Dr. Feelgood

Monique Love, the demure, bespectacled 26-year-old who fills orders for the women’s aphrodisiac Dream Cream, was sitting in her office the other day when she got a call from a desperate customer. “She said, ‘My knuckles hurt from scraping the bottom of the jar!’” Love recalls. “‘I need this cream! I can’t believe I waited this long to reorder.’ She paid twenty-five dollars to have me overnight a new one. That’s half the cost of the jar.” Love leans back in her chair and spreads her palms out. “But the more people that are able to have orgasms, the better place the world will be.”

Monique works for Manhattan urologist Jed C. Kaminetsky, the Dr. Feelgood of the post-Viagra era. Kaminetsky was already an expert on erectile dysfunction back in 1998 when the blue guys hit the market, but in the past few years he has seen increasing numbers of women, who shell out fifty bucks a jar for Dream Cream, a non-prescription arousal cream he invented that increases blood flow to the clitoris and vagina. All the pleasure meds have turned Kaminetsky’s once-quiet urology office into a kind of Sex Inc., the Kinsey Institute crossed with Good Vibrations.

It’s enough to put a smile on a nice Jewish doctor’s face. “If I can make people’s sex lives better I can make their lives better,” says the trim, handsome 45-year-old from his office overlooking the Empire State Building. “A central part of the male identity, and the female, as I have learned, is the ability to have pleasurable sex.”

Kaminetsky began looking into female pleasure back in 1997, when early forms of Viagra came out. “I was always trying to adapt whatever we were doing in men for women,” he says nonchalantly, though it’s the rare doctor who thinks that way. When Viagra received FDA approval in 1998, he began prescribing it for more and more of his male patients and opening conversations with them about sexual satisfaction. Along the way, something strange happened. “My erectile dysfunction patients would come in with their wives, I’d talk to the man and then I’d say to the woman, ‘What about you? Are you OK?’ He’d say, ‘She’s fine,’ and she’d be sitting there rolling her eyes. It was apparent to me that we were only treating half of the problem.”

“Jed’s really remade himself in the last couple years,” says general internist Dr. James Underberg, who did his training at Bellevue Hospital with Kaminetsky. “The stuff he does with men is what a lot of urologists do but what makes him unique is that he’s also focused on women.”

Once Kaminetsky started asking women about their sex lives, it didn’t take much for them to spill. They’d complain they could come from masturbation but not with their spouse, or that their libidos had dropped after menopause, or that they could only come with certain boyfriends. “Everybody knows that a lot of a men’s ego is wrapped up in his sexuality and performance and ability to please,” Kaminetsky says, “but what I didn’t realize is that it’s true of women too. I’ve had women come in and say, ‘Doctor, I’m impotent.’ It was shocking to me, moving and eye opening.”

To help these women, he concocted a cream form of sildenafil citrate, the active ingredient in Viagra, got a little publicity and started receiving emails from all over the world from eager women. But Viagra is a drug and he couldn’t prescribe the cream to people he hadn’t seen, so he began looking into an over-the-counter.

That’s how he came up with Dream Cream, whose main ingredient is L-Arginine, an amino acid that facilitates blood flow to the genitals. (L-Arginine had already been used in anti-aging creams and diet supplements and is found in rice, corn, carob and nuts.) Women liked Dream Cream – reporting better orgasms, better sex, and more lubrication, and it began flying off his shelves. Patients told friends, other doctors started selling it in their offices, a web site was born ( HYPERLINK “http://www.dreamcream.com” www.dreamcream.com) and it’s now sold in fifty pharmacies in the US, as well as in Australia, Taiwan, and the Caribbean.

Kaminetsky’s timing was good. With millions of men popping Viagra in the late 90s, women all over the country were asking their doctors what was out there for them, and drug companies smelled green in pink. Researchers took a sudden interest in that murky arena of female sexual pleasure, something ordinary men had been trying to figure out since the dawn of time. A 1999 study in the Journal of the American Medical Association reported that 43% of American women had female sexual dysfunction (FSD), but defined it as any one of the following symptoms for two months or more:  anxiety about performance, pain during sex, difficulty with lubrication, or failure to achieve orgasm. The sociologist whose results had been used in the study later complained about the way the data was presented, two of the study’s authors belatedly disclosed links to Pfizer, and feminists charged that an illness was being manufactured in the hopes of creating a drug to treat it. (Kaminetsky himself is on the Pfizer Advisory Board but says he receives no money from the company except when he lectures on erectile dysfunction at a Pfizer-sponsored event.)

Whether FSD is real or manufactured, medical or psychological, it has yet to be seen, but until there’s female Viagra (Vulvagra? Clitagra?), Kaminetsky’s patients are relying on Dream Cream and the plethora of other over-the-counter medications that have shown up at high-end pharmacies over the past few years, like Allura, Femore, and Viva. 

Sue, 44, is one Dream Cream happy customer. She first went to Kaminetsky a few years ago for a bladder infection and in the course of her treatment Kaminetsky asked her about her sex life. “We had a conversation about orgasm, and sex, and the cream,” she recalls. “I had had trouble achieving orgasm and when I did it took me forever. The cream made it much easier and made the orgasms more intense. I use it sparingly because it’s expensive but if I could have a huge vat of it by the bedside I would.”

Sue uses Dream Cream most often for oral sex because that’s how she comes most easily. So far her husband hasn’t complained of any tongue swelling (Kaminetsky says cunning linguists need not worry about side-effects because the cream is absorbed into the vagina after it’s rubbed in). But it doesn’t taste wonderful. “My husband says it’s a little bitter,” says Sue. “I think it would be great if it came flavored.” 

Kaminetsky’s working on it, but as with any serious science, progress takes time. “So far I can get it to smell like the flavor,” he says, “but I can’t get it to taste like the flavor.”

Many of Kaminetsky’s patients are couples; the man comes in for ED and walks out with Viagra and some Dream Cream for his wife. Ted, 56, a retired financial officer, came to Kaminetsky for ED in 2001; he had been on Zoloft and was diabetic and was going through a severe depression. Under Kaminetsky’s guidance, he tried Viagra and prostaglandin injections (neither worked) and wound up getting an implant. “I have been happy with the implant. It worked out very well, and two months after my operation my wife started on Dream Cream. She thanks Dr. Kaminetsky for putting romance back into our lives.”

Until she tried Dream Cream his wife, Diana, 54, a speech pathologist, had only one orgasm a year, through masturbation, and had trouble getting lubricated during sex. After she tried Dream Cream, she says, “I got lubricated and aroused and sex became much more pleasurable. Now I have orgasms when I’m having sex. I think it’s a miracle drug.”

Most of the women in the office – including knockout nurse Nikita Moore, 28, who was wearing a fuchsia sleeveless turtleneck the day I met her – have test-driven Dream Cream; after all, they wouldn’t be good caregivers if they didn’t. “My boyfriend and I enjoy each other anyway,” she says, “but it definitely added a new spin.”

Another loyal creamer, a 30-year-old exotic dancer and patient of Kaminetsky’s, told him she viewed sex with her husband as an obligation and was only able to orgasm rarely. Kaminetsky gave her the cream and she was a changed woman. “What effect did the Dream Cream have on your arousal?” he asked her in a questionnaire. “Out of this world,” she replied. “Lubrication?” “Like a hot waterfall.” “Desire?” “You can’t even stop it.” “Partner’s reaction?” “He said he’d forgo paying rent to buy a truckload of it.”

Kaminetsky acknowledges that there may be a placebo, or pussy-bo effect with Dream Cream; the instructions say to apply it 10-15 minutes before making love, which is enough to get most women in the mood, whatever you’re rubbing on them. “Rub it on your clit and vagina for fifteen minutes?” muses sexologist and masturbation expert Dr. Betty Dodson, author of the recently published Sex for Two. “Hmm. Sounds a lot like foreplay. If you rub any cream or massage oil on your pussy it’s going to feel good. If Dream Cream works it’s because the man is focusing on rubbing her clitoris for ten to fifteen minutes. Most women are clitorally starved when it comes to partner sex.” 

Whether Dream Cream’s effect is psychological or physiological, the phone keeps ringing. Monique Love, who says she thinks Kaminetsky hired him because of her name, fills Dream Cream orders in a small unassuming room next to Kaminetsky’s office. At first glance there’s nothing unusual about the room; Monique answers the phone “Sensaquest,” takes order information, and responds to customer emails. But open up the gray metal credenzas around the perimeter and you’ll find dozens of blue curved Ultime vibrators, shelved next to videos like Discovering Extraordinary Sex and Unlocking the Secrets of the G-Spot, and jar upon jar of Dream Cream (I grab one for later use with my boyfriend.)

“We joke that we work next to drawers full of sex toys,” says Moore, munching happily, on a shiny red apple. 

The phone rings and Love takes down some information and smiles. “The woman didn’t get her Dream Cream,” she tells me after she gets off, “so I’m sending her a new one. She said if she gets the first one she’ll send it back. But ” – she sighs and shakes her head – “they never do.”

Though most orders are from women, Love occasionally hears from some men – who can be more eager than their partners to try something new. “One guy called and asked if there was a way he could slip it on without her knowing,” she laughs. “I said he could leave it on her fingers and not let her see his hand. I guess he was thinking if she knew she might be too self-conscious.”

While Love is filling Dream Cream orders, Kaminetsky is the adjoining exam rooms asking male and female patients about their sex lives next door. Every patient, no matter what they come in for, is asked about sexual functioning. “Very often men come to me with a mild problem,” Kaminetsky smiles, “and I know this guy did not get up, leave work, and come to see me about this problem. So I ask him about his erections and he says, ‘Yes, I have a problem.’ Most doctors don’t ask about sex because they don’t care, they’re too busy, or they’re uncomfortable. But it’s good medicine to ask and it makes you a better doctor.”

For men, who can have particular trouble opening up about their sexual insecurities, it helps that Kaminetsky’s young and laid-back. “He’s a young, handsome, very hip guy,” says Ted Edelman, 57, a patient of eight years, “and very thorough. He holds your testicles in your hand like he’s preparing to make an omelet. I remember when he was examining the jewels I said, ‘Does this mean we can start to look for furniture?’ and he laughed. I could see right away that he was connected.” 

Because Kaminetsky also happens to be good-looking, he’s found that some female patients give him TMI, too much information. For a woman alone in a room with a hot doctor there can be a thin line between patient intake and dirty talk. “Sometimes women will get graphic,” Kaminetsky admits. “They’ll start confiding their fantasies. One woman spoke to me for an hour, going on and on about her perceptions of a good lover. She went through every partner, what her fantasies were, which ones she had with each partner. It was more than I needed to know to help her.”

The first person new patients see in Kaminetsky’s office is his nurse, Betsy Ortiz, 29, a voluptuous Latina with a sweet smile. Sometimes men get over-excited at the prospect of telling her their sexual history to such a nubile young woman. “One guy said, ‘If I were younger I’d throw you right down on the floor.’ I thought, That’s not what I need to hear right now.

Another patient was more downbeat; she asked him if he had ever used Viagra and he said solemnly, “I used it once by myself. It was the loneliest night of my life.” “We both started laughing,” she remembers. “It can be hard to keep a straight face.”

Though the staff discourages recreational use of Viagra, they do get some patients who just want a little help when they party. A gay patient told Ortiz he takes Viagra at orgies because of performance anxiety. “You don’t want to be the only guy that can’t maintain an erection in a group of twenty guys,” she clucks understandingly.

Ted Edelman was doing well on Viagra when one weekend, an old girlfriend came into town and he had a crisis. The office usually gives out small amounts at a time to prevent black market sales and he had used all his booty. “With this woman I knew it was going to be a marathon,” he recalls, “and I couldn’t show up with a limp noodle. So I called Betsy and said, ‘You’ve got to help me!’ I went in and she gave me a few free samples. Betsy made me the king I once was.”

Like a liquor store or florist, the office is busiest on holidays and Friday afternoons. Patients say they need a refill on the double – New Year’s is coming, or they’re about to go away on vacation. “They act like Viagra is heart medication,” says Moore. “They say, ‘If I don’t get it, you don’t understand what’ll happen!’” She flails her arms around in mock desperation. “They don’t care that the pharmacies are already closed and we’re about to leave the office. But that’s why we’re here. People in New York play hard and work hard, and sometimes they need help getting hard.”

Sex is so important to Kaminetsky’s patients that some literally come to him through hell or high water. One Friday afternoon a few years ago there was a bitter Nor’easter. People were emptying out of the city, leaving work early, but one very determined patient made it into the office. “She was a little old Jewish lady from Queens and she took the subway in,” Kaminetsky recalls. “She told me she may have had an orgasm once when she was younger when she was molested, but these days she doesn’t with her husband because he smells, he’s diabetic and stains his underwear. When he goes out to play cards she plays with her vibrator and has what she thinks is an orgasm. So she came to me to see what we could do to make it better. She was on a quest.”

*

Every genius has a muse – Stieglitz had O’Keeffe, Godard had Seberg, and Sartre had de Beauvoir. Kaminetsky’s muse is his TK-year-old wife, Terri. I visit Terri and Kaminetsky in their sprawling Westchester home on a sunny Sunday afternoon. The place is immaculately decorated, earth-toned rugs, no clutter, modern art, bound copies of Balzac and Dickens on the bookshelves next to audiotapes of Viagra-lit like Philip Roth’s The Human Stain. As we sit on the living room couch their young son and daughter keep coming in and out of the room just as we start talking about sex, and Terri and Kaminetsky shoo them away lovingly, if firmly. Kaminetsky is dressed in a pristine Viagra-blue button-down and neatly pressed slacks, despite the fact that it’s a weekend afternoon. Terri, a fit blonde, wears jeans and a cream-colored turtleneck sweater that shows off her figure. As they tell me their story it is sadly apparent, from the look on Kaminetsky’s face, that there is only room for one woman in his life. 

They met in 1988 [TK] when a mutual friend set them up on a date. Terri was an attorney with a loft in SoHo and Jed was still in med school [TK]. She looked familiar to him – he was certain she’d rebuffed him at the nightclub Area one night – but she claims to have no recollection. 

They got engaged three months after they met. “It wasn’t love at first sight,” she says, “but when we got engaged I had a gut feeling that he was the right guy.”

“Well, that’s good,” he says, pretending to be wounded.

“I felt very sure it was right,” she coos, “and I’m still sure it’s right. He’s a good husband.” 

Of course, back when he was in med school, urology seemed like a relatively humdrum specialization. But when he began experimenting with female arousal drugs, she says, “I was very supportive. There was a need to focus on female sexuality.”

She was so supportive that she agreed to be his guinea pig. In 1998 as he was beginning to prescribe Viagra, he and Terri went out to an Italian restaurant in Manhattan and in the middle of the meal he took out two blue guys. He’d never tried it before and felt it was good medicine to do so. They popped the pills – but not in the most scientific way. Viagra is supposed to be taken without alcohol and on an empty stomach and they took their pills on a full meal and a bottle of wine. When they got home, sex was no different than usual, and they went to sleep. Half an hour later, it kicked in. “We were up all night,” he recalls, “me with erections and her aroused.” But both were too embarrassed to say anything so they suffered in silence.

“It was ridiculous,” Terri says, rolling her eyes. “You don’t want to stay up all night. I’m too old. I have things to do. And he doesn’t need it.” She leans down and knocks on the wooden coffee table. 

As he began to develop Dream Cream, she tried the different formulations and gave him feedback. “I enjoyed the research,” he smirks. “I had a little bit of an ulterior motive.”

The first time the Dream Cream worked, Terri was convinced he had changed his technique. “I thought he was doing something different,” she recalls. “I said, ‘Honey, wow.’ But he hadn’t done anything different at all.” 

Most recently she’s tried testosterone, one of the more promising arousal drugs on the market. It was a weekend afternoon and he rubbed some on her arm when they were in the bathroom. “I was a man for a day,” she says. “I felt very urgent about the need to have sex.”

Because of her inside track to the doc, Terri has become a reluctant confidante to the other women in her town. “I became something of an expert,” she admits. “My friends and I would compare notes and talk about it. But I don’t bring it up with them. We live in a small town and I don’t need to talk about my sex life.”

She made an exception, though, a few years ago when Kaminetsky went on The Howard Stern Show to promote the cream, getting on the phone with the shock jock herself. Stern asked her if it turned her into a whore and she coolly replied, “I wouldn’t go that far.” Stern proclaimed the doctor “the Edison of poontang” and urged him to rename the product Taco Sauce.

The Kaminetskys have given Dream Cream to both sets of their parents – on request – but are loath to ask for progress reports. “My mother asked for Dream Cream samples for her friends,” says Kaminetsky, “but the conversation we had could have been about teeth whitener. There was no discussion at all of what it did.”

Their kids are still young, pre-adolescent, but lately they’ve been asking questions. “My daughter saw a box of Dream Cream,” says Terri, “and asked me what it was. I said, ‘It’s a cream that gives you good dreams.’ It’s way beyond what they need to know at this age.”

*

As Kaminetsky’s office has transformed from a humdrum urology practice into an international clearinghouse for sex, his own role has transformed from friendly neighborhood doctor into impromptu sex therapist. Part shrink, part sex toy shiller, he has become a mid-life expert on the female orgasm, and the female psyche. “Women’s arousal has a lot to do with the brain,” he says. “For men it’s much more about hydraulics. When a man has an erection you can hang your hat on it. For women it’s much more subtle.”

To help them deal with the psychological factors, he gives women books such as Five Minutes to Orgasm Every Time You Make Love (which encourages them to get on top) and recommends vibrators, like the Hitachi Magic Wand. “I have women patients who say they come when they masturbate but not with a partner, I’ll ask, ‘Well, what happens when you masturbate?’ They’ll say, ‘I’m fantasizing, using a vibrator or my hand.’ I’ll say, ‘Try to incorporate that into sex. Fantasize. Use a vibrator. It doesn’t matter if you have to stand on your head.’ Women have to take control over their orgasms.”

I nod and sigh lovingly. It’s about seven-thirty on a weeknight and he and I are the only ones left in the office. Monique, Betsy and Nikita have all gone home; even the receptionists are gone. “So,” I say, trying to sound professional, “what new drugs can we expect to see in the future?”

“We’re doing a lot with hormones,” he says. “I saw one woman with early ovarian failure who had gone into menopause in her late twenties. She had no desire for sex. Zero. We gave her testosterone and she came back saying she’d look at a man across from her on the subway and imagine him naked. She could not get sex off her mind.”

Does this mean in a few years, women will be acting like men, wolf whistling at hot guys and chasing them down the street? “It’s not going to happen,” he smiles. “It sounds good, but no. Women don’t want to be like men.”

I do,” I say.

“No you don’t,” he says. “Women’s orgasms are more intense.”

“Then how come men make more noise?”

“It must be the men you’re with,” he says.

I clear my throat and look down at my notes. “So what new medications can we see on the horizon for men?”

He tells me about a so-called “weekend” form of Viagra that’s designed to last three days, a topical that you rub on the head of the penis, and a sublingual (under-tongue) pill that works on the brain. “They’ll work in synergy with Viagra for people who don’t respond to Viagra or the other drugs in that class.”

“So they’re cock-tails,” I say, and he laughs.

The office is very quiet. The only sound is a vacuum cleaner running in a distant hallway. I stare at the soaring and regal Empire State Building and think about how Dr. K understands. He’s told me he’s bothered by women’s magazines that encourage women to rank their orgasms, he’s not intimidated by a vibe, and he gets that sex itself does not make most women come. I’ve never met someone so radical who’s also so attractive.

Next door to us are hundreds of Dream Cream jars and there’s a stack of Viagra six-packs sitting on his desk. I’m supposed to meet my boyfriend downtown to see a comedian, but what difference would an hour make? I could always tell him it was research.

“Well, I guess that’s about all I have,” I say to Dr. Kaminetsky, reaching across the desk for my recorder and letting my décolletage linger in his face. 

The phone rings. I jump back.

“Hi,” he says lovingly into the mouthpiece. “I’m just finishing. I’ll meet you there in half an hour.” He hangs up and smiles. “I turned forty-five last week,” he says. “Terri and I are going out to dinner to celebrate.”

I sigh sadly. Only a cruel God could create a being as necessary and beautiful as an orgasm doctor, give him all the aphrodisiacs and potions in the world, then turn around and make him married. 

“Could I get some Dream Cream, and some Viagra for my boyfriend?” I ask. He passes me a jar and a sampler.

“Have a good weekend,” he says.

“I’ll try,” I sniff. “I’ll try.”