The Little Pink Pill
A couple of weeks ago the FDA decided unanimously against approval of the female libido-boosting drug flibanserin. The FDA's panel felt that the drug's modest increase of sexual fulfillment did not make up for its various side effects. The results of clinical trials were inconclusive as to whether the drug increased women's sexual desire, and while it did increase the number of "satisfying" sexual events women experienced, it did so from a dismal average of 2.7 a month to .... a slightly less dismal 3.7 a month. Not exactly a dramatic improvement, though one that many women would probably be grateful for. While flibanserin won't be coming to the US market, there are plenty of other drugs in the works that pharmaceutical companies are hoping will be the female equivalent of Viagra -- a sexy money maker that doesn't treat an actual disease but does improve people's perceived quality of life. This has generated a lot of discussion on whether we should be looking for medical solutions to quality of life problems like low sex drive, and whether female sexuality is just too complicated to fix with a pill (unlike male sexuality, which presumably requires only an erection and a hole to stick it in).
The actual condition flibanserin and drugs like it aim to treat is hypoactive sexual desire disorder, which the FDA defines as a distressing loss of sexual desire. The "distressing" is key -- low sex drive is only considered a disorder if the loss of libido upsets the subject. It's tempting to dismiss this as drug companies just trying to make money by making people (women in this case) think that there is something wrong with them that requires them to shell out money for an expensive medication. To an extent this is true. If any of the drugs aimed at increasing women's libidos are ultimately approved, it's certain that the drug company behind it will market it aggressively and deliberately mislead the public about what constitutes a "need" for the drug. That's what drug companies do. But it's also true that there are women who suffer from unexplained loss of libido that they want to reverse. Sex is an important part of many romantic relationships, and most of us want to connect with our partners sexually even when we don't necessarily feel the need for sex itself. Many women may also simply miss having an active sex drive -- I know I'd be pretty upset if mine disappeared overnight. Therapy for emotional issues or treatment for underlying health problems that might cause low libido are probably the best course for women dealing with this issue, but in cases where these techniques aren't able to help, a drug that boosts sex drive could be a huge boon for women. With its ruling on flibanserin, the FDA has made clear that to be approved, such a drug must have a low incidence of side effects and lead to a marked improvement -- in other words it has to be both effective and safe, which in my opinion are pretty good benchmarks. With so much profit potential, it's entirely possible that we'll see such a drug in the next few years.
Here's my personal wish when it comes to such a drug, however: that the pharmaceutical companies extend their focus to men. Sure, men already have drugs to help them out in the bedroom, but those drugs are aimed at treating erectile dysfunction, i.e. the inability to achieve or maintain an erection. They're meant specifically for cases where the spirit is willing but the flesh is limp. No doubt there are men out there that use Viagra to get it up when they aren't really in the mood but want to please a demanding partner, but that isn't the purpose of the drug. There's a fundamental difference in the way sexual dysfunction drugs are designed for men and women that reflects our cultural assumptions about male and female sexuality. Men are assumed to be always willing but sometimes incapable, while women are assumed to be always (or almost always) capable but sometimes (frequently) unwilling. Drug companies therefore aim their efforts at men's flesh and women's minds. Initial attempts at finding a "female Viagra" did focus on increasing blood flow to the genitals (essentially what Viagra does), but those drugs were found to have little effect on women's sexual desire despite creating a physical arousal response, leading researchers (or at least reporters) to conclude that for women, sex is indeed in the mind. As far as I know, nobody derived the same conclusion about men from tests on Viagra, despite the fact that Viagra actually doesn't increase sex drive at all, it just...increases blood flow to the genitals creating a physical response.
It does make sense to target the brain when searching for drugs to address women's sexual issues. After all, there really isn't much need for a drug to make sex physically possible for women -- men need a physical reaction to have sex, but women can usually get away with some lube if the physical response is lacking. But the assumption that only women suffer from and want to improve low sex drives, as opposed to a lack of physical response, is pretty foolish. There are plenty of men out there with low sex drives, and while some may be perfectly okay with that, there are probably quite a few suffering from low libido-related effects ranging from self esteem issues to relationship problems. It's not something that gets talked about a lot, because it tends to be embarrassing for all parties involved, but there are lots of couples out there whose low frequency of sex is due to lack of desire on a man's part (I know from personal experience that this can be a problem for straight couples, I assume it can be for gay couples as well). Viagra may work in the short term for some men with low sex drive, but it won't help the underlying problem. As with women, other possible solutions should probably be explored before resorting to what's essentially an unnecessary drug, but a drug that targets sex drive rather than just the ability to have sex could be provide just as much relief for men as for women.
Dr. Pisaster has a doctorate in biophysics, not actually anything sexy. She does however enjoy having sex, reading about sex, and talking about sex. Especially when she's had a little whiskey.
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