Everything you need to know about the 'female Viagra' (Flibanserin)

Flibanserin was approved by the US Food and Drug Administration (FDA) this year for the treatment of diagnosed hyposexual desire disorder (HSDD) in women. The condition is characterised by a persistent or recurrent lack of desire for sexual activity that causes significant distress for the subject or their partner.

For the drug to be prescribed, HSDD must be diagnosed after consideration of other factor that may contribute to low libido such as menopause. 

Addyi—flibanserin’s US trade name—works very differently from Viagra, though both have become aligned in the media. Hailed as a wonder treatment in the early nineties by men suffering from erectile dysfunction, Viagra directs blood flow to the penis and would not be prescribed for women with suffering a lack of arousal.

Conversely, flibanserin works in the brain.

By raising levels of serotonin the drug operates almost like an antidepressant. It targets neurotransmitters to increase serotonin levels, Sprout Pharmaceuticals claim flibanserin activates sexual impulses in the brain. The drug is designed to be taken every day as a long term measure and can take up to eight weeks before users begin to notice its effects.

Though the results are real and beneficial for some women suffering from diagnosed HSDD, they are limited.

According to studies brought to the FDA around 10% of women taking Addyi in controlled trials experienced an increase of ‘sexually satisfying events’ when compared to women taking a placebo.

As with similar acting drugs, such an antidepressants, flibanserin’s commonly reported side effects are nausea, drowsiness, dizziness, insomnia and dry mouth. Due to an increased risk of fainting, users of the drug cannot drink alcohol in the long term.

Addyi is also not recommended for women with blood pressure conditions due to a high risk of fainting and information about long-term health risks is not available due to the length of trials.

Flibanserin failed to gain FDA’s safety approval twice in previous years as a result of reported side effects. Some have felt the prolonged distress of women living with HSDD was discriminatory when a treatment is available for the condition.  

With the support of women’s groups in the US, a lobbying campaign was launched by Sprout Pharmaceuticals who took flibanserin back to the FDA. Pointing to the number of approved treatments for sexual disorders in men and the lack of similar treatments for women the campaign called, Even The Score, accused the FDA of gender bias.

The administration strongly refuted the claim, agreed to reconsider the evidence, and eventually approved the drug for the treatment of HSDD.

Many doctors and campaigners remain unconvinced of the wider benefits of flibanserin, stating that sex drive in women is a much more complex issue than that of men.

Referring to research done by Rosemary Basson in the early 2000s, Dr. Karen E. Adams, clinical professor of OBGYN and Director of the Midlife Women’s Clinic at Oregon Health and Science University, argues that the model for sexual arousal in women is no longer understood as a linear road to orgasm.

Basson’s work refined the model in circular terms, incorporating emotional experience, and explaining that sexual desire is often not the entry point for sexual intimacy as previously assumed.

Mental and physical health can be causes of low sex drive, and the pressures of new relationships, particularly later in life, are some of the background factors. Dr. Adams believes all these factors need to thoroughly considered and treated with therapy before women are prescribed pills to cure a low sex drive.