Can Viagra, testosterone, or other drugs really restore your love life?
Poor health can put a crimp in your love life. But the reverse is true, too: Good sex may help keep you healthy.
“A satisfying sex life can foster good emotional health, which in turn can promote good physical health,” says Julia Heiman, Ph.D., director of The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University. Moreover, sex itself ple, orgasm or any loving touch may cause the body to release substances that ease pain, bolster immunity, or elevate mood long after the immediate pleasure passes. Indeed, people who have strong, intimate relationships tend to have fewer chronic diseases and to live longer, some research suggests. So there can be good reasons beyond just pleasure to address any significant loss of sexual appetite or activity, regardless of your age.
The introduction of sildenafil (Viagra) a decade ago has graphically demonstrated that some sexual problems can be eased. But it has also fed the misconception that every sexual difficulty can-and should-be cured by popping a pill. More and more doctors, with little supporting evidence, are now prescribing sildenafil and related drugs not only to men but women too, as well as the hormone testosterone, in an effort to boost libido. And many consumers are buying DHEA (see caution) a potent hormone sold as a dietary supplement that the body converts to both testosterone and estrogen, with hopes of improving their sex drive and performance.
However, psychological issues, not physical ones, are usually the major culprits in the two most common sexual problems-lack of desire in women and premature ejaculation in men. Even with largely physical problems, such as vaginal dryness or erectile difficulties, certain nondrug steps may be worth trying. Furthermore, not everyone who experiences changes in sexual desire and function as they age is bothered by those changes, and shouldn’t be made to feel either abnormal or in need of a cure.
This report will help you talk intelligently with your doctor about when sex-enhancing drugs may be appropriate and when other steps-including leaving well enough alone-are 
enough.
Boosting low libido
Despite the increasing use of testosterone to stoke waning sexual desire, our consultants say that it’s rarely worthwhile, for several reasons. There is little or no correlation between libido, sexual performance, and the normal age-related decline in testosterone. There’s little evidence of the therapy’s long-term efficacy and safety. And many other factors-from stress and lack of sleep to changed feelings about a partner-can contribute to decreased sex drive.
When low testosterone levels are well below normal, sexuality and performance may be affected. But those declines often stem from correctable health problems, notably pituitary or testicular disorders.
Even when those causes have been ruled out, taking testosterone is still a gamble. In men, while it can boost libido in those who have clearly low levels, side effects include breast enlargement and decreased sperm production. And it may speed the growth of prostate cancer and increase the risk of blood clots.
In women, some research suggests that restoring testosterone to a high normal level can increase sexual desire, at least temporarily. But it can also cause hair growth and acne, and may raise the risk of breast cancer. And other possible risks are largely unknown because of lack of long-term studies.
Moreover, the only testosterone product (EstraTest) approved for women in this country uses a combination that can reduce HDL (good) cholesterol. And while some doctors and pharmacists now compound special testosterone formulations for women, or use creams or gels intended for men, the safety and efficacy of such products or such use is even less well understood.