Dr. Jess on Sex: Stop calling it the female Viagra

Why the little pink pill may not be the answer to boosting a woman’s libido


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Health Canada is considering approving a pill to treat hypoactive sexual desire disorder in women

Health Canada, following in the footsteps of the U.S.’s FDA, is considering the approval of Addyi (also known as flibanserin) to treat so-called hypoactive sexual desire disorder (HSDD) in women. 

HSDD is described as “low sexual desire that causes marked distress or interpersonal difficulty and is not due to a co-existing medical or psychiatric condition, problems within the relationship or the effects of a medication or other drug substance.”

According to the drug maker, seven per cent of premenopausal women suffer from HSDD, and now headlines have touted the little pink pill as the answer to the little blue pill, Viagra. But there are considerable differences.

Addyi functions by modifying serotonin in the brain, whereas Viagra works by increasing blood flow to the penis. Unlike Viagra, which is taken on demand when a man is in the mood for sex, Addyi is taken every day regardless of whether or not a woman plans to have sex. Viagra helps men to achieve an erection when they’re horny, whereas Addyi is supposed to help put women in the mood to begin with. Despite approval, the FDA acknowledges that the mechanism by which Addyi might increase sexual desire is unknown and the increase in sexual desire amounts to a mere 0.5 to 1.0 additional encounters per month.

It makes sense that we would be attracted to a pill that promises a libido boost. After all, many of us find that our interest in sex dwindles with time, parental responsibilities, stress, relationship struggles, work and aging. Research also suggests that sexual desire declines with every month of a relationship for Canadian women — even among those in new relationships. Lowered libido may be a near-universal experience, but this doesn’t make it less stressful.

The challenge with Addyi as the answer to low libido is that it doesn’t address the diverse range of reasons women lose interest in sex. A pill that tweaks the brain’s serotonin system won’t help women who struggle to communicate their needs to their partners. It won’t address underlying issues related to relationship resentment or exhaustion. And it won’t tackle challenges related to body image, a lack of exercise, imbalanced diets and overbooked schedules. Each of these factors can slaughter libido, even in the best of relationships.

Whether Health Canada moves forward with its approval or not, experts agree that Addyi will only help a tiny segment of the population. After all, the drug trials included healthy women who were already having satisfying sex up to six times per month — a frequency that might be more cause for celebration than distress for many busy couples. This discrepancy highlights the subjectivity of HSDD and the reality that we can’t address so-called low libido with a one-size-fits-all approach.

If you’re worried that you have low libido, it’s time to ask yourself why you care and whether or not it is causing you (and your partner) any distress. Some people are perfectly happy in their experience of low/no desire, and some couples are even opting to forgo sex altogether. It’s true!

The challenge arises when there is a discrepancy in desire between partners. If this is the case, you both need to realize that compromises, change and efforts need to come from both sides. The low-desire partner can not accept all of the responsibility. Labelling low desire as a disorder is inexact, because it’s often framed only in comparison to one other person and would not exist problematically in other contexts/relationships.

Though sex drive is natural, desire needs to be cultivated — especially in the context of long-term relationships. Even if we want to want sex, sometimes the desire for sex with a long-term partner just isn’t there.

If you want to want (more) sex, you have a range of options at your disposal. Regular exercise, a low-fat, high-fibre diet and a good night’s sleep are all positively correlated with higher levels of sexual desire.

Maca, an herb marketed for its supposed benefits for sexual performance, has been approved by Health Canada to support the emotional components of sexual health, and masturbating has been linked to an upswing in sex drive. In some cases, low desire is related to low satisfaction and can be resolved by teaching your partner what feels good for you sexually. Do you need more flirtation? Longer foreplay? Manual stimulation?

If your low desire is associated with stress, anxiety, distorted thoughts or depression, seek out a cognitive behavioural therapist, and if you’re dealing with unresolved relationship issues, consider attending a few solution-focused therapy sessions as a couple. If your partner is entirely unwilling to attend therapy with you, perhaps you should consider whether your desire levels are related to his/her willingness to share responsibility for working on your relationship.

None of these solutions is a quick fix, but unlike most drugs, they come with a host of positive side effects rather than negative.

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Jess O’Reilly is a sought-after speaker, author and sexologist. SexWithDrJess.com.

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