(WebMD) A drug to boost female sex drive could be worth billions to the company that manages to get it approved by the FDA. Recently, two new treatments have made strides towards that goal. But some are skeptical of the real value of such a drug to the women it's supposed to help.
In late 2004, FDA approval of Intrinsa, a testosterone patch for low female sex drive, seemed imminent. News reports heralded Intrinsa as a "Viagra for her," suggesting that it would revolutionize sexual health for women just as erectile dysfunction pills had for men.
Except an FDA advisory panel saw things differently. Finding numerous problems with the evidence for the drug's effectiveness and safety, experts on the panel voted against approving it. Procter & Gamble, the company responsible for Intrinsa, withdrew its application. Procter & Gamble is a WebMD sponsor.
Now the frontrunner in the race to market the first prescription drug for low female sex drive is Boehringher-Ingelheim Pharmaceuticals. It has a drug called flibanserin in phase III clinical trials, the final phase of drug testing required for FDA approval. The company is a WebMD sponsor.
Flibanserin is a bit mysterious. It is a kind of antidepressant, but it hasn't been approved previously for any use. Boehringher-Ingelheim is saying little publicly about the drug. The company declined WebMD's request to interview a company representative, instead issuing a prepared statement. The statement does not explain how the drug is supposed to work, other than that "flibanserin is a molecule acting on the central nervous system and is not a hormone product."
Another drug, called bremelanotide, is in development for low female sex drive and male erectile dysfunction at the same time. Both potential uses are being tested in phase II clinical trials, which are early studies to assess how well a drug works and how safe it is.
Bremelanotide is a new chemical created in the laboratory. It's given in the form of a nasal spray, and it acts on the central nervous system.
"It's actually working in a region of the brain called the hypothalamus, which is known to be involved in sexual arousal in both men and women," says Carl Spana, Ph.D., CEO of Palatin Technologies, the company researching bremelanotide.
What Is Desire?
Arousal — that is, erection — is the goal of treatment for men. For women, researchers hope that ease of arousal will translate to increased sexual desire.
Technically, arousal and desire are not the same thing. Arousal is the physical and psychological state of being primed for sex. The penis becomes erect, the vagina lubricates, heart rate increases, and blood vessels dilate.
Whereas arousal can be easily seen, sexual desire is vague. It has to do with wanting to become aroused, but there are a lot of questions about what that really means.
Not everyone thinks that sexual desire is a medical issue. Lenore Tiefer, Ph.D., a psychologist at the New York University School of Medicine, is an outspoken critic of what she sees as a trend toward unnecessary medical intervention in sex. She is a founding member of a group promoting "A New View of Women's Sexual Problems," and editor of a book by that title.
The idea that desire is a thing women have or lack, apart from any object of desire, is mistaken, she says. But it is convenient for the purpose of selling pharmaceuticals.
"I don't think people desire sex, or rather, let's put it this way: They're learning to desire sex," she tells WebMD. "It used to be I thought that people desired people: 'I desire Fred' or 'I desire Louise.' Then there was masturbation, which was a kind of tension-relieving thing where you felt like having an orgasm, but it wasn't sexual desire. It wasn't anything like that. Sexual desire was this longing that you felt in your body or in your heart to be with that person over there."
Tiefer contends that there are too many other reasons why desire for sex might wane to pin it on a biological cause. Fred is emotionally distant and snappish. Louise feels bad about how her body looks. Early in her life she learned that sex is dangerous and yucky. At the end of the day, after the kids are tucked in and dinner dishes are washed and put away, she has only enough time to catch a few minutes of American Idol before lights out.
Another prominent sex researcher, Rosemary Basson, M.D., of the University of British Columbia, Canada, agrees that the medical focus on desire is misplaced. Women and men "have multiple motivations to be sexual, and 'desire' — as in urging 'lust,' 'horniness,' or 'drive' — is only one of these reasons," she tells WebMD. Desire for sex can also be the desire to feel emotional closeness with someone, to please that person, or to feel attractive.
She points out that the definition of this "mental disorder" assumes that all women have a constant amount of sexual desire that is normal, like the pilot light of a stove. Just turn up the gas, and you're cooking. But there's no definition for what a normal level of desire is, so no one can say what's "low," Basson says.
Sometimes when the motive to have sex is something other than a physical
drive, some women just can't get into it.
Continued
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