What is Female Viagra?

Bryn Mawr Center for Pelvic Medicine’s director of female sexual medicine explains more about the “little pink pill.”

Comedians had a field day when the FDA approved flibanserin—aka the “little pink pill.” But it’s no laughing matter for women who suffer from female sexual dysfunction. What is FSD, and how does “female Viagra” work? Dr. Susan Kellogg Spadt, director of female sexual medicine at Bryn Mawr’s Center for Pelvic Medicine, explains. 

MLT: What is the medical definition of female sexual dysfunction?

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SKS: FSD is difficulty experienced during normal sexual activity. The most common form is hypopactive sexual disorder, persistent or reoccurring deficiency or absence of sexual desire that causes marked distress or difficulty. It’s not caused by another medical condition, side effects from medication, or trouble in a relationship. Lack of sex is for at least six months and related to pain, plus an absence of desire, arousal and orgasm.

MLT: Pain?

SKS: Pain during sex is the second most common FSD. Sex shouldn’t hurt—period. But women usually normalize the pain. They think it’s because they’re not aroused. In fact, a medical condition may be causing the pain.

MLT: It must be difficult for partners, too. 

SKS: They don’t always know. I had a patient who came in with her husband, which is not uncommon. He thought she was having a transient dip in her desire. She said, “Dr. Kellogg, I never, ever desire sexual activity with my husband.” And they’d been having sex twice a week for 14 years. She never told her husband because she didn’t want to hurt him. 

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MLT: How does flibanserin—or Addyi—work?

SKS: Addyi reestablishes the balance between the neurotransmitters dopamine and serotonin, and sets the neurochemical stage for arousal. Addyi allows women to have spontaneous thoughts about being with their partners and be more receptive to their approaches. It’s a pill that’s taken every day. It takes two to four weeks to start working, and if it doesn’t work in eight to 12 weeks, a woman would stop taking it. It’s approved only for premenopausal women.

MLT: And the side effects?

SKS: Dizziness, sleepiness and nausea—but those are side effects of many medications. There’s a warning not to mix with alcohol. 

MLT: Viagra put the spotlight on erectile dysfunction. Might the same happen with Addyi?

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SKS: That’s my hope. Millions of women have lost their sexual desire and are fine with that. But FSD does, by definition, cause distress. Women in their 30s, 40s and 50s have lost the special energy that happens when a couple has intimacy on a regular basis. But there are treatments. I encourage couples to take this journey to wellness together. That creates a dialogue and helps couples grow together, not apart.

Dr. Susan Kellogg Spadt//Photo by Tessa Marie Images

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