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Wife not into it? There's a drug for that! - (7/30/2019)

By Dr. Ron Gasbarro

Ed, 44, came into the pharmacy just to shoot the breeze with his old friend the pharmacist. “Doc, you were the best man at my wedding. You remember how beautiful my bride was that day.” “She still is!” chuckled the pharmacist. “As much as I love her, she just doesn’t seem to be interested in, well, you know, sex.” “Has she discussed this with her doctor?” the pharmacist asked. “Are you kidding? She’s not going to bring up that topic with her doctor!” Ed replied. 

According to a 2019 survey of 4,418 women, a mere 6% sought help for sexual dysfunction. Reasons participants gave for being sexually inactive was that their partner had a physical problem (23%); their partner was not interested (21%); the respondent herself had a physical problem (11%); the respondent was too tired (9%); the partner was too tired (8%). However, the biggest reason was that the women themselves were not interested in sex (30%).

“Okay,” said Ed. “So, about 1 out of 3 women are not interested. My wife falls into that category. Isn’t there something she can take to get into the mood? I know that Viagra helps me a lot!” The pharmacist explained that a “female Viagra” exists. In 2015, the US Food and Drug Administration (FDA) approved oral flibanserin (Addyi®) for “acquired, generalized hypoactive sexual desire disorder (HSDD).” 

Flibanserin works by raising levels of dopamine and norepinephrine in the brain while lowering levels of serotonin. In other words, chemicals that help promote sexual desire are increased and the chemical that can suppress desire is decreased. Thus, for women, it’s all cerebral. Conversely, Viagra works in men by blocking an enzyme called PDE-5. When the enzyme is curbed, blood flow increases to the areas where PDE-5 is most concentrated – namely the penis. To summarize, women respond to the things that equate with love and stimulation, whereas men generally go by the idea that if they can poke a hole in the drywall, they are ready to rumble. Does flibanserin work for every gal? In the pivotal clinical study, there were significant improvements in libido. But there was also was a very large placebo effect. Of patients taking flibanserin, 51% said their desire had improved, but 38% of placebo patients indicated the same. This shows you what pink carnations, a Whitman’s Sampler, and a little sweet talkin’ will do. 

Another libido-boosting new drug is about the hit the market called bremelanotide (Vyleesi™). The molecule works the same as flibanserin except that it is injected subcutaneously into the abdomen or thigh only. In that respect, the women have it easier than men who are on alprostadil (Caverject™) for erectile dysfunction in which that drug is injected directly into the penis. Could be a buzzkill! The manufacturers state that women should use bremelanotide no more than 8 times a month. The prefilled auto-injector pen is self-administered at least 45 minutes before anticipated sexual activity and can be taken at any time of day.

Bringing up sexual dysfunction to health care professionals can be difficult for both men and women. Yet, sex is part of living and is intended to be enjoyable for both genders. The pharmacist encouraged Ed to talk to his wife about speaking with her doctor about her sexual dysfunction and to explore her options in satisfying both herself and her loving husband. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com


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