Less than one-hundred years ago, the rallying cry for women was to claim the right to vote. In democracy as practiced through the centuries, the electorate was men only. Looking back, it seems strange we should have excluded half the adult population from the right to an opinion at the ballot box. Yet, in life generally, sexism remains with women still denied real equality despite the enactment of anti-discrimination laws, and nowhere is this more obvious than in the bedroom. Because of the distribution of sexual apparatus, women have been cast in the passive role of accepting the penetration. The idea of "women on top" has been slow to gain acceptance. Indeed, when you look at cultural attitudes towards sex, we still label women as loose and promiscuous if they engage in premarital sex, whereas their male peers are allowed to sow their wild oats. In religious terms, sex outside marriage is sinful, using guilt to enforce control over access to sex. Women are cast in the role of mothers. Whether they actually enjoy the sex to get pregnant has never been of much interest to the average man. As a result, up to half the adult women find sex unsatisfying. They report low levels of libido with men just expecting them to lie there and be happy they have been noticed. This often translates into low levels of lubrication and a failure to achieve an orgasm.

Before 1998 when the first of the erectile dysfunction drugs was released on to the market, there was little open discuss of the level of satisfaction in sex. Now that we have erectile dysfunction drugs advertised on television, there's a slightly more open attitude. Yet the result of this cultural shift has not been so good for women. In research, more than half the women questioned said they would like help to improve their levels of satisfaction. But they refuse to discuss this with their doctors because most are men and their responses to this "problem" are unsympathetic. The majority of women who do go to their doctors report a failure to conduct a proper examination, no tests performed, no referrals to a specialist, no treatment plan and no interest to follow up with questions on the next visit.

So how do men react when their women find sex unsatisfying? This is a whole new reason for performance anxiety. Men who cannot bring their women to orgasm are failing. Their self-esteem is under threat. Yet, there's no convenient little pill like Levitra for women. All the tests show the erectile dysfunction drugs have no effect on women's interest in sex. This is hardly surprising. Levitra is designed to enable the penile artery to dilate. Without a penis, women are at a disadvantage. Yet the feminist movement and doctors cannot agree whether this is a psychological or biological problem to be solved by creating a new drug, just for women. Until this debate is resolved, men will just have to soldier on, hoping the lack of response from their partners is not a judgement on their sexual adequacy.