The Scary Science Behind Female Viagra

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Pink viagraTake it from me, by the time you are in your 60’s you have experienced the highs and lows of female sexuality. The idea that a little pink pill could wipe out the lows leaving you only with bliss for the rest of your life is appealing.

But, as a long-time women’s health advocate, I greeted the news about the “pink Viagra” for women with skepticism. Another magic pill that will fix all our problems?

I’m not alone. The women’s health community is embroiled in debate about Flibanserin (let’s just call it “Flib”), a sexual dysfunction drug for women. Some, including a group called Even the Score, accuse the FDA of sexism because it has been slow to approve the drug. The National Women’s Health Network and others say the risks outweigh the potential benefit.

The new pill is intended to address lack of sexual desire. But desire is just one part of the sexual health picture. There is a difference between “desire disorder” (you’re not interested in sex, but your body responds to it) and “arousal disorder” (you want sex, but your body doesn’t respond).

And that’s one of the issues in this debate. Viagra doesn’t make a man want sex; it only works if he is already aroused and then it helps him have an erection. Flib works on the brain to boost sexual desire. That’s a big difference. Another big difference is that viagra is taken only when needed. “Pink viagra” needs to be taken every day.

It’s not clear how many women have desire problems. How do you even decide what a “normal” level of desire is?  In one study 12% of women said they had “had a sexual problem and felt distress over it”. In another study, 43% said they had experienced “sexual dissatisfaction” in the previous two months. You can see why these estimates are suspect.

Even the Score says there are now 26 drugs for male sexual dysfunction. (This is a little misleading because most of these are generic versions of four main drugs). This group is supported by long-time women’s health associations such as the Black Women’s Health Imperative, as well as pharmaceutical companies, including Raleigh-based Sprout Pharmaceuticals, which submitted the application to the FDA.

Potential side effects of the drug include low blood pressure, fainting, nausea, and dizziness. Women who took part in the clinical trials for the drug had an increase of about one “sexually satisfying event” per month.

I guess for me this issue comes down, like so many other women’s health issues, to one of informed consent and choice. Women who are troubled by low desire, who are not being pressured or coerced to take the drug and who understand the risks should have access to it.

The FDA advisory committee studying the drug recommended approval in June.  They recommended that it be limited to use by women whose lack of sexual desire is not due to other causes such as disease or relationship troubles.  They also suggested that steps be taken to minimize the risks, including informing women of the side effects and suggesting that physicians might have to become certified to prescribe the drug.

The FDA has until August 18 to make a decision.




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