Dubbed the “Female Viagra,” Addyi has been available for four years with much less success than its male counterpart. While Viagra is both widely used and effective against erectile dysfunction, the same can’t be said about Addyi and what it’s supposedly useful for—female sexual dysfunction. Far from being hailed as the answer to women’s sexual health, some have said it did little or nothing to improve sexual desire and overall satisfaction. Why isn’t female Viagra working?
Complexity of Female Sexual Dysfunction:
One significant reason a direct equivalent to Viagra has not been successful in treating FSD is the inherent complexity of the condition itself. FSD is a multifaceted issue, influenced by a variety of factors, including psychological, hormonal, and interpersonal issues. This contrasts significantly with ED, which is often rooted in physical causes, such as poor blood flow.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) recognizes several subtypes of FSD, including female sexual interest/arousal disorder, female orgasmic disorder, and genitopelvic pain/penetration disorder. Each subtype has unique diagnostic criteria, reflecting the complexity of the condition. Furthermore, FSD can co-occur with other mental health disorders, such as depression and anxiety, further complicating the diagnostic process and treatment approaches (American Psychiatric Association, 2013).
The multifaceted nature of FSD is challenging to address with a one-size-fits-all solution such as Viagra. While Viagra targets the physical aspect of ED by enhancing blood flow, FSD may require a more comprehensive, individualized approach that takes into account the various psychological, hormonal, and interpersonal factors contributing to the disorder. This complexity necessitates a more nuanced understanding of female sexuality and the development of tailored treatment approaches to effectively address the diverse needs of women experiencing sexual dysfunction.
Different Physiological Mechanisms:
Another critical factor contributing to the limited success of a “female Viagra” is the difference in the physiological mechanisms underlying sexual arousal in women and men. Viagra works by enhancing blood flow to the penis, facilitating an erection, and addressing the primary physical component of ED. However, female sexual arousal is not solely dependent on blood flow but involves a complex interplay of neurological, vascular, and hormonal factors (Basson, 2001).
Furthermore, women’s sexual response is often characterized as more subjective and psychologically driven compared to men’s, with factors such as relationship satisfaction, emotional well-being, and body image playing significant roles in arousal and satisfaction (Basson, 2001). Consequently, pharmacological interventions that target only one aspect of female arousal, such as increasing blood flow, are unlikely to be as effective as those that address the multifaceted nature of women’s sexual response.
Lack of Adequate Clinical Trials:
The clinical trials for Female Viagra have been criticized for their small sample sizes, short durations, and lack of diversity. These factors make it difficult to draw definitive conclusions about the drug’s efficacy. Furthermore, the definition of female sexual dysfunction used in these trials has been called into question, with some arguing that it is too broad and encompasses normal variations in female sexual response.
Side Effects and Safety Concerns:
One reason Female Viagra has not gained widespread acceptance is due to its side effects and safety concerns. According to the American Journal of Obstetrics and Gynecology, Flibanserin is associated with several adverse reactions, including headache, dizziness, and nausea. Additionally, flushing, fatigue, and nasal congestion have been reported (1). These side effects can be severe enough to deter women from continuing the medication, thus reducing its overall effectiveness.
Furthermore, there are serious concerns about the long-term safety of these drugs, particularly regarding their potential impact on cardiovascular health. The limited research available raises questions about the possible link between Female Viagra and increased risk of heart problems, high blood pressure, and stroke (2). Considering that cardiovascular disease is a leading cause of death for women, it is crucial to thoroughly investigate and address these safety concerns before promoting widespread use.
Stigma and Social Factors:
Another reason for Female Viagra’s limited success lies in societal and cultural stigma and a lack of understanding and support for women’s sexual health issues. Women might be less likely to seek treatment for sexual dysfunction due to feelings of shame, embarrassment, and the existing social stigma. Additionally, society often prioritizes male sexual satisfaction over female sexual wellbeing, further contributing to the limited understanding and support for women’s needs.
Compared to male sexual dysfunction, female sexual dysfunction has received significantly less attention and research. This disparity can be attributed to cultural norms and gender stereotypes, which can make it more difficult for women to openly discuss their sexual concerns (3). In many cases, this stigma and lack of social support can be just as detrimental to a woman’s sexual satisfaction as the dysfunction itself.
The bottom line of the failure to work by female Viagra is because of many reasons, especially owing to factors such as the difference at the genuinely basal level of sexuality dysfunction in both men and women, the complexity of women’s sexual desire, dosage and time of medication, its side effects, and lack of awareness and education related to female sexual health. Though Addyi was marketed as the game-changer in women’s sexual health, it is obvious there is no one-size-fits-all solution for female sexual dysfunction. If anything, it just goes to prove that much more sophisticated study and understanding of women’s sexual health are needed in the pursuit of an effective treatment for this complex issue.
