Do you need this sex pill?

In her leopard-print shirt and plumped-up ottoman pout, soap star Lisa Rinna tells CBS news, "I lost my sex drive." It seems we now have our own female Bob Dole.

If you've never heard of hypoactive sexual desire disorder (HSDD), check out a site called Sex Brain Body, where Rinna is featured. You'll learn that while the cause of low libido is unknown, the brain's neurotransmitters are thought to play a role. You have to read the fine print to make out the astroturfing ("with the support of sponsorship from Boehringer Ingelheim Pharmaceuticals.") What's interesting is how this sex- brain-body campaign (also check out the Discovery Channel's series on female sexual dysfunction) is being rolled out before the star is born. That would be the HSDD drug Boehringer Ingelhiem has developed for young women-it works on the brain-which will go before the FDA on June 18th for approval.

I wouldn't have known anything about it, had I not gone to a screening of Orgasm Inc., a documentary about another drug company trying to come up with the next female Viagra. Several people from Boehringer Ingelheim were there to check out the climate. Let's just say, it was testy.

"I think the Boehringer Ingelheim campaign is unethical," says Karen Hicks, PhD, a spokesperson for The New View Campaign, which is trying to block the drug's approval. "Even though they don't mention the drug on the site, and the quality of the information they have about HSDD-if you believe in it-is quite good, this is totally premature."

Should this sex drug pass? I don't have the answer, but I know we should be asking the questions:



So what is this drug? Flibanserin-or Girosa, the likely brand name-was originally tested as an antidepressant (it didn't work) and targets serotonin receptors. When I asked Boehringer Ingelheim how it affects libido, they responded via email through Ogilvy PR, "It is hypothesized that neurotransmitters within the brain are affected in women suffering from HSDD. While the specific mechanism of action is still being studied, flibanserin is believed to act on these neurotransmitters." That's a lot of hypothetical for a drug you have to take every single day.

Does it work?According to the company's studies (read a report here), premenopausal women with HSDD who took flibanserin, reported increased desire and sexual function. Further-and the part the FDA will likely focus on-the 450 subjects who took the drug, had more "sexually satisfying events" during the 24-week study period than the 521 women on a placebo. The difference was an increase of 2.1 verses 0.9-in other words, a little over 1 more "sexually satisfying event" during the 6 months. "I don't think that's enough of an improvement to fix the disparity between a woman's libido and her man's," says Susan Bennett, MD, assistant professor of medicine at Harvard Medical School, where she teaches a class on women's sexuality. "Targeting the central nervous system for the treatment of sexual dysfunction is a really good idea. But even if this drug is safe, I don't think it will be a big seller."

Is HDDS even a disease? Many experts, including Bennett, are dubious. What is "normal" desire for women? Wanting to get it on every day? Once a week. Twice a year? "For the vast majority," Bennett says, "low desire is just a normal part of their existence. The reasons are myriad-work, kids, lousy relationships, and a natural tendency not to have the libidinous drive men do."

Liz Canner, who made Orgasm Inc., believes the whole thing has been pushed on us by the drug industry. (The film is great-I highly recommend watching it-alone or with the girls.) Canner's almost decade-long journey started when she was hired by Vivus, a biopharmaceutical company, to make erotic videos so they could test an orgasm cream they were developing for women with "female sexual dysfunction" (which includes HSDD.) They let her film while she was there. At one point in the movie, she asks the company's founder, Virgil Place, MD:

"Is there anything organically wrong with these women you can locate that [the cream] will address?" From behind his desk, he thinks a minute, then looks into the camera: "I can't answer that question."

Darby Stephens, the manager of clinical research, awkwardly explains the company's interest in female sexual dysfunction this way: "We had concepts in development, but somehow it got picked up that we had drugs. The market went wild. We didn't even know what the disease was."

(When I contacted Vivus's CFO, Timothy Morris, he responded, that the footage of the company was "filmed nine years ago and is out of date. Over the past few years,the compay has discontinued the development of products for female sexual health." Vivus's current focus, he says, is new obesity drugs.)


"I didn't go in trying to frame anyone," Canner tells me recently. "I liked the people I worked with. It wasn't until later when I looked at the footage that I started realizing they were in the business of developing a disease in order to sell the drug-and putting women's health at risk for their own profits."

Is it safe? So far, Boehringer Ingelheim, hasn't found reason to suspect otherwise. The side effects, which include daytime sleepiness, insomnia, nausea, and anxiety, appear mild to moderate, and fade in a couple of weeks. But a six-month trial is not very long, and we only have company studies to go by. New View is extremely concerned. "There isn't enough safety information and we just don't know enough about the effect of serotonin on the brain," says Hicks. "Without having good evidence of all the effects that flibanserin will have, it's a complete crap shoot."

Do we need a sex pill?I certainly hope that any woman who is distressed about her sex life gets help. But even if this drug turns out to be safe and effective, I'm concerned about the idea of libido pills playing into a culture that is already hyper-sexualized, raising our expectations about how much we should want sex and get off on it. To our endless list of things we fail to live up to-beautiful, thin, smart, busty, cellulite-free-now we're going to add "always hot to trot"? Bennett would rather see an Rx for knowledge. "I'm not anti-pharma, and I believe in better living through chemistry," she says. "But I think there's a tremendous misunderstanding in society about women's sexuality. Just because you don't have an orgasm, doesn't mean you aren't enjoying sex. Men and women are very different. And their libidos are very different. And I don't think all of that can be fixed even if they develop the perfect drug."

What do you think? Should flibanserin be approved June 18th?

If not, you can find out about taking action at the New View Campaign.
For more about sex drive...

How active is yours?
Ways to increase it
Female Viagra: Bad News?





[Photo Credit: Getty Images/MedicalRF.com]

























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