Who's afraid of Viagra Woolf? As it happens, quite a few people.
Given the prevalence of what is known, controversially, as "female sexual dysfunction," the search for a woman's wonder drug is on. And, according to researchers for a German pharmaceutical company, Boehringer Ingelheim, we've found it. Sort of.
A drug known as flibanserin, which was originally developed as an antidepressant, turns out to have unexpected aphrodisiacal effects on women. In a recent clinical trial, the drug yielded "significant improvements" in libido measurements among women who had lost interest in sex.
Professor John Thorp of the University of North Carolina at Chapel Hill presented the results last week at the Congress of the European Society for Sexual Medicine, hailing the discovery as "a Viagra-like drug for women in that diminished desire or libido is the most common feminine sexual problem, like erectile dysfunction is in men." A blue pill for him and a pink pill for her. Middle-aged bed death solved.
If only it were quite so simple. In her recent book, Perfectly Normal: Living and Loving with Low Libido, psychologist Sandra Pertot reports that 33 per cent of U.S. women suffer from low sexual interest. Numbers from other recent American studies range from 10 to 43 per cent. While there are no comparable numbers for Canada, low female libido, if you believe what my girlfriends say, is widespread here as well.
Despite the numbers and anecdotal evidence, though, there is a growing backlash against the need to treat female sexual dysfunction, with many researchers and commentators questioning the need for a "female Viagra" at all. Over all, the women who participated in the flibanserin study reported experiencing only 0.8 more "sexually satisfying events" per month when taking the drug. The events were anything from masturbation to intercourse and, like almost everything to do with female sexuality, the definition of "satisfying" is relative and difficult to measure. The fine print on flibanserin raises the question: How hard up would you have to be to take a pill every day for less than one full sexual encounter a month?
Still, the market for a female Viagra is out there – and the fact that pharmaceutical companies are predictably keen to cash in on it doesn't nullify the need. As Liana Palmerio-McIvor, a psychotherapist who runs a counselling group at Women's College Hospital in Toronto, put it, "Lack of interest in sex is a huge problem for many women." And she doesn't just mean her patients, many of whom have serious sexual disorders. "Most of my girlfriends have been happily married for 10 to 12 years and if I polled them to find out how often they're having sex, it wouldn't be a lot." Nonetheless, the notion of widespread female sexual dysfunction – and the idea that women might benefit from a drug to treat it – is being met with resistance in many parts of the clinical community.
The New View Campaign ( www.newviewcampaign.org) is a North American network of physicians, clinicians and health organizations determined "to challenge the distorted and oversimplified messages about sexuality that the pharmaceutical industry relies on to sell its new drugs." Last spring, documentary filmmaker Liz Canner released Orgasm Inc., her documentary casting a similarly jaundiced eye on the quest to develop a cure for female sexual dysfunction.
For them and others, the argument against a pink Viagra hinges on female sexual dysfunction being a fabrication of greedy pharmaceutical firms keen to make a profit by preying on the insecurities of otherwise healthy women. It's a position that syndicated sex columnist and author Josey Vogels supports. "There isn't a disease to treat," she said, adding that, if women want to have better sex, they'd be better off "looking at the underlying problems" rather than simply popping a pill.
But the idea that there is no such thing as female sexual dysfunction and that women wouldn't benefit from a viable pharmaceutical option is shortsighted and obtuse. Sure, women's sexual complaints tend to be very different physiologically from those of men. (Whereas flibanserin aims to alter brain chemistry to increase desire, Viagra works more like a hydraulic lift, causing increased blood flow to the genital area.) But does that mean female concerns should be dismissed as too complicated to treat or, worse, purely mythical?
Palmerio-McIvor, who works with sexually troubled women every day, doesn't think so. She is open-minded about low-female-libido treatments such as the testosterone patch (which is approved in Europe but not in Canada) and says a pharmaceutical option would help to "take some of the pressure off" sex therapists such as herself. She is also impatient with the critics of the pharmaceutical option and dismisses the argument that female sexual dysfunction is a conspiracy by men in white coats eager to sell drugs.
"If anything, there's a lot of politics around making sure men have what they need to perform and therefore we don't get the same energy put into similar research for women," she says. "Because women can technically still perform without being interested in sex – in intercourse we're the 'receivers' – it is expected women should be able to simply push past our issues and perform anyway."
Flibanserin may not be the magic bullet we're looking for, but that doesn't mean we should give up on the search for a little pink pill. In the meantime, we'll just have to enjoy the foreplay.
Editor's note: Liana Palmerio-McIvor's credentials were mistated in the original version of this article. This version has been corrected.