“desire drug” for women almost a reality

Dutch scientist Adriaan Tuiten is close to perfecting the first successful female desire drug that, if approved by the Food and Drug Association, could be available by 2016. It’s the biggest medical breakthrough in women’s sexual liberation since the birth control pill, writes Daniel Bergner for the New York Times.

‘The promise of Lybrido…is that it will be possible to take a next step, to give women the power to switch on lust, to free desire from the obstacles that get in its way.’

Since Viagra launched in 1998, many have wondered when women would have something similar. Though, to be clear, Lybrdio is not exactly the same as its famous predecessor. While Viagra targets blood flow to combat erectile dysfunction, Lybrdio is aimed at the brain – specifically, the neurotransmitters responsible for sexual dysfunction of another kind.

The subjects of the Baltimore trial Bergner observes meet the Diagnostic and Statistical Manual of Mental Disorder standard for HSDD – hypoactive sexual desire disorder, one of six specific female sexual disorders listed by the American Psychological Association. The women featured anonymously in the NYT’s piece (well worth reading in its entirety) have found their sex lives with their husbands and partners dwindling. Not because they don’t enjoy sex, but because they can’t work up the interest.

‘There’s something that’s stopping me from wanting it,’ says one woman, “Linneah”. ‘I don’t know what it is, I can’t tell you what it is.’

Though some like Linneah can’t explain the lack of lust, others can. People on anti-depressants often experience a numbed sex drive thanks to an increase in serotonin, the neurotransmitter involved with mood, reports Bergner.

Lybrido is a peppermint-flavoured testosterone coated capsule that, when dissolved in the patient’s mouth, is designed to alter her serotonin and dopamine levels. Lybrido gives dopamine – associated with pleasure and impulsivity – the upper hand while simultaneously increasing blood flow to the genitals.

The new chemical balance combined with sensation produces arousal.

There have been at least three trials like this before: LibiGel, Filbanserin and Bermelanotide, which never got off the ground. Besides the scientific roadblocks, FDA resistance to a female pleasure pill has gotten in the way. There were “concerns” about nymphomania.

Psychologists and academics have turned to evolution, statistics surrounding monogamy (apparently there is a sharp decline in arousal for both men and women in monogamous relationships), and neuroplasticity to explain the puzzle of reduced female arousal, and Bergner addresses each one.

Neuroplasticity, for instance, suggests internalised messages about gender-differences in sexuality may be responsible for turning the diverging sex drives of men and women into a self-fulfilling prophecy. The classic joke of the male brain being overwhelmed by thoughts of sex while women’s libidos occupy just a fraction of space somewhere between “shoes” and “feelings” may be causing us all to unknowingly reshape our brains.

If that’s true, do we need a pill for HSDD, a cultural shift, or both?

Without dismissing the psychological root of the problem – to meet the diagnostic criteria for HSDD, there must be intense, emotional distress over the loss of interest in sex – it seems fair to wonder what happens if Lybrdio becomes available. Tuiten conceived of the idea after his girlfriend, inexplicably he says, broke up with him 30 years ago. Does not wanting sex with your partner anymore signal a problem with you, them, or the relationship? If there’s a pill available to solve the problem of intimacy, at least, there’s a little less pressure to figure it out.

In a feature for the Globe and Mail, Patricia Pearson asks what happens when we start “treating” life, and the question is applicable here. The DSM, she reports, has gotten much larger and more comprehensive since it was introduced in 1952 with just 95 disorders. The DSM-IV included 283. By treating women’s libidos like a switch that’s just been jammed, other more complicated explanations for decreased arousal go unexplored. Even simple ones – like the fact that there is no magic number to police when a couple is having enough sex – become pathologised.

One point that does go unaddressed in the article is that psychiatrists, even when guided by the updated DSM, are susceptible to other biases. Bergner’s article mentions married couples, or couples in long-term relationships, both hetero and same-sex. Will physicians readily prescribe the pleasure pill to single, sexually active but upsettingly inhibited women as well? Even in 2013 there are plenty of hang-ups around women’s sexual autonomy, even without intersecting assumptions about race, ability, and sexual orientation that may get in the way of equal access for all women.

Nevertheless, Lybrido’s approval would be an enormous coup.