Flibanserin, the drug better known as “female Viagra,” first stirred up controversy last year after hitting the market in a flurry of debate among researchers and lawmakers over its efficacy. Now, flibanserin is back in the spotlight: A recent review of eight studies reports the drug gives women seeking to boost a chronically low libido an average of one-half an additional “satisfying sexual event” per month. That’s a pretty underwhelming rate for a pill some researchers and activists hope will revolutionize drugs to enhance desire—though only time will tell the role flibanserin plays in altering our sex lives through medicine.
Some news reports on the study are taking the “one-half” statistic at face value, but it’s less perplexing than it sounds. It’s not suggesting that women, say, have half-orgasms each month. Rather, it means women using the drug reported one more satisfying sexual event per two months, on average, than those getting a placebo, according to one of the study’s lead researchers, Ellen Laan of the University of Amsterdam. (Laan has also advocated against selling the drug until more research is done, as the New York Times reports.) That one-half rate falls on the low end of estimates the Food and Drug Administration cited last year to justify selling flibanserin—currently the only drug approved by the FDA to treat low libido. The most optimistic range landed between 0.5 and one additional satisfying sexual event per month, as Maya Dusenbery reported in the January/February 2016 issue of Pacific Standard.
But the debate surrounding flibanserin extends far beyond its ability to re-charge women’s libidos, Dusenbery found. The FDA rejected the drug twice before approving it last year, following a few years of lobbying from women’s interest and health organizations partnering with its then-owner, Sprout Pharmaceuticals. While some feminists have hailed flibanserin a victory against a pharmaceutical industry—and wider culture—that largely ignores women’s sexual needs, others have decried it as an attempt to police sexuality through medicine. Dusenbery wrote:
After speaking to several experts on both sides of the debate, this much is clear: Flibanserin is far—really far—from being enough of a slam-dunk to support the charge that the FDA’s hesitancy about it was due to sexism. It is also clear that how one assesses the data on this particular drug is inevitably influenced by one’s beliefs about the benefits and risks of designing a pharmaceutical treatment for low sexual desire in the first place. The controversy has stirred up important, unresolved debates within feminist circles about the advantages and pitfalls of turning to the medical system to address sexual problems. It’s a conversation that speaks as much to the limitations of modern medicine as to its promise.
These latest findings further suggest flibanserin is no slam-dunk for the women it’s designed to treat. All of the women in the eight reviewed studies have been diagnosed with hypoactive sexual desire disorder, or HSDD. Until 2013, the Diagnostic and Statistical Manual of Mental Disorders included HSDD as a unique diagnosis defined by a lack of sexual desire that causes women psychological strain or relationship conflicts. When the American Psychiatric Association revised the DSM in 2013, it combined HSDD with an arousal disorder, in part to acknowledge the close, complex relationship between arousal and desire, Dusenbery reported. Women now receive the same diagnosis for any distressing lack of desire or lack of physical response to sexual activity. This broad diagnosis leaves it an open question what exactly constitutes a “disorder” of women’s sexual desires. In the meantime, women seeking relief from a continued, upsetting lack of sex drive have to weigh the benefits of the pill against the side effects identified in the recent review. The researchers found a clinically and statistically significant increased risk of dizziness, nausea, and extreme sleepiness from taking flibanserin.
So far, the drug’s target audience doesn’t look impressed. Sales of Addyi, the brand name version, are running at a rate of $11 million a year, well below its parent company’s target of $100 to $150 million, the New York Times reports. Some people will pay for six more orgasms a year (and who’s to say they shouldn’t?), but right now, not many are turning to “female Viagra” to get there.
Since We Last Spoke examines the latest policy and research updates to past Pacific Standard news coverage.
