The U.S. Food and Drug Administration is being lauded for approving a drug to rescue women from weak sexual desire, but Israeli doctors question the pill’s effectiveness and risk profile.
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Women’s groups are mixed on the treatment, known as Addyi. Critics point to its many possible side effects and alleged low efficacy, while advocates note that it’s the first drug ever to treat inhibited sexual desire.
Addyi, the brand name for the chemical flibanserin, is produced by U.S. drug maker Sprout. In their campaign for FDA approval, the company and women’s groups accused the agency of ignoring women’s sexual needs. The PR effort, called Even the Score, noted that there was nothing for women while men had options like impotence pill Viagra.
Flibanserin was originally developed to treat depression in both men and women. The benefits were minor, but women taking it reported improved libido.
Dr. Arik Shechter, who heads the sexual dysfunction clinic at Haifa’s Rambam Medical Center, said it’s inaccurate to call Addyi female Viagra because the men’s drug addresses blood flow, not desire.
“Men are like a machine with one on-off switch, but women’s mechanism of sexual desire is like a fighter jet — it requires a delicate balance and is influenced by a lot of external things that don’t directly relate to the sexual issue. Solving this with this drug is too simplistic,” Shechter said.
Dr. Einat Elran, a gynecologist and sexologist at Sheba Medical Center, called Addyi “more of a cultural and marketing story than something truly medical.” She worries about possible interactions between the drug and birth control pills, as well as Addyi’s long-term effects.
“The main thing about this drug isn’t medical, it’s political pressure on policymakers,” she said.
Sex-drive disorders have been reported in the professional literature for more than 30 years. About two years ago, the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association was revised to feature the condition under the name female sexual interest/arousal disorder.
“A decline in sexual desire is very common,” said Dr. Yael Barkan, a director of women’s health for one of Israel’s four official health insurance funds, Clalit.
“Most women experience it in the course of their lives, either for physiological or hormonal reasons such as breast-feeding, or due to ... a deterioration in marital relations, emotional stress or similar causes.”