'Viagra for women'

What's the difference between flibanserin and Viagra?

Viagra is for men who would like to, but can't. Flibanserin is for women who can, but just don't feel like it.

The active ingredient of Viagra - sildenafil - widens blood vessels. Originally it was intended to treat hypotension and angina pectoris, a blood circulation disorder of the heart. Viagra helps erectile tissue take in blood.

Flibanserin affects the psyche. It influences different receptors inside brain cells and changes the way neurotransmitters relevant for the control of sexual functions work. On the one hand, the drug inhibits the production of serotonin, a hormone responsible for reducing sexual arousal. Meanwhile, it also stimulates the production of two hormones, dopamine (known as a "happiness hormone") and norepinephrine, a hormone that stimulates circulation.

Can I buy the drug right now?

No! The Food and Drug Administration (FDA) licensed flibanserin for the U.S. on August 18, 2015. But doctors are only allowed to prescribe the medicine for a condition called "hypoactive sexual desire disorder" (HSDD). Further, the drug can only be given to patients who do not have another medical or psychological condition, such as depression. Finally, the drug can only be prescribed to women before menopause.

In the European Union and most other countries worldwide, flibanserin has no official approval.

Are there dangers?

The reason for the restrictive prescription policy is due to possible side-effects. Flibanserin reduces blood pressure and can even result in fainting. The danger is gravely aggravated in the case of parallel consumption of alcohol.

Furthermore, the active ingredient interacts with other medical substances from the group of CYP3A4-inhibitors. Those include ingredients for the treatment of fungal infections of the skin, some hormonal contraceptives and a number of antiretroviral drugs against HIV.

Since few women will be able to assess these risks, there is no way around doctors prescribing the drug.

How high is the demand?

It's hard to estimate. There are many external factors at play. When a woman experiences a lack of sexual interest, is it a medical condition or a normal phase in her life?

The answer depends partly on one's social surroundings, on expectations from that person's sexual partner, and on influences from friends, relatives or the media. These factors will also play a role in the patient's feelings of distress: Is her sexual drive further affected by feelings of guilt, inferiority or aggression? Or on a subconscious or conscious level, does she want to separate or divorce her partner, and is that affecting her sex drive?

In other cases, the source of lowered libido is clearer to identify. Circumstances may include medically induced hormonal changes, post traumatic stress disorder - e.g. after a case of rape - or depression, a condition that would exclude the use of flibanserin.

A reduced sex drive often occurs after pregnancy and birth, triggered by natural hormonal changes. Under such circumstances, medical treatment is probably not advised. Typically, these symptoms will eventually vanish.

The drug, therefore, will most likely be prescribed after a clear-cut medical diagnosis.

In many other cases, however, psychotherapy or couples therapy may be the right choice.