Apparently, there have been a lot of satisfied yet exhausted male rats lying about in Montreal research labs lately, smoking that post-coital cigarette and wondering what on earth has gotten into their little nympho rat partners all of a sudden. This is largely thanks to an experimental drug designed to reawaken female sexual desire by blunting inhibition. (We used to call this ‘getting wasted’ back in art  college, a pastime which had a similar inhibition-blunting effect on us). Although yet to publish any clinical test results showing the drug is actually effective, the German drugmaker Boehringer* is putting the finishing touches on a pill that, unlike Viagra which targets the mechanics of sex by boosting blood flow to the penis, works on the female brain. 

According to the business resource Bloomberg, Boehringer has borrowed a page from Pfizer, back when the world’s biggest drug company launched its Viagra in 1998.

“Pfizer broadened the appeal of Viagra by steering clear of the word impotence and instead saying that the blue pill addressed a disease called erectile dysfunction. Boehringer is also avoiding potentially offensive words such as frigidity, and refers to the female problem that its pill cures by its clinical name, hypoactive sexual desire disorder, or HSDD. Boehringer’s ‘desire drug’ called flibanserin has the potential to revolutionize sexual medicine much as Pfizer’s blue pill did a decade ago. That could put the family-owned drug company Boehringer at the center of a debate about whether the medicine is a chemical shortcut around a complex dysfunction involving body and mind – or whether disinterest in sex is a legitimate medical condition.”

“This drug has the potential to finally open the door to acceptance of the idea that decreased desire can be something that involves a dysfunctional way the brain works, and not only a bad partner,” said Dr. Jim Pfaus of the Centre for Studies in Behavioural Neurobiology at Concordia University in Montreal, who conducted early tests of the drug on rats. “Of course, it’s in your head.”

(On the other hand, most women I know could introduce Dr. Pfaus to a few ‘bad partners’ out there who’d be a threat to any woman’s healthy libido).

But Dr. Pfaus is a heavyweight when it comes to examining how our brains are wired for sex. Inducted into the International Academy of Sex Research in 1997, Dr. Pfaus has been paid to do research in this area by drugmakers like Pfizer and Wyeth as well as Germany’s Boehringer.

Some experts predict that the market for drugs to rekindle female libido could be even bigger than the $2 billion a year in North American sales alone for erectile dysfunction treatments, because apparently more women report sexual problems than men. And North Americans, who make up 5% of the world’s population, account for 42% of the spending on prescription drugs.

Documentary filmmaker Elizabeth Canner told the Toronto Star in April at the premier of her highly recommended documentary film Orgasm Inc, a scathing indictment of Big Pharma’s search for the ‘female Viagra’:

“There is more money to be made in lifestyle drugs than in a cure for malaria. We are putting a tremendous amount of resources into drugs for the healthy and wealthy.”

But Dr. Elaine Jolly of the University of Ottawa, one of the Canadian physicians participating in this drug’s Phase III trials, defended the drug in a corporate news release this week from the Congress of the European Society for Sexual Medicine:

“Flibanserin is believed to act on neurotransmitters within the brain that play a role in sexual response. By modulating these neurotransmitter systems, flibanserin may help to restore a balance between inhibitory and excitatory factors leading to a healthy sexual response.”

(That’s if women can get past the reported side effects such as nausea, fatigue, dizziness or insomnia that forced up to 18% of women in the trials to give up on the drug. Those women might want to consider my ‘getting wasted’ inhibitory factor option, described earlier).

And before you go too far down that neurobiology theory road, consider how experts at Mayo Clinic explain some of the practical scenarios that influence a woman’s sexual desire in the first place:

• The extreme stresses of daily life can deplete women’s desire for sex.
• Highs and lows in sexual desire may coincide with major life changes, such as pregnancy, menopause, loss, grief, or with chronic physical conditions that can cause discomfort.
• Preoccupation with the elusive orgasm can lead to women’s loss of interest in sex.
• Desire is connected to a woman’s sense of intimacy with her partner; current relationship frustrations and past experiences can contribute to biological problems and vice versa.

Sex researcher Rosemary Basson, MD, of the University of British Columbia in Vancouver would likely agree.  She claims that this “medical focus on sexual desire” is misplaced.

“Women and men have multiple motivations to be sexual, and ‘desire’ ( ‘lust,’ ‘horniness,’ or ‘drive’) is only one of these reasons. Desire for sex can also be the desire to feel emotional closeness with someone, to please that person, or to feel attractive.

“The definition of this as a ‘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  is low.”

UK investigative journalist Ray Moynihan, author of the book Sex, Lies, and Pharmaceuticals, writes in the British Medical Journal this definition of female sexual dysfunction:

“. . . the freshest, clearest example we have of a disease created by pharmaceutical companies to make healthy people think they need medicine”.

Still, Boehringer is poised to aggressively proceed on the launch of this moneymaking ‘pink Viagra’ if it’s approved.  The path from laboratory to your bathroom medicine cabinet is never short or easy for any drug company. (See also: How A New Drug Gets Approved.)

Boehringer was initially searching for a depression treatment in the 1990s when it stumbled on the desire drug compound. By 2002, researchers were startled when test subjects rated sexual appetite (one widely accepted measure of well-being) consistently higher than the other measures.

And not a moment too soon!  The German drug company desperately needs new drugs to sell now because it faces the loss of 1 billion euros ($1.5 billion) in annual revenue when its two older medicines, Mirapex for Parkinson’s disease and Flomax for treating prostate enlargement, lose patent protection next year, thus freeing the consumer to purchase cheaper, identical generic drugs instead.

And speaking of Mirapex, Boehringer has been ordered to pay punitive damages in a growing number of class action lawsuits after the company was found in U.S. courts to have “breached their duty of care to individuals taking Mirapex, since they knew or ought to have known of the serious behavioural related complications associated with Mirapex, and failed to adequately warn patients and physicians about the dangers of Mirapex.” 

So is this the drug company you’re willing to now trust with your prescription desire drug?

The proposed introduction of flibanserin illustrates three influential factors common in pharmaceutical industry marketing:

• 1.  Disease-mongering: when you run out of good diseases that are already being treated appropriately with existing drugs on the market, you can attempt to either invent a new disease or focus on a little-known disorder like HSDD that may respond to your new drug, once consumers can be convinced that they, too, suffer from this disorder. Viagra, for example, was initially approved for purely clinical erectile dysfunction – such as a post-surgical complication. But after soccer star Pelé and Montreal’s NHL hockey legend Guy Lafleur were hired to pitch the blue pill, the market expanded to include nearly every middle-aged male.

• 2.  Falling off the patent cliff: when blockbuster drugs (like Boehringer’s Mirapex and Flomax) lose their patent protection, the company can face a catastrophic loss of future sales unless there is another blockbuster waiting in the wings to launch.

• 3.  Don’t call a spade a spade: those playful and extremely successful Direct To Consumer Viagra ads you see on television (“Ask Your Doctor!”) don’t even mention potentially offensive words like impotence or erectile dysfunction or any clinical reason patients would even take the drug or any possible side effects, so prepare for clever marketing campaigns for flibanserin, if approved, that are equally vague around the word frigid, a word that is clearly more a petulant accusation in the bedroom than diagnostic terminology.

Meanwhile, for men who are anxiously awaiting final regulatory approval of the female ‘desire drug’ so it can be prescribed to their disinterested partners, it might be time to review the sex ed lessons from the Cambridge Women’s Pornography Collective, who  asked women the eternal question: “What really, really gets you hot?”

The answers, published in the book Porn for Women, describe a fantasy world where men give their partners exactly what they want: clothes get folded just so, delicious dinners await, and flatulence is just not that funny. Photos are entertainingly accompanied by steamy captions like: “As long as I have two legs to walk on, you’ll never take out the trash.” Now, boys, that’s erotic sex talk for you!

Even some researchers have confirmed Porn for Women’s cheeky conclusions.

One study defined housework as basically nine chores: cleaning, preparing meals, washing dishes, washing and ironing clothes, driving family members around, shopping, yard work, maintaining cars and paying bills. Women in the study spent an average 41.8 hours per week on these tasks, compared with 23.4 hours for husbands – a split that is considered fairly typical, yet often regarded by women as unfair.

Another study placed “sharing household chores” as the third most important factor in a successful marriage, behind faithfulness and a happy sexual relationship, says the non-profit Pew Research Center. That’s a sharp increase: 72% of respondents gave high importance to housework, up from 47% in a comparable study in 1990.

Yet another study by Dr. Scott Coltrane, a sociology professor at the University of California Riverside, linked men’s housework to “more feelings of warmth and affection in their wives”.

And Neil Chethik‘s 2006 book VoiceMale, linked a woman’s satisfaction with the division of household duties to her husband’s satisfaction with their sex life.

One husband, Chethik said in a Wall Street Journal interview, reported that although his wife did enjoy flowers or a candlelit dinner out, “if he wants to be sure of a romantic evening, he goes for the vacuum cleaner.”

Finally, documentary filmmaker Elizabeth Canner reminds us of a widely ignored issue around a ‘desire drug’:

“Even the idea that there’s a sexual dysfunction for women implies that there’s a norm. But there is nothing in the literature that says what ‘functional’ is. There is no norm, no medical study that says woman should be having five orgasms a month or 20 sexual encounters.

“So this idea that women are dysfunctional can be problematic, dangerous and inaccurate. And it’s just one more way women are made to feel inadequate by media and medical types who have seized upon a flawed 1994 study to spread the false information that 43% of women ‘suffer’ from HSDD.”

Canner might have a point. Remember those heady days after Viagra exploded into the medicine cabinets of  middle-aged men?  Women began to report sexual encounters with their blue pill-popping partners that resembled endurance marathons, as delighted men discovered they could suddenly perform – and perform! and perform! – leaving women so sore they could barely walk the next day. It may have been heady stuff for his Inner Porn Star, but for many women, it did not mean better sex – just sex that went on and on and on. Because he could.

Read how the medical journalism watchdog Health News Review rated the extensive media coverage of this flibanserin “news”. Or find out more in this Australian Broadcasting Corporation‘s feature by Ray Moynihan called The Merging of Marketing and Medical Science.

NEWS UPDATES:

• * October 8, 2010 – The German drug company Boehringer Ingelheim has abandoned development of its ‘female desire drug’ flibanserin after U.S. regulators said the pill was not proven to be safe and effective.

• November 15, 2014 – Read the editorial from Drs. Ellen Laan and Leonore Tiefer in the Los Angeles Times:  The Sham Drug Idea Of The Year: ‘Pink Viagra’

• August 18, 2015:  – The Food and Drug Administration has approved flibanserin, manufactured by Sprout Pharmaceuticals.

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