Whatever Happened to the “Pink Pill”?

You know what there’s no shortage of? Products and pills that promise to enhance men’s sexuality or help with their arousal, or commercials for these products and pills. Our supposed taboos surrounding sex and sexuality don’t really seem to apply when it comes to finding ways to make sure that a male partner can perform the way they want to, and get the pleasure that everyone should be able to get out of sex. But men aren’t the only ones who can experience sexual “dysfunction,” or who might have trouble getting aroused, or experiencing pleasure in the way they are looking to. 

pink pills next to a bottle of medicine
The “pink pill” was meant to help women with low libido, but what happened to it?

There are a lot of women out there who have struggled for a long time with their experience of arousal and sexual pleasure, but we just don’t seem to be as open about finding solutions. Although, with that being said, did you know that a little “Pink Pill,” marketed under the name Addyi, was approved in 2015, and was touted as the female counterpart to Viagra, the little blue pill for men? Don’t worry if you’ve never heard of it: it has never been very aggressively marketed, and it has faced continual setbacks and criticism. So what exactly is it? And does it do what it promises to – or can any drug actually help with female arousal?

The Promise of the Pink Pill

Addyi (flibanserin, as it’s known in pharmaceutical speak), or simply the “Pink Pill,” was approved by the FDA in 2015 to treat what’s known as “hypoactive sexual desire disorder” (HSDD), or low libido. HSDD is believed to affect up to six million pre-menopausal women in the U.S., and is characterized by persistent low sexual desire and emotional distress that are not attributable to an existing medical condition or relationship issue. In other words, Sprout Pharmaceutical, the creator of the drug, told women they had a pill that could actually boost their levels of sexual arousal. 

How was it meant to do that? Well, it works nothing like Viagra or any of those pills meant to help men achieve an erection. Unlike Viagra, Addyi was created to “fix” something that is all in the brain. In fact, the drug, an oral tablet that needs to be taken every day (unlike Viagra and similar drugs, which can be taken “when needed”), alters the balance of brain neurotransmitters linked to sexual function. So, no, it is definitely NOT a “female Viagra”: Viagra (sildenafil) boosts blood supply, while Addyi promises to increase sex drive.

So, the million dollar question is: does it increase sex drive in women? And how safe is it? The answer to both of these questions will probably leave you, sadly, back at the drawing board when it comes to dealing with low libido.

The Problems with the Pink Pill

As we said, Addyi has never been popular, so we wouldn’t be surprised if you didn’t know it even existed. It was very expensive when it was initially launched, and had a poor uptake;  when it  was relaunched in 2018, it didn’t do much better, despite a 50% price cut and a shiny new telemedicine prescribing model. It just never seemed to be what women really needed, and the results of real-world use bear that out. Improvement in libido in Addyi users isn’t remarkable: using a pretty lax set of criteria, Addyi was deemed effective in about 10% of the women who used it. Those women reported experiencing one more sexually satisfying event per month, on average, than they did before taking the drug (an increase from two to three events).

There’s another reason the Pink Pill has not taken off. Not only has Addyi been underwhelming in terms of popularity and usefulness, there have also been numerous safety concerns surrounding it. One of the main ones? During the drug’s clinical trial, twice as many women using flibanserin had accidents (including car accidents) compared to the control group.The FDA asked Sprout to study whether these dangerous complications resulted from women drinking alcohol while taking Addyi, and the results were extremely concerning, in more ways than one.blood pressure being taken by a doctor

First of all, the resulting study of alcohol use found that the combination of taking Addyi and having two to four drinks (defined as 1.5 ounces of alcohol) caused unconsciousness and dangerous drops in blood pressure in some participants. That meant that it was recommended that women avoid alcohol completely when taking the Pink Pill, since they had to take it everyday to see any results. 

The other worrying part? That study included 23 men, and just 2 women – very strange, considering that the drug is specifically designed for use by women. This is a pretty big issue, since women absorb more alcohol in their blood when they drink the same amount as men, and so experience alcohol’s effects faster than men. Because of this bizarre study, women still lack clear information about Addyi’s risks and potentially harmful effects, although the FDA now says that alcohol does not have to be avoided completely.

In addition to the safety concerns, there’s another big problem: no pill can actually be a female counterpart to Viagra. As we mentioned above, what Viagra does is basically increase blood flow – in other words, it’s goal is to fix a physical problem. Addyi works on the brain, by increasing dopamine and norepinephrine (neurotransmitters responsible for sexual excitement) while lowering levels of serotonin (which contributes to sexual inhibition) in the brain’s prefrontal cortex. But is tinkering with chemicals in the brain enough to really give women with low libido a satsifying sex life? Guess we’re back to the million dollar question.

Addressing Women’s Libido

We can give some credit to advocates of Addyi, who have pointed out that women need an option to help them increase sexual desire, and have drawn attention the fact that there is a multibillion-dollar men’s sexual health field, with no female counterpart that even comes close. Not only that, but it’s pretty troublesome that insurers have imposed fewer barriers to coverage of erectile dysfunction drugs than they have for HSDD therapeutics. 

So what can women who are distressed about their low libido levels do? First of all, it might be useful to examine the reasons that can sometimes lie behind low libido. Consider if any of the following might apply to you:

  • Are the stresses of daily life affecting your desire for sex?
  • Could the highs and lows in you sexual desire be coinciding with outside events, like the beginning or end of a relationship, or major life changes, such as pregnancy or menopause?
  • Do you find it difficult to orgasm? This could cause concerns or preoccupations that lead to a loss of interest in sex.
  • Do you think your past (or present) is affecting your libido? Desire is often connected to a sense of intimacy between partners, as well as past experiences. Over time, psychological troubles can contribute to biological problems and vice versa.
  • Are you living with any chronic conditions, like diabetes or multiple sclerosis? Some conditions can alter the sexual-response cycle, causing changes in arousal or orgasmic response.

Next, consider trying some of the following:

  • Seeing a sex therapistpurple sex toy
  • Experimenting with sex toys
  • Changing the dose or type of medicines that are known to reduce libido (like antidepressants and high blood pressure medication)
  • Addressing relationship and/or personal stressors, perhaps again with a therapist
  • Discussing the possibility of using medications or hormone therapies with your doctor, if nothing else works

It might be interesting for all of us to know more about the Pink Pill, or any drugs that promise to “fix” low libido in women – but it’s probably more worthwhile for us to get more information about women and desire in general. The list of things we don’t know about women’s libido is distressingly long: how many women struggle with low libido and why? What are the experiences of lesbian and bisexual women compared to heterosexual women? How effective are non-medical approaches to enhancing libido versus taking medications? Before we start wishing for a female Viagra, we should first give women’s sexuality the respect and consideration it deserves.