the problem with ‘female viagra’.
Recently, the Food and Drug Administration (FDA) approved Bremelanotide (commercially sold as Vyleesi), a drug that treats Hyposexual Desire Disorder (HSDD) in premenopausal women. Injected into the thigh or abdomen at least 45 minutes before a sexual encounter, and used no more than eight times a month, the drug aims to increase the number of satisfying sexual encounters that premenopausal women experience, however, the headlines that announced it as a ‘female viagra’ are awkwardly misleading, and show that we have a long way to go in normalising female sexuality, and pharmaceutical attitudes to reproductive health in general.
It’s important to note that it’s not a Viagra, not only in the literal sense, but also in the mechanistic one. Viagra is the commercial name given to Sildenafil Citrate- a drug discovered by accident after it was originally aimed to treat hypertension, with inventors Peter Dunn and Albert Wood soon realising that it was more efficient at inducing erections than it was in treating hypertension. Viagra thus enables one to act on the sexual desire. In stark contrast, Vyleesi acts by altering the neural and chemical networks that govern sexual desire. The mere fact that it had to be likened to Viagra when discussing it with the public indicates that there is a lack of accessible means to openly discuss issues of female sexuality.
As author Yuval Noah Harari frequently notes, emotions can be reduced to biochemical reactions. This kind of thinking has formed the basis for ‘psychiatric pharmaceuticals’, such as antidepressants, and is thus the pedestal upon which the sale of Vyleesi is premised on. However, desire is a multi-faceted phenomenon that has both a psychological and biological premise, where fixing it strictly from either end does not offer relief: a wildly different scenario to fixing the inability to act on a sexual desire due to physical limitation, which has strictly biological solution; increasing blood flow.
With 25% of women in the clinical trial experiencing noticeable changes in sexual desire industry experts are torn: according to TIME magazine, some experts feel that these modest increases evidence that desire is a multifaceted phenomenon that can not be remedied from a strictly biochemical perspective, as it is affected by a wide range of factors such as lifestyle and relationship circumstances. In contrast, other experts such as Dr Leah Millheiser of Stanford University, believe that the neurological changes observed in women with HSDD evidence that even the smallest triumph can go a long way for patients.
Additionally, one of the problems with studies in which people are entrusted with reporting their feelings is that humans are intrinsically biased and subjective creatures. What constitutes an increase in sexual desire in one person could be an actual increase- in another person it could just be because they started paying more attention to their sexual fantasies since the onset of the study.
Decreased libido in both sexes due to age is a natural occurrence, but is more prominent in females than in males. My grudge is thus whether the release of this new drug for HSDD criminalises a natural occurrence. Furthermore, menopause is accompanied by complex hormonal changes; one of which is the inactivity and decreasing sensitivity of the female gonads: the ovaries. There is a complex interaction between the brain and the ovaries, which ends in the regulation of ovulation, as well as oestrogen release: the chief hormone regulating female sexual desire. It can thus be hypothesised that the low efficacy of the drug is due to the fact that it can not correct this pivotal imbalance. Where female contraceptives have existed since the 1950s, and male contraceptive clinical trials seem to be constantly underway, can one conclude that pharma views women more as biological engines than as harbourers of sexual desire? Maybe. WIRED’s Arielle Pardes hypothesises that it was easier to produce a female contraceptive pill because female fertility is cyclical, whereas male fertility is continuous. But female fertility is just like sexual desire, in that it is cyclical, and if one can not develop a drug that is protective against the degradation of this cycle that dawns with age- then we are bluffing people.
I remember the moment when my entire class laughed at a Lecturer who was addressing the psychological aspects of ageing- one of them being the ‘myth’ that libido decreases. By releasing such a drug, we help many women, but I think we also push them further into a corner by proposing that there is a problem when the desire for sex or the number of satisfying encounter decreases with age. Furthermore- it seems as if it’s release gives credence to the myth of ‘women not wanting it’- because now there is a way to fix that. There are many ways in which ‘BIG PHARMA’ fools us- is this one of them?
