Addyi may not be a wholly satisfactory answer to women’s prayers for a drug to treat hypoactive sexual desire disorder. But for now, it’s the only game in town.
When Viagra was launched in 1998, pharmacies couldn’t keep the stuff on the shelves.
It was the first of many drugs that helped to resolve the simple, yet common problem of erectile dysfunction by improving blood flow to the penis.
More than 17 years later, the U.S. Food and Drug Administration approved the first prescription medication designed to treat hypoactive sexual desire disorder, or HSDD, the most common form of female sexual dysfunction. That HSDD drug carries the brand name Addyi, and it still is something of a mystery to many Americans.
To be fair, Addyi hasn’t been marketed with nearly as much fervor as Viagra. But at this point, one wonders if that would have made a difference. Though touted as a medical way to help women have a greater interest in sex, its effects on women are nowhere near as specific and obvious as Viagra’s effect on men.
The Long Road to FDA Approval
Addyi didn’t gain FDA approval the first two times it tried. The FDA had concerns about side effects, especially sleepiness, and they wanted clinical studies to be performed on women’s driving ability after having taken the medication. Sprout Pharmaceuticals, the U.S. pharmaceutical company that later sold the drug to Valeant and subsequently bought it back, performed the required tests and eventually gained FDA approval, with several stipulations.
For one thing, not just any doctor could prescribe the drug, and not just any pharmacy could sell it. Both had to go through an online certification process first. Combined with lukewarm press and lackluster results, all the factors added up to a drug that didn’t sell well at all.
Is Addyi ‘Female Viagra’?
If Addyi were “female Viagra,” women could take it on demand, experience its effects for four to five hours (like Viagra), and then get on with life. Addyi is not that. Since it acts on brain chemistry rather than circulation hydraulics, it won’t work on demand. For Addyi to be effective, a woman has to take it daily for weeks, and while taking it, she cannot drink alcohol because of a heightened risk of dangerous side effects. And at a cost of at least $400 per month, it represents a major financial commitment as well.
Addyi vs. Viagra
When a man takes Viagra, the drug inhibits a circulating enzyme called phosphodiesterase-5, or PDE5. Too much of the enzyme results in too little of another circulating chemical called cyclic guanosine monophosphate, or cGMP. When there’s not enough cGMP, blood vessels can’t open up fully to allow for optimal blood flow. Therefore, less PDE5 means more cGMP, which means better circulation and easier, stiffer erections. Viagra boosts circulation, not sex drive.
Addyi, on the other hand, slowly and subtly alters brain chemistry. Specifically, it regulates three neurotransmitters that are related to mood: serotonin, dopamine, and norepinephrine. In clinical trials, enough women reported higher scores on something called the Arizona Sexual Experience Scale to be statistically significant.
What Women Really Want
Women tend to care more about quality of sexual experiences more than quantity. While Addyi theoretically helps women want sex more (between 8 and 13 percent of them, anyway), a new study from the University of Zurich in Switzerland finds that more sex isn’t necessarily what they want from a drug.
The study of 159 Swiss women from ages 18 to 73 found a willingness to try medication for boosting sexuality: 61 percent agreed to try it. But what they really wanted from the drug was to make sex more fun, not necessarily more frequent.
Sprout’s Plans for Addyi
Just a little over two years after snapping up Sprout Pharmaceuticals and its rights to Addyi for a cool $1 billion, Valeant sold the rights back to Sprout in November 2017. The latter has mounted an aggressive marketing plan for the drug and offers to supply the drug for a maximum of $99 per month to women who have no drug insurance or whose insurers refuse to cover the medication.
Women like the idea of having their own medication for better sexual experiences, something comparable to what men have with Viagra and its competitors.
Addyi is a start, and for women with the right brain chemistry and enough money, it can offer relief from HSDD. But it is far from ideal, mostly due to the fact that it represents a long-term commitment and alters brain chemistry.
In the meantime, much of the advice physicians give their male patients about how to have a more enjoyable sex life applies to women too. Give up cigarettes, get more physical activity, and cut down on the cholesterol and saturated fats, and you’ll enjoy more energy and better circulatory health, both of which benefit sexual enjoyment. If you would like to learn more about ED, HSDD, or other important consumer health topics, follow eDrugstore’s blog on a regular basis.
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