Her Eyes Say Yes (It’s Just the Medication Talking)

http://www.legendswebdesign.comLet me tell you the number of times I’ve tried to write this post: four. You can see my attempts, lying stillborn, in my drafts folder.

So why has it been so hard for me to write about flibanserin, the so-called female Viagra? The topic seems a natural fit for a sex-crazed  horny  frisky  intellectually curious blogger: it’s got sex, it’s got science, and it goes to the heart of a subject that I dance around when I’m writing about dating and marriage and monogamy and polyamory. What I’m really talking about when I talk on the internet is desire.

And flibanserin is supposed to deal with desire, or rather, the lack of desire, in women. Among those who believe this is an actual medical condition (many don’t; hang on, I’ll get to them in a moment), it’s called hypoactive sexual desire disorder. Or it used to be called that. HSDD is the name the shrinks came up with back when they classified this as crazy a psychiatric disorder. Then they decided it wasn’t. Now the DSM-V has something called “female sexual disinterest/arousal disorder” which is not quite the same thing, and does not lend itself as easily to an acronym.

Anyway, the people who are trying to sell the pills have resurrected HSDD as a sort of nom de guerre, no doubt in preparation for their military marketing campaign, having learned from Pfizer that initials (“ED”) sell way more little blue pills than phrases like “limp dick.”

He's taking boner pills, and she's taken meds that make her think he's attractive.

The happy couple: He’s taking a pill so he can get a boner, and she’s on meds that make her think he’s attractive.

Speaking of that marketing campaign, I imagine a television commercial something like this: An attractive couple of indeterminate age hold hands and smile at one  another as the sun sets behind them. Then, a soothing voiceover.

With the help of flibanserin, she won’t have a headache tonight. 

Flibanserin. For Really Great Sex.™

Well, maybe not quite “really great sex.” Sprout Pharmaceuticals, the company that acquired the rights to the drug after Boehringer Ingelheim, the original developers, threw up their hands in despair, promises only that their research shows an increase of satisfying sexual events (SSEs) of .5 to 1 per month when using the drug over taking a placebo.

Perhaps you, like me, wonder, “What’s an SSE?” Is it an earth-moving, make-the-neighbors-call-the-cops (“Officer, I swear I thought he was killing her!”), I-can-die-happy-now orgasm? No, it’s not that. An SSE is whatever the participant in the study finds satisfying. That definition makes sense to me, as I can understand how an SSE would be different for different people, and might be different even to the same person, depending upon their stage of life. Back when I was younger, any sexual event that didn’t end up with me pregnant was satisfying. Now that I’m married, any sexual event that isn’t interrupted by my kids is satisfying.

But is an increase of 1/2 to 1 more SSEs a month enough to justify altering your body’s chemistry? From the Sprout Pharmaceutical website, here’s what the drug does.

Flibanserin is believed to work on key neurotransmitters, or chemicals, in the brain that affect sexual desire. More specifically, it is thought that flibanserin corrects an imbalance of levels of these neurotransmitters by increasing dopamine and norepinephrine (both responsible for sexual excitement) and decreasing serotonin (responsible for sexual inhibition).

For a long time, the opponents of the drug argued against it based on efficacy: “minimal results” did not outweigh the potential risks (fatigue, low blood pressure) and, for a long time, that argument won the debate. The FDA refused to approve the drug in 2010, and then again in 2013.

Now, last week, after all this time saying “No! No! No!” to flibanserin, sounding just like that Catholic girl back in high school who wouldn’t let you under her sweater, an FDA panel has done a complete reversal, and not only lifted up the sweater, but also spread its legs (metaphorically!) and said, “Yes!” to flibanserin. It looks like the government agency will follow the panel’s adivce and ultimately approve the drug for sale.

What brought about the change of heart? Did some new study show flibanserin really is super effective, and now women everywhere can have as many SSEs as their hearts desire? Nope. Still only 1/2 to 1 more SSEs per month from the group that didn’t take the placebo. What changed is that Sprout Pharmaceutical lobbied hard for the drug and enlisted the media in the effort (Google and you’ll find a news story in the Washington Post that reads like it was written by the company’s PR department) and appealed to feminism and fairness: men have twenty-odd drugs approved for male sexual dysfunction and women have nada.

I’d be lying if I said Sprout Pharmaceutical’s argument doesn’t sway me. Why hasn’t more effort been made toward solving the sexual problems of women? I’ve been called (derisively, but I wear the label with pride) a sex-positive feminist and it pains me that, out of necessity, so many feminist discussions of sexuality center around rape, abuse, and exploitation. I wish there were more opportunities to celebrate female sexuality, because it’s an aspect of my life where I’ve found a lot of joy as a woman. Maybe if more women were having great sex, there would be.

So why didn’t the FDA approve flibanserin sooner? Could it be that as a society we’re still uncomfortable with the sexuality of women? Did the rejection of flibanserin amount to the FDA saying “Nice girls don’t”?

Maybe.

Maybe not.

Even as a sex-positive feminist, I see the problems with treating lack of sexual desire in women, because from there it’s a very short walk to that icky place where we find ourselves having sex when we maybe don’t really want to have sex.

And is “hypoactive sexual desire disorder” even a thing? The American Psychiatric Association said no, it’s not. Sexual desire varies in humans, there is no norm from which one can be “hypo” or “hyper” and anyway, it’s not something that can be measured like blood sugar level. In addition, there’s is a long and tortured (literally!) history of the medical industry treating people (especially women) for “diseases” that they did not have. Normal female behavior has been pathologized in the past, and the story of flibanserin sounds an awful lot like something we’ve seen before.

1401853_83250194

“. . . and the next time you have sex it will be so great your neighbors will call the cops!”

After all that I’ve written here, perhaps you can see why I’ve struggled so long with writing this post. I don’t know how I feel about flibanserin. I guess I’m okay with the FDA’s recent decision, and I do believe women should have the choice to get relief from their situation if it’s troubling them. Anyway, it’s not my place to tell other women what’s good for them or not. If I could, I would wave a magic wand so that every woman gets to experience sex with caring, thoughtful, respectful partners and they’re so full of desire nothing else ever gets done in their lives.

How’s that for an unintended consequence?

Royalty free stock photos, including the images in this post, can be found at freeimages.com. 

Advertisements

15 thoughts on “Her Eyes Say Yes (It’s Just the Medication Talking)

  1. Ellen Hawley says:

    The stuff “is believed to work” on neurotransmitters? Sounds like they don’t have a clue what they’ve bottled. That alone would make me a little nervous about the stuff.

    I read somewhere or other that female sexual dysfunction (if that’s what, in fact, it is) is more complicated than the male version, hence the lack of offerings–and probably of research. With men, they’re basically researching hydraulics. With women, they’re less sure where to start.

    Like

    • Karen says:

      All very true. It’s not accurate to call flibanserin a “female Viagra” because men who take drugs for impotence want to have sex, they just can’t. Women who lack sexual desire don’t want to have sex. That could be a problem for some; for many others it’s probably more like not wanting to eat green beans. You can get along just fine in life without eating green beans.

      Liked by 1 person

      • Karen says:

        And just to clarify–how psychotropic drugs work isn’t always well understood (we really don’t know a whole lot about how the brain/emotions work!), so the fact that Sprout Pharmaceuticals hedges a bit in their description is not surprising.

        One of the selling points for flibanserin that I neglected to mention in the post is that it’s not a hormone–you can make women (and men) crazy horny by giving them testosterone, but there are really terrible side effects, so it’s kind of a good thing that (maybe) they’ve found something that can improve libido without all that other stuff.

        Like

      • Karen says:

        And it is easier to address the symptom than determine the underlying cause in lots of psycho-social difficulties, let’s call them. As someone who’s benefitted from the use of psychotropic drugs, I’m all for feeling better. That’s what’s important to me. We can sit down and chat about all the reasons why I felt anxious in the first place, but first, I need to be able to get through the day.

        Like

  2. Michelle at The Green Study says:

    I think having 1/2 SSEs might be part of the problem. Take it all the way, fellows.

    Human sexuality, like the brain, is so damned varied and complicated. Pharmaceutical industries, like some doctors, are only treating bits and pieces of the human condition. It’s like when the nutrition industry separated various nutrients from whole food and repackaged them, unregulated, for profit, with no clue as to their efficacy.

    The FDA is one of the more corrupted government institutions, especially when it comes to women’s medicine. They have failed repeatedly to put the public’s health and safety as first priority.

    Liked by 1 person

    • Karen says:

      Hah! You know, for a lot of years when I would hear women say they didn’t care much about sex I always thought (and sometimes said) “They just haven’t been with the right person yet. ” Eventually, I’ve come to realize, “No, they really don’t care much about sex.”
      And sexual response is really complicated but so is heart transplant surgery and yet we managed to figure that out.

      Like

  3. Belladonna Took says:

    I think what bothers me about this story is that, once again, something that’s essentially a scientific decision was made based on political grounds. You suggest that the FDA may have rejected it because some (presumably male) FDA person was uncomfortable with the idea of female sexuality. On the other hand, it’s entirely possible that some (male OR female) FDA person didn’t like the side-effects, and thought the results were questionable. I mean, shit, some months we want it more than others. Some YEARS we want it more than others. Wouldn’t that also account for a 1-1.5 differential? But then along come a bunch of lobbyists – i.e., people who are paid a shitload of money to feel things on behalf of the rest of us – and yee haw, women now have yet another tool in their sexual equality toolbox.

    I’m not opposed to the idea of this stuff. If a woman is informed about the risks, chooses to take it, and has Happy Feelings as a result, that’s fine by me. I won’t even ask how much the Happy Feelings were as a result of expecting to have Happy Feelings. Also, I think the FDA sucks – but that’s another story. But I still think it’s bollocks when decisions that are supposed to be based on science… aren’t.

    Like

    • Karen says:

      Well, I don’t believe that humans make any decisions without subjectivity entering into the process. People that say they’re making “unbiased” decisions are just unaware of their biases. “Science” is not cold hard facts, though there are folks that like to pretend that it is–data can be interpreted any number of ways and it is and it has been and will continue to be forever and ever as long as there’s a human being at the end of the line attempting to figure out what the experiment he/she just conducted means.

      I think the FDA panel could have gone either way on flibanserin–but it’s been used as an antidepressant in the past, it’s mostly safe, and maybe if it gives some women relief and makes a boatload of cash for Sprout Pharmaceuticals (we shall see if that happens), there will be more research into sexual health issues that affect women.

      Like

      • Belladonna Took says:

        I agree with you as regard the end result … but seriously, are you comfortable with the fact that ultimately this decision was reached because a bunch of highly-paid industry lobbyists took a bunch of politicians to lunch? Do you think that’s the way we actually want such decisions to be made?

        Like

        • Karen says:

          I don’t know if that’s exactly how the decision was made–certainly Sprout Pharmaceuticals was behind the media campaign, but they got an awful lot of people and organizations to buy into their argument, and as I said in my post, I find it convincing. You can question Sprout Pharmaceutical’s motives because they’re not altruistic, but, hey, few motivations are.

          Liked by 1 person

    • Karen says:

      You know, the really uncomfortable thing is that while I was researching (hah!) this bit, I read the conclusions/recommendations of one of the researchers who noted that what the subjects reported in their diaries (the women were asked to keep diaries as part of the experiment) did not always correspond with the other measures the researchers were tracking, i.e. the subjects were lying in their diaries. How about that?

      So anyway, yeah, I guess you can, and they did.

      Like

Comments are closed.