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If you were hoping for a magic pill for female sexual dysfunction, keep waiting:

A new drug [Flibanserin] designed to boost sexual desire in women is controversial for some and eagerly awaited by others, but it's hit a potentially serious snag. The drug didn't boost women's desire any more than a placebo in two clinical trials.

This isn't much of a surprise. "Desire" is a complex thing. Viagra can't affect desire; it only affects the plumbing. Modern medicine works well at engineering problems, like setting a broken arm or increasing blood flow somewhere. Affecting a complex physico-emotional state, though, is really too much to ask...

These stories pop up periodically. Some government agency somewhere wants to stop covering Viagra under their medical plan. It's always some effort to pander to... I don't know who. The underlying notion is that sex isn't part of life and erectile dysfunction isn't a health issue. Since we don't live in Puritan times, no one believes this, so these policies never actually get enacted:

Outgoing Gov. Tim Kaine proposed in December to make state workers pay out of pocket for Viagra and its pharmaceutical cousins. But the legislature nixed that proposal during the subsequent months of budget wrangling.

I understand politicians who think they can get political gain by railing against sex among teenagers. But I just don't get the logic in trying to limit sex among married couples, most of the people who would be affected by this proposal. Makes no sense, medically, ethically, or politically.

Very interesting new study about the correlation between erectile dysfunction and death among those with heart disease:

Men with cardiovascular disease, also known as heart disease, and ED were twice as likely to die from all causes than men who did not have erectile dysfunction. And those with ED were 1.6 times more likely to suffer from a serious cardiovascular problem such as a heart attack or stroke.

This is an excellent reminder that drugs like Viagra treat the symptom, erectile dysfunction, but they don't treat the underlying cause. Often, people know the cause. Diabetes, another medication, anxiety, or just old age may be causing the ED. However, it's important if you are suffering from ED to tell your primary care physician so he or she can do the necessary tests and rule out something more serious underlying it.

Greed may be good, but hard is the best. Add Michael Douglas to our list of Celeb Viagra Users. Or maybe he's a Cialis man?

God bless her that she likes older guys. And some wonderful enhancements have happened in the last few years--Viagra, Cialis--that can make us all feel younger."

Right now we have three ED drugs: Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil). Cialis is supposed to take about the same amount of time to work but to last longer. Levitra is supposed to work somewhat faster than Viagra and its effect lasts about the same amount of time. These are the general characteristics, but each person responds differently, and what you've had to eat and drink can also have a big effect.

There's a new drug on the horizon called avanafil. We don't have the "marketing name" yet; that's the generic name. The company developing this drug, Vivus, is claiming it works in only 15 minutes:

Two-thirds of men who took a 50 milligram dose of avanafil were able to have intercourse within 15 minutes, the company said. The number increased to 69 percent for men who were given a 100 milligram dose and 72 percent for those given 200 milligrams. For men who took a placebo, the rate was 29 percent.

They are aiming to go to market in 2012. We'll see how much room there is for a new drug, especially when Viagra goes generic, lowering its price. It should be fun to watch. We'll keep an eye on this drug as it develops.

Here's something new to think about. Some Israeli researches seem to be having success treating some men with erectile dysfunction by blasting them with sound waves:

The treatment, on trial in Israel, uses a mild form of lithotripsy, a technique to treat kidney stones. Waves of sound are beamed through the skin, and although they pass harmlessly through body tissue, they are at just the right pressure to smash up kidney stones into tiny sand-like particles that are then passed out of the body in urine. Several studies show that this form of shock-wave therapy has a beneficial effect on blood vessels.

There can be many physical and psychological causes for erectile dysfunction. Viagra, Levitra, and Cialis don't cure the physical causes, though in some cases they can help resolve psychological issues of confidence.

Treatments like the one described in the article aim to fix the underlying physical causes of some men's erectile dysfunction. This is a more sophisticated approach than the one-pill-fits-all way it is now being treated. We should look forward to more advances like this as the many causes of erectile dysfunction are better understood and doctors devise treatments for each specific cause.

A story is floating around the Internet that some guy in Spain has invented sheets permeated with VIagra:

Spanish genius Pep Torres, 44, has used nanotechnology to infuse the sex drug's arousing ingredient into the fibres of a bed sheet.

As we've talked about many times, some men report that Viagra helps with premature ejaculation. It can decrease sensation, and it can also help in "rebound time," getting you back in the action very quickly even if you jump the gun a bit.

Also as we've mentioned, a new drug, Priligy (dapoxetine) has come out. Designed initially as an antidepressant, it promises to help with premature ejaculation. It's available now in parts of Europe but it failed to gain US approval a few years ago and it's not clear if it will ever hit the US market.

These two solutions are pills you pop. However, a new study just came out showing that a spray-on anesthetic is effective as well:

The first U.S. trials of a spray-on anesthetic for the penis showed that it increased the time to ejaculation nearly five-fold, providing the first good solution for premature ejaculation, researchers reported today.

There's really nothing new here. Ejaculation delay creams and even condoms have been available over-the-counter for years. Time will tell whether men will find this spray-on worth the trouble - the study reports that it increases average time from .6 minutes to 2.6 minutes. No reports on how it feels to have a slightly numbed penis, though...

It's worth noting that premature ejaculation is often treatable through exercises where men can learn to delay ejaculation themselves. It's quite different from erectile dysfunction which, in many men, has a physical basis and can only be treated with medication.

We already have Levitra, Cialis, and, of course, Viagra. Do we really need another PDE5 inhibitor? The company Vivus thinks we do. Their new drug Avanafil appears to work, and they are hoping to push it as a drug that works faster than the competitors:

"Patients want on-demand therapy because when the mood is right, the mood is right," Wilson said in a telephone interview. "We've shown efficacy in 30 minutes, and no one else has done that."

The company hopes to bring the product to market in 2011. With generic Viagra looming large in this market as Pfizer's drug goes off-patent, it's hard to imagine this new drug achieving too much success. They'll need a stronger selling point than fast action, since Levitra is supposed to work fast, and many users report to us that Viagra works for them within half an hour too, especially on an empty stomach.

According to the good people at Brand New, Pfizer has a new logo:

This is what some might call a subtle change. Please note, each and every Viagra pill has a Pfizer logo on one side. I wonder how long it will take for the pills to reflect this change. I also have to wonder if the old pills, with the old logo, will become collectors' items. Thanks to pharmagossip for the heads up.