Coming Soon: The Female Viagra

Ever since Viagra, the blockbuster drug by Pfizer for erectile dysfunction (ED), was introduced in 1998, researchers and ordinary people alike wondered if there would ever be a female version of the drug.

Since the introduction of Viagra, trials have been completed using drugs designed to address female sexual desire and excitement, but the results haven’t been promising. Three drugs that were tested, but which were not successful in FDA trials, were LibiGel, Flibanserin, and Bremelanotide:

• LibiGel was a testosterone gel made by BioSante. FDA trials concluded in 2011 found that it was not more effective than a placebo.
• Flibanserin, by Boehringer Ingelheim, addressed various neurotransmitters in the brain, and it too failed to produce statistically significant results.
• Bremelanotide, a non-hormonal drug taken with a nasal inhaler, did generate good results in some subjects, but had unfortunate side effects like blood pressure spikes and vomiting.

All three of these drugs are undergoing new trials, with Bremelanotide now being delivered by injection rather than nasal inhaler.

Emotional Brain and its Founder

Two drugs currently being studied for possible effects on female sexual desire and pleasure are from a Dutch company called Emotional Brain. Founded by psychopharmacologist Adriaan Tuiten, the company is devoted to the study of female sexual health. The two drugs being studied are named almost identically: Lybrido and Lybridos. Tuiten says that each drug addresses female sexual functioning, but through slightly different mechanisms.

Lybrido and Lybridos

Each of these drugs contains two active chemicals that are time-released for maximum effectiveness. Each affects the levels of brain chemicals serotonin and dopamine, increasing lust-inducing dopamine levels while keeping a lid on calming, cerebral serotonin levels. Each drug has a testosterone coating that dissolves in the mouth to give a temporary boost to dopamine levels. The innards of the drugs differ, however.

Lybrido contains a drug that is molecularly similar to Viagra and which increases blood flow to the genitals, increasing sensation. The goal is for the drug to activate the mind to greater awareness of erotic impulses and increase dopamine action in the brain.

Lybridos, rather than containing a Viagra-like substance, instead contains buspirone. Buspirone is an anti-anxiety medication that, when taken long term, increases serotonin levels. However, when buspirone is taken less frequently, it actually suppresses serotonin for a few hours, again giving dopamine a temporary boost in the brain.

So ultimately, only Lybrido (the one with the Viagra-like compound) has any claim as “the female Viagra.”

Why These Drugs Aren’t Exactly “Female Viagra”

Jim Pfaus is a professor of psychology and neuroscience at Concordia University in Montreal, and is one of the researchers Emotional Brain consulted with in the development of Lybrido and Lybridos. According to Pfaus, sexual excitement in men and women begins in two parts of the brain: the medial preoptic area and the ventral tegmental area. Dopamine is released outward from these brain areas, generating a “rush” or a feeling of pleasure associated with sexual desire. So it stands to reason that drugs that give dopamine an edge over serotonin would boost sexual arousal.

The reason Lybrido and Lybridos aren’t really female Viagra is because Viagra goes to work on blood flow, causing physical changes in the smooth muscle lining blood vessels in the sexual organs and producing an erection. Both Lybrido and Lybridos mainly address neurotransmitter levels in the brain.

When Is It Expected to Hit the Market?

Tuiten published preliminary results in March of this year in The Journal of Sexual Medicine. He is expected to submit trial results to the FDA later in 2013 in hopes of winning approval. The results with Lybridos have not been completely tabulated, so it could be longer before it makes it to the market, if it indeed receives FDA approval. Tuiten says that early results with Lybridos appear comparable to results from Lybrido trials. The next steps are larger trials involving 1,200 subjects. If the drugs do not fail at that stage, FDA approval could be granted in time to have both drugs on the market in 2016.

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