Female 'Viagra’ – but how useful will it be?
If a pill is developed that is safe and effective, lets not put up any barriers to it.
The launch of Viagra by Pfizer in 1998 transformed the sexual landscape – and a female equivalent is once again on the horizon. While previous attempts at a “pink Viagra” – including nasal sprays and testosterone patches – have floundered, a Dutch company called Emotional Brain claims that early clinical trials of a new drug, Lybrido, shows promise in the treatment of hypoactive sexual desire disorder (HSDD), defined as a lack of sexual fantasies or desire for sexual activity.
If the research proves successful, the pill could be on the market as early as 2016. But the hype around the new drug has reignited the controversy about female sexual dysfunction. Critics claim that the £1.5 billion annual market for Viagra has encouraged the pharmaceutical industry to repackage lack of sexual desire in women – triggered by factors as diverse as new motherhood, stress, ageing or a failing relationship – as a medical condition.
Viagra targets a specific physiological problem, erectile dysfunction, by improving blood flow to the penis. The problem with creating a version for women is that female arousal is thought to be more complex, involving psychological as well as physical aspects.
Emotional Brain claims to have resolved this problem. Animal research has identified two chemicals as key to sexual desire: testosterone, which fuels dopamine, the “lust” chemical, and serotonin, which gives a sense of well-being. The theory is that if the balance of the two is incorrect, the result can be loss of libido.
The company says its new pill, Lybrido, combines Viagra-like chemicals that stimulate blood flow to the genitals with a “coating” of testosterone. A second drug, Lybridos, appears aimed at the “psychological” aspect by temporarily suppressing serotonin, although it is still unclear how this might work.
The journalist Ray Moynihan, author of Sex, Lies and Pharmaceuticals (Greystone Books, 2010) has called female sexual dysfunction the clearest example yet of “corporate-sponsored creation of a disease”. In the British Medical Journal, he compared industry-sponsored research, which regularly finds sexual dysfunction to affect 30-40 per cent of women, to a well respected survey of 10,000 people in the UK carried out in 2003 by independent researchers, which found that, though sexual problems were common, those lasting longer than six months were far less prevalent.
Dr Petra Boynton, a psychologist and sex researcher from University College London, argues that a flagging female libido should not necessarily be viewed as a medical disorder. “ 'Good’ sex is now presented as lots of sex and mind-blowing multiple orgasms. So you end up with people going to their GPs thinking they have sexual problems, when they may be misinformed, or may have relationship rather than sexual problems.”
Dr Sandy Goldbeck-Wood, a gynaecologist and specialist in psychosexual medicine, is worried that too much focus on medicalisation can result in women’s real problems being neglected. “We fail patients if we dismiss it or minimise [their sexual issues] as 'we all have problems from time to time’.” She thinks the chances of a pill working for such women are “quite slim”.
“We should treat loss of libido in women as seriously as we treat it in men,” argues Dr Clare Gerada, chairman of the council of the Royal College of General Practitioners. “You can overdo the concern over medicalisation. If a pill is developed that’s safe and effective, let’s not put up any barriers to it for women who are going through sexual difficulties.”
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