Why calling this drug ‘viagra for women’ undermines the complexity of female sexuality

June 25, 2019 at 10:03AM by CWC

The FDA’s approval of Vyleesi should, in theory, be a triumph for women’s health, an opportunity for us to practice autonomy over our own bodies in a time when many of our sexual rights are being threatened. However, instead it serves as the latest example of women’s health care being unjustly oversimplified, with multiple headlines conflating HSDD with erectile dysfunction (ED). Calling Vyleesi “Viagra for women” ignores the fact that the two conditions are biologically dissimilar, explains Kameelah Phillips, MD, an OB/GYN in New York City, and creates a larger issue in the women’s health space. “Equating HSDD with erectile dysfunction, in my mind, minimizes the complexity of female sexuality,” she tells me.

In June, the U.S. Food and Drug Administration (FDA) approved Vyleesi, a drug designed to treat hypoactive sexual desire disorder (HSDD) in premenopausal women. HSDD is a complicated disorder defined as a “lack of interest” that results in “personal distress.” In other words, you—and only you—decide if your lack of sexual interest merits a trip to the doctor to get a prescription for Vyleesi or Addyi (another FDA-approved medication for the HSDD).

ED, or the inability to keep an erection during sex, can have a psychological component, according to Dr. Phillips. However, it differs from HSDD largely because its physical solution is more readily available. Doctors address erectile dysfunction by prescribing drugs, like Viagra, that increase blood flow to the penis. “So, for example, even if a man isn’t so content in the relationship, he can still manage to get an erection for sex by taking a pill,” explains Dr. Phillips.

“Equating hypoactive sexual desire disorder with erectile dysfunction, in my mind, minimizes the complexity of female sexuality.” —Kameelah Phillips, MD

For women, the stimuli that cause—or block—arousal are far more emotionally and psychologically nuanced. “Many women in my practice express the need for psychological, emotional, and even financial needs to be met before she can even think about having sex—hence a low libido. A pill has typically not been a quick fix because our desire and libido requires more attention than increased blood flow to the genitals.” When we call drugs like Vyleesi “Viagra for women,” we deny the complicated reasons behind the need for the drug itself.

The intricate nature of female sexual desire is evident in the trials conducted to test Vyleesi. According to an FDA press release, the drug activates melanocortin receptors, which control key biological functions in humans and other multicellular animals. However, a large part of how it works remains a question. The randomized trials showed that, of 1,247 premenopausal women with HSDD, about 25 percent reported their sexual desire score (ranging from 1.2 to 6.0) increased by 1.2 while on Vyleesi; 17 percent of the placebo group reported the same. In addition, 35 percent of subjects showed a decrease in their distress score, “with higher scores indicating greater distress from low sexual desire,” reads the press release.

The parameters used to measure the efficacy of the drug are subjective—just like female sexual desire itself. “Hypoactive sexual desire disorder is often multi-factorial. So while a pill or shot may help, it might not get women over the finish line if her other needs are not met,” explains Dr. Phillips.

“Hypoactive sexual desire disorder is often multi-factorial. So while a pill or shot may help, it might not get women over the finish line if her other needs are not met.”

Emily Nagoski, PhD, author of Come As You Are, previously told Well+Good: “When people struggle with pleasure, desire, and arousal, it’s very rarely because there’s not enough stimulation to the accelerator. It’s mostly because there’s too much stuff hitting the breaks.” It’s true: Research has debunked the notion that we all arrive here on Earth with a standard sex drive that idles throughout the course of a lifetime. The National Health Service reports that factors like stress, relationship issues, and mental health all contribute to your own libido equation, which will change and evolve over the years.

The unique needs of a women’s anatomy deserve to be addressed in the sexual health conversation without leaning on the vocabulary traditionally associated with men’s health. That’s true regardless of whether drugs like Vyleesi are “accelerators” for you—or not.

A lot of women just aren’t in the mood for sex nowadays—here’s why. And if you’re ready to talk about a past sexual assault with your partner, experts share the best way to go about it

Continue Reading…

Author Kells McPhillips | Well and Good
Selected by CWC

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