Sex Pill for Women: Big Pharma Trying to Profit from Low Sex Drive?

Drugs to boost women's libido are not recent. They date all the way back to Roman times when the wife of Augustus Caesar dosed her guests to liven a party. Marquis de Sade did the same, seventeen hundred years later.

Now a new female libido drug, dubbed the Pink Viagra, has husbands, boyfriends and Wall Street cheering, if not its intended patients.

On June 18 an FDA advisory committee will consider approval of flibanserin, manufactured by Germany-based Boehringer Ingelheim Pharmaceuticals, for "treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women."

Flibanserin was rolled out at the European Society for Sexual Medicine's annual meeting in Lyon, France last November as an exciting new treatment for libido impaired women. Volunteers reported the number of "satisfying sexual encounters" they had on the drug increased from 2.7 to 4.5 times a month in pooled data from placebo-controlled Phase III studies in the U.S. and Europe. Placebo worked too, with women reporting satisfying sexual experiences increased to 3.7 a month. (Evidently just thinking about sex, rather than "England," stokes desire.)

To participate in trials, women had to be "in a stable, monogamous, heterosexual relationship" for a year, free from depression and parenting, eldercare and income stress -- but who does that leave? -- and "willing to try to have sexual activity" at least once a month.

Like Pfizer's 12-year-old Viagra, which was meant as an angina drug until its erectile effects appeared, flibanserin was groomed to be an antidepressant until its effect on female sexual desire surfaced during the study and trial participants didn't want to return their unused pills, according to Medpage. It wasn't effective as an antidepressant despite 15 years of forced swim, "learned helplessness" and stereotactic experiments in animals.

Chemically, flibanserin modulates dopamine and serotonin like other psychoactive drugs but is less like current SSRI antidepressants than older drugs like Buspar and Serzone says an article on Neuroskeptic.com. (The antidepressant, Serzone, barely used today because of liver toxicity, was linked to male and female priapism, an abnormal and painful erectile state.) Flibanserin may even share antipsychotic effects with Haldol and Zyprexa speculates a 2002 article in CNS Drug Reviews.

Despite its rep as a female Viagra, flibanserin really isn't. Viagra exerts mechanical actions, increasing blood flow to the genitalia without increasing desire while flibanserin does the opposite -- increasing desire, not blood flow.

But the bigger difference is dosage: while Viagra is taken as needed and even impulsively, flibanserin is taken all the time for the 4.5 or 3.7 times a month sexual activity occurs.

While the push to take daily drugs for occasional occurrences, like antidepressants for anxiety and "prevention" drugs for disease "risks" certainly turbo charges pharma sales, some wonder if women will want to alter their chemistry for a few enchanted nights. Sure, women take birth control pills all month long but when women were offered the chance to treat painful periods by taking a repurposed Prozac called Sarafem every day, there were few takers.

Of course, to be covered by insurance, women who take flibanserin need to suffer from hypoactive sexual desire disorder, or HSDD, which is where the controversy about the Pink Viagra starts.

HSDD is defined in the current Diagnostic and Statistical Manual of Mental Disorders (DSM) as "the persistent or recurrent lack (or absence) of sexual fantasies or desire for any form of sexual activity" causing "marked distress or interpersonal difficulty."

In light of the fact that many women have low sexual desire and are okay with it and other women have low sexual desire because of very real things their partner (or partners) is doing or not doing, do women really want to be told there's something wrong with them?