Viagra does not affect the desire for sex in men, it just helps with the hydraulics. The drug boosts blood flow to the genitals so men can get and sustain an erection. Yet the female libido drug that passed muster at a U.S. Food and Drug Administration advisory panel this week will not live up to the “female Viagra” hype it’s been getting. The new drug, Flibanserin, is designed to alter women’s brain chemistry over time to help increase sex drive. Unlike Viagra, it does not spark an immediate physical change in the body.
Flibanserin is designed to address chronically low sexual desire in woman that causes distress. (The condition is distinct from fluctuations of sexual desire that occur naturally over time.) Exactly how many women experience it has been hard to pin down—one study suggests as many as one in three women, although the pharmaceutical company producing the drug told the FDA advisory panel that about 7 percent of premenopausal women have the condition, according to The New York Times. Women with the condition may still enjoy sex when they are having it but typically do not have the desire to engage in sex in the first place.
Whereas Viagra is a little blue pill men would take directly before sex to help direct that blood flow, Flibanserin needs to be taken daily. Over time it can affect two neurotransmitters in the brain and that may help influence libido. Exactly how Flibanserin restores desire, however, is murky. The drug acts to increase the neurotransmitter dopamine—a chemical that modulates motivation and reward—by binding with dopamine receptors. It also suppresses serotonin—a neurochemical linked to appetite and feelings of fulfillment or satiety—by acting on serotonin receptors.
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Other drugs on the market target some aspects of sex for women, such as helping treat vaginal dryness, but none have been approved for treating low female sexual arousal. Flibanserin was originally developed as an antidepressant drug by pharmaceutical company Boehringer Ingelheim although it is now produced by Sprout Pharmaceuticals. Several other antidepressants are currently prescribed off-label to treat sexual desire disorders but some of those drugs have can cause unwanted side effects such as irregular heartbeat or shortness of breath. Flibanserin, in fact, was rejected by the FDA twice for side effects that include fainting spells and low blood pressure.
The FDA advisory panel that voted on June 4 to recommend approval of the drug did not discount those risks. They came to their decision after hearing testimony from women about how the drug significantly altered their lives for the better. The panel voted 18–6 in favor of putting the drug on the market alongside information about its side effects. Panelists agreed that the benefits of the drug were not large but still meaningful for patients. The FDA is not obligated to approve the drug now but the agency often follows the recommendations of its advisory panels.
Yet whichever way the FDA goes with their approval one thing remains clear: calling it “female Viagra” is misleading.
