Ukuhlaziywa kokusetshenziswa kwe-Viagra kwenzalo yesifazane / isifo se-arousal
Kusukela lapho kutholakala khona abantu abaningi ekuqaleni, ukukhubazeka kwesifazane ngokocansi (FSD) kuye kwaba yinkinga yezibhamu, nezinkampani zezidakamizwa kanye nochwepheshe abathile bezokwelapha (cabanga odadewabo baseBerman) bese bekwenzela imbangela yayo. Konke lokhu kunentshisekelo kunengqondo; emuva kuka-2005, imakethe yemikhiqizo ye-FSD yayinganiselwa ku-$ 1.7 billion.
Kuze kube manje, akubanga nephilisi evunywe yi-FDA yokwelashwa kwe-FSD.
Kodwa, kholwa mina, akukho ukugunyazwa kwe-FDA akukhona ngenxa yokuntuleka kokuzama. Okokuqala, uPfizer wazama ukufakazela ukuthi i-juggernaut yezidakamizwa ze-Viagra ingasiza ngo-FSD. Okwesibili, ngo-2004, i-P & G yazama ukuthengisa i-FDA kwisigqoko sayo se-testosterone, i-Intrinsa. Isikhathi asikwazi ukubi nakakhulu. Ukushaywa ngokushaywa yi-Vioxx, ukubhekwa okungaphezu kuka-FDA kukhonjiswe ngokukhathazeka ngokuphathelene nokuthi imitholampilo ye-Intrinsa iyinhloso nokuphepha. Iningi lwakamuva - futhi alutholakali - i- Sprout Pharmaceuticals izame ukuthola isidakamizwa sayo se-neurotransmitter-acting, flibanserin, esavunyelwe.
Ngomzamo wokunikeza ukubuyekezwa okuphelele kwezokwelapha ezihlongozwayo ze-FSD, ngiye ngidinga ukuhlola ukungenelela okulindelekile kulesi simo emaqenjini amathathu ahlukene. Lesi sihloko sihlolisisa ukusetshenziswa kukaViagra ngabesifazane, isihloko sesibili sihlola i- testosterone patch, futhi isihloko sesithathu sihlola i- flibanserin . Inothi, naphezu kwe-P & G yokuyeka ukuhlolwa kwayo ku-Viagra kwabesifazane ngo-2004, kanti i-FDA ivimbela i-Intrinsa ngalowo nyaka, abanye odokotela baqhubeka beka i-Viagra off-label kanye nezokwelapha ze-testosterone kwabesifazane abane-FSD.
Nokho, i-Flibanserin, noma kunjalo, ayisafanele ivunyelwe.
I-Viagra Work?
I-Viagra yi-phosphodiesterase type 5 (PDE5) inhibitor.which ithuthukisa ukukhiqizwa kwe-guanosine monophosphate. I-Guanosine monophosphate ivuselela amangqamuzana abushelelezi obuhlungu futhi i-vasodilates futhi ikhulise ukugeleza kwegazi kuya ezifweni zobulili. Njengoba sonke sazi, emadodeni, umphumela we-Viagra uyindlela yokulungisa.
Kodwa-ke, i-PDE5 iphinde iboniswe ngesisindo esithintekayo se-vagina, i-clitoris, ne-labia eholele ekugumbeni kwesisu nangokwakhiwa kwe-clitoris. Kukholelwa ukuthi kubantu besifazane abanezizathu eziphilayo ze-FSD, igazi eligeleza ezifweni zobulili liyancipha. Encwadini ehlobene, ucwaningo lubonisa ukuthi kwabanye besifazane abane-atherosclerosis, igazi eligeleza ukuya emithini yezocansi liyancipha.
Njengazo zonke izidakamizwa, i-Viagra inezimo ezimbi ezibandakanya ikhanda, ukuxubha, isicashu, ukuphazamiseka okubukwayo nokunye. Ngaphezu kwalokho, abantu abathatha i-nitrate ekwelapheni i- angina kufanele bagweme i-Viagra ngokwesaba i-hypotension noma umfutho wegazi ophansi ngokuyingozi.
Ukukhubazeka ngokobulili (FSD) Izincazelo
Njengamanje, noma yikuphi ukusetshenziselwa abesifazane kwe-Viagra kuhilela abesifazane abanehlobo oluthile lwe-FSD olubizwa ngokuthi isithandwa sobulili / isifo se-arousal . Leli gama lisanda futhi lisungulwe ku-DSM-5. Intshisekelo yocansi / isifo sokuvuthwa singachazwa njengalokhu okulandelayo:
- Ukwehluleka kokukhathazeka ngokocansi (noma okuncishisiwe kakhulu) nokuzizwa kokuvusa okubandakanya imfashini yocansi. imibono yezocansi, isithakazelo kwezocansi, ukuvuswa komzimba, ukuqalisa ubulili nokunye;
- Izinyanga eziyisithupha noma ngaphezulu ezihlala njalo;
- Akuchazwa kangcono ezinye izifo noma izimo;
- Kungakhathaliseki ukuthi impilo yonke ikhona noma itholakele;
- Kungakhathaliseki ukuthi yenziwe ngokujwayelekile noma ehlelekile;
- Ngobunzima obumnene, obukhulu noma obunzima.
Njengoba ngezinye izikhathi kunjalo ngocwaningo olusanda kuvela, ukungahambisani kokuqala kwezincazelo zesimo socansi kwafaka imiphumela yocwaningo. Ngokucacile, izifundo zokuqala ezibandakanya izidakamizwa zesilisa zobulili zahamba ngezwi elisemuva elihlukanisa izinkinga ngokuvusa kanye nezinkinga ngesifiso emaqenjini amabili ahlukene: ukucindezeleka kwesifazane ngokocansi kanye nesifo socansi ngokungafani .
Encwadini ehlobene, ezinye izinhlobo ze-FSD zihlanganisa ukugula kwesifazane noma i-orgasmic disorder, ubuhlungu be-genito-pelvic / ukungena kwesifo, nokuhlukumeza ngokobulili okubangelwa yizidakamizwa / izidakamizwa.
(Ngokusobala, i-DSM iyakuthanda.)
Ucwaningo nge-Viagra kwabesifazane
Ucwaningo oluvelele kakhulu olubonisa ukuthi i-Viagra ingase inzuze abesifazane nge-FSD yenziwa nguDkt. Jennifer Berman, ubulili kanye nobudlelwano bobudlelwane, noDkt Laura Berman, uchwepheshe wezocansi kanye no-urologist, ngenkathi besesesikoleni. Imiphumela evela ekutholeni kwabo iphakamisa ukuthi i-Viagra ingathuthukisa umsebenzi wobulili kwabesifazane abanezinkinga zokuvusa kodwa hhayi abesifazane abanezinkinga zesifiso. Ngaphezu kwalokho, imiphumela yalolu cwaningo yathwala umphumela we-placebo omkhulu.
Kumele kuqashelwe ukuthi odadewabo baseBerman banamacala abo okubandakanya uDkt Heather Hartley, "osesidlangalaleni" kanye nomphakathi wezokwelapha kanye nommeli wezempilo wesifazane obenzima kakhulu ukuphikisana nokwelashwa ngokobulili. Ngokudabukisayo, uHartley wafa eneminyaka engu-39 ubudala. (Hartley's life short).
Ku-athikili ka-2006 okuthiwa "I-Pinking" ye-Viagra, "uHartley ugxeke kakhulu odadewabo baseBerman. Usola odade ngokuthi "bayakwazi ukusebenzisa imidiya ukuze bakhuthaze imboni yabo." U-Hartley uphinde ugxeke ama-Bermans 'ayekhethwe ngokuthandwa kwemithi ngenxa yokwelapha. Ngaphezu kwalokho, wathi odadewabo berman '"baqhubeka bephikelela ekudaleni i-Viagra nezinye izidakamizwa' zesilisa 'zobulili ngaphandle kwelebuli yabesifazane kubonisa ukuhamba komkhuba wesayensi nokuvuma i-Viagra culture."
Kuyathakazelisa ukuthi uHartley naye udweba isithombe samadadewabo aseBerman njengama-opportunists ahlawula amanani amakhulu kakhulu emisebenzini yabo yokuhweba kakhulu. I-Hartley ithi impumelelo kaBermans ivuselelwa ngombono ohlangene wokuzibonela ngenhloso yokuhlakulela "umuzwa wokusondelana nokubuka kwabo komphakathi, njengoba kuboniswe, isibonelo, ngokuxhumanisa kwiwebhusayithi yabo kwividiyo 'ecacile ngemithi' ye-Jennifer's elective cearean ukuzalwa, ephelele nezincazelo zakhe siqu zenqubo yakhe yokutakula. "
Eminyakeni yamuva, odadewabo baseBerman baye bajabulela ukutholakala kwemithombo yezindaba. Njengamanje, uJennifer Berman ungomunye wamaDokotela , kanti uLaura Berman unzima no-Oprah noDkt Oz.
Ngaphandle kokubaluleka okuphawulekayo kwesifundo se-Berman, ezinye izifundo zibonise i-Viagra ukuthi ayinamandla ekwelapheni izinkinga zokuvusa nokufisa. Isibonelo, isilingo esisodwa sokulawula okungahleliwe esenziwe nguBassson nozakwabo sibonise ukuthi i-Viagra ayizange ibangele izinguquko eziphawulekayo ekuphenduleni ngokomzimba ngenkathi umsebenzi wezocansi kokubili abesifazane be-premenopausal ne-postmenopausal. Olunye ucwaningo lwabonisa ukuthi ngenxa yokuhlushwa okuphansi kwe-PDE5 emkhatsini wesifazane kanye ne-clitoris uma kuqhathaniswa ne-penis, umphumela we-Viagra ubonakala uncishisiwe kwabesifazane.
Uma wena noma othandekayo ehlushwa isifiso sobulili / ukuvuthwa kwesisu njengoba kuchaziwe yi-DSM-5, kungenzeka ukuthi uyazibuza ukuthi uthatha i-Viagra. Mayelana nalokhu kukhathazeka, nginikeza ngesiphetho sokuhlaziywa kuka-2014 nguLo Monte kanye nosebenza nabo kusukela encwadini ethi Drug Design, Development and Therapy :
I-FSAD [isifiso sobulili besifazane / i-arousal disorder] yisifo esiyinkimbinkimbi, okubangela isizathu esinzima ukuyihlolisisa. Ukuhlolwa kokuqala komlando wezocansi, wengqondo, kanye nezokwelapha kunesibopho sokukhipha izifo ezingahle kwenzeke futhi ukuhlonza uhlobo lwe-FSAD. Ama-Generalists kufanele aphishekele indlela yomhlaba jikelele ngesiguli ngokuhlukunyezwa ngokobulili, kanti ukwelashwa okungenayo i-hormone njenge-PDE5 inhibitors (isib. I-sildenafil citrate) [i-Viagra] kufanele igcinwe njengendlela yokugcina.
Ngamanye amazwi, ungase uthande ukucubungula i-Viagra kuphela njengokwelapha okugcina ngemuva kokubuyekezwa okuphelele kanye nokusebenza komzimba wesithakazelo sakho socansi / isifo sokuvuthwa ngumhlengikazi oyinhloko [noma ochwepheshe].
Imithombo
Isihloko esithi "Ukuphepha nokusebenza kwe-Sildenafil Citrate for Treatment of Female Sexual Arousal Disorder: Isifundo Esilawulwa Ngama-Double-Blind, i-Placebo-Control" "JR Berman, LA Berman kubalobi ababambisene nabo abashicilelwe kuyi -Journal of Urology ngo-2003. Ukufinyeleleka ku-3 / 15/2015.
Isihloko esithi "I-Pinking of Viagra: Imithi Yomsebenzi Wezidakamizwa Ukudala Imithi Yezocansi Kwabesifazane" kanye noHeather Hartley eyanyatheliswa ngocansi ngo-2006. Yatholakala ngo-3/15/5.
Isihloko esithi "abesifazane abathatha ipilisi 'eluhlaza okwesibhakabhaka' (sildenafil citrate): into enkulu kangaka?" eshicilelwe kuDrug Design, Development and Therapy ngo-2014. Ithole ngo-3/15/2015.