Everyone, it seems, has an opinion on the FDA’s approval this week of the drug Flibanserin, aka “pink viagra,” to boost women’s sexual desire.
“This is the biggest breakthrough for women’s sexual health since the pill,” Sally Greenberg, executive director of the National Consumers League told The New York Times.
Others have their doubts. Cindy Pearson of the National Women’s Health Network told NPR that approval of the drug “is a triumph of marketing over science” and added: “To have any chance of benefit from this drug they’re going to have to take it every day for months on end, years…We just don’t know what the long-term effects will be of changing brain chemistry in this way.”
Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research (CDER) said the approval “provides women distressed by their low sexual desire with an approved treatment option…The FDA strives to protect and advance the health of women, and we are committed to supporting the development of safe and effective treatments for female sexual dysfunction.”
The drug, which will be sold under the brand name Addyi, is expected to go on sale Oct. 17, according to its maker, Sprout Pharmaceuticals. And along with the potential to ignite a low (or non-existent) libido among some women, the drug comes with a boxed warning, the strongest kind, on contraindications and potential side effects, including low blood pressure, fainting, nausea, dizziness and sleepiness.
Here’s more on the site Throb, about how the drug actually works.
Still others have extreme doubts.
Emily Nagoski, a feminist sex educator and author of the book “Come As You Are” wrote a smart, thoughtful piece on the site, Medium, about why Flibanserin isn’t addressing the true nature of women’s sexual desires. Here’s a bit of that piece, called: “Pleasure is the Measure:”
I believe that the folks at Sprout Pharmaceuticals — the company that owns Flibanserin, the so-called “pink viagra” — have good intentions. I believe that they want to help women who are struggling with sexual desire.
And I believe that they feel sure — as most people do— that lack of spontaneous, out-of-the-blue desire for sex is a problem. A disease.
They are wrong — as you now know.
It’s not their fault, really, that they’re wrong. Cindy Whitehead, Sprout CEO, isn’t a sex researcher, educator, or therapist. She’s a marketing professional, and she’s darn good at her job. But why would she believe anything except what mainstream culture taught her?
In fact the drug is designed — they’ve said explicitly — as though responsive desire were a disease, as though spontaneous desire were the only “normal” way to experience desire.
And that’s a problem.
The drug is designed to create spontaneous desire — and it doesn’t even work for the vast, overwhelming majority of women, even within the highly selective group it was tested on: it was only tested on pre-menopausal cisgender women in monogamous heterosexual relationships, who had not given birth or breast fed in the last six months and had not had depression or other mental health issues that can interfere with sexuality in the last 12 months, among other exclusions. Also 90% of them were white…
But millions of women will want it, because the very fact of the drug’s existence reinforces the myth that lack of spontaneous desire is an illness that requires medical intervention — that is: It makes women focus on whether or not they “CRAVE” sex,
distracting them from whether or not they ENJOY sex.
In another Medium piece written by Nagoski just before regulators approved the drug, she envisions two possible scenarios for women who don’t always feel instantly the mood:
Imagine one year from now.
Imagine you’re a premenopausal woman in a long-term, monogamous heterosexual relationship (the only people included in the drug trial). Previously in your relationship, you experienced spontaneous, out-of-the-blue desire for sex, but these days you’re not experiencing that. Your relationship is strong, your health is good, and when you can get yourself into a sexy scenario, it goes well — you’re not just going through the motions, you actually enjoy sex with your partner — but you aren’t experiencing that urge.
So you ask your doctor about it. Is there anything she can offer to help you experience that out-of-the-blue desire?
What if your doctor says: “Yes there’s a drug that you take every day, indefinitely, that could possibly increase your sexual frequency by approximately one ‘sexually satisfying event’ per month above placebo. Also, about 10% of women experience side effects like dizziness, fainting, somnolence or nausea.”
And then she holds up her prescription pad and says, “Want it?”
How do you feel? What do you do next?
Okay. Now imagine a different scenario.
What if your doctor says: “Actually, though spontaneous desire is lots of fun and most of us grew up learning that it’s the only ‘normal’ kind of desire, it turns out that responsive desire is also normal. Responsive desire is when you don’t get that urge, but if you put your body in a sex positive scenario — for most people that means low stress and high affection — your body experiences pleasure, and desire emerges from there. Most people experience both styles at different points in their lives. Spontaneous desire isn’t a measure of sexual wellbeing. Pleasure is the measure.”
And then she holds up a booklet called something like 10 Tips for Making the Most of Responsive Desire, and she says, “Want it?”
Women are struggling. They want to feel normal and healthy in their sexual functioning, and they deserve safe, effective treatments. Fortunately, an expanding body of research has shown that sex therapy, couples therapy, bibliotherapy, mindfulness, and sex education can improve sexual satisfaction. They work more effectively, for more women, with less health risk, than any drug.
By approving Addyi, it seems, the FDA is ensuring Option 1 will become a reality for more women. But maybe along with it, we can gain some knowledge about the non-drug options for sexual pleasure.
Readers, chime in and share your thoughts. Are you running out to get a prescription today, or will you stay away from Addyi?