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The hormone testosterone is the driving force behind libido; a man with little or no testosterone will not have any desire to have sex, Viagra or no.Moreover, even with normal amounts of testosterone, "Viagra does not just instantly give a man an erection," says Abraham Morgentaler, MD, associate clinical professor of urology at Harvard Medical School and author of The Viagra Myth.Sadock, MD, director of the program in human sexuality at New York University Langone Medical Center. "We don't want an interminable two hours." Not to mention the fact that prolonged intercourse, particularly without sufficient lubrication, can do damage."So with Viagra, they think, Oh, it's not me he wants; it's the Viagra talking. It can lead to vaginal abrasions and even tearing and can expose a woman to risk of getting yeast infections and — particularly for a woman who is dating or divorced — to sexually transmitted diseases.It's put the world on 'tilt.'" Andrea D., a twice-divorced physician from Santa Monica, CA, and an over-50 dater, put it more bluntly."Viagra has been liberating for men, but unless a woman is taking hormone therapy, she may have vaginal dryness and really not be that interested in the kind of driving, pounding intercourse he's now capable of." There is also fallout from the erroneous belief that Viagra causes not just greater blood flow but also greater desire.

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One study conducted by Express Scripts, a pharmacy benefit management company, found that nearly 20% of all American men over age 45 have tried them.

Perhaps the woman doesn't really want it anymore, for one reason or another.

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