“Female Viagra” Could Soon Be Available At A Doctor’s Office Near You

Yesterday, a federal advisory committee recommended in an 18-6 vote that the FDA approve the controversial drug flibanserin, which is now on track to become the first drug approved to treat "sexual interest/arousal disorder," or low libido, in women. Given its track record of siding with its advisory committees, the FDA is expected to green-light the drug (developed by Sprout Pharmaceuticals) by August 18, its decision deadline. This is coming after two previous rejections of Sprout's push to get flibanserin on the nightstands of American women struggling with low sex drive. The third time may be the the charm for the pharmaceutical company, which led a coalition of 24 organizations, called Even the Score, in a campaign to frame the approval of flibanserin as a matter of sexual health equity. One stat often cited by supporters of the drug is that there are no fewer than 26 FDA-approved drugs on the market to increase male sexual performance (41, counting generics), but none to increase female sex drive. But, this comparison is an uneven one, as drugs prescribed for male sexual dysfunction typically work by alleviating erectile dysfunction rather than increasing sex drive. Flibanserin, which acts on the neurotransmitters dopamine, norepinephrine, and serotonin, is the first medication designed to boost women's libido by altering brain chemistry rather than hormone levels — meaning "female Viagra" is something of a misnomer for the drug (Viagra works by increasing blood flow to the genitals). While many are applauding this development as progress for women, others are wary of the further medicalization of female desire it signals, questioning whether low libido has a place in the DSM at all. It can be difficult if not impossible to distinguish someone's desire to feel "normal" (as defined by third-party sources) from her own distress over her sexual functioning. What's more, if we don't believe a disorder is real, pharmaceutical companies can't sell us drugs to fix it. One PR firm, Ogilvy, even codified a strategy for pharma companies to establish official-sounding acronyms for conditions and present them as purely physiological in order to position medication as the only solution.

At a recent meeting organized by Even the Score, however, Cindy Whitehead, co-founder of Sprout, argued that flibanserin is a promising option for women who have ruled out other factors that could be to blame for low sex drive (including depression, mood disorders, and relationship and emotional problems). "We're very content to reduce all things in the bedroom for women to psychology, and all things in the bedroom for men to biology," she observed, criticizing the tendency to tell women that their problems are "in their heads."

Whitehead compared asking women interested in flibanserin if they want to have sex all the time to asking people on antidepressants if they want to be happy all the time, stressing that if neurochemical differences can explain women's worryingly (to them) low interest in sex, those women deserve access to appropriate treatment. As flibanserin moves though the pharmaceutical pipeline, the risk that the drug could become a first resort for women who aren't "in the mood" deserves our attention, and neurochemical adjustment will not likely crack the complex equation of female sexuality. It could, however, offer a glimmer of hope to women for whom nothing else has worked.