Female Viagra Stirs Up Passion On Both Sides

Women may be one step closer to having a medical treatment for low sexual desire.

It’s taken several years, but after intense lobbying, an advisory panel for the US Food and Drug Administration recommended approval of a drug called flibanserin, the first drug designed to treat lack of libido in women. In an 18-6 vote, the committee favored approval of flibanserin for women for whom lack of sex drive is not due to causes such as relationship problems or disease, as long as steps are taken to limit risks associated with the drug. Would FDA approval for the drug be a major win for women hoping to enjoy a better sex life, or would it be an example of “medicalizing” something that many people consider an ordinary fact of life? There are plenty of arguments on both sides.

Argument in Favor of Flibanserin: Parity in Lifestyle Medications for Men and Women

Men who have difficulty getting or maintaining erections – a condition known as erectile dysfunction – have their choice of several prescription medications like Viagra, which has been on the market for 17 years now. Women who are unable to be interested enough in sex to enjoy it have essentially zero medical options right now. One of the most powerful arguments in favor of FDA approval of flibanserin is that it would be a step toward parity between men and women in terms of acknowledging that a woman’s sexual enjoyment is just as important as a man’s. While there are a couple of other drugs under development for addressing low sexual desire in women, they could be years away from approval, if they’re approved at all.

Another Argument in Favor: Renewed Hope for Some Clinical Trial Patients
Another argument that favors FDA approval of flibanserin comes from women who participated in clinical trials and were happy with the results. One of the most vocal supporters of the drug is a Nashville woman named Amanda Parrish, who said the drug really did make a difference in her sex life and relationship with her husband. Moreover, Parrish has said that since the clinical trials ended, her libido has fallen off, and she has tried unsuccessfully to rev it up again. She tells Nashville news station WKRN, “Since that time I’ve done anything from read ‘Fifty Shades of Grey’ 12 times, to ordering voodoo medicine off the Internet.” Parrish says that if the drug does win FDA approval, she will one of the first in line to buy it.

Argument Against Flibanserin: It Might Be Dangerous
At the same time, some researchers worry that the FDA is being pressured into approving a drug that may not be all that safe or effective, and think that approval of flibanserin could set a dangerous precedent. Unlike Viagra and its counterparts for men, which address erectile dysfunction as a blood flow issue, flibanserin addresses brain chemistry. Clinical trials were performed on 11,000 women, and women taking flibanserin reported an extra 0.5 to 1 sexually satisfying event per month compared to those on a placebo. Also unlike Viagra, which is taken on demand, flibanserin is taken daily long term. Some researchers see that as too high a price to pay for modest improvement, particularly when nobody knows the long term safety profile of the drug.

Another Argument Against: We Shouldn’t “Medicalize” Lack of Sex Drive
An argument against flibanserin approval from a feminist perspective is that decreasing sex drive shouldn’t be classified as a medical problem. Libido naturally falls off with age (in both men and women), and some people worry that women will be pressured into taking the drug by husbands or partners rather than working on more substantial relationship issues. By making lack of satisfying sex the woman’s problem, they say, pharmaceutical companies trivialize women’s concerns about sex, saying essentially, “It’s all in your head. Take this pill to fix it.” Some critics point to past attempts to “medicalize” normal events like menopause, which eventually resulted in serious questions about the safety of hormone replacement therapy and the halting of clinical trials in 2002.

There Are Feminist Arguments on Both Sides of the Issue
While some think flibanserin is an important milestone in treatment of sexual dysfunction in women and others think it simply throws pills at something that is infinitely complex, both sides generally agree that women’s sexual enjoyment should receive just as much attention as men’s does.

A clear female counterpart to Viagra, that addresses sexual enjoyment as a blood flow issue, hasn’t been created. At the same time, a drug that addresses male sexual desire by changing levels of brain chemicals hasn’t been developed either. Whether flibanserin will offer women a powerful new option for improving their relationships probably won’t be known until it has been used for a while, assuming it receives FDA approval.

What Happens Next?
The vote for approval of flibanserin by the FDA advisory panel is nonbinding, but typically the FDA goes along with what the panels advise. Most watchers of flibanserin’s journey through the approval process expect the FDA to approve the drug, something that could happen as early as August of this year. If approval is granted, Sprout Pharmaceuticals, the company that owns flibanserin, is ready to start manufacturing it on a large scale right away. If approved, the drug may be required to carry a “black box” warning on the advice of some advisory panellists, who say that alcohol increases risk of fainting in women taking flibanserin and this should be prominently noted on the packaging.

Conclusion
Research into female sexual enjoyment is taking place, but so far women don’t have their equivalent to Viagra, which has been nothing short of revolutionary to millions of men. Flibanserin, even if approved by the FDA, won’t work like Viagra, and it remains to be seen if it will attain “blockbuster” status the way Viagra did when it was introduced to the market.

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