Do Women Really Need ‘Pink Viagra’?

Just because the FDA approved it doesn’t mean it’s good for us
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Just because the FDA approved it doesn’t mean it’s good for us
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Photo Credit: The Denizen Co.

The sexual revolution has reached its apex. Today’s modern woman is free to enjoy casual sex and to objectify or be objectified—and, when our bodies or minds (I hear they are attached . . .) aren’t “in the mood,” we now have access to a drug that will give us the kick in the pants needed to ensure the sex(y) lives we desire. It’s all in our hands . . . or so we’re told.

In today’s sexualized climate where vaguely politicized words such as “choice” and “empowerment” are king, the idea that we, as women, should have access to all the sexual pleasures that men do can feel like a logical conclusion. So last week’s decision by the U.S. Food and Drug Administration to approve flibanserin—the so-called “pink Viagra”—might feel like a victory for women who’ve lost that loving feeling toward their partners. But before you get out the champagne (no, really, don’t pop that cork—flibanserin may not pair well with alcohol), let’s look a little deeper.

We’re told that flibanserin (to be sold as Addyi) is intended to treat something called “hypoactive sexual desire disorder” (HSDD)—a “sexual dysfunction” characterized by lack of desire for sexual activity. Unfortunately, not only is the “disorder” it claims to treat not a real medical condition, but there is also little evidence to show that the drug actually works at improving sex lives.

If we look at the research, the drug has hardly any effect on women’s libido. Thea Cacchioni, a professor of women’s studies at the University of Victoria in British Columbia and the author of Big Pharma, Women, and the Labour of Love, told me, “In the American clinical trials, the best they could come up with for this daily-use drug was that women experienced an additional, on average, 0.7 sexually satisfying events a month.” These “sexually satisfying events,” for the record, include sexual thoughts and fantasies, which for all intents and purposes have little impact on women’s actual sex lives. “To me, that kind of efficacy is just laughable,” Cacchioni says.

Even the FDA admitted in a recent report that it didn’t actually know how the drug works to treat this supposed disorder. “Flibanserin’s mechanism in the treatment of HSDD is unknown,” it says.

Cacchioni, who testified against the approval of flibanserin during the 2010 hearings—the drug was rejected by the FDA twice previously—says that HSDD has been removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) on account of it being “too abstract.” So if it doesn’t technically qualify as a mental disorder in the psychology community, what is it?

It may in fact be a made-up problem looking for a lucrative solution. Think about it. How does one quantify desire? How much sex is the right amount? How many sexual fantasies a month make a person normal? No wonder the DSM dropped it.

Leonore Tiefer, a psychiatrist and founder of the New View Campaign, a grassroots network aimed at challenging the over-medicalization of sex, believes that HSDD isn’t a real disorder. More importantly, though, she questions why we are treating low libido as a problem in the first place.

“I don’t think that HSDD exists because I don’t think there’s a disorder," she told me. “I think low libido exists, but so what? Who cares?” Tiefer doesn’t dismiss women’s distress about sexual desire but wishes to point out that it is perfectly natural for a range to exist, from low libido to high libido to none at all.

The problem with this drug is that it posits there is some kind of normal libido when, in fact, there is no such thing as a normal level of desire. Even among individuals, desire waxes and wanes over time, due to circumstances both connected to our intimate relationships and not.

Flibanserin has effectively created a problem where there was none.

What the FDA?

If the drug doesn’t work and the disorder doesn’t exist, how is it that Sprout Pharmaceuticals succeeded in gaining FDA approval? Shrewdly, it appealed to feminism.

In order to politicize the drug, Sprout created an advocacy group called Even the Score, which aimed to position the “pink Viagra” as a woman’s right. “What it did was quite clever,” Cacchioni says. “Even the Score co-opted feminist rhetoric around ‘choice’ and ‘empowerment’ for its own profit.” It came up with a slogan that’s difficult to contest—“Women Deserve”—and claimed that it was demanding “equal treatment when it comes to sex.” In the end, the FDA caved to this pressure and the insinuation that to deny approval of flibanserin would constitute sexism. (If there’s any lingering doubt as to whether Sprout’s efforts were rooted in concern for women’s rights and well-being, the company sold the drug for a billion dollars the day after it was approved.)

While all of this is disturbing, the question that is most often ignored is the one that’s likely to have the most serious impact on women: Where does this idea come from—that a woman’s desire for her male partner is a problem that needs to be fixed?

The potential for something such as Addyi to actually increase already existent pressure on women to perform to their partners’ or society’s satisfaction is high. If “maybe there’s something wrong with you” or “just take a pill” are possible responses from men when their wives say they don’t feel like having sex, this puts women in a place of having less agency, not more.

Tiefer points out that women’s distress around their slowed libidos is a “social suffering.” Our culture sells an idea that “it’s socially incorrect not to be interested in sex,” she says. Tiefer compares this to the way that women who are considered overweight suffer in our society—which is to say that the suffering comes from societal norms and pressures, not necessarily because women who wear above size 8 clothing are unhealthy.

Male expectations, tied to social expectations about what a normal sex life should look like, can affect our relationships and self-esteem, to be sure, but this does not mean that we as women are dysfunctional.

While it might be troubling for women to find that ten or twenty years into their relationship, they don’t feel the same passion toward intercourse that they did decades ago, the reality is that this is pretty normal. The excitement and infatuation that exists during the early days of meeting someone you are attracted to and/or falling in love with isn’t something that can be replaced with a drug or, really, with anything else. . . . But, as Tiefer says, who cares?

What would happen if, instead of seeking medical solutions to invented problems, we simply accepted that it’s OK to feel like having sex or not feel like having sex? What if we stopped quantifying our sex lives? What if we stopped trying to live up to externally set standards? (“This infographic says happy couples have sex two to three times per week. My relationship is doomed!") In a world that teaches women to always put their needs and desires last, rejecting these ideas strikes me as a far more empowering solution than popping a pill.