Sex Drugs for Women: Myths and Marketing Messages

Myth:  Addyi is female Viagra

Headline writers like cute titles, so “female Viagra” was an inevitable nickname for a women’s sex drug.  And Addyi pills are pink, sending a not-so-subtle message that women have a pink pill for sex, just like men have a blue pill for sex. But that’s where the similarities end.

Viagra (chemical name: sildenafil) helps people who want to have sex, but who can’t maintain an erection, by increasing blood flow to the penis. Viagra is taken only when needed, usually 30-60 minutes before sex.

Addyi (chemical name: flibanserin) helps cisgender, heterosexual women (the only group tested in clinical trials) feel more interested in sex roughly 10% more frequently than they would otherwise.  It affects naturally occurring chemicals in the brain and is taken every day.

Addyi doesn’t impact the mechanics of sex, only the desire to have sex. Nor is it a pill a person can take only when they’re “in the mood.”

 

Myth:  Men have lots of sex drugs, women only have one

This is a myth created by Sprout Pharmaceuticals, the company selling Addyi.  Sprout had a hard time getting Addyi approved by the FDA, so they charged the FDA with sexism and started an advocacy campaign claiming that men had dozens of sex drugs and women had none.  The actual facts are quite different:  men have nine drugs for sex; women have four.[1]

The NWHN fights hard for gender equity in research and drug development.  We support the FDA’s approach to sex drugs for women.

 

Myth:  There’s a big unmet need for sex drugs for women

Sometimes the FDA approves drugs that don’t work very well because there’s nothing else available to treat the condition.  The first drug approved to treat pre-term labor wasn’t very effective, for example.

The FDA is also more willing to approve a risky drug if it treats a life-threatening condition.  Cancer chemotherapy drugs are often quite dangerous, but worth the risk.

Addyi isn’t very effective and causes serious complications.  The FDA turned it down twice and seemed likely to turn it down for a third time,[2] when Sprout countered with a campaign that stressed the “unmet need.”

To bolster their claim that the FDA needed to approve a sex drug for women, Sprout said that 43% of women suffered from sexual dysfunction.  But do they really? Sprout asked women if they’d had any of several common sexual problems for several months.  If women answered yes to a single question, they were counted as having a sexual dysfunction.[3]  There was no consideration given to personal circumstances, such as a recent death in the family, or a cancer diagnosis, that could have explained why some women experienced problems with sex for a while.  Elevating common problems, such as not being able to orgasm, to the status of a medically defined dysfunction is a disease-mongering.

 

Myth: Lack of desire is always a problem

Research into women’s sexuality has made it clear that there is an important difference between spontaneous desire and responsive desire. A simple way to understand the difference is to think of feeling an urge for sex when no one is around—spontaneous desire—compared to “getting into it” when a partner initiates physical contact—responsive desire.  Responsive desire often leads to satisfying sexual experiences.

We don’t know how common it is for people, both men and women, to lose spontaneous desire but still feel responsive desire.  Insisting that “not wanting it” is always a problem over-simplifies women’s sexuality.

Also, there is a vocal group of asexual people who believe that asexuality is a sexual orientation, not a problem.  In contrast to people who experience desire as normal, and the lack of it as a problem, asexual individuals experience lack of desire as normal.  They oppose the depiction of lack of desire as problematic for everyone.[4]

While we don’t know how prevalent, it’s clear that some women do experience lack of spontaneous desire, don’t like it, and would like to find a solution. What causes the loss of spontaneous desire?  We don’t know.  How often does it happen?  We don’t know.  Is it different in lesbians?  We don’t know.  How many women who are distressed by lack of desire could be helped by non-medical approaches?  We don’t know.  In fact, we don’t even know what the range of normal desire is in women.

 

Myth: Sex drugs can fix the sexual problems caused by other drugs

Many drugs cause sexual side effects, including lack of desire.  Drugs taken for high blood pressure, depression, and anxiety are some of the most commonly used medications that cause lack of desire.[5],[6]

Addyi has not been shown to reverse the desire-suppressing effects of other medicines. In fact, women whose lack of desire was caused by another medicine were not allowed to participate in the clinical trials of Addyi.[7]

We encourage researchers and others to investigate this problem and develop a solution.  Drugs that cause sexual side effects are often necessary and effective treatments for other important conditions.  Inventing another pill that could reverse the side effects of the first pill would be welcome.

 

 

[1]FDA Presentations for the June 4, 2015 Joint Meeting of the Bone, Reproductive and Urologic Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee Meeting.  Slide 26.

https://wayback.archiveit.org/7993/20170405210518/https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/ReproductiveHealthDrugsAdvisoryCommittee/UCM452159.pdf

[2]FDA Briefing Document. Joint Meeting of the Bone, Reproductive and Urologic Drugs Advisory Committee (BRUDAC) and the Drug Safety and Risk Management (DSaRM) Advisory Committee June 4, 2015.   Section I, pages 3-4.  (PDF pages 7-8). https://wayback.archiveit.org/7993/20170405210445/https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/UCM449088.pdf

[3] Moynihan, Ray & Cassels, Alan.  “Selling Sickness” 2005, Nation Books, New York.  Page 175.

[4] “About Asexuality” The Asexuality Visibility and Education Network.  https://www.asexuality.org/

[5] Nicolai, MPJ, et al. A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice.  Neth Heart J. 2014 Jan; 22(1): 11–19.

[6] Higgins, A.  Antidepressant-associated sexual dysfunction: impact, effects, and treatment. Drug Healthc Patient Saf. 2010; 2: 141–150.

[7] Same as footnote 2. Section II, page 17.  (PDF page 30)

 

Updated October 2018





 

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