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Here’s Why Female Viagra Won’t Work… Again

The market for products that claim to make you horny is centuries old. Everything from Oysters, to herbs like ashwagandha and maca, to alcohol (but of course) have long been hailed as ways to make both sexes want to have sex. Their mileage varies, however, in terms of effectiveness. Until, that is, Viagra came along in 1998 and fixed that problem.

Well, at least for men.

For women, the search for a magic pill that inspires arousal has been more complicated.

Big Pharma first took interest in sexuality in the 1950s, when frigidity and impotence were added to the first Diagnostic and Statistical Manual of Mental Disorders. From there, companies began developing different estrogen and testosterone treatments until 1991, when Pfizer birthed the failed hypertension medication that became Viagra. Since being approved by the FDA seven years later, Viagra has been readily available for men who want — or need — an extra push in the erection department.

For women, the solutions have been harder to come by (pardon the pun). Recently, the pharmaceutical company Sprout announced that it would be reintroducing a pill called Addyi, touted as a sort of “female Viagra,” which claims to increase sexual desire and pleasure for women. Unfortunately, though, like past iterations of the female boner pill, this one probably won’t be a magic balm to women’s lagging libidos either. The main reason: Whereas the men’s pill works by targeting a physical issue — i.e., increasing blood flow to the penis — women’s versions target the psychological issue of a disinterest in sex. That’s obviously a much more complicated task than sending blood to the male nether regions.

Why don’t pharmaceutical companies develop a pill for women that focuses on the physical? It’s unclear. Pfizer attempted to study Viagra as a treatment for low sexual desire in women until 2004, but found that, though it increased blood flow in women, there remained a mental disconnect. From there, Pfizer gave up.

More generally, scientists can’t seem to pin down women’s sexuality. Alfred Kinsey started studying American women’s sexual habits in the 1930s, disputing the notion that they weren’t sexual. Kinsey also challenged understandings of female orgasms, particularly those of Freud, who asserted in 1905 that vaginal orgasms were superior to clitoral orgasms. Though we now know — in large part because of Kinsey’s research — that women are horny beings (just like men!) and that clitoral orgasms are far easier for them to achieve, we still don’t exactly understand the neuroscience of it all. (There’s a plethora of reasons why a woman may not be horny — including issues with a relationship, medications, menopause or mental health.)

For its part, Addyi is intended solely to treat something called HSDD, or Hypoactive Sexual Desire Disorder, a diagnostic criteria that’s been removed from the DSM-V for being “obsolete.” (Though, some doctors will still diagnose women with it.) Essentially, HSDD is a method of pathologizing a woman’s disinterest in sex that seems to have no cause — as opposed to Viagra, which will make your dick hard even if you’re depressed, in a shitty marriage or simply gotten older. The Addyi website states that it won’t work if any of these things apply to a woman, as they’re not symptoms of HSDD.

Instead, it will — maybe, potentially — make a woman slightly horny rather than not horny at all. But just barely, according to clinical trials. Not to mention:

  • It’s potentially unsafe (drinking even two beers while on it could cause hypotension).
  • It takes weeks to work.
  • It costs a ton of money (up to $800 a month without insurance in the past).
  • It isn’t easy to find.

Addyi became FDA approved in August 2015, and it was acquired by Sprout for distribution that October. The FDA originally rejected a previous version of Addyi in 2010 and again in 2013 because trials showed it didn’t work any better than the placebo. After being approved in 2015, Addyi quickly failed as a result of cost, lack of availability and general ineffectiveness. However, Sprout is giving it a second try, this time at a lower price (under $100 a month, without insurance) and with online prescriber/delivery options. (Basically, a woman can now speak with a specialist online for a fee, and then have the medication discreetly delivered to her door.)

Previously, there was a pill called Lybrido, which in 2013 had allegedly undergone “impressive” clinical trials. And in January of this year, Netherlands-based company Emotional Brain published a second report on its Phase 2B trials of the pill, which is intended to treat what they refer to as “Female Sexual Interest/Arousal Disorder.” In these second trials, Lybrido was labelled as “highly effective” and safe, with few side effects and minimal interactions with alcohol.

Lybrido may be more effective than Addyi because it utilizes testosterone and sildenafil, the active ingredient in Viagra. Together, these two chemicals work to increase blood flow to the genitals as well as lubrication. Emotional Brain is also working on a related pill, called Lybridos, that achieves the same physical effects while also treating women “whose sexual response is overly inhibited, for instance due to negative associations with sex.” It works more like Viagra, too, in that it’s meant to work within a few hours.

Maybe the biggest problem with both Addyi and Lybrido is that they don’t account for the fact that there isn’t a one-size-fits-all solution for female sexuality. That is, what’s truly “normal” for a woman varies by individual. So yes, women who want to be hornier deserve a product that’s as fast, safe and effective as Viagra. But that product should also offer a more nuanced understanding of their sexuality, too.