Does the Female Viagra Pill Really Work?

When Addyi was originally released to the market, the initial response by gynecologists was, to put it mildly, negative. As Dr. Lauren F. Streicher, a Chicago gynecologist who specializes in sexual health, was quoted in the New York Times, “Women think, ‘Wow, this one must be really bad.’” However, the company pursued a strategy of pricing the product the same as the pills used for erectile dysfunction in men so insurance companies could not avoid a claim of discrimination if they did not approve it. The strategy worked, until the company was bought out by Valeant.

A bigger question, of course, is whether the pills really work. Here's what is known.

• Addyi (flibanserin) was approved as a treatment for "acquired, generalized hypoactive sexual desire isorder" in pre-menopausal women. It was never intended for women who have had hysterectomies or who have passed menopause.
• By the time Addyi was actually approved by the FDA, the American Psychiatric Association no longer recognized "acquired, generalized hypoactive sexual desire disorder" as a treatable condition.There is a condition known as "female sexual interest/arousal disorder," although this is not precisely the condition for which the drug was approved.
• Addyi works by reducing the production of serotonin. Many antidepressants work by increasing production of serotonin. However, serotonin release at the wrong time reduces sexual desire. Addyi counteracts this effect.
• Addyi also works by increasing the product of dopamine, the brain's reward chemical. Increasing the production of dopamine increases the drive for rewarding behaviors such as sex, but also food, gambling, adventure, theft, and so on.
• The effectiveness of Addyi was measured in terms of "satisfying sexual events." This was not necessarily intercourse. Masturbation would also count as a satisfying sexual event. The average increase in satisfying sexual events was one per month.
• Only 23 percent of women taking the drug reported "greatly improved" sexual desire. In the clinical tests for Addyi, 16 percent of women taking the placebo also reported "greatly improved" sexual desire.
• The clinical trials for Addyi were limited to heterosexual women who had a partner available for sex at least 50 percent of the time. Women who had a history of endometriosis or urinary tract infections or who took antidepressants or sleep aids were excluded from the clinical trial. 

READ Interesting Facts About Viagra You Probably Didn't Know

• Addyi can't do anything about "boring" sex, lack of interest in sex on the part of the woman's partner, or problems with the attractiveness of the sexual partner.
• Much of the advertising for Addyi emphasized "evening the score," giving women a pill the way men have a pill, not about how well it worked.

What about using men's Viagra to treat women's sexual issues? Oddly enough, there is some evidence that the men's pill, which is all about "plumbing" rather than desire (which is presumed), shows some evidence of efficacy for post-menopausal women. A study of 202 women, 52 of whom were post-menopausal and 150 of whom had had hysterectomies, found that taking men's Viagra (sildenafil) significantly improved sensation and satisfaction during intercourse. It wasn't a wonder drug for women. Only 57 percent of women taking sildenafil reported improvement, compared to 44 percent taking a placebo. However, for some women, men's Viagra can improve the quality of sexual intercourse by increasing circulation to the sex organs. A "pink Viagra" is on its way to the American market.