The medication Flibanserin is being used to treat sexual dysfunction in women.

Dear Dr G,

Thank you for answering my email.

I heard there is a new “Blue Pill” for women being developed recently.

I am curious to find out whether it will bring some extra “spices” to the intimacy with my wife?

What is the pill? Is it widely available?

How effective are the pills compared with the male pills?

Are they expensive? Sorry to put Dr G on the spot, but I am rather excited.

Regards

K

Believe it or not, it has been nearly two decades since the discovery of the blue pills in 1998. The quest for the female equivalent has been in place all this time, but the excitement has been dampened on several occasions with doubts in the treatment efficacy and side effects.

Part of the problem is that scientists cannot even agree on the very existence of the female sexual dysfunction and the parameters to evaluate the condition. In contrast, the male sexual dysfunction is visible and measurable.

It has been reported that around one in 10 women may encounter the problems of HSDD (Hypoactive Sexual Desire Disorder), and this is also believed to affect 40% of women at some point of their lives.

Some experts claim this is a condition that can lead to stress and low self-esteem, other specialists reckon lifestyle habits, fatigue and regular hormonal fluctuations contributing towards low sexual desires. Besides, the assessment of the desire is highly variable and the outcome evaluations are subjective.

The medication Flibanserin, with the trade name Addyi, had been considered and rejected by the US FDA in 2010 and 2014, but the drug was finally approved as the treatment for HSDD in women in October 2015.

This makes Flibanserin the first treatment available for sexual dysfunction in women, and often considered the female equivalent of the blue pills.

The clinical trials of three randomised double-blinded evaluations involving nearly 2,400 participants suffering from HSDD, with the average 36 years of age, demonstrated the outcome in the 24 weeks of treatment with Flibanserin versus placebo.

In the medication arm, the sexual encounters increased from 2.8 to 4.5 times a month, while the placebo arm showed a difference from 2.7 to 3.7 times of “satisfying sexual events” in a month.

The onset of the treatment effect was noticeable after four weeks of medications and the efficacy maintained throughout the treatment period.

Many specialists considered the results to be unimpressive, but others consider the data to be cornerstone research.

The real concerns of the Flibanserin are their side effects. The adverse effects were reported to be mild and moderate, and these include dizziness, nausea, insomnia and constant tiredness.

During the trials, the associations with severe low blood pressure and loss of consciousness, particularly with alcohol consumption had led to the approval of the drug with REMS (Risk Evaluation and Mitigation Strategy), which requires prescribers to enroll and complete a training programme before prescribing the medication.

The obstacle may explain why only 227 prescriptions were written in the first three weeks since the introduction of Flibanserin.

The approval of Addyi has brought mixed reactions among the public and medical professionals.

The coalition of women’s group called “Even the Score” and experts consider that putting the spotlight on women’s sexual health is the first step in the right direction.

On the other hand, the opponents are concerned how the introduction of the drug can potentially lead to over medicalisation and treatment of sexual dysfunction in women.

On this occasion, Dr G is truly put on the spot and confessed that he is unfamiliar with the diagnosis of HSDD and the use of Flibanserin.

The reality is, the largest sexual organ in the body, the brain, controls sexual functions in women. This makes the understanding of sexual responses in women illusive and never straightforward.

The quest for female sexual satisfaction is part of the journey for men and how nature intended. The key of finding the solution is not with a pill, but constant exploration and communications of love!

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