The FDA approved Addyi. But was there a hidden agenda?

Ladies, the moment you have all been waiting for is here!  No, not affordable childcare.  Not equal pay for equal work. Not gun control.  Not abortion rights or paid maternity leave or a female majority in Congress or a constitutional ban on the words “chick lit.”  Girls, it is so much better than all that.  We got pink Viagra!

Flibanserin.  Catchy name.  Addyi for short.  Approved by the FDA for hypoactive sexual desire or, for clarification, inhibited sexual desire, sexual aversion, or sexual apathy.  The New York Times defines this disorder as follows:

Inhibited sexual desire refers to a low level of sexual interest.  A person with ISD will not start, or respond to their partner’s desire for, sexual activity.  It often occurs when one partner does not feel intimate or close to the other.  Communication problems, lack of affection, power struggles and conflicts, and not having enough time alone together are common factors.  ISD can also occur in people who’ve had a very strict upbringing concerning sex, negative attitudes toward sex, or traumatic sexual experiences.

No way.  You can take a pill for the disorder called Brought Up Baptist?  Here’s more:

Illnesses and some medications can also contribute to ISD, especially when they cause fatigue, pain, or general feelings of malaise.  Commonly overlooked factors include insomnia or lack of sleep, which can lead to fatigue.

Wait.  Is the problem that I have inhibited sexual desire or that I just want to go to sleep?

The FDA actually rejected Addyi twice, in 2010 and 2013.  The reasons cited included the fact that it doesn’t really work.  Women who took it didn’t experience an increase in desire on a daily basis, but did have one more “satisfying” sexual experience per month than the placebo group.  Plus, it has side effects, like low blood pressure, fainting, nausea, dizziness, and, hilariously, sleepiness.  And, it has a boxed warning that the drug should not be used by people who drink.  Which is problematic, to say the least.  But, no worries.  The pink Viagra can only be prescribed or dispensed by practitioners who have watched an online slide presentation and passed a test of their comprehension.  So, thank God for that thorough education at least.

So why did the FDA decide to approve Addyi this time?  Lobbying money.  Plus the deployment the biggest money word there is: sexism.  Some women’s groups have accused the FDA of sexism for not approving a women’s libido pill while sanctioning a men’s version.  Or rather, a few vocal women have.  Prominent Washington feminists, together with the (female) co-founder and CEO of Sprout Pharmaceuticals (the company that makes the pill), the president of the National Organization for Women, and the help of a public relations company, managed to convince some people in Washington that the FDA was being discriminatory.   A very effective social lobbying campaign sealed the deal.

What all these feminists have missed is the very sexist labeling of yet another normal human female function as a “disease.”  Men can get inhibited sexual desire, too, but no one is talking about that “problem.”  (Viagra, by the way, is not a libido enhancer.  It is an erection enhancer.)  All of this looks very much like a mirror image of the Victorian-era belief that women should, in the immortal, and paraphrased, words of Queen Victoria, “Lie back and think of England.”

Low sexual desire in women is, if it is a problem at all, a symptom, not a disease.  Some women don’t desire sex and are fine with it.  For everybody else it is a normal response to normal life problems.  But, hey.  Maybe there’s a pill for that too.

Shirie Leng, a former nurse, is an anesthesiologist who blogs at medicine for real.

Image credit: WJBK

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