Why "Female Viagra" Isn't The Magic Pill For Women

Everyone’s been talking about flibanserin, “female Viagra”, which was approved by an FDA advisory committee on June 4. I first heard about it on sex advice guru Dan Savage’s Savage Lovecast and, since then, its been popping up everywhere. Many feminists, including the National Organization for Women, are championing the approval of this libido-boosting drug as a step forward in the fight for sexual equality. There’s even a whole movement called Even the Score which rose up to help push the drug through the advisory committee (after it was rejected twice before) which points out that there are a whole range of pharmaceutical options for men who are dealing with sexual dysfunction but notably fewer for women.

But a closer look at flibanserin suggests that the little pink pill for ladies may not be the sex savior we’ve been waiting for. In fact, flibanserin is shaping out to be potentially dangerous. Put away those champagne bottles, folks. It’s not quite time to celebrate yet.

First of all, let’s take a look at the what the drug actually does. David Kroll points out in Forbes that while Viagra boosts blood flow to the penises of men who have sexual desire but are unable to act on it do to a physical ailment, flibanserin was create to target the brain, not the genitals. Instead of boosting blood flow, flibanserin boosts serotonin and dopamine, the brain chemicals that control desire-related feelings like motivation, appetite, and desire.

Also unlike Viagra — which only needs to be taken right before a guy thinks he’ll be needing a hard penis— flibanserin has to be taken every day, for the rest of a woman’s sexual life.

So what’s the payoff for adding one more pill to our daily routine and messing with our brain chemicals? Sprout Pharmaceuticals, the company that created the little pink pill, says that their studies have proven that flibanserin improves the sex lives of women who take it. Here are their results, as reported by Kroll: Women who took the pill reported an increase of “satisfying sexual episodes” by 2.5 per month (an increase from 2.5 to 5.0).

If you’re underwhelmed by that number, I’m about to take it down another notch. The placebo group in the study reported an increase of 0.8 sexual episodes per month. That means that flibanserin was better than a sugar pill by 1.7 sexually satisfying sexual episodes per month. What does 0.7 sexual episodes even mean? A half-finished handy?

The study did measure sexual desire using the Female Sexual Function Index (FSFI) and they also looked at how the ladies felt about their low sexual desire by employing the Female Sexual Distress Scale. According to Sprout Pharmaceuticals, three phase three studies found "highly statistically significant difference over placebo on these three key endpoints, including increase in sexual desire, decrease in distress from the loss of sexual desire and increase in the frequency of satisfying sex."

However you feel about those numbers, flibanserin also has a bunch of scary potential side effects. Kroll describes something called syncope, which is when you pass out due to a sudden drop in blood pressure. He also pointed out that while Sprouts was specifically told to test the effects of the drug in combination with alcohol, 23 of the 25 people in the testing group were… Dudes. Yup, you read that right. The pharmaceutical company recruited… men… to test… the effects of alcohol in combination with… their female libido drug.

The drug was also found to react poorly with anti-fungal medications (like those women take for yeast infections), and included the usual laundry list of dizziness, nausea, fainting, and sleepiness, according to the Washington Post. Oh, and they also think, based on a mouse study, that it could increase the risk of breast cancer. But, you know, juries still out on that, ‘cause they haven’t really had the time to thoroughly test it yet.

And yet, despite all of that, an FDA advisory committee voted for approval of the drug in a 0-18-6 vote, with zero members voting to release it with only label advisories, 18 voting for approval “if certain risk management options beyond labeling are implemented,” and six voting “no.”

Some opponents of the drug believe that its passing was due do the passionate supporters who were present at all three hearings, including this final one. The panel and audience heard heartfelt stories from women who had suffered from sexual dysfunction but some are claiming that those women were recruited by Sprout to be cheerleaders for the new drug. Lenore Tiefer, PhD, told Forbes that a lot of the same people testifying in front of the committee had previously admitted to being paid by Sprout during a workshop on “patient-focused drug development in female sexual dysfunction” last October.

Sprout has come to the defense of their little pink pill, pointing out that a “moderate” increase in sexual desire was really all they were going for in the first place. CEO Cindy Whitehead pointed out to Kroll that the goal wasn’t to boost the ladies into “hypersexuality” but rather to give them a nice little nudge upwards. Boners for hours in senior citizens is fine, of course, but we wouldn’t want the ladies to turn into super sluts, would we?

Ultimately, the biggest issue with this pill is that while it absolutely addresses a need, the solution to sexual desire should not be pharmaceutical for the vast majority of women suffering from low libido. Rather than throwing a pill that may or may not work and may or may not cause you to faint or give you breast cancer or make you dizzy, solutions addressing female libido should be focused on the real and actual reasons that woman don’t want to have sex.

What are some of those reasons? Studies have shown that desire often drops for women when they’re experiencing stress, hormonal changes like menopause, and — as Dan Savage repeatedly pointed out on the most recent podcast — boredom. For a lot of women, the simple fact of being in a long term monogamous relationship is the reason behind their lack of desire. In fact, some research suggests that women are more turned on by a stranger than by a known partner, which means that bed death is an unfortunate possibility for so many of us in this culture that believes in long-term monogamy.

But you know what? I’m all about choice. From the results so far, it sounds like this pill could work for a small number of women who are suffering from a low libido. I think that a serious, long discussion between those women and their doctors could lead to some life changing experiences. What worries me is that I already see women not being fully informed by doctors about the effects of another common, daily pill: hormonal birth control. There are so many risks and side effects that most women (and girls) don’t even know about. Without that kind of information, how can we really make informed choices about our sexual health and the chemicals we’re putting into our bodies?

For the majority of women, dealing with a low libido is going to take a lot of work. It’s going to take serious reflection and life changes, not a little pink pill that may or may not make it unsafe for you to drive. Laken Howard has some all-natural alternatives to flibaserin that she suggests, and I’d like to add one more: Be honest with yourself about what you need. Do the hard work of making the changes that you need to bring your sex drive back. It’s gonna suck, but it’s worth it.

Correction: An earlier version of this article stated that the Sprout studies only measured incidences of sex, and not actual pleasure. That was inaccurate.

Images: Moyan Brenn/Flickr; Giphy (4)