Where’s the Viagra for Women?

You’ve seen the ads. Rugged middle-aged man, oozing virility, builds campfire, obviously capable of meeting all of life’s physical challenges. Mature couple dances on beach; man confident he’s ready to perform when things turn frisky. Campaigns for drugs like Viagra and Cialis strongly reinforce the idea that men deserve to enjoy sex throughout their lives, but when it comes to similar messages for women, cue the crickets.

There are more than 25 FDA-approved drugs to treat male sexual dysfunction, a multi-billion dollar industry. But with the exception of some drugs for vaginal dryness, treatments for women are non-existent. Since women suffer from sexual dysfunction at least as much as men do, this is concerning. Women deserve lifelong satisfying sex, too! Is this gap in health care due to biology, or is it—as some claim—discrimination?

Like most things sexual, this issue is complicated. Dr. Stacy Lindau, Associate Professor of Obstetrics/Gynecology at the University of Chicago, says sexual desire is a bio-psychosocial phenomenon for both men and women. People’s turn-ons are influenced by multiple factors beyond physical readiness, including values, culture and motivation. “Desire is the combination of stimuli,” Lindau says. “A person’s biology could be working just fine, but if they’re not exposed to stimuli, what is there to desire?”

Drugs like Cialis and Viagra don’t treat lack of desire; they treat erectile dysfunction (ED) by increasing blood flow to the penis. According to Viagra’s website, “You will not get an erection just by taking Viagra. You must be sexually stimulated for it to work.” So men must experience both desire and physical readiness to have intercourse, but women can engage without necessarily feeling much of either. This anatomical difference makes it harder to pinpoint women’s sexual problems as well as evaluate drugs that could treat them.

In fact, a widely quoted American Journal of Medicine study says that sexual dysfunction is more prevalent in women (43 percent) than men (31 percent).

According to Sheryl Kingsberg, Chief of Behavioral Medicine at Case Medical Center, quoted on the Even the Score website, there’s a double standard in the medical community. “Women’s sexual problems aren’t seen as valid, or are assumed to be in their heads so there’s no physical basis for the problem.” And when drugs for women are analyzed by male standards (like the ability to get an erection and have penetrative sex), it’s more difficult to prove that they work.

Elevating the debate is a potential new drug by Sprout called Flibanserin, which is seeking FDA approval after being rejected twice. This is the first drug intended to treat women’s most common sexual problem—Hypoactive Sexual Desire Disorder (HSDD)—by focusing on the chemistry of a woman’s brain. Whether or not Flibanserin will pass approval isn’t certain, but there’s a growing demand for the FDA to make products like it to available to women, who want and need support for a satisfying sex life as much as men do.

Without pharmaceutical options, there are still many things women can do to improve a waning sex life. “In my practice, libido concerns are very common and we are successful when we treat other conditions like sleep, pain, and problems in the intimate relationships,” says Lindau, a leader in integrative sexual medicine. Often, treatable medical issues—like incontinence, indigestion and hormonal changes—create embarrassment or discomfort that interferes with intimacy. It’s important to discuss how these problems affect your sex life with your doctor.

Surprisingly, Lindau’s research shows that a woman’s sexual enjoyment is not determined by her age. Instead, the biggest factors are her overall health and access to a healthy partner. So while we wait for that little pink pill, the best path to a life of great sex is to take care of ourselves and pay more attention to our partner, because even a few extra minutes a day can make a difference.

“If you spend as much time on your sex life as you do your hair,” Lindau says, “we would expect things to improve.”


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