterone comes with its own set of problems, though: powerful -- and irreversible -- side effects. Women need only between one-tenth and one-twentieth the amount of testosterone as men, and too high a dosage can have disastrous consequences: deepening of the voice, excessive hair growth, and even enlargement of the clitoris. "If you get androgenic effects, if you start to sprout terminal black hairs, or the clitoris enlarges, or you start to have hair on your chest or back," says Romanzi, sounding suitably grave, "those things may very well be permanent." Not content with the dosage level of the only commercially available, FDA-approved testosterone replacement for women, called Estratest, Romanzi enlists a local pharmacist to whip up her own preparations -- low-dosage vaginal suppositories. "We're treating something that's not life-threatening -- it affects quality of life, but having a low libido is not going to kill you," Romanzi says, explaining the need for extra caution as far as side effects. "It's not like having coronary-artery disease."

Leiblum also cautions against a rush to declare testosterone the new miracle drug. "I've heard various people on TV lately saying that women who have no desire are testosterone-deficient and the way to deal with it is to put all women on testosterone. Which is ridiculous. In peri- and post-menopausal women, many will have low testosterone. But that's not true of the normal 25-year-old."

The "normal 25-year-old" might, however, respond to Viagra, side effects or no. This is the hope of Pfizer, which is currently conducting clinical trials of Viagra in women; the results of preliminary studies indicated that the drug "did not appear to significantly increase sexual arousal in women," according to a company spokesman. It did, however, increase blood flow. And in testimonial evidence, many women have responded well, saying they've achieved their first orgasm ever on Viagra, or, like actress Kim Cattrall, who has publicly discussed her Viagra fetish, that it enables them to have multiple orgasms.

Jed Kaminetsky tested Viagra in women, beginning with the wives of his patients, with mixed results. But even some women who claimed they had better sex, greater sensitivity, or more intense orgasms on the drug complained of side effects. The revolutionary little pill made them nauseated or congested, turned their vision blue, and, worst of all, gave them headaches. ("And you know the old jokes about women having a headache, so that was the last thing they wanted," says Kaminetsky.)

Kaminetsky says he can count on one hand the number of impotent men he's treated with Viagra who have stopped taking the drug because of side effects. But he's also given the drug to loads of male friends who want it for presumably more recreational reasons, and about a quarter of them have complained about side effects. "The bottom line is, the side effects are there. It's just your perception of them," Kaminetsky says. "If you're impotent and you need it, the side effects are tolerable. If you're not impotent, they're annoying. In women, the result was not as dramatic. It wasn't that they had a flaccid penis that suddenly they could hang their hat on."

While Pfizer continues its studies, virtually every pharmaceutical company on the planet is testing a product for FSD, whether a new medication or an adaptation of a drug originally designed for men. "In men, it's simple -- it's a plumbing problem. But until we get a handle on this, it's like shooting in the dark," says Dr. Carl Spana, president and CEO of Palatin Technologies, a small biotechnology company in Princeton, New Jersey. Palatin is evaluating a product called PT141 -- an "initiator" of erectile response in men -- for use in women. But Spana believes that the medical community is still in need of more female leadership in research. "At one of our initial meetings, we had five guys sitting around a table talking about female sexual dysfunction," he recalls with amusement. "Five guys. I don't even know how to figure out women when they're healthy. It was absurd."

Last summer, Pharmacia introduced a new product called Vagifem, and on Valentine's Day, the company became the first to devote an advertising campaign to a drug that treats a symptom of FSD. Vagifem helps relieve the common condition in women after menopause in which the genital skin becomes dry. Despite its unappealing name (don't they have focus groups for that sort of thing?), Vagifem, say its proponents, represents a breakthrough in its delivery system: It's a tiny estrogen tablet, smaller than a baby aspirin, which is administered vaginally. It replaces estrogen levels locally, allowing the body to absorb only as much as it needs. "The major point is that you're correcting a problem, which is that the vagina isn't functioning in a way that makes sexual exchange pleasurable for a woman, and that is a turnoff," says Dr. Gloria Bachmann, chief of the OB-GYN service at Robert Wood Johnson and a participant in Pharmacia's clinical testing for Vagifem.

But while the drug companies rush to get products into the testing phases, only one product has thus far been FDA-approved specifically for female sexual-arousal disorder. It's called Eros-CTD, and it's a small suction device intended to increase blood flow to the clitoris, both by vacuum action (like a vacuum pump for the penis) and, through daily use, by breaking up collagen deposits in the bloodstream. On a recent Oprah segment (featuring Jennifer and Laura Berman), Oprah Winfrey was skeptical, proclaiming the Eros unlikely to gain mass-market appeal.

Testing the Eros on my palm in her office in Hartford, Siskind admits that "it takes time to see the effects." A patch of skin the size of a penny is sucked into the Eros's cup, leaving me with a hand hickey. The Eros apparently has no side effects -- though women are cautioned not to fall asleep while using it.

Beverly Whipple is unimpressed by the device. "It makes the clitoris larger," Whipple muses in her home in Medford, New Jersey, and you can almost hear her head shaking in exasperated wonder through the phone. "Why, pray tell, do we want the clitoris to be larger?"