Dr Manny's Notes

Is there a Viagra for women?

Manny Alvarez

Ups and downs are normal in any relationship, but what happens when sexual desire disappears completely? Low libido can strike men and women, but it’s more common among women. One study found that 36 percent of women between the ages of 30 and 70 had low sexual desire and that 8 percent had hypoactive sexual desire disorder (HSDD), a disorder characterized by low desire that causes the patient significant distress.

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Sexual intimacy is an important part of life for most healthy adults. It helps partners feel closer to each other and is linked to lower blood pressure, better sleep, and even better heart health. But doctors hear often from women, even women in their 20s and 30s, that the desire for sex just isn’t there anymore. This lack of desire affects women’s quality of life and their relationships. It’s common for women with low libido to have sex only to make their partner happy. Many report that they want to want sex, but it’s like someone flipped off a switch.

For years, there have been prescription medications that help men achieve erections, and now there’s a pill that claims to be able to help women with HSDD reclaim their desire for sex. The drug is called flibanserin, and instead of driving blood to the genital area like Viagra, it targets the brain. It claims to change the balance of the neurotransmitters serotonin and dopamine to create an environment that’s favorable to sexual arousal.

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Flibanserin is marketed as Addyi. It’s been approved by the FDA since the fall of 2015, but this may be the first you’re hearing of it. Despite a lot of pre-approval hype, Addyi has been much less popular than anticipated. One reason is that doctors have to undergo a short training in order to prescribe it, and pharmacies have to be certified to carry it. So it can be hard to get your hands on.

But that’s not the only reason Addyi hasn’t been a success. There are questions about its efficacy. Clinical trials showed that women taking Addyi had about one more sexually satisfying experience per month than those taking a placebo. The FDA has expressed concerns that the side effects of the drug, which can include dizziness, nausea, sleepiness, and trouble sleeping, outweigh the relatively small benefit.

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Proponents of the drug argue that women should have the right to accept the risks and that some women would try anything to see even small improvements. When the FDA eventually approved the drug, it was with an intimidating black box warning, the most serious warning label that can come with a prescription medication.

There are also practical issues with the drug. The first is that women are strongly advised not to drink any alcohol while taking the drug. Seventeen percent of patients in one study had severely low blood pressure after only two glasses of wine. Since the pill is supposed to be taken every day, women have to give up alcohol entirely in order to undergo treatment with Addyi.

The other practical concern is that Addyi is expensive, sometimes costing more than $800 for a month’s supply. In fact, lawmakers have accused Addyi’s manufacturer of predatory pricing, and as of 2016 the firm was still under investigation for price gouging.

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Practical and safety concerns aside, Addyi is the only FDA-approved pill claiming to help women with HSDD, and women should know that it’s available. If you experience low libido, talk to your doctor about HSDD. They can help you rule out other causes of low libido like depression, anxiety, and stress and help you explore your treatment options.

This article first appeared on AskDrManny.com.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.