Sexual desire is different from sexual performance. There are several medications that address male sexual dysfunction. But none that address loss of sexual desire in women. Until now. In 2015, the FDA approved flibanserin, the first medication designed to treat female hypoactive sexual desire disorder (HSDD), or loss of sexual desire in premenopausal women.
“This innovative medication is well-studied and it does help restore sexual desire in women who have HSDD,” says Holly L. Thacker, MD, Professor and Director of Cleveland Clinic’s Center for Specialized Women’s Health."
HSDD is described as the long-term loss of desire that results in distress or interpersonal difficulty, and is not caused by medical or psychiatric disorders, relationship issues, or the effects of another medication. It is believed to affect up to 1 in 10 premenopausal women.
Many descriptions of the newly approved drug for HSDD focus as much on what it is not, as what it is. Flibanserin is not the female counterpart of medications that treat male erectile dysfunction (ED). It is not meant for transient or episodic use rather it is taken orally daily. It is non-hormonal and it is not approved for post-menopausal HSDD.
Flibanserin (Addyi) is classified as a multifunctional serotonin agonist antagonist (MSSA). It increases the levels of the neurotransmitters dopamine and norepinephrine (associated with sexual excitement) and decreases serotonin (associated with sexual satiety and inhibition). Although the precise mechanism is not completely understood, this neurotransmitter rebalancing is believed to restore sexual desire.
“The medication is intended to restore a woman’s sexual desire to her personal baseline,” says Dr. Thacker. “It is not an aphrodisiac.”
Flibanserin was studied in 11,000 women. Subjects reported significant differences in sexual desire, more frequent satisfaction, and less distress caused by low sexual desire.
“As with any medication,” says Dr. Thacker, “Adult women will consult with their physician to make an informed decision about whether this is an appropriate therapy for them.”
Where Are They Now
Since 2016, the sales of the approved drug have been less than optimal. It is speculated that low sales are due to poor efficacy, issues with dosing and contraindications, presence of side effects, and regulatory restrictions. In 2017, the pharma company announced a relaunch of the treatment featuring drug ads and consumer “education awareness” campaigns in hopes to boost popularity in response to largely underwhelming sales of the drug. In June 2018, the company announced it would relaunch the drug again with a large price reduction. Recently, a second HSDD drug appeared on the FDA’s radar. Currently under review, the drug will be discussed in an advisory committee meeting in January 2019.