A new drug aimed to help women who have lost their sex drive was recently green-lighted by the FDA earlier this month. Addyi (flibanserin), which has been coined the “female Viagra,” is reported to help with the prevention of HSDD in premenopausal women. HSDD is a relatively new term developed to describe Hypoactive Sexual Desire Disorder, a condition where a woman is otherwise healthy, but lacks libido or sexual desire that is not due to a medical or psychiatric condition, problems within the relationship, or the effects of a medication or other drug substance. Studies show that about 10-20% of women have this problem and some say HSDD outnumbers men with sexual problems. Although the demographics of these particular women has not been the primary focus of recent studies, there is no reason to believe Black women are exempt from experiencing HSDD and therefore should be well informed if considering such treatment.
If Viagra was FDA approved in 1998, why has it taken so long for drug companies to come up with a medication for women?
Some tout gender bias and even a lack of interest in women’s sexual health matters by the FDA. Others say treatment of HSDD in women is complicated. According to Judy Kuriansky, a clinical psychologist and certified sex therapist, “You have to feel good about your body. You have to feel good about yourself. You have to feel the guy really loves you…It’s complex. It’s not the same as a man taking a pill.”
How does Addyi work?
According to a 2001 study, up to 1/3 of adult women suffer from HSDD. But some experts say that for women, the cure for low libido is more likely to be found in their brains than in a bottle. And before women start running to their doctors asking for a prescription of this miracle sex drug, it is important to understand that this is NOT a women’s Viagra. Viagra focuses on the physical aspect of sexual dysfunction by treating erectile dysfunction. It sends more blood to the penis to keep it erect. Viagra assumes that sexual drive is present and it doesn’t create it.
Addyi, doesn’t work that way. It doesn’t work on the women’s genitals, but rather her central nervous system. In fact, the pill was originally developed to treat depression. Researchers initially feared it would hurt, not promote, sexual desire. Addyi is what’s known as a 5HT1A agonist and a 5HT2A antagonist. It shares mechanisms in common with the antidepressant and anti-anxiety drug buspirone (Buspar). As a 5HT1A agonist, it promotes the release of dopamine. But nobody’s really sure exactly how it elevates lust. According to the FDA, “Flibanserin’s (Addyi) mechanism in the treatment of HSDD is unknown.”
What are the side effects?
Addyi has the potential to cause severely low blood pressure (hypotension) and loss of consciousness (syncope) in some people. These risks are increased and more severe when taken with alcohol or if one takes Addyi with certain medicines or foods, known as moderate or strong CYP3A4 inhibitors, that interfere with the breakdown of Addyi in the body. Grapefruit juice is a common CYP3A4 inhibitor. Because of the alcohol interaction, the use of alcohol is contraindicated while taking Addyi. So if alcohol is a part of your romance regimen, be sure to change that once Addyi is on deck.
Other side effects were dizziness, anxiety, fatigue, dry mouth, insomnia, and nausea. Not everyone who partook in the study experienced these effects, but there were more occasions being reported compared to the placebo group. Because the drug is still fairly new, no long term studies on side effects related to HSDD have been executed, according to an FDA briefing.
So if you are considering Addyi, it will be necessary to do an honest self-assessment and have a discussion with your doctor not only about your physical health, but your emotional, mental and relationship health. There may be other underlying causes for your lack of sexual desire. It could be stress, depression, a side effect of other medications, a medical condition you’re unaware of or even relationship issues. As Black women, we are predisposed and have higher rates of high blood pressure and depression. You might have either of these and not know. And if you are someone who is being treated for either of these conditions, know that some high blood pressure and anti-depression medications when taken in combination with Addyi can cause your blood pressure to become dangerously low. So speak with your doctor about what’s going on and disclose all medications you may be taking.
It is anticipated that Addyi will be available by October 17th 2015.
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