By Dr. Tiger Devore

When Viagra first hit the market for men, it was obvious within a year of its introduction that it was going to be one of the most successful medications ever marketed by a pharmaceutical company, with $4 billion in sales reported in 2014. In fact, in its first month, Viagra had over 500,000 prescriptions. The new sex pill for women, Addyi (flibanserin), had 227 prescriptions in its first month.

So what’s the difference? Viagra works by increasing blood flow to the pelvis, making it easier for men to get and maintain an erection (just like those TV commercials tell you) within 20 minutes or so. Addyi works by changing brain chemistry, much like antidepressants, which requires taking the drug daily as the effect builds over the first two to six weeks. Viagra makes it easier for men to get an erection, a functional effect that is easy to measure. Addyi is advertised as being able to increase sexual interest, a much harder effect to measure. Both Viagra and Addyi cost about $26 per pill. Men usually use Viagra four to six times per month, costing them about $100. Women will be looking at spending around $780
per month.

There are side effects with this drug, including low blood pressure and risk of fainting. Women are encouraged not to drink alcohol while taking Addyi.

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The Food and Drug Administration had rejected Addyi twice before finally giving it approval. Some people asked, “If there is a drug for sexual performance enhancement for men, why isn’t there a drug for women as well, and if there is, why isn’t it being approved?”

Finally, the FDA gave a kind of approval that included conditions: Doctors must be certified to prescribe Addyi, to be sure that they understand the risks of taking the drug and are competent to counsel women before they use Addyi. Doctors have to take an online course to prescribe, all of which the FDA sees as providing an additional safeguard against misuse of the drug. Viagra was initially a drug only for men with diagnosed erectile dysfunction; it’s now clear that many men are using Viagra to enhance their performance as they age, or in many cases, simply as a recreational drug. Addyi doesn’t have that potential for abuse.

Addyi is approved to be prescribed for women who are premenopausal and have been diagnosed with hypoactive sexual desire disorder. The low sexual interest must be as a result of HSDD, not a psychiatric condition like anxiety or depression, or relationship problems.
So does it work, and is it worth it? Like many drugs on the market, if it works for you, then you are glad that it exists and can help you with your medical complaint. The first months of this drug being on the market are not making it look like the kind of blockbuster drug that Viagra became. Given the side effects, the alcohol restrictions, the extra requirements to become a prescriber that doctors must complete and the small population of women with diagnosed HSDD, who are therefore eligible to receive the drug, Addyi is not for everyone, and indications
are it’s going to be for a relatively small number of women. That pill for an enhanced sexual experience for women, like Viagra for men, is still waiting to be discovered, approved and marketed.

Dr. Tiger Devore, known as Dr. Tiger, is a clinical psychologist, AASECT Certified Sex Therapist and media expert on sex and relationships. But most important, he is a person who cares with over 25 years of practice and expertise working with women and their specific issues.

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