Women Deserve Equal Access to Drugs That Treat Sexual Dysfunction

A doctor holds a pile of blue Viagra pills in his hand. Nito/Shutterstock.com

I’d venture to say that post-porn I had a fairly high libido. I found the joy of sex exclusively with my partner exhilarating—more intimate and satisfying than ever before. In some ways, my sex life after porn felt like an awakening. Soon we were blessed with an adorable, helpless child who required constant attention and care. And suddenly, there was less time for everything, from sleeping to sex. I still enjoy sex, but these days I hardly think about it.

Whereas I used to find myself daydreaming about it regularly, today it’s more of an afterthought following cooking, cleaning, toddler chasing, and so on. I’m sure my husband wishes I’d initiate sex more often, but I know I’m far from alone in that department. This is a common problem for new mothers, as they figure out how to balance parenthood, personal lives and work. I can’t help but wonder: where did my libido go?

Although I realize this is perfectly normal at this time in my life, and likely just a phase, if I could take a pill to get it back I would.

For women who do suffer from a chronic lack of desire, we’re closer than ever to having a female Viagra-like option. On June 4, a Federal Drug Administration advisory committee voted in favor of recommending Flibanserin, the drug many are hailing as the “female Viagra,” for FDA approval. While the FDA is not required to follow the advisory panel’s suggestions, history shows they often do. If approved, Flibanserin will be on the market as Addyi, a drug that some sections of the media have been—misleadingly—implying functions like Viagra for women.

Yet Flibanserin doesn’t work the same way Viagra does. There’s no rush of blood to the genital area—in fact it doesn’t target the genitals at all. For men, Viagra is only effective if they are sexually aroused but it doesn’t help get them to that state. The drug touted as the “female Viagra” works in an almost opposite fashion: it targets the brain to boost libido. According to its makers, Sprout Pharmaceuticals, “ADDYI increases dopamine and norepinephrine (both responsible for sexual excitement) while transiently decreasing serotonin (responsible for sexual satiety/inhibition) in the brain’s prefrontal cortex.” Unlike Viagra, however, it cannot be taken on demand before desired intimacy occurs. It must be taken daily to be effective. And as with most medications, Flibanserin has its fair share of side effects to consider—some which are fairly common—including, but not limited to, fainting, fatigue and dizziness.

Designed to improve the lives of women suffering from Hypoactive Sexual Desire Disorder (HSDD is defined as the persistent distressing lack or absence of sexual fantasies and desire for sexual activity), Flibanserin would be the first of its kind to legitimize the women who struggle with real, and at times debilitating, sexual dysfunction. According to a study conducted by The Journal of the American Medical Association, sexual dysfunction is more common in women than men, with 43 percent of women reporting that they had experienced sexual dysfunction compared to 33 percent of men. But up until now, there hasn’t been much pharmacological help for women who suffer from a low libido.

Flibanserin has been rejected twice in the past five years by the FDA, as it continued to request more data about the pill’s side effects and interactions with other medications. The FDA’s reluctance to approve a drug for female sexual dysfunction spurred some in the women’s health sector to create Even the Score, a coalition of 24 organizations fighting for equality in women’s sexual health. Among those supporting it are Sprout Pharmaceuticals. Considering that Sprout Pharmaceuticals has raised an estimated $50 million from private investors to develop the highly anticipated Flibanserin, a failure to obtain FDA approval could crush future developments in this field. This isn’t just about women’s health, it’s business.

Even the Score cites gender bias as the core problem, stating that “there are 26 FDA approved drugs to treat various sexual dysfunctions for men (41 if you count generics!), but still not a single one for women’s most common sexual complaint.” In response, the National Women’s Health Network recently published a statement declaring that the problem is not sexism at play but the lack of drugs that actually work. “Even the Score’s gender equity argument is catchy, but ignores the real safety differences between drugs tested for FSD [female sexual dysfunction] and those already approved for men,” it says. Perhaps the problem we face is as simple as not being able to accurately gauge female desire. Not knowing when it’s lack of interest or a real disorder.

Chauntelle Tibbals, Ph.D., a sociologist and the author of Exposure: A Sociologist Explores Sex, Society and Adult Entertainment, says she has concerns about a pill that can’t be popped on demand like Viagra, but has to be taken daily, as this requires a lifestyle shift. “Bored in the bedroom or bored in a relationship, certainly there are some women who have an issue or need that will be met in this manner. But to say to a women who doesn’t desire sex, ‘hey here’s a mood altering drug to fix yourself,’ well, that seems a little dangerous to me,” she says.

Yet even if the drug itself doesn’t live up to the expectations that it will be a Viagra for women, its mere approval could be groundbreaking. “Approval of Flibanserin will be proof of concept that a biological treatment for a women’s sexual problem can be approved by the FDA,” says New York City sex therapist Dr. Stephen Snyder. “This will give the green light to pharm industry decision-makers to invest in research to develop newer and more beneficial medications.”

When a man experiences erectile dysfunction he’s no longer able to perform the physical act, but a woman experiencing sexual dysfunction can, technically, still have intercourse. “It’s not just that she’s having an off day. Many women with desire problems clearly express that they’ve lost something and want it back,” says Snyder. “The availability of a medication will draw attention to the fact that this is a real condition that causes suffering.”

Sexual dysfunction in women is hard to quantify, primarily because it isn’t purely physical. Sometimes you’re just not in the mood. And that’s okay. But what if you’re in a happy, healthy relationship but never in the mood? In my personal life, I often go with it even if I’m not entirely in the “mood,” and shortly thereafter find myself in the midst of an enjoyable experience. Arousal works differently in men and women and in my own experiences, I’ve found men are faster to become aroused than women. I think women take a while to heat up—like an oven—whereas men are like microwaves, hot and ready in seconds. That said, for some women the desire just isn’t there anymore. In those cases, the ability to take a pill to restore libido could be liberating.

Couples bond over sexual experiences; intimacy is necessary to maintain a healthy relationship. “Desire in both genders starts in the mind,” says Snyder. “People have this crude Viagra-based notion that you can spark desire by increasing blood flow to the genitals. Under some circumstances that can happen, but it doesn’t reliably work that way. Desire is not mainly a genital thing. It’s more of a mind thing.”

One thing’s for sure, if Flibanserin gains FDA approval in August, it will open the doors for more to come. While it’s not exactly the magic pill the public is hungry for, it has the potential to encourage other companies to come up with something even better. Moreover, women deserve the choice to treat their sexual disorders, and it’s time our society recognizes that.

Aurora Snow is a former adult actress and a contributor to the Daily Beast.