A Dirty Word by Steph Auteri

Author:Steph Auteri
Language: eng
Format: epub
Publisher: Cleis Press
Published: 2018-01-19T16:00:00+00:00

8 YOU ARE NOT ALONE

In 2010, flibanserin—touted as the female Viagra—was rejected by the Food and Drug Administration (FDA) for the first time. In 2013, it was rejected again. In January 2014, the FDA requested even further safety testing. The primary reason? The risks (and the side effects, such as nausea, dizziness, and drowsiness) were considered greater than the reward.5

Still, on February 27, 2015, Sprout Pharmaceuticals, which had taken charge of the drug’s development, announced that it had submitted a New Drug Application (NDA) to the FDA. Though initially developed as an antidepressant, flibanserin was allegedly found to boost libido.6 On the evening of Tuesday, August 18, 2015, flibanserin—a nonhormonal pill developed to treat Hypoactive Sexual Desire Disorder (HSDD) in premenopausal women, and which would need to be taken daily—was approved by the FDA.7

There are those—especially women with lackluster libidos—who think it’s about damn time. Women’s sexual health advocacy group Even the Score, for example, pointed out at the time that there were already twenty-six government-approved drugs made available to treat sexual dysfunction in men. They accused the FDA of being sexist because of the lack of a comparable drug for women.8 And they were thrilled that an FDA advisory committee finally voted to recommend approval of flibanserin.9

So why haven’t sexual health care providers collectively lost their shit over flibanserin, throwing confetti into the air and twerking around their offices?

For one thing, if we’re going to get technical, we can’t really develop a female version of Viagra, because the problems of erectile dysfunction (ED) and HSDD are very different. ED is primarily a mechanical issue, not an issue of desire, and Viagra is meant to increase blood flow to the genitals that may be hindered by circulatory system problems.

Women’s desire is another thing entirely: a complex confluence of circumstances that includes our hormones, our brain chemistry, our cultural expectations, and a barrage of interior questions in reference to whether or not we did the laundry (or the food shopping, or that work task, or that diaper change) yet. Something this multifaceted is much more difficult to manage than what can be accomplished by simply popping a pill every night before bed.

Which is why flibanserin has taken so long to hustle its way into existence. The drug has to work in a completely different way than Viagra, targeting women’s brains in order to counteract all the chaos that may be suppressing our desire to get it on. It has to increase the effects of desire-enhancing chemicals such as dopamine while simultaneously decreasing the impact of inhibitors such as serotonin.10

And in fact, according to research published in the Journal of Sexual Medicine, after studying more than eleven thousand women who tried taking flibanserin for their HPDD, there was a 37 percent reported increase in desire among the study’s participants.11

This is all well and good, but there was a second issue causing skepticism among many sexologists at the time flibanserin was approved, the very people Sprout Pharmaceuticals would hope to have on its

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