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The Advent of Psychedelic Therapy for Low-Libido Women

Investment firms are putting their money behind MDMA as an intervention for women with lagging sex drives. But can psychedelics really improve desire, or is this another pharmaceutical cash grab?

When 45-year-old Kelsey Ramsden entered the psychedelic scene, she was at a breaking point. Stuck in a never-ending grind cycle after finishing her MBA, she hustled for years to establish herself as a titan in the business world. It paid off — she was named Canada’s Top Female Entrepreneur twice — but still, something felt off. “I thought I’d arrive at the mountaintop and feel whole,” Ramsden tells me. “But I worked my way to the top and didn’t feel great.”

Overwhelmed with anxiety, Ramsden headed overseas to try psilocybin, the naturally occurring psychedelic compound in magic mushrooms, via psychedelic-assisted psychotherapy, or PAP, which isn’t yet approved in North America. “It was transformative,” she says. “I was on the airplane home, and I thought, ‘Is this how normal people feel all the time?’”

Floored by her experience, Ramsden co-founded MINDCURE, a “life sciences” company that invests in psychedelic research. MINDCURE’s latest endeavor is called The Desire Project, a proposed series of clinical trials that plan to “focus on the root cause of millions of women’s sexual desire issues” and “level the desire playing field” through MDMA-assisted psychotherapy. “The capitalist in me knew this was a space in the market that no one was paying attention to,” Ramsden says. “It became apparent to me as [one of the few] female CEOs of a publicly traded psychedelics company that there probably wasn’t anyone else willing to take this topic on.”

The topic in question is Hypoactive Sexual Desire Disorder (HSDD), a type of sexual dysfunction said to affect around 10 percent of adult women. (HSDD is now classified as Female Sexual Interest/Arousal Disorder, or FSIAD; however, the condition is still listed as HSDD in MINDCURE’s marketing materials.) The condition is controversial to say the least — in 2019, STAT reported that some researchers felt the condition represented “pharmaceutical overreach” and “another effort that reduces the complexity of human sexuality to a set of measurable dots on a chart.” That, in turn, creates an opening for high-dollar pharmaceutical “solutions” to enhance the female libido. 

This happens frequently in the pharmaceutical world. For example, Robert Pyke, one of the advisors listed for The Desire Project, had a lead role in developing a drug called Addyi, which was approved by the FDA in 2015 for the treatment of HSDD in premenopausal women. It was widely touted as the “female Viagra” despite its inconclusive efficacy and the fact that it resulted in relatively little increase in “sexually satisfying events” during clinical trials. Addyi also came with major side effects like dizziness, sleepiness and nausea, as well as a shockingly high price tag — around $800 a month — that led to disappointing sales and a predatory pricing investigation. (It was relaunched in 2018 at a lower price, but the side effects remain.) Many experts also argued that it constituted a fundamental misunderstanding of female libido and desire, neither of which are purely physical problems that can be easily treated with a miracle drug. 

All of which raises a question: Are ventures like The Desire Project truly revolutionary pursuits, or are they just another way for the pharmaceutical industry to make a buck off of women’s sexual struggles?

While psychedelic therapy isn’t currently approved for use in the U.S., there’s plenty of precedent for The Desire Project. MDMA causes the release of neurotransmitters, including “feel-good” hormones like dopamine, serotonin and oxytocin. That reaction creates a positive clinical setting for individuals to open up about their emotions and process their trauma. In fact, before the drug was outlawed, psychotherapists used MDMA in therapeutic settings in the 1970s and early 1980s

Fast forward to 2017, when the Food and Drug Administration granted Breakthrough Therapy Designation to MDMA for the treatment of post-traumatic stress disorder (PTSD). The Breakthrough Therapy Designation was intended to expedite further review of MDMA-assisted psychotherapy, and Phase 3 clinical trials are currently underway in the U.S., Canada and Israel to explore its efficacy for PTSD. These trials, led by the Multidisciplinary Association for Psychedelic Studies (MAPS), are the last step in figuring out whether MDMA can be safely and legally prescribed to treat PTSD. (MAPS declined to comment for this story.) 

The MAPS trials could also pave the way for endeavors like The Desire Project. Per Ramsden, the treatment paradigm will begin with a therapeutic session, followed by a drug-therapy session similar to those involving MDMA for the treatment of PTSD. “After that, you have a therapy session to further understand your experience without actually having the drug in your body,” Ramsden says. She adds that, ideally, patients would only require two to three treatment cycles to experience the positive effects. “It’s our great hope that this will be sufficient,” she says. “But we’ll only find out once we start doing the research.” Of course, that research can’t begin until the MINDCURE team identifies the optimal MDMA synthesis for HSDD treatment.

Syntheses aside, there are already plenty of people using MDMA recreationally to enhance their sex lives. VICE compares sex on the drug to “swimming in a pool of warm orgasmic water.” One redditor wrote that “every thrust felt like its own individual burst of starlight and sunlight and pleasure.” And, sure, recreational MDMA enhances sensory pleasure and helps release inhibitions — but whether that effect will translate in a sexually therapeutic setting remains unclear. However, it’s worth noting that The Desire Project’s ideal drug protocol involves supervised dosing and processing in a clinical setting. That would almost certainly guarantee a more therapeutic experience than experiencing fleeting emotional vulnerability with a random hookup, but whether that can impact low desire in women over the long term remains to be seen. 

Ramsden has heard the skeptical chatter, too. She acknowledges the concerns behind female libido drugs and the “quick fix” mentality. However, she welcomes medical innovations in this space, especially given the relatively little attention paid to women’s libidos in clinical settings. “If women are making complaints about something that causes them duress, it merits our attention,” Ramsden says. “Personally, I’m curious about why so much attention has been paid to men’s sexual health and so little to women’s — and when women’s sexual health does become a topic of conversation, we start to hear the commentary about overmedicalization.” (It’s worth noting that Viagra has also been criticized for overmedicalization, as well as its role in “passive medicalization,” despite being marketed to men.) 

Sarah Melancon, a sociologist and clinical sexologist, calls drugs like Addyi “a classic example of pharmaceuticalization — an attempt to solve complex problems with a pill that has negligible positive effects and an increased risk of side effects, with the primary goal of profit over patient health.” She does, however, point out her own positive experience using psychedelics alongside her now-husband. “My sexuality began to open up in ways I didn’t know were possible,” Melancon says. “After trying sex on MDMA for the first time, I became comfortable showing [my husband] how I masturbated and in time experienced my first orgasm with another human being present — while sober.”

One thing that does set The Desire Project apart from drugs like Addyi is its intended therapeutic protocol. Addyi was intended as a daily drug, but its prohibitively high price point initially made ongoing use unrealistic. However, The Desire Project’s intended protocol doesn’t involve regular MDMA use; again, it’s meant to be used in a limited, supervised capacity. If a drug comes out of the trial, it won’t be a means to make users instantly horny, either — instead, the goal is to help women explore what Ramsden calls “the issues between our ears.” That includes anything that could impact sexual desire, including body image issues, trauma and any history of negative interpersonal relationships. “It’s not really about the psychedelic session,” Ramsden says. “It’s really about what happens when you go back into your life and you’re capable of integrating what you learned. The promise of psychedelics for me is embedded with the promise of incorporating big changes into, say, your typical Tuesday.” Of course, the “typical Tuesday” promise hinges on the affordability and accessibility of The Desire Project’s treatment paradigm — both of which are far from certain.

Melancon agrees with that sentiment, noting that any insights she and her husband experienced on MDMA “tended to stick, at least to a degree, in our everyday lives.” “[The benefits weren’t] limited to experiences on the drug alone,” she continues. “Within six months, it was completely normal to talk about fantasies, buy toys, watch porn and generally experiment with almost anything within our comfort zones.” 

That seems like an ideal outcome for The Desire Project, which Ramsden says is moving “full steam ahead.” Will it work? Only time will tell. In the end, we’ll have to wait and see whether MINDCURE’s trials could deliver a life-changing drug — or if The Desire Project is just another big-money Band-Aid.