New Treatment Option for Decreased Sex Drive

An advisory committee to the Food and Drug Administration (FDA) has recommended the approval of Sprout Pharmaceutical’s flibanserin, for premenopausal women who are distressed by decreased sex drive. The little pink pill, marketed under the name Addyi, has been hailed by some as “female Viagra”.

Up to one third of all women experience decreased sex drive, termed Hypoactive Sexual Desire Disorder. Women’s sexuality is very complicated and it is uncertain if “just taking a pill” will significantly improve things. There are complex issues that can lead to decreased libido, including fatigue, stress, and problems in the relationship.  In addition, many medications, including antidepressants and some birth control pills, can also suppress desire. While some advocacy groups claim approval would be a pivotal step towards gender equality, others question whether low sexual desire in women can actually be “fixed” by a drug. However, a 2013 study in The Journal of Sexual Medicine showed that women taking the drug reported an average increase of 2.5 satisfying sexual events in four weeks, compared with an increase of 1.5 among women using a placebo.

Racing to liken the drug to Viagra, however, may be a mistake. Flibanserin works on the central nervous system by increasing dopamine and dealing with two different forms of serotonin. In this way, it is more similar to an antidepressant (and in fact was initially tested as an antidepressant before researchers realized it had pro-sexual effects) rather than Viagra which increases blood flow to the genitals. Also unlike Viagra, which is taken only when needed and works within 45 minutes, flibanserin must be taken every day. Potential side effects include low blood pressure, fatigue, and fainting, which may be worsened if a person drinks alcohol while taking the medication. The newest recommendation is to not drink any alcohol within two hours of taking the drug.

What Else is on the Horizon?

Another possible option for female decreased libido is treatment with a testosterone pellet.  The pellet is injected into the patient’s buttocks every three months.  This treatment is not FDA-approved, but is has been shown to be successful in many patients.  Dr. Astrid Von Walter is trained in this treatment for our patients. Additionally, Dr. Astrid Von Walter attends training every three to four months. To learn more, please call our office directly.