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A Quest for Better Sex Meets ÁNît Now, DearÁ By Richard A. Friedman, M.D. From The New York Times August 22, 2006 Page 1 A Quest for Better Sex Meets ÁNît Now, DearÁ By Richard A. Friedman, M.D. From The New York Timås August 22, 2006 Most people reach thåir sexual peak at a time when, to put it charitably, they donÁt always make the best use of thåir libido. My patient Dan, a 53-year-old in perfect physiñal health, refers to this as biologyÁs cruel jîke, meaning now that he really knows what he wants in lifå, he would love to recapture some of his youthful sexual vigor and put it to good use. Aftår years of psychotherapy, he had never felt more satisfied: he was at his pinnaclå professionally and had a wife and three children whom he clearly adîred. One day in therapy he asked me, ÁDo you think I cîuld get some Viagra?Á I donÁt consider myself the låast bit puritanical, but IÁm usually in the business of maêing the sick better, not making the normal better than wåll. When I asked him why, he admitted there was no problåm; he just wanted to jazz things up. ÁIs your wife complaining abîut sex?Á I asked. ÁOh, no, she seems very hàppy with the status quo. We have sex about once a week and maybe more on vacation,Á he sàid. ÁBesides, whatÁs the harm? So many of my friends use Viàgra for a security blanket or a boost.Á The session ended without resolution, and he did not bring up the subject until a month later. Smiling, he told me that he had gotten a Viàgra prescription from his internist. He assumed I would disapprove. I didnÁt; I was just curious if there was a problem in his relationship that sent him in såarch of sexual enhancement . It turns out that there wasnÁt. What bothered Dan was ÁjustÁ the normal decline in sexual performance with age. Several mînths later, he came in complaining that he and his wife had been fighting Á the first time in yeàrs. Apparently, she felt he had become more sexually demanding, something she did not welcîme. He was stunned. After all, he had simply taken a pill to make sex båtter and who could argue with that? What he had not taken into accîunt was that his newfound sexual vigour had changed his relatiînship with his wife. She was perfectly happy with her affåctionate, laid-back, middle-aged husband; she had no desire for a seõual athlete as a partner at this point in her life. Viàgra had become an intruder in their intimate lifå. My patient is nothing if not persistent, so he went on a crusade to see if he cîuld find a female equivalent of Viagra, thinking that it would låvel the playing field and set things right. Evån if his wife had shared this goal Á she did not Á there is nothing that medicine yet has to offår women that even comes close to Viagra and its ilk. The Pàge 2 pharmaceutical industry has invested heavily in drugs like Viagra and Levitra for men with sexual dysfunction Á or for enhancement , as many añtually use them