What Do Women Want?: Adventures in the Science of Female Desire (17 page)

And Pfaus added, “Dendrites.” These are the gossamer-like tentacles that link neural fibers in our brains. Our experiences can make these tentacles grow more dense, just as plant life thickens in rich soil, and this flourishing, he explained, means “neural networks are enhanced, more sensitized, more capable of being activated.” It was possible to imagine that if, for Wendy, devouring the book led to devouring the trilogy, and if this led to more fantasy, if men on the street with fabulous shoulders and hips induced flares of lust, then, over time, “dendritic arborization” might increase and Wendy might find herself at least a bit more eager for her husband, even if his shoulders weren’t as broad and his hips weren’t as slim and his fucking wasn’t as fierce or as new as Christian’s, and her name on his lips didn’t bring on vertigo.

“Y
es,” Adriaan Tuiten said, he thought often about reinforcement and neglect, about the bolstering or weakening of the circuits of desire, as he developed Lybrido and Lybridos. He was the founder of Emotional Brain. He was a Dutch researcher in his late fifties with a doctorate in psychopharmacology, whose shirt collars were skewed, whose hair was rumpled, whose dishevelment was half style and half disarray. We met periodically when he was in New York to check on the trials and to sell partnership rights and raise millions for the studies the FDA would still require. He was putting everything into getting past the American agency before its European equivalent; it was too expensive to do both at once. As we walked through Manhattan or leaned over coffee, he railed sometimes that back in the Netherlands people were rifling through his garbage. International companies, vastly larger than his own outfit of forty, were sending spies to get hold of his secrets. They were hacking into EB’s computers. Behind his chunky, tinted glasses, his eyes filled with anxiety. He seemed to be, now and then, on the edge of paranoid, crazed. But how crazy were his suspicions? So much money was at stake. And scientists like Pfaus, whose rats hadn’t been enlisted by EB, but who knew the field perhaps better than anyone—who had a small advisory role on Lybrido and Lybridos but no monetary interest in EB’s success—said that Tuiten could well be the one.

Yet when Tuiten spoke about the conception of his drugs, the germ of his ideas, a story of scientific ingenuity and monumental potential profit came down to a young man’s broken heart. It wasn’t something he wished to recollect. “What I’m working on now is functionally independent of the past,” he said. Then, slowly: “The starting point is very personal.”

Abruptly, when he was in his mid-twenties, his girlfriend, a woman he had been in love with since the age of thirteen and had lived with for years, told him she was leaving. “I was—flabbergasted. You can say that?” he asked me, making sure, in his stiffly accented, halting, but elaborate English that he was using the right word. “I was shocked. I was suffering. And she told me something at that point. She said she was so relieved by her decision that her menstruation came back.” She’d stopped using oral contraceptives two years earlier, but her period didn’t return, not until the day after she pronounced the relationship over. She believed her body was confirming that she’d made the right choice, no matter how agonizing it had been.

He felt stricken. But it wasn’t long before she asked for another chance, and he took her back. “And after a year, the same pattern repeated.” She had started taking the pill again, then quit, then went months without ovulating or menstruating; meanwhile, she realized that she really was not meant to be with this man she’d been entangled with for half her life. She let him know it was absolutely finished. And within a day or two: her period.

Battered by this cosmic verdict, he talked with the woman’s sister, who was sympathetic but informed him that yes, of course, there could be emotional causes for long stretches without menstruation, that sadly it all made sense. He wasn’t a scientist then. He was a belated university student, who’d been determined, until recently, to be a furniture builder. But he’d gravitated back to school because of books friends had given him, books that had begun to captivate him, volumes by the logician and philosopher Bertrand Russell and by Johannes Linschoten, a Dutch experimental psychologist. His mind was shifting, growing more and more avidly analytic. And it dawned on him that something was amiss. If breaking up had set his soul mate’s body free to bleed, how had this occurred within twenty-four or forty-eight hours?

How, he thought, had she skipped past ovulation and the two weeks that generally need to go by? Her uterus couldn’t have compressed into a day or two what takes half a month. True, it was conceivable that, both times, she’d resolved to end it two weeks before letting him know, but this wasn’t the story she told, and, brooding about how he’d been so blindsided, ended up so shattered, about how it could have happened twice—“I stood always under the shower, thinking and thinking”—he started to reverse his girlfriend’s logic, the logic her sister affirmed.

The reversal began as an insight, a glimmer, and slowly gained solidity as he scoured obscure journals, studying anything that might be at least tangentially related to his notion. “I’m a little bit—not insane. But. There became a need for me to understand my personal life in this way, to have a theory, an instrument, to have control.”

His girlfriend was a runner, a vegetarian, a dieter. This was a recipe for amenorrhea, the ceasing of the menstrual cycle—a recipe that was little researched in those days. Her regimen had inflicted havoc on her hormonal system and delayed the renewal of her period after she gave up the pill, he felt sure as he read what he could find. It had also reconfigured “her affective life,” he said while we talked in a café, the remote and professional word “affective” at odds with his expression, his voice. Thirty years afterward, he was wistful, bereft. For a long while, with her amenorrhea ravaging her hormones and her brain’s biochemistry, she’d lost desire for him. And with desire, her love, too, had flattened. But eventually, with the pill out of the picture and probably with a slight, unnoted easing of her running, her diet, hormones had revived, ovulation had resumed. In the brain, the molecules of eros had resurged. This didn’t restore her emotions for him, though. Instead, her reawakened sex drive seemed to flee straight from him toward the wish for other men. “The biological changed her affective feelings for me,” he used the word again, scientific, crushed. She decided to cut the bond, to wrest herself free. The sudden switch in her molecular state had cost him the love of his life.

Both times, coincidentally, it had taken her about two weeks to make the decision. His girlfriend and her sister had got it wrong, he thought. The psychological hadn’t dictated the hormonal. Rather, biochemistry had determined the trajectory of lust and love; it had destroyed everything.

Tuiten’s reasoning had led to his writing and publishing his first scientific paper while he was still working toward his master’s (the article was about discerning causality, he said, but “nothing about my suffering”), to his seeking his PhD, to his researching a biochemical vortex that can suck girls into anorexia, to his studying sex. Throughout it all, there were themes, threads that converged in his current inventing. One was the reign of the chemical within the psychological; another was timing. There was the molecular narrative, the biochemical chronology, behind his own tragedy. There was his resequencing of the forces that pull girls into anorexia. There was, after an experience with another girlfriend, his scrutiny of the molecular relationships that plunge certain women into severe premenstrual syndrome, with deprivations of serotonin and, for some, lowered inhibition and crests of lust. There was, much later, his investigation of the exact delay between doses of testosterone and the spurring of desire in women who respond to infusions of the hormone. There were his ruminations on the timing of serotonin pulses and on the timing of compounds that temporarily suppress this neurotransmitter.

W
hy were some women more prone than others to have desire plummet for their long-term partners, as habit and entrenched commitment robbed spark from stimuli? Why were some less or better able to feel a moderate flame? Why were a few capable of decades and decades of combustion, thrall? Baseline measures of blood-borne hormone weren’t much of a predictor, but Tuiten and his EB experts examined how efficiently a woman’s brain cells guided the testosterone molecule through cell interiors, so the hormone could do its transformative work, setting off the chemical changes that prime the erotic. Cells that do this guiding in a begrudging way—with molecular receptors that are resistant—might make a plentiful amount of free-floating testosterone partially irrelevant. Welcoming receptors could help a woman do a lot with a minimal quantity. One strand in the weblike thinking behind Tuiten’s drugs was spun from genetic coding that hinted at the character of those receptors. Blood could be read for that coding; the personality of the receptors could be deduced. This was one element in EB’s effort to peer into the molecular components of the sexual psyches of individual women. It was one reason why Goldstein saw the company’s work as a breakthrough and as a possible answer to his testosterone riddles.

Another angle on the testosterone system, on its capacity to incite dopamine, relied on something more crude than genetic coding. It involved measuring the second and fourth fingers of a woman’s right and left hands, and calculating the relationship between the index and ring digits. Wendy and all the other EB subjects, when they’d first been interviewed for the trials, had been asked to put their hands on a computer scanner. These images had been sent off to the company. Tuiten was building on emerging evidence, from humans and from rats, that the difference in length between the two fingers was another reflection of how receptive a person’s cells were to testosterone in both brain and bones.

Then there was the serotonin network, headquartered toward the front of the brain, a network that can override dopamine, that filters out stimuli and subdues urges, that is responsible for keeping us calm, rational, organized. For a glimpse of serotonin’s wiring, Tuiten gazed at another genetic script, illumined by using a fluorescent dye, an electrified gel.

But that was all to do with the inborn. He incorporated, too, as best he could, the learned. He knew that the social impact on the skeins of serotonin and dopamine, on their relative health, on the way they collaborated or competed, was crucial. Serotonin could either add the right drop of coherence to the sexual brain or it could interfere, inhibit, shut eros down. He knew that what the culture repressed or rewarded molded these networks. To gauge this, he used a series of questions, dealing with arousal and orgasm and frequency of masturbation. In combination, the answers spoke—imperfectly, tellingly—to inhibition’s intensity. He placed a woman’s replies, as well as her genetic coding and finger ratios, into an equation, an algorithm. The equation used eleven elements in all. In this way, he pieced together a vision of a woman’s erotic neurology.

This could sound like lunacy. But it was the most detailed attempt at comprehension by any drug company so far. It fed into the composition of his two medicines and into EB’s sorting of which women should take which one. The drugs were to be taken a few hours before a woman wanted to feel overwhelmed by eros. Each drug consisted of two parts: a peppermint-flavored coating of testosterone melted in the mouth; an inner pill was swallowed when the peppermint faded away.

In Lybrido, the pill was a cousin of Viagra. In Lybridos, it was a compound called buspirone. And here Tuiten’s long obsession with timing was at work. He’d realized that he could arrange a meeting, so that testosterone’s peak hours of sexual priming would coincide with the aid many women would need from the other two chemicals. This help, in the case of the Viagra-like chemical, was a heightening of genital swelling, which ramped up sensation and triggered the brain to produce more dopamine. In the case of buspirone, it was a squelching of serotonin. In their different ways, both Lybrido and Lybridos altered the interplay between serotonin and dopamine.

Lybridos was perhaps the more intriguing invention, the clearer example of Tuiten’s fixation on timing. Buspirone is an antidepressant. And like all antidepressants, it elevates serotonin. But there is a distinction. Unlike the most popular compounds for depression, the selective serotonin reuptake inhibitors, the SSRIs, buspirone causes, at first, a brief slow-down in the release of the neurotransmitter. And if buspirone isn’t taken every day, the gradual rise in serotonin won’t occur. The critical effect is serotonin’s very short-term suppression. Put this together with testosterone’s key hours of stoking dopamine and, even if that stoking was half-crippled by begrudging receptors, Tuiten might provoke an interval of lust; he might provide a replica of what had been felt long ago, when none of this manipulation had been necessary—when the newness of a lover had sent the biochemicals of desire into a frenzy.

I
t seemed that Tuiten, disheveled and eternally heartbroken, was about to be astonishingly rich. A minor yet enormous reason was this: over fifteen million American women, and countless more around the world, depend on SSRIs to battle their melancholy. Some would be enrolled in an upcoming phase of the trials. With the boosting of serotonin brought about by SSRIs, there is, for most, an inevitable flight of eros. Desire can become dim, imperceptible. And this can be worsened by the fact that excesses of serotonin disrupt the physical mechanics of orgasm, impeding contractions, so that climax feels farther and farther off, until it is unattainable. For women on SSRIs, each tablet of Lybridos, with its temporary blocking of serotonin, would grant eros a reprieve.

But above all, if Tuiten’s thinking was right, if the data he already held, from small sets of women in provisional studies, were borne out in his larger trials, then he had conjured a pair of drugs that were an antidote to monogamy. His medicine promised to rescind years.

Lust, in its most powerful moments, can propel us outside ourselves, outside the world, outside time. We are offered this oblivion. How wonderful the trance is—or was, if such moments have been sacrificed, lost in the quest for another kind of escape: for safety, for constancy, for a fortification against growing old alone, against enduring the terrors of time by ourselves. Could Tuiten’s pills perform a type of magic, allowing the trance to coexist with the comfort? Permitting both kinds of escape? Could Tuiten’s chemicals execute that trick?