A new drug called flibanserin promises to do for women what Viagra did for men, although it acts in an entirely different way. Here is what every couple needs to know about flibanserin for female hypoactive sexual desire.
Millions of women just aren't interested in sex. They don't have sexual fantasies. They feel they "should" want to have more sex, but they just don't. There's nothing detectably wrong with them physically. They don't have a psychiatric condition. They simply don't want to engage in lovemaking and the absence of sexual desire causes emotional upset and strained relationships.
Women who don't want to have sex often don't enjoy sex when they do. The condition of low libido in women known as female hypoactive sexual desire is often accompanied by female orgasmic disorder, an inability to come to a climax during intercourse. The fact that doctors often ignore complaints from their female patients that they don't have orgasms, obviously, makes it impossible for some women to get medical treatment. Not getting medical treatment is not necessarily a bad thing.
The fact that women who don't want sex and don't enjoy sex when they have it makes them depressed, so that they are given modern selective serotonin reuptake inhibitors for antidepressant therapy. These drugs have the side effect of depressing sexual desire and the aiblity to have orgasms even more.
How Common Is Low Sexual Desire in Women?
The largest American study of female sexual dysfunction, Prevalence of Female Sexual Problems Associated with Distress and Determinants of Treatment Seeking (PRESIDE), asked 30,000 women about their sexual experiences. It found that about 21 percent of women in the US reported not having orgasms during sex. In other countries, the problem is even worse. The Global Study of Sexual Attitudes and Behaviors (GSSAB) found that for women aged 40-80 year worldwide, about 41 percent reported not having orgasms and 43 percent reported not being interested in sex.
What Is The Outlook For Women Who Lose Interest In Sex?
Most medical researchers are of the opinion that women who have a lifetime loss of interest in sex, oddly enough, are those who are most likely to respond well to medical treatment. Without pharmaceutical intervention, however, the problem persists.
Remedies For Hypoactive Sexual Desire In Women
Many male doctors aren't especially sensitive to complaints from their female patients that they just aren't interested in sex. After all, in men, the problem is more usually seen as a "plumbing issue." Sure, men want to have sex, but they just can't because of vascular and/or neurological issues. Empower a man to have erections, and sexual activity more than likely follows (although extremely low testosterone levels may interfere).
READ Why Don't We Have Libido-Boosting Drugs For Women?
Women also respond to testosterone therapy, although they are given much smaller doses. The bigger problem for most women, however, is in the brain.
While a multitude of personal and social factors influence women's sexual desire, a common problem is too much serotonin in the brain. Medications designed to prevent the uptake of serotonin, consequently, make sexual problems worse. Women who don't want sex also tend to have low levels of the pleasure chemicals dopamine and norepinephrine in their brains. When they have good sex, their brains don't respond by making them feel good. A developmental medication called flibanserin addresses brain chemistry in women suffering loss of interest in sex.
Five Things Women Need to Know About Flibanserin
The most important thing to understand about flibanserin is that it is not a hormone. The standard treatment for female anhedonia, loss of sexual desire, involves supplementing both estrogen and testosterone or giving a medication called tibolone. It doesn't raise estrogen levels, or lower them. It won't have any bearing on unpleasant symptoms of menopause, but it won't cause cancer, either. It won't cause women to break out in acne or to sprout body hair. Unlike Viagra, Cialis, and Levitra, flibanserin has no effect on blood flow to the genitals. The makers of flibanserin (Sprout Pharmaceuticals in Raleigh, North Carolina) believe that the medication works by lowering brain concentrations of serotonin, which inhibits sexual desire, while simultaneously raising levels of dopamine and norepinephrine, which increase it. What else do you need to know about it?
Flibanserin Doesn't Work Right Away
When the problem is blood flow, fixing blood flow takes care of the problem. The effects of Viagra (sildenafil) in men kick in just 30 to 45 minutes after taking the medication. Flibanserin isn't a medication that women can take before a date or an anniversary or a scheduled date for lovemaking and expect to feel sexy. It has to be taken for several weeks before it begins to have an effect.
Flibanserin Isn't For Every Woman Who Has a Low Sex Drive
As mentioned earlier, pharmaceutical treatments for loss of interest in sex in women tend to work best for women who have had little interest in sex for a very long time. In the clinical trials for this drug, most women have been in relationships for 10 years or more and had suffered low sexual desire for five years or more. They tend to respond to the drug. However, women who have short-term loss of interest in sex (after an illness, after a spouse has cheated, during short-term financial stress, when kids are running around the house, and so on) are less responsive to the drug, just as they are less responsive to treatment with estrogen and testosterone.
Flibanserin Isn't A Miracle Drug
Sprout Pharmaceuticals report that women in their study reported, on average, having sexual intercourse 2.7 times a month before taking the drug, and 4.2 times a month after taking it. For this reason, the FDA was not especially impressed the first two times Sprout Pharmaceuticals applied for approval of the drug. However, the company has been able to make the argument that it should be up to individual women to decide how much more sex is enough. Some women are happy to have just a single additional satisfying session of lovemaking every month, and for them, the cost of the drug is worth it.
Like Every Other Drug, Flibanserin Can Have Side Effects
In the clinical trials of flibanserin, 9.8 percent of women reported daytime drowsiness when taking the drug. This will probably lead to a long list of medications that should not be used with the medication, and advice not to drink when on the drug. Increasing dopamine levels can lead to increased satisfaction with other activities, such as eating, gambling, and taking risks, although these have not been reported as a problem in clinical trials.
Flibanserin will be marketed under the trade name Addyi. Final approval for release in the USA could come as soon as August 2015.
- Dennerstein L, Alexander JL, Kotz K. The menopause and sexual functioning: a review of the population-based studies. Annu Rev Sex Res. 2003. 14:64-82.
- Meston CM. Sympathetic nervous system activity and female sexual arousal. Am J Cardiol. 2000 Jul 20. 86(2A):30F-34F.
- Photo courtesy of JavierPsilocybin via Flickr: www.flickr.com/photos/santoposmoderno/5608185709
- Photo courtesy of Adrian Fallace Photography via Flickr: www.flickr.com/photos/69187071@N02/14648182507
- www.forbes.com/sites/davidkroll/2015/06/04/more-complicated-than-pink-viagra-what-you-should-know-about-flibanserin-addyi/
- www.sproutpharma.com/sprout-pharmaceuticals-receives-clear-guidance-from-fda-on-path-forward-to-resubmit-new-drug-application-for-flibanserin-the-first-potential-medical-treatment-for-hypoactive-sexual-desire-disorder-in/