TheConversation: An advisory committee to the Food and Drug Administration (FDA) has recommended the approval of the drug, flibanserin, for premenopausal women who are distressed by a lack of sexual desire. The little pink pill has been hailed as “Viagra for women”. But it’s not like Viagra. Viagra targets the hydraulics of erectile dysfunction. The mechanism of flibanserin is to increase low sexual desire by acting on dopamine and serotonin receptors in the brain, much like an antidepressant. In fact, flibanserin has been unsuccessfully trialled as an antidepressant.
The recommendation has been welcomed as a win for sexual equality by a controversial advocacy group called Even the Score
which is backed by Sprout Pharmaceuticals, the developers of the drug.
The campaigners argued that because men have Viagra, it’s only fair that
women should have access to a similar medical solution to their sexual
question whether “hypoactive sexual desire disorder” exists and whether
low sexual desire in women can actually be “fixed” by a drug. Is it
helpful to medicalise low sexual desire among women when fluctuations in
sexual desire over the life cycle, and in response to life events, are
perfectly normal? There are also concerns
about the impact on gender relations, increased pressure on women to
enjoy and initiate sex, and the potential coercive use of the drug.
This is the third time that the advisory committee has considered
whether to recommend the approval of flibanserin. Why did it get through
this time? Supporters of the Even the Score
campaign packed the advisory committee meeting room in a move
orchestrated to create the perception of unmet and urgent need for the
drug. It is this perception of need that swayed the committee’s
decision, not robust evidence of effectiveness in combination with a
reassuring safety profile. In fact, flibanserin has been described as a “mediocre aphrodisiac with scary side effects”.
presented to the committee about the effectiveness of flibanserin was
not compelling. Compared to a placebo, flibanserin increased the
reported number of “sexually satisfying events” for women by around one
event per month, with a very tiny increase in women’s perceived sexual
desire. The risks associated with the use of flibanserin are significant
enough to be concerning – low blood pressure, fainting, nausea and
dizziness – and were higher when women drank alcohol or used the
contraceptive pill, both common behaviours among sexually active women.
The question now is whether flibanserin will be approved by the FDA.
If it is approved, to what extent will there be real benefits for women?
The deadline for a decision is the 18th August. Watch this space.