Sizing Up the Little Pink Pill

Women have been feeling "gender injustice" in the bedroom for a long time. If you look at the sexual dysfunction scoreboard you would see 26 FDA-approved medications for men (erectile dysfunction) and ZERO for women. It is clear not much attention has been paid to women’s struggles between the sheets.

The most common female sexual dysfunction is called "hypoactive sexual disorder" which is low or completely absent sexual desire. It is estimated that 1 in 10, or more than 16 million women in the United States suffer from lack of libido. Enter "the little pink pill," a drug called Flibanserin. Also known as Addyi, this was the first official drug to show some benefit in improving sexual satisfaction in premenopausal women. After being rejected twice by the FDA, Addyi has now been approved for use.

Unfortunately, Addiyi is not a "miracle drug." While women showed an improvement in the number of satisfying sexual events, frequency and intensity of desire, studies have shown a "modest 8-13%" increase in sexual satisfaction. Sexual desire is much more complicated in women compared to men. While improving male arousal in many cases is a matter of bringing more blood flow to the penis, women’s sexual desire, excitement and energy tend to begin in the organ above the shoulders rather than the one below the waist. Daily life stresses around work, money, children, relationship challenges and low energy are common issues contributing to having a low libido in women. Addyi works by increases the hormones serotonin and dopamine, in the brain to improve libido. If women do not show any improvement after 8 weeks then Addyi is not effective in their case.

It was the drug’s side effects that were a primary concern in the FDA’s decision-making process and resulted in the two previous rejections. Side effects of Addyi include drowsiness, fainting and low blood pressure which are all exacerbated when taking certain medications (such as antidepressants) and when drinking alcohol. So taking Addyi and going to “Happy Hour” with your favorite bed buddy would not be a good idea. As a group of physicians wrote in a letter to U.S. Congress supporting  Addyi's approval, however, these side effects were less serious than many of the side effects described with FDA-approved drugs for male sexual dysfunction. As with any medication, discussing the benefits versus the risks with your physician is part of the process in determining if you are an appropriate candidate for this medication.

It’s exciting for women who have struggled with hypoactive sexual disorder to be recognized and have a viable medical alternative. Not only is it a viable option for this disruptive sexual dysfunction, but the FDA is showing support in the challenges with female sexual health. Women simply want to have the same attention as men in sexual health and responsiveness from the medical community.

Some women may want to try Addyi for 3 to 6 months to see if there is any improvement in sexual desire. Others may choose to take their partner away for a long weekend in a romantic and relaxing setting leaving all electronics behind and perhaps packing some new toys, creams or lubricants. As it should be – the choice is yours!


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