Let’s be honest, ladies: We know we’re a little more complicated than men (especially when it comes to sex). We know that our desire can be elusive and maybe even a little unreliable. For some women, desire seems to disappear altogether. This can be deeply distressing and can create problems in intimate relationships. If this sounds familiar, then perhaps you are a candidate for a new medication called flibanserin (trade name: Addyi). At first glance, a pill claiming to increase desire sure sounds enticing, but a closer look reveals a far less compelling picture.
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Flibanserin Is Not “Female Viagra”
Viagra and similar vasodilating drugs work the same way in men and women, increasing blood flow to the genitalia. While Viagra and others have been wildly successful at treating male sexual dysfunction, they have proven ineffective in increasing desire in women. Flibanserin is not a vasodilator. Rather, it is taken daily and targets neurotransmitters in the brain that directly influence desire. Flibanserin was originally created as an antidepressant. It failed to gain FDA approval, but researchers noticed that it had the side effect of slightly increasing sexual desire and decided to repackage the drug.
Studies and Politics
At this point you might be wondering if Addyi could work for you. While the decision to take medication is entirely up to you and your medical provider (and the FDA), a quick examination of the research paints an underwhelming picture. To begin with, before gaining approval this past August, flibanserin had been rejected by the FDA twice on account of the health risks not outweighing its tenuous benefits. Serious risks include low blood pressure, fainting, and sleepiness.
Despite these rejections, the drug company, Sprout Pharmaceuticals, Inc., pushed onward and conducted yet another round of safety studies. These new studies were comprised of 23 men and surprisingly, only two women. In addition, the drug company launched a public relations campaign that aggressively reframed the approval of flibanserin as a feminist issue. The drug company funded a media onslaught in favor of the pill, putting tremendous pressure on the FDA to approve lest they appear to ignore a woman’s right to sexual pleasure. The third time was the charm! In August 2015, the FDA approved Addyi to treat premenopausal women with female hypoactive sexual desire disorder, described as a lack of sexual appetite that causes emotional distress.
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Efficacy (or Lack Thereof)
Women taking flibanserin reported an average of 0.5 to 1 more sexually satisfying events per month compared to a placebo. And these “sexually satisfying” events weren’t even necessarily orgasmic. Test subjects also reported a minuscule increase in desire and an equally small decrease in their “distress” regarding low desire, as compared to a placebo. Also, it’s important to remember that the drug company is allowed to run as many studies as they want and report only the most efficacious results (aka cherry-picking), burying the studies with underperforming results. Apparently, it’s completely valid to roll the dice enough times until you get the results that you want. They won’t let you get away with that in Vegas, but for some reason they’re able to do it in Washington, D.C., at the FDA.
Furthermore, for flibanserin to be effective it needs to be taken every day for the rest of your sex-having life. And as long as you are taking it, you can’t drink alcohol: Drinking while taking flibanserin can lead to dangerously low blood pressure and passing out! On top of all that, the drug was only tested for 24 weeks, and there have been no tests at all to see what happens to desire if a women decides to stop taking the drug.
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Female Arousal Is Complicated
Is it possible that, due to the complex nature of female sexuality, a drug might not be the answer? For women, sexual desire is a result of both physiological and psychological factors. No one pill could possibly address the myriad underlying causes of why a woman may or may not feel aroused at any given moment. Considering that every woman is different when it comes to arousal, along with the fact that this daily pill only moderately increases desire and has significant side effects, perhaps that delicious glass of wine you will no longer be able to drink would be more effective to get you in the mood.