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The Little Pink Pill

By Dr. Pisaster | Posted Under Pajiba Dirty Talk | Comments (56)



women-orgasm-299x300.jpg

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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Comments

"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 . . . "

That's not how Viagra works. My husband had prostate cancer and was required to take Viagra to get the blood flowing back into the penis after surgery. It didn't give him an erection. The reason is, it doesn't give you an erection automatically. You have to want one, and manipulate the penis alot to get yourself interested. Viagra doesn't work unless you already have the desire. If you're not in the mood, it isn't going to give you an erection.

Posted by: BWeaves at June 29, 2010 4:20 PM

Some of the testimony surrounding this was a little troubling. "Just more corporations telling women there's something wrong with them to make a buck", and the whole characterization of many womens' sexual experience as "archipelago of regret". I among women am glad someone is working on this; if my sex drive disappeared, and there was a pill to get it back, I'd take it.

I, for one, want to have as much hot sex as is feasible from now until the day I die.

Posted by: RhymesWithSilver at June 29, 2010 4:27 PM

RhymesWithSilver: AMEN!

Posted by: esme at June 29, 2010 4:32 PM

which presumably requires only an erection and a hole to stick it in . . .

HEY! I . . . Okay, you have a point. But I have a strict "No more gloryholes" rule. After the first seven or eight months, it only took me a year or two to decide that blowjobs from anonymous strangers in truck stop restrooms was simply not for me.

Is it wrong to say that, in general, the average man will have a higher sex drive than the average woman? I've never seen any studies on the point. Certainly, our culture teaches us that women need a reason (or a ring. Or a BMW) for sex while men just need a place, but I have no idea how true that is.

Posted by: Tracer Bullet at June 29, 2010 4:54 PM

Ha, Tracer that comment was actually meant to be sarcastic. I think it's a particularly annoying assumption our society has that men have completely uncomplicated sexual desires. As far as whether men have higher sex drives or not, I don't really know if that's true or just the perception. Lord knows no man's ever been able to keep up with me, but I'm not about to generalize based on my personal experiences. And I know that men with lower sex drives than their female partners is actually an incredibly common issue.

Posted by: dr. pisaster at June 29, 2010 5:01 PM

When it comes to the brain, we invent drugs and then go looking for a disease to treat with it. We kinda need to because we don't actually understand the implications of messing with the vast majority of transmitters and receptors.

It's an inherently dangerous process. We have invented new "diseases" that we can't really be sure would have existed if we didn't have the drugs sitting around without a strong purpose.

I'm all for helping people maintain their libidos, but their brain shouldn't be pharmacological playground for industries looking for a buck. Hell, we still haven't determined how the farking birth control pill is affecting people, and we're a couple generations deep in that one. And anti-depressants are a pure guessing game.

The profit motive and human medicine have a history of very scary interactions.

Posted by: ZombieScientist at June 29, 2010 5:09 PM

Hey! You are supposed to get a BMW!?!?!
Maaaaan....

Posted by: Lindsey with an 'e' at June 29, 2010 5:11 PM

women who suffer from unexplained loss of libido
---
What about explainable loss of libido, such as in postmenopausal women? Not that I'm married to anybody like that ...

Which leads me to: Who and where are these women who are only enjoying it 3.7 times a month (and presumably doing it lots more)? Really, for some of us guys, 3.7 represents 2-3 months' quota.

I know it looks like I'm trying to make Mrs. , look bad here, but that's not the case. We love each other lots. When we do it, we enjoy it much. It's just that we've hit a certain age where the frequency is dropping off. Body parts get dry, sometimes she hurts a little, none of us has the endurance we had 30 years ago.

So a drug that doubles the freuqency, if it's relatively cheap?

Sign me (us?) up.

Posted by: , at June 29, 2010 5:12 PM

I've read on several presumably reputable Web sites (notably the Smell & Taste Treatment and Research Foundation's) that the odor of cucumbers can stimulate blood flow to a woman's vagina. The first thing that came to mind was that all those family BBQs over the years may have been weirder than I even knew (all those sexy salads flaunting their scents!) and that future ones will feel awkward because I cannot unlearn this knowledge.

But I now feel there's a golden opportunity to follow the lead of many celebrities and come out with my own body wash/skin lotion that will facilitate sex. Look for my new product, Kraft Creamy Cucumber Dressing Uriah's Engorge, available at markets everywhere.

Posted by: Uriah Creep at June 29, 2010 5:16 PM

That has to be one of the least sexy names big pharma has ever rolled out. Viagra sounds virile. RAWR! Strong like bull! Flibanserin sounds flabby and meek. Ugh. It's almost as bad as the word moist.

Posted by: Ulterior Motive Girl at June 29, 2010 5:29 PM

I think that most of sex is mental, particularly for women. So a pill that spices things up a little might be nice, but it also might just be pretty icing on a shit cupcake.

Posted by: Lindsey with an 'e' at June 29, 2010 5:33 PM

The most I ever wanted sex was when I was pregnant, which coincided with the time my (now ex-) husband wanted it the least. He was seriously freaked out by the thought of a fetus being present. Yes, he had issues, thanks for asking.

Anyway, that was my one experience with desire being amped up by something other than my brain. It had to be something hormonal in the mix, though I couldn't begin to guess what it was. I just know that I wanted sex ALL THE TIME, anywhere, with anyone. It was extremely distracting. And frustrating, given the ex's weirdness.

Posted by: Wednesday at June 29, 2010 5:47 PM

For scientific information about what happens in women's brains and bodies before and during sex, see Dr. Louann Brizendine's book "The Female Brain." Lots of research and science with interesting conclusions. Here's one: "Female sexual turn-on begins, ironically, with a brain turn-off. The impulses can rush to the pleasure centers and trigger an orgasm only if the amygdala—the fear and anxiety center of the brain—has been deactivated. Before the amygdala has been turned off, any last-minute worry—about work, about the kids, about schedules, about getting dinner on the table—can interrupt the march toward orgasm."
If scientists can invent a pill that will get dinner on the table, the laundry folded, and all my students' papers graded, I'll buy it!

Posted by: mamasez at June 29, 2010 5:52 PM

Pregnant sex is great and technically, it's a threesome.

Posted by: Tracer Bullet at June 29, 2010 6:27 PM

It's really heartbreaking to see how this country is going to hell. First Obamacare and now unruly females wanting orgasms as if they were some sort of male. Neo-lesbo-commies the lot of them. If our Founding Fathers meant for women to have orgasms they would have written it into the Constitution.

/strict constructionist

Posted by: BarbadoSlim at June 29, 2010 6:37 PM

BSlim,

I am now hopelessly in love with you.

Don't worry, I know it's my problem and doomed to be unreciprocated.

Posted by: MM at June 29, 2010 6:51 PM

That has to be one of the least sexy names big pharma has ever rolled out. Viagra sounds virile. RAWR! Strong like bull! Flibanserin sounds flabby and meek. Ugh. It's almost as bad as the word moist.

That was just the generic name. I have it on good authority that the trade name was going to be Jorjkloonytin.

Posted by: OscarTamerz at June 29, 2010 7:06 PM

Flibanserin's side effects include dizziness, nausea, and anxiety. It's also better at improving 'global' arousal rather than the intensity of 'acute episodes of arousal'.

Based on that, millions of women have already taken something very much like flibanserin. We call it alcohol.


(All joking aside, a great big AMEN! to everything Zombiescientist said.)

Posted by: ScienceGeek at June 29, 2010 7:30 PM

New idea... Perhaps a vibrating insertable pill?

Posted by: Kim at June 29, 2010 9:15 PM

was actually looking around for a blog post on this issue, but stumbled across your site on Google!! I’m actually quite interested so will keep an eye out for updates

Posted by: Clifford Schrayter at June 29, 2010 9:33 PM

During clinical trials, I believe its code name was Labiatin RDJ.

Posted by: Uriah Creep at June 29, 2010 9:45 PM

Oh I think I'd think twice about unpleasant side effects. They're important. They're the trade-off. If the trade-off ends up too much in the negative column, the pill is worthless.

Posted by: Snuggiepants at June 29, 2010 11:53 PM

unlike male sexuality, which presumably requires only an erection and a hole to stick it in

I am confused by the use of word "presumably".

Posted by: EricD at June 30, 2010 12:16 AM

Harrison Pasqua

Posted by: Frederic Pacewicz at June 30, 2010 12:45 AM

Overnight loss of female libido? Yeah, not a lot of fun...and if you are post (mid?) menopausal the options are very limited.HRT can actually further decrease libido,since the culprit isn't lack of estrogen (nevermind the dangerous side effects of HRT), but testosterone. Start taking testosterone and you grow facial hair as well as a host of unpleasant side effects.And what really yanks my chain is that the focus of research now seems to be related to 'mood disorders' that could be treated with SSRI's...menopausal women aren't necessarily depressed or have issues with sex. My experience has been a total, utter and complete loss of the desire to have sex, including masturbation.To say this is frustrating is a huge understatement. I, for one, would love a magic pill that would instantly return my sex drive. Until then, I'm open for suggestions.

Posted by: brite at June 30, 2010 1:43 AM

This is starting to be my favourite post every week. Dr. P, you're doing a great job!

Posted by: AgoGo at June 30, 2010 1:55 AM

Before this year (age 37 for scientific purposes), I don't think I'd have even credited the idea of personally having a low(er) sex drive - until I hit this weird blast of...hormonal imbalance is my best guess. I feel like the stereotypical eighteen year old boy. It is very distracting. It's not like I'm feeling new things so much as it's like a rocketship vs a tugboat.

It's actually a little worrisome wondering what the drastic change is being caused by. I'm almost scared to check it out and find out I need to do something about it. I will be sad when the utterly lame 'probable reduction of drive' comes along - especially after this uptick.

Mind you, lately no man is safe. Seriously - I want them all. My confidence is at an extreme peak and my judgement is WAY off. I wish this for everyone.

Also, that flibanarstarinflan or whatever it is called is a terrible name. Unsexy in the extreme.

Posted by: replica at June 30, 2010 1:56 AM

Off-topic:

Dr. Pisaster, this is worth your time (and possibly a column): There's a pediatrician who is trying to drug away the gay, using phrases like "low maternal interest" and linking it to genital characteristics.

Dan Savage column re: drugs against the gay

Posted by: Brenton at June 30, 2010 4:19 AM

replica

What with your spiked libido and bad judgement, I have to ask: where could I go to "accidently" run into you? I'm good to go.

Posted by: Uriah Creep at June 30, 2010 4:51 AM

replica, I'm right there with you. How about you work your way through North America and I'll hit Europe, then we can compare notes and exchange recommendations?

Posted by: cinekat at June 30, 2010 7:43 AM

Thanks Brenton. The evidence that homosexuality is nature and not nurture and the implications (i.e. that some people will interpret that to mean it's a disorder that should be treated) is one of the topics I definitely intend to cover at some point, the research highlighted in that post falls right into that category.

Posted by: dr. pisaster at June 30, 2010 11:36 AM

Now there's a topic fraught with peril. Prepare flame-retardant clothing before putting that one up.

Posted by: ZombieScientist at June 30, 2010 12:07 PM

@Brenton & dr. p:

That Dan Savage post actually is tied in to the "clit-reduction" post from last week (last week? 2 weeks ago?), since they're actually using the drug to try to prevent CAH in fetuses. Because obviously having CAH means you're going to become a lesbian. (Duh.)

Fuckers.

Posted by: MM at June 30, 2010 2:15 PM

@replica & cinek

If y'all have North America and Europe covered, can I have dibs on Australia?

There was a time, prior to my recent libido upswing (which includes spontaneous orgasms that are not quite as fun as they might sound), when I would have paid big money for a magic pill to bring my drive back. I hope the research continues, for the sake of women everywhere.

Posted by: the*redhead at June 30, 2010 3:02 PM

@replica: Hasn't it long been held that while men reach a sexual peak around the age of 18, women don't hit theirs until the mid- to late 30s? Could that explain your recent uptick? Dr. Pisaster, any comments?

And here's a question for the ladies: In reference to what mamasez said about the amygdala, if it's true that one of the major barriers to female arousal is anxiety, have any of you ever tried marijuana as an aid? Since it induces states of relaxation and mild euphoria (in most users), it seems it would work, and with mild, VERY limited side effects. I'm just musing here, as I have no real evidence or support for this idea. Just curious to hear the female perspective.

Posted by: JustBill at June 30, 2010 3:13 PM

JustBill, there's evidence from early Kinsey studies that women experience more orgasms at that period of life, but the evidence for an actual increase in desire is sketchy.

Somewhere I have a paper on the effects of marijuana on sexual behavior, for use on one of those weeks when the news is slow. I don't remember off the top of my head if it increased female libido, though.

Posted by: dr. pisaster at June 30, 2010 4:38 PM

In Mexico they have a shot to treat this very disorder. I think it starts with a "T". Side effects include worms and Deeze Nuts.

Posted by: L.O.V.E. at June 30, 2010 7:20 PM

@JustBill:

I have no paper on the subject, but I have conducted my own experiments, and can attest to the fact that, for me, it most definitely made it easier to relax and enjoy myself.

One woman's perspective.

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