Where's the female viagra, already?
Ah, flibanserin, we hardly knew ye.
The U.S. Food and Drug Administration's Reproductive Health Drugs Advisory Committee voted 10 to 1 on June 18 that flibanserin, 100 mg (Girosa; Boehringer Ingelheim), was not significantly better than placebo for hypoactive sexual desire disorder (HSDD). They also voted unanimously that the benefits did not compensate for its adverse effects. (Medscape, June 21)
Sometime last fall my friend Yvonne and I stood in front of a Sex Information class, systematically dismissing once-promising sex-enhancing drugs. This one works for men, but not for women;. this one doesn't work at all; this one may work but causes vomiting and loss of consciousness. And there we left it, except for — what was that new one called again — flibanserin, a.k.a. Girosa! The next great hope for women suffering from hypoactive sexual desire disorder (HSSD). "We'll be back with an update," we promised. "Hell, if we can get our hands on some we'll even try it for you."
What was new and intriguing about this one was that it purported to affect the emotions, via our old neurotransmitter friends dopamine, norepinephrine and serotonin. Now that sounded promising.
To be fair, flibanserin did not in fact completely flunk the test, it just didn't do well enough to impress a conservative (scientifically, not necessarily politically) voting panel at the FDA.
A clinical trial of flibanserin presented last year in 1,378 premenopausal women found that after 24 weeks, the frequency of satisfying sexual events increased significantly in women taking flibanserin 100 mg, from 2.8 at baseline to 4.5 at study end, compared with placebo, which was 2.7 at baseline and increased to 3.7 at the study end. Women taking flibanserin also demonstrated improved sexual desire vs. placebo as measured by a daily electronic diary and the Female Sexual Function Index desire domain.
I have to say, 4.5 vs. 3.7 "satisfying sexual events" per month for the placebo is not chopped liver. Then again, a well-marketed, completely physiologically inactive miracle sex pill, with plenty of anecdotal bolstering and a neat-o name and a very strong suggestion from a caring physician that this was the drug that would actually work better than anything out there and without any pesky vomiting and passing out even — it's really most inconvenient that a campaign like that would be illegal as well as unethical. Not to mention short-lived — heads would roll when word got out.
I'm bummed, personally, to be denied another chance to offer myself up to science for your amusement and edification. Oh, and also that there's still nothing out there for the millions of women who are, for whatever reason, just not feeling it.
Personally, I think those reasons include but go so far beyond biology and chemistry, into sociology, history, and politics ... I hope you brought a magazine, it's going to be a hell of a wait.
P.S. Viagra can totally work for some women, you know, just not on the self-reported dysfunction-sufferers studied
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