So-called ‘Viagra for women’ leaves me cold
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Version 0 of 1. TV presenter Davina McCall caused a small kerfuffle on social media last week by giving an interview in which she cautioned women to keep their husbands “satisfied in the bedroom department…even if you’re absolutely exhausted. Otherwise he will go elsewhere”. Tiredness schmiredness, ladies – what kind of an excuse is that for not putting out on demand? Well, none at all from now on, at least not if you live in the US, where an FDA advisory committee has just voted in favour of approving the controversial drug Flibanserin, better known as “female Viagra”. Flibanserin has had a complicated journey, having been twice rejected by previous advisory committees on the grounds that its benefits are at best modest compared to the unpleasant side-effects. But it’s been championed this time around by a high-profile coalition of women’s groups called Even the Score, which argues that there is inherent gender discrimination in the FDA’s decisions to approve Viagra and other drugs to treat male libido while blocking the licensing of an equivalent for women. I’m all for the idea that advances in sexual health research should not be all about men, but I’m not convinced that Flibanserin is the great beacon of sexual equality that Even the Score wants to claim. Its nickname is misleading, for a start: Viagra does not target a lack of desire in men, but the medical problem of erectile dysfunction, while Flibanserin works more nebulously on levels of serotonin, dopamine and other neurotransmitters in the brain. The New York Times said last week’s FDA committee only recommended approval for “women whose lack of sexual desire was not attributable to other causes such as disease or relationship troubles” (my italics). Good luck to any physician who has to chart that hinterland of interconnected biological, emotional and circumstantial causes that often lies behind a woman’s loss of interest in sex, and decide who deserves treatment. Would anxiety count as an illness? What about stress, tiredness, hormones? How do you decide whether “relationship troubles” are a cause or an effect of a flagging libido? But the most problematic aspect to me is how some men might respond to the idea that there is now a magic bullet to “fix” women’s lack of desire. We’re already assailed on every side by the message that we’re expected to be enthusiastically up for it at all times, even before Davina weighed in. How many women might feel pressured into taking medication to combat a dip in desire rather than examining the possible causes? Many women experience natural fluctuations in libido; the idea that popping drugs with distinctly unsexy side-effects such as nausea, dizziness, fatigue and fainting is the answer to a temporary low patch seems inherently dangerous, another instance of big pharma gleefully rushing to profit from something that isn’t a clear-cut medical problem. It’s worth noting that the women’s groups under the Even the Score banner were brought together by a consultant to Sprout Pharmaceuticals, the company that developed Flibanersin. In clinical trials, Flibanserin only barely outperformed a placebo, which suggests that it may be the mere belief in a pill’s aphrodisiac powers that does the trick. If that’s the case, I think I’ll stick to oysters and champagne. |