With Costs Rising, Treating Back Pain Often Seems Futile

By GINA KOLATA

Published: February 9, 2004 by the New York Times

ABSTRACT - Duke University study finds treating back pain costs Americans $26 billion a year, or 2.5 percent of total health care bill, and far more if disability payments, workers compensation and lost wages are taken into account; Dr Richard Deyo, medical professor, notes that variety of studies suggest that in 85 percent of cases it is impossible to say why person's back hurts; says most of time pain goes away with or without medical treatment; says that for small number of patients, surgery can offer quick relief, but even then it is common to have recurrences; doctors note that back pain has always been around, but that people's expectations have changed and they are demanding treatment; say medical profession has turned to ever more aggressive medication and surgery, even though studies find little evidence that patients are better off for all the treatment.

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Pfizer Gives Up Testing Viagra on Women

By GARDINER HARRIS

Published: February 28, 2004 by the New York Times

Women, the maker of Viagra has found, are a lot more complicated than men.

After eight years of work and tests involving 3,000 women, Pfizer Inc. announced yesterday that it was abandoning its effort to prove that the impotence drug Viagra improves sexual function in women. The problem, Pfizer researchers found, is that men and women have a fundamentally different relationship between arousal and desire.

For men, arousal almost always leads to desire. So by improving a man's ability to have erections, Viagra measurably affects his sexual function. But arousal and desire are often disconnected in women, the researchers found, to their consternation.

Although Viagra can indeed create the outward signs of arousal in many women, that seems to have little effect on a woman's willingness, or desire, to have sex, the researchers said.

"There's a disconnect in many women between genital changes and mental changes," said Mitra Boolel, leader of Pfizer's sex research team. "This disconnect does not exist in men. Men consistently get erections in the presence of naked women and want to have sex. With women, things depend on a myriad of factors."

Dr. Boolel said that he and his team were continuing their research. But he said the researchers were changing their focus from a woman's genitals to her head. The brain is the crucial sexual organ in women, he said.

Drugs that affect brain chemistry "could be an extremely interesting area of investigation," he said.

Pfizer's problem has been that its research effort has largely been led by cardiologists and urologists, said Dr. George Nurnberg, professor of psychiatry at the University of New Mexico School of Medicine. "Psychiatry hasn't been a major player," he said.

That is a mistake with women, he said, because psychology is more important in their sexuality than it is in men's.

Still, Viagra can be effective in some women, Dr. Nurnberg said. Women who once had normal sexual function but then suddenly lost all desire - often as a result of taking antidepressants - can be helped by Viagra, he said. Women who have always had low libido levels are unaffected by Viagra, he said.

"That's because hormones trump Viagra," said Dr. Jennifer R. Berman, assistant professor of urology at U.C.L.A. and director of the Female Sexual Medicine Center. Much of Pfizer's research found that the real factor in determining desire and sexual function in women is hormone levels, Dr. Berman said.

Procter & Gamble is testing a patch with testosterone, the male hormone, as a means of improving female sexual function. Some gynecologists are already prescribing testosterone for patients who complain of low libidos. Estrogen treatments and supplements are also commonly used.

The market for such treatments could be huge. A study published in 1999 in The Journal of the American Medical Association found that 43 percent of women experienced some form of sexual dysfunction, compared with 31 percent of men.

But that study has been roundly criticized, and some women's health researchers say the entire search for a female Viagra is wrong-headed. "The idea that there is some normal level of sexual functioning drives me up the creek," said Leonore Tiefer, a clinical psychologist in New York. "These companies believe that sex is matter of organ function, like breathing or excretion. I don't think there's an answer to the question of what women should want sexually."

But Dr. Boolel say critics like Dr. Tiefer are being insensitive. "To women who have it, female sexual dysfunction is real and distressing, and to say it's an invention is an insult to women's health," he said.

Karen Katen, president of Pfizer Global Pharmaceuticals, said the company's lack of success in its Viagra for women program was, unfortunately, all too typical. "We make substantial financial investments, marshal the talents of our best scientists and clinicians and spend years studying potential treatments only to find that they do not meet the requirements for regulatory approval," she said.

Pfizer once had great hopes for its clinical program testing Viagra in women. Viagra works by blocking an enzyme that normally inhibits blood flow, causing penile tissue to swell. That enzyme is found in great quantities in the penis and is also found in the pelvic region of women.

In one early clinical trial, researchers gave six women Viagra and six others a placebo, sat them in front of erotic videos and used a pelvic probe to measure any change in genital blood flow. The sex organs of women given Viagra were more engorged than those given placebos. The program seemed to be succeeding, Dr. Tiefer said.

But a larger trial that included a questionnaire found that although Viagra was associated with greater pelvic blood flow, the women experiencing this effect did not feel any more aroused, Dr. Boolel said.

Pfizer researchers spent years trying to find some well-defined group of women for whom increased pelvic blood flow and desire could be linked. They failed, he said.

Dr. Marianne Legato, professor of clinical medicine at Columbia University and director of the Partnership for Gender Specific Medicine, said that the disconnection between arousal and desire in many women was so profound that they "often don't have any desire for sex until they are physically in the act of lovemaking."

Indeed, getting a woman to connect arousal and desire, Dr. Legato said, requires exquisite timing on a man's part and a fair amount of coaxing. "What we need to do is find a pill for engendering the perception of intimacy," she said.

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My Husband's Business

Get The Body You Adore In 2004!

Exciting 30 Minute Audio Seminar.

It's Shorts Season Again!

The Barbell Lunge Shapes Your Entire Lower Body

This "gym" variety is done by using an 8 foot barbell without any weight (or with as much as you can handle for 12-15 repetitions) to tone and strengthen. Remember it should be difficult or it isn't working! For proper form, keep your body upright, your forward knee directly above your foot, your back knee near the floor and your face forward.

Your Spiritual Health

"For the word of God is quick, and powerful, and sharper than any two edged sword, piercing even to the dividing asunder of soul and spirit, and of the joints and marrow, and is a discerner of the thoughts and intents of the heart." (Hebrews 4:12)

The living Word of Almighty God is the only power strong enough to discipline your flesh. It's the only power that can cause you to think, look, talk and act like a born-again man.

When I became a Christian, I was dominated by a horrible smoking habit. I tried to quit every way I could think of but nothing worked. After months of struggling and failing, I decided to attend some meetings in Hilton Sutton's church in Houston, Texas. Before I went into those meetings, I tucked my cigarettes above the sun visor in my car and left them there.

Up to that time, I hadn't learned much of anything about the Word and had never been exposed to the power of God. So when I began to hear those ministers preaching under the anointing of the Holy Spirit, it captivated my mind. I was caught up in the living Word. My desires changed. All I wanted was more of God. For the first time in my life, the Scriptures came alive.

When those meetings ended and I started driving back home, I found those old, stale cigarettes tucked up in my sun visor and realized I hadn't even missed them.

What happened? The Word separated me from the desire to smoke. The Word empowered me to discipline this flesh of mine. When I saw Jesus in the Word and under the anointing of Almighty God, I was totally set free, not only of the habit but of the desire!

Get caught up in the living Word today and discover the power that can set you forever free.

Scripture Study: Psalm 119:1-9

The Body Sculptress says, "I always tell people that the truth will set them free. It is a truth, and when combined with the living power of God's word, which is all that was required to create heaven and earth, split a sea wide open, impregnate a virgin, and bring a human body back to life, it most certainly is powerful enough to help you overcome the desires that are keeping you from the lean and healthy body that you deserve.

1 Corinthians 6: 19-20 says, "What? Don't you know that your body is a temple of the Holy Spirit which is in you, which you have of God, and that you are not your own? For you are bought with a price: therefore glorify God in your body, and in your spirit, which are God's."

Not only has he given you his powerful word found in the bible which is your handbook for success, but your body is His, and He asks that you take care of it. Trust Him to help you today. He will never let you down."

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