Abstract:
A method of sexual enhancement in women includes the steps of identifying a woman requesting sexual enhancement, testing the blood of the woman to determine the levels of free estradiol and free testosterone therein, assuring that the woman&#39;s blood includes free estradiol with a first predetermined range and free testosterone within a second predetermined range, and thereafter administrating a drug selected from the group consisting of LEVITRA® (vardenafil hydrochloride) and CIALIS® (tadalfil) at least one hour prior to sexual activity.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]     This application is a continuation-in-part of application Ser. No. 10/936,965 filed Sep. 8, 2004, currently pending. 
     
    
     TECHNICAL FIELD  
       [0002]     This invention relates generally to enhancement of sexual arousal and satisfaction in females, and more particularly to the use of drugs already approved for the treatment of erectile dysfunction in males to enhance sexual arousal and satisfaction in females.  
       BACKGROUND AND SUMMARY OF THE INVENTION  
       [0003]     As is universally known, various drugs are now available for the treatment of erectile dysfunction. By stimulating the erectile process, these drugs promote sexual arousal and ultimately sexual satisfaction in men. The first drug of this type to gain widespread acceptance by VIAGRA® (sildenafil citrate) which introduced in 1998. LEVITRA® (vardenafil hydrochloride) and CIALIS® (tadalfil) have been introduced more recently. Despite the fact that drug therapy which provides sexual enhancement in males has been available for at least fifteen years, corresponding sexual enhancement for women has not heretofore been available.  
         [0004]     The present invention comprises a method of female sexual enhancement which overcomes the foregoing and other problems which have long since characterized the prior art. In accordance with the broader aspects of the invention, the same types of drugs that are utilized to treat erectile dysfunction in men are used to provide sexual enhancement in women. More particularly, it has been demonstrated with a drug selected from the group consisting of LEVITRA® (vardenafil hydrochloride) and CIALIS® (tadalfil) prior to sexual activity results in significant enhancement of sexual arousal and sexual satisfaction in females.  
         [0005]     More particularly, the initial step in the process of the present invention comprises identifying a woman desiring sexual enhancement. The process can be started either at the request of the woman herself, or at the suggestion of her physician. Thereafter, the woman&#39;s blood is tested to determine the presence of free estradiol and free testosterone. If the woman&#39;s blood contains estradiol within a first predetermined range and free testosterone within a second predetermined range the process of the present invention continues. If not, the woman is treated utilizing conventional techniques to bring the level of free estradiol in her blood to within the first predetermined range and/or to bring the level of free testosterone in her blood to within the second predetermined range.  
         [0006]     After the required amount of free estradiol and the required amount of free testosterone in the woman&#39;s blood has been assured, the woman is treated with a drug selected from the group consisting of LEVITRA® (vardenafil hydrochloride) and CIALIS® (tadalfil). In most instances the drug is self-administered by the woman desiring sexual enhancement. The typical dosage is ½ of the recommended dosage of the same drug for the treatment of erectile dysfunction in males. The selected drug is preferably administered at least one hour before sexual activity.  
         [0007]     The use of the drug VIAGRA® (sildenafil citrate) to achieve sexual enhancement in women has heretofore been attempted. The use of VIAGRA® (sildenafil citrate) for such purposes has been found to be unsatisfactory because of unacceptable side affects. The unacceptable side affects that are observed in women using VIAGRA® (sildenafil citrate) for sexual enhancement include: 
        Headaches     Facial flushing     Nasal congestion     Indigestion     Bluish tinge to vision lasting up to a few hours. 
 
 Due to the foregoing side affects, it has been determined that VIAGRA® (sildenafil citrate) cannot be successfully utilized for sexual enhancement in women. 
       
 
     
    
     BRIEF DESCRIPTION OF THE DRAWING  
       [0013]     A more complete understanding of the present invention may be had by reference to the following Detailed Description when taken in connection with the accompanying Drawing, wherein:  
         [0014]      FIG. 1  is a flowchart illustrating the method of the present invention.  
     
    
     DETAILED DESCRIPTION  
       [0015]     Referring to the Drawing, the first step in the practice of the method of the present invention comprises the identification of a woman desiring sexual enhancement. Typically this step occurs as part of a consultation between the woman and her physician. The consultation may be specially scheduled in order that the woman may avail herself of the present invention. More often, however, the identification step occurs during a meeting of the woman with her physician for other purposes, such as a regularly scheduled consultation, an examination unrelated to the present invention, a procedure, etc. The woman may be identified as a participant in the method of the present invention either at her own request or at the suggestion of her physician.  
         [0016]     After her identification as a participant in the method of the present invention the woman&#39;s blood is tested for the presence of free estradiol and free testosterone therein. The successful practice of the method of the present invention requires that the woman&#39;s blood contains free estradiol within a first predetermined range and free testosterone within a second predetermined range. For example, one laboratory has established the first predetermined range as between about 0.5 picograms and about 1.5 picograms of free estradiol per 1 cc of blood serum, and has established the second predetermined range as between about 2.2 picograms and about 7.2 picograms of free testosterone per 1 cc of blood serum. Other laboratories have similar, but not necessarily identical definitions of the first and second predetermined ranges.  
         [0017]     If the blood test reveals that the amount of free estradiol in the woman&#39;s blood is below the first predetermined range the amount of free estradiol in the woman&#39;s blood is raised utilizing conventional practices and procedures. For example, non-oral, bio-identical estradiol administered as a transdermal cream, as a patch, as a sub-cutaneous pellet. Similarly, if the blood test reveals that the amount of free testosterone in the woman&#39;s blood is below the second predetermined range, conventional practices and procedures are undertaken for the purpose of raising the amount of free testosterone in the woman&#39;s blood. For example, non-oral, bio-identical testosterone administered as a transdermal cream, as a patch, or as a sub-cutaneous pellet. In some instances it may be necessary to raise both the amount of free estradiol and the amount of free testosterone in the woman&#39;s blood.  
         [0018]     After the required level of free estradiol and free testosterone in the woman&#39;s blood have either been confirmed or established, a drug selected from the group consisting of LEVITRA® (vardenafil hydrochloride) and CIALIS® (tadalfil) is administered to the woman prior to sexual activity. In most instances the selected drug is self-administered. It has been determined that the selected drug should be administered at least one hour prior to the beginning of sexual activity. The optimum time interval between administration of the selected drug and the beginning of sexual activity may vary depending on the particular circumstances and is best determined by the woman through experimentation. It has also been determined that the appropriate dosage a drug selected from the group consisting of LEVITRA® (vardenafil hydrochloride) and CIALIS® (tadalfil) in order to enhanced sexual stimulation and satisfaction is one half of the dosage of the same drug that is recommended for administration to males to treat erectile dysfunction. The exact amount of the drug that is appropriate for a particular woman may vary depending upon a variety of circumstances all of which are best explored through consultation between the woman and her physician.  
         [0019]     It has been determined that the method of the present invention results in substantial sexual enhancement in women, including in particular substantially improved sexual arousal and substantially improved sexual satisfaction. This in turn results in an improved overall feeling of wellness, an improved sexual relationship between the woman and her partner, and an overall improvement in self esteem.  
       Clinical Study Protocol  
       [0000]     Enhancing the Efficacy of LEVITRA® (Vardenafil Hydrochloride)  
         [0000]     Summary:  
         [0020]     The ability of Levitra to stimulate female sexual response depends upon the circulating levels of free, unbound sex steroids. This hypothesis will be tested in a double-blind, placebo-controlled study with measurement and adjustment of free estradiol and free testosterone.  
         [0000]     Introduction:  
         [0021]     Previous studies by Glaxo-Smith Kline indicated that LEVITRA® (vardenafil hydrochloride) was ineffective in women. This occurred because normal free estradiol and free testosterone levels were not established or achieved with non-oral hormone replacement before the drug was used. Experiences over the past 2 years indicate that LEVITRA® (vardenafil hydrochloride) is even more effective (lower dosage) in women than in men when used correctly.  
         [0000]     Objectives:  
         [0022]     The purpose of the present study is to determine the efficacy of LEVITRA® (vardenafil hydrochloride) in stimulating female sexual response in women with adequate levels of free estradiol and testosterone.  
         [0000]     Study Design:  
         [0023]     The study group will consist of 100 healthy, sexually active women between ages 20 and 70. The women will not be taking exogenous hormones, either oral contraceptives or postmenopausal hormone therapy. The participants will be cautioned to use appropriate contraception, as the safely of LEVITRA® (vardenafil hydrochloride) during pregnancy has not been definitively demonstrated.  
         [0024]     After a 4-week baseline period, the participants will be randomly assigned by a computer-generated schedule to receive either LEVITRA® (vardenafil hydrochloride) in doses of ½ of a 20 mgm tablet at least 1 hour prior to each sexual experience and no later than 24 hours or placebo for a period of 2 months, followed by a 2-month period with randomized cross-over. Serum free estradiol and free testosterone levels will be measured at baseline by Interscience Institute, Inglewood, Calif. Blood samples will be obtained approximately one week before menses. A normal level of free estradiol, between about 0.5 pg/ml and about 1.5 pg/ml, and a normal level of free testosterone, between about 2.2 pg/ml and about 7.7 pg/ml, will be required for inclusion in the study.  
         [0025]     Sexual response and any side effects will be recorded monthly using one of the available and accepted methods for this purpose, such as the Sexual Function Index. In addition, each subject will keep a daily event log diary.  
         [0026]     A second study is recommended for women with low blood levels of estradiol and testosterone, with randomization to either placebo or treatment with supplemental non-oral estradiol or testosterone administered by transcutaneous cream, cutaneous patch or subcutaneous pellets.  
         [0000]     Inclusion Criteria:  
         [0027]     A) Sexually active (defined as coitus, foreplay, manual or oral stimulation).  
         [0028]     B) Satisfying monogamous relationship with a partner.  
         [0029]     C) No evidence of sexual dysfunction in partner.  
         [0030]     D) Distress over reduced level of sexual desire, arousal, and/or low libido during sexual intercourse or masturbation, and difficulty achieving orgasm.  
         [0031]     E) Healthy by medical history and physical examination.  
         [0032]     F) BMI between 20 and 30.  
         [0033]     G) Voluntary consent to participate following full explanation of nature and purpose of study by signing an IRB-approved protocol.  
         [0000]     Exclusion Criteria:  
         [0034]     A) Use of exogenous hormones.  
         [0035]     B) History of vaginismus or vulvodynia dyspareunia.  
         [0036]     C) Evidence of clinical depression.  
         [0037]     D) Use of drugs that induce sexual dysfunction (such as SSRIs, spironolactone, GnRH agonist, adrenoreceptor antagonist) within 3 months of enrollment.  
         [0000]     Ethical Aspects:  
         [0038]     The method of the present invention provides means for women to achieve maximum sexual satisfaction.  
         [0039]     Although preferred embodiments of the invention have been illustrated in the accompanying Drawings and described in the foregoing Detailed Description, it will be understood that the invention is not limited to the embodiments disclosed, but is capable of numerous rearrangements, modifications, and substitutions of parts and elements without departing from the spirit of the invention.