Text: Andrée-Marie Dussault
Photo: DR

A pill named desire

A drug designed to enhance women’s sexual desire has recently been given the green light for sale in the United States. But is it anything to get excited about?

My husband has Viagra, but is there anything out there for me?” Many women direct that question at Sandra Fornage,
chief of the Obstetric Gynaecology and Sexual Medicine Clinic at Lausanne University Hospital. “Lots of them explicitly ask for a drug,” the specialist says. “They are upset that things are not what they ‘used to be’ and would like to feel more desire for their partner.”

The little blue pill for erectile dysfunction – which does not affect sexual desire – has been on the market for nearly 20 years, but until now no drug addressed women’s sexuality. But the situation has changed. Last August, the U.S. Food and Drug Administration (FDA) approved Flibanserin after rejecting it twice, in 2010 and 2013, for its limited effectiveness and side effects.

The new drug – sold under the brand name Addyi – should allow all women to boost their sexual drive, says its manufacturer, the American laboratory Sprout Pharmaceuticals. For now, Addyi is only available in the United States with a prescription. The drug is aimed
at pre-menopausal women suffering from a decline in libido.

Sandra Fornage believes the release of the little pink pill
is a positive step. “We really have very little to offer women,” she says. While research to find treatments that solve men’s sexual issues has been around for a long time, women’s desire was not studied until recently. “Women’s sexual pleasure is taboo,” wrote Odile Buisson in the French newspaper “Libération”. The gynaecologist authored the book “Qui a peur du point G? Le plaisir féminin, une angoisse masculine” (Who’s afraid of the G-spot? Women’s pleasure, men’s fear) published in 2011.

Since the 1970s, the scientific community has acknowledged that women can also experience pleasure and have orgasms, says Sandra Fornage. “These days, especially since the phenomenal success of Viagra, pharmaceutical companies are competing in a mad dash to find a ‘miracle’ product for women.”

“Significant” effect

The supposed aphrodisiac properties of Flibanserin were discovered accidentally while the drug was being tested as an anti-depressant. The pill acts on the brain, by increasing dopamine and norepinephrine – two neurotransmitters that affect pleasure (the shiver that we sometimes feel when we listen to music is caused by dopamine), addiction, arousal and attention, to mention just a few of their capabilities – and by lowering levels of serotonin, which influences several physiological functions such as sleep and mood.

“While research to find treatments that solve men’s sexual issues has been around for a long time, women’s desire was not studied until recently.”

Sandra Fornage, gynaecologist

The findings from the most recent clinical trials, led over a period of two years on more than 1,300 women in Canada and the United States, showed that, for the majority

of them, taking Flibanserin daily had a “significant” effect on their desire, and they experienced more satisfying sexual events. “Interestingly, nearly all the participants who took a placebo also experienced increased desire and sexual satisfaction,” says Francesco Bianchi-Demicheli, sexologist and physician at the Department of Obstetrics and Gynaecology at Geneva University Hospitals (HUG), highlighting how much psychology can play a role
in sexuality.

And not just psychology. Sexual desire is the result of multiple and complex interactions. “It involves relational, social, cultural, biological, genetic, chemical and overall health factors,” says Francesco Bianchi-Demicheli.
“We can’t act on all those aspects with a single drug.” But that doesn’t mean that chemistry is at a complete loss.

“A growing number of neurobiological studies on animals show that sexual behaviour can be controlled by a pharmacological substance.” The physician believes that Flibanserin, along with the proper monitoring, can be useful for women experiencing a lack of sex drive, or “hypoactive sexual desire disorder”, which affects nearly 35% of women. However, only 10% of women are believed to truly suffer from this problem of sexual appetite. “They can feel frustrated, disappointed or diminished in their identity as women, or maybe had to end one or more relationships because of the situation,” says Francesco Bianchi-Demicheli. “

We will assess patients’ level of satisfaction over time,” says the sexologist Sandra Fornage. “We are only at the very beginning of the process.”


Rina Nissim, a nurse specialised in gynaecology in Geneva who has written several books on women’s sexual health, feels that nothing good will come of the release of Flibanserin on the market, especially due to the drug’s side effects. “Today, we hear about low blood pressure, fainting and nervous depression, but it’ll take years before we know everything.”

Rina Nissim is co-founder of the former Women’s Dispensary in Geneva, a health centre that encourages women to take control of their health. She laments that “we live in an oversexed society where women – and girls – are constantly pressured to be ‘sex bombs’.” The nurse believes that a lack of desire cannot be treated. “Their relationship simply has to be worth it - women have to get something out of it - and men have to learn how to satisfy their partner.”

That is clearly not the opinion of the pharmaceutical industry. Several companies are developing their own chemicals to compete with Flibanserin, following the example of Emotional Brain. This Dutch company hopes to bring two drugs to market, Lybrido and Lybridos, in 2017. Lybrido is aimed at women who only lack sexual drive, while Lybridos addresses women with inhibitions due to anxiety or complexes. Lorexys, another remedy developed by the U.S. firm S1 Biopharma, completed its second phase of clinical trials in the United States this year. /

An inappropriate comparison

Addyi, the first drug to boost women’s sex drive, is often dubbed the “female Viagra”, likening it to the famous little blue pill for men. Yes, both drugs are designed to improve one’s sex life, but they do not act in the same way. Viagra affects the vascular system by inducing the relaxation of blood vessels in the penis during sexual stimulation. Blood therefore flows more easily to the penis, causing an erection naturally. The effect is short-lived, beginning about 30 minutes after the pill is taken and lasting nearly four hours. Flibanserin, which is sold under the trade name Addyi, is a psychotropic drug similar to an anti-depressant. It does not act “mechanically” for sexual events to occur, but rather on the patient’s brain by lowering levels of serotonin, the hormone that causes certain sleep disorders, aggressiveness and even depression. Addyi must be taken daily.