Mary Roach Considers Drugs for Better Sex

Question: What does Viagra do for women?

 

Mary Roach: The Viagra is...You know, it affects the vascular system so that...And that... They try...They were very eager to test that out on women, hoping that they could, you know, sell the drug to the other half of the planet. And it... it doesn't work. It does actually increase genital blood flow in women but it doesn't create a change that the women, then, interpret as I'm really aroused, I want to have sex, I feel really sexy. It doesn't... It doesn't do that. They don't even notice. It's a small enough change that it's not... it's not something that they would pay for. It's not really doing anything. So they then looked at...

 

Well, there's the other approach to libido in women is hormonal. And there was... There actually is a patch, testosterone patch, which was all set to go, called Intrinsa. And the FDA, then, wanted longer term safety data, I think, because of hormone replacement therapy. Remember there was a big... You know, we thought that hormone replacement therapy was the next greatest thing since whatever, sliced bread. Then, they came up with this, you know, long-term findings, sort of saying that, you know, they were actually increasing risk of stroke. There was that big study that scared everyone off so the FDA kind of backed off hormones.

 

So now, the only thing left is central nervous system, you know, affecting the brain. And I think that that's going to be tricky because I think that the FDA... The FDA considers sex a lifestyle issue, not really a medical issue. So in order to pass something for what is considered... a pass to get a drug approved for something as considered a lifestyle issue, it's... you know, they're going to be pretty squeamish about affecting your, you know, your brain for that purpose. So they may have, maybe, a bit of a long road to get something approved.

 

Question: Do herbal medications work?

 

Mary Roach: Well, for the most part, it's the placebo effect. One researcher told me about... She actually took a few of these... bought a few of these just to see what was going on. And there was... They were for... There was one for women. And she said, it had in it sort of... like a topical, almost like a capsicum, like a red hot pepper substance. And she said, you know, it did generate a little heat. But she said, in the directions, there was this line that says, you know, apply to vulva. Rub really well. Rub really, really, really well.

 

And they're like... So they got people that go, "hey, that really works." So I... My sense is that there's not... other than the placebo effect. I don't mean to knock the placebo effect because it's really... it works, you know. You tell somebody something works and they make it work. And if it works, it works, I don't care how it works so I don't want to dismiss everything. You know, I don't want to tell people don't even try it because if it's harmless and it's a harmless placebo and it works, then more power to it. But I don't know. You know, the safety of... I wouldn't feel comfortable purchasing a drug online, from a supplier that I didn't know. I don't know. Whether they're coming out of China, a lot of these things...

 

Question: What about aphrodisiacs?

 

Mary Roach: I was in Taiwan with a researcher. And he took me to a traditional pharmacy. And there's just... The guy kept coming out from the back with these boxes. It was like, you know, shoe salesman guy when I was young, with these big stack of boxes. Here, will be old dinosaur bones. And that was supposed to be, you know... And the researcher would go, "just because they're hard," You know, and anything shape like a penis, that was a treatment for erectile dysfunction. Just one after another, bringing out all of these herbal and other sort of natural things from the natural world that were supposedly cures for... But as for something, being... Things that work well, testosterone, small amounts of testosterone for women are pretty reliably effective and you don't have to... the patch, which is sold in Europe, isn't sold here but you can go to any compounder and say, look, you know... or just get a prescription for your... from your physician, saying I want a very low dose of testosterone for libido. And people... doctors prescribed that all the time and it's fairly effective, from what I understand. But outside of that, I think it's, again, a question if you... if you think it'll work, maybe it'll work, so give it a try.

 

Recorded on: April 6, 2009

 

The author says Viagra’s physical effect in women does not translate to arousal.

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Yale scientists restore brain function to 32 clinically dead pigs

Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.

Still from John Stephenson's 1999 rendition of Animal Farm.
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  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
  • They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
  • The research raises many ethical questions and puts to the test our current understanding of death.

The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.