Will there ever be a Viagra for women?    If so, would the FDA ever approve it?    How many women would actually want to try it?

This month,  the U.S. Food and Drug Administration is expected to consider drug manufacturer Boehringer-Ingelheim’s new drug  flibanserin — a medication reported to somewhat improve female sexual desire.   The flibanserin hearings will be the next big battle in  the current contest  over the so-called “medicalization of sexuality” — pitting the advocates of “sexual medicine,” on the one hand, and  a grassroots anti-medicalization movement on the other.

As this contest heats up, one repeatedly hears Boehringer-Ingelheim’s new drug for women’s sexual desire referred to as a possible  “Viagra for women” or “Pink Viagra”

These phrases make little logical sense in reality, since the two drugs have little in common.  Viagra works on arousal, flibanserin works on desire.  Viagra works on the genitals.  Flibanserin works on the mind.    In addition, it’s likely that flibanserin will have a much more modest impact on female desire than Viagra has on male erections.

So why the repeated references to flibanserin as “Viagra for women” and “Pink Viagra”?

Ignorance, for one.  Never bet against ignorance in the field of sexuality.  (More on that later).   And money, certainly.  There’s always someone hoping that a drug for women will make as much money from women as Viagra has from men.

But I think there’s another important factor at work.  Phrases such as “Pink Viagra” refer, however unconsciously, to an important divide between male and female sexuality:  the relative complexity of women’s sexual response, compared to men’s.   Behind the hope for a “Viagra for women” is a wish by some that female sexuality would just be simpler and easier to understand.

Why is it that sex for men seems to be so simple?  Even the molecular process is simpler. There just happens to be a switch, and Viagra just happens to pull it.   Pfizer tested Viagra in women, and it didn’t do much.   This was hardly surprising.   Who could have doubted that sexuality, even molecular sexuality, would be more complicated for women?

The anti-medicalization movement warns us that the drug companies are trying to oversimplify sex.   The movement argues that sexuality, and women’s sexuality in particular, should by rights remain complicated – because that’s how it’s intended to be.

I agree.   And I doubt there ever will be a molecule that does for female desire what Viagra did for male erections.

But I question the movement’s mission.   I do not share its worry that new medications will make us  more simple-minded about sex.   Our collective level of sexual ignorance as a society is still pretty high.  I don’t think it could get much worse.

Instead, I think we should cautiously welcome the chance to integrate biological and psychological approaches.   Let’s find out what flibanserin can and can’t do, and for whom.   And let’s figure out how  to use it in an integrative fashion when  sex therapy alone doesn’t work as well as we’d like.

The anti-medicalization movement is right — sex is more complicated than taking a pill.    But let’s offer practitioners and their patients real choices.   I’m hoping flibanserin gets approved someday.

Stay tuned.

Copyright © Stephen Snyder, MD 2010
www.sexualityresource.com New York City

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