The ‘Little Pink Pill’ is Now Available, Will It Help Your Sex Life?
Flibanserin, the first and only medication available for use in reproductive aged women with low libido, becomes commercially available this week after a rocky and controversial road that led to its FDA approval Aug. 18. The view on the medication whose brand name is Addyi (pronounced ADD-EE) ranges from a historical achievement in women’s health care to an epic failure of commercialized medical propaganda. Despite the lengthy debate that has surrounded flibanserin, what most people want to know is whether it will help their sex life or not now that it is here.
First Things First
While sexual concerns can be difficult to discuss for many women and their partners, it is important to acknowledge that sex and intimacy are some of the great extraordinary experiences of being human. When sex goes badly, which statistically it does for 43 percent of US women, the consequences can devastate a relationship and personal health. One of the biggest applauds I have for the FDA is their statement of recognition that female sexual dysfunction is an unmet clinical need.
Sexuality is Mind-Body but Not-Body?
Sexuality is usually complicated, and problems with sex such as loss of libido are multifactorial for most women. Antagonists to flibanserin cite psychosocial contributions such as relationship discord, body image, or history of sexual abuse to be the most pinnacle causes of a woman who may complain of problematic lack of sexual desire, and that sex is always a mind-body phenomenon. While these factors often implicitly correlate to loss of sexual interest for a woman, they don’t always, and you cannot advocate that women’s sexuality is all inclusive of her mind, body, and spirit — and assert simultaneously that a biochemical contribution which flibanserin is designed to address in the brain to improve satisfying sexual experiences does not exist.
The Biochemistry of Sex
Antidepressant medications that alter brain biochemistry are notorious for having sexual side effects which can be prevalent up to 92 percent of the time, and are known to decrease sexual interest, disrupt arousal, and truncate orgasm in some women. Ironically, flibanserin was originally studied as an antidepressant, and while the exact mechanism of how a medication can impair or improve sexual interest is unknown, it should not be difficult to consider that if biochemical tinkering can crush sexual function, it may also be capable of improving it.
Efficacy Data Dance
Flibanserin is a pill taken once nightly, and has been critiqued as showing only modest increases in sexual desire, with improvements in sexually satisfying events rising 0.4 to 1 per month compared with placebo. However just because flibanserin has lackluster efficacy data, that does not mean it is ineffective, and even small improvements in sexual function can be life altering for a woman struggling with disabling intimate problems. If only one percent of women with low libido were to improve their sexual function with use of flibanserin, that equates to 160,000 women, or the population of Tempe, Arizona.
Blue Sky Side Effects
Flibanserin has side effects and the sky is blue. All medications have pro and con profiles, and for flibanserin the most common consequences of use include fatigue, dizziness, sleepiness, and a rare but precipitous drop in blood pressure. Women may not drink alcohol while taking this medication. Providers who will prescribe it and pharmacies that will dispense flibanserin must be approved through what is called a Risk Evaluation and Management Strategy, or REMS, which means they are educated on advising women on how to take flibanserin safely. While a REMS program is arguably overkill compared to numerous higher risk, common prescriptions which do not require a REMS, it is an excellent opportunity for clinicians who have a background in sexuality to be the main applicants since they are far more qualified to assess proper candidates for treatment as well as continue to endorse holistic measures alongside flibanserin. Women who are interested in trying flibanserin should only obtain it from sexuality trained professionals.
The Proof is in the Sexy Pudding
If flibanserin is worthless, the marketplace will bury it in a shallow grave quickly. Women will stop paying for it, and conscientious medical providers will stop prescribing it. Yet 8,500 women taking flibanserin were studied, over a 1,000 of them for one year, and the data suggests it will help some. Women deserve to be educated on their options, because sexual health is worth fighting for.
Changing the World, One Orgasm at a Time
We simply cannot overlook how astronomical of an achievement it is to even have a mediocre medication approved for female sexual dysfunction. Women’s sexuality has been ignored by medicine for most of history. At least now we have something to fight over.
The controversy about flibanserin is in fact magnificent, and frankly, the entire point. We must talk openly about sexuality and sexual concerns to improve them, personally for one woman at a time, but also uniformly to embrace female sexuality as a vastly larger societal allowance.
A satisfying sexual life is far more than the restoration of sexual dysfunction, it’s a thriving, multi-dimensional, ever-evolving weave of psychology, relationships, life circumstances, and, yes, you can include a milieu of biochemistry and neurotransmitter pools.
Is a pill ever going to replace the vastly complicated arenas that fuse into our sexual experience? Of course not — it’s absurd and lazy minded for anyone to suggest that is even being proposed. But it is necessary and inherently responsible to allow for all possible puzzle pieces to be utilized through the ever evolving navigation of sensuality, intimacy, and erotic fulfillment.
So will flibanserin make your sex life better? Maybe. But considering the conversation about it valuable as well as its use as merely one tool among many options to improve sex & intimacy would be the better bet. Ultimately, we “desire” sex that is meaningful, erotic, and dynamic. The journey of seeking sexual vitality deserves every key, crowbar, heathen kick, graceful acrobatics, or little pink pill that lends its part to the process, no matter how small or big, for the opportunity to discover and embrace a sexual aliveness.
NOTE: Dr. McKenzie has no affiliation with flibanserin.
6 Surprising Insights About Sex From A Sex Doctor
July 8, 2016 by Serena McKenzie • Healthy Sexuality, Sexual Enjoyment • Tags: optimal sexuality, pain during sex, science •
Many people are desperately seeking great sex in ordinary life but are entirely at a loss of how to achieve it. Our culture today is riddled with contrasting and confusing messages about sexuality. Beer commercials insist everyone is having spontaneous, sexy fun at every given moment. Institutions ranging from religious leaders, politicians, to our parents and even our own children are chastising us for every possible expression of a sexual existence. With all of these mixed messages abounding us, what in fact is a thriving sexuality supposed to look like? We all know sex is complicated. Having a unique job of talking with people about their sexual experiences and concerns for over two decades has led me to appreciate sex as even more complicated than most realize. Here are six surprising insights about sex to help guide the exploration of embracing a satisfying sexuality in our everyday lives:
1. Being good in bed is a learned skill: People confuse sex as a strictly bodily function that should innately work with no effort, like a heart beating or lungs breathing. The truth is that we are all born with parts, but making those parts (including our mind) sexually flourish requires education and practice more like a high art. Becoming skilled in bed is closer to training for a sport, becoming a performance artist, or crafting any other talent than having our body sneeze during allergy season.
2. Sex problems are more common than you think: If you have concerns about your sexual function then you are not alone. Several studies have found that up to 44 percent of the population has a persistent sexual dysfunction, such as problematic disinterest in sex or difficulty with erections or orgasm, and almost everyone will have transient experiences of sexual malfunctioning at one time or another.
3. Sex hurts for many women: One out of every five or six women experience painful sex or are completely unable to engage in sex at all. Many different things can cause a woman to have painful sex, including involuntary vaginal muscle spasms called vaginismus, nerve pain, and change in hormones — and all are treatable. If sex hurts, get help.
4. A limp penis can suggest more serious disease: The penis is essentially a tube of small blood vessels, and arousal leads to enlargement of these vessels which causes an erect, hard penis. Loss of erections during partner sex, masturbation, and non-sexual morning erections can suggest a hormone imbalance or a developing vascular disease that prevents the penis to properly engorge. A recent study suggests there is a window of opportunity of 3 to 5 years from the onset of ED to subsequent cardiovascular events. ED isn’t just embarrassing or frustrating, it’s an important medical symptom to talk openly about with a healthcare provider, especially for men at risk for heart disease.
5. Avoiding bad sex is not a medical condition: Not wanting to have sex is one of the main concerns for which people seek sexual medicine treatment. While low libido is almost always multifactorial and can have numerous psychological and medical causes such as diabetes, depression, medication side effects, or menopause and aging, it is important to fundamentally understand that we “desire” awesome sex. If sex is painful, boring, repetitive, or if we are resentful towards our partner but having sex anyway, then sex can become unpleasant. Furthermore, if a sex partner is not supportive of sex being pleasurable for the other person, it is not helpful to tell that the lower libido partner to fix-their-not-wanting-sex-problem on their own. Instead, couples should work together to create a sexual experience that is meaningful for both people. Not wanting to have bad sex isn’t a medical disorder. Reinventing a symbiotic relationship of eroticism, intimacy, and adventure in the bedroom are key factors towards improving the drive to have sex.
6. Our mind is our greatest sex organ: Sexual function is a reflection of our physical health, and a wide variety of illness can impair satisfying sex despite provocative stimulus, but being sexually charged is also directly an expression of our level of mental and emotional arousal. If we are not turned on in our mind, it can be difficult to be turned on in our body, yet this is a fundamental key piece that many people overlook when they are unsatisfied with sex. Many common sexual complaints such as dry or painful sex, the inability to get or keep a hard erection, and trouble having an orgasm actually stem from the mind not being sexually engaged. When this is the case, medical treatments such as erection medications or hormone therapy to improve sexual function are likely to be ineffective.
Many people know how to put a key in the car ignition, but turning the key to engage the entire car into motion requires a live connection between hormones, muscles, and nerves, but most importantly it requires the spark from an erotic mind. Living a life of sexual fulfillment is a process of ongoing exploration, physical health advocacy, a spirit of curiosity and embracing our unique sexual truths. Great sex in ordinary life also requires intentional communication with our partner, and a will backed by action to create a dynamic sexual experience for ourselves and our relationship.