Wednesday, August 19, 2015

"Female Viagra" In A Little Pink Pill? - Women Had Best Not Bet Their Sex Lives On That PR Claim

Image for the news result

Evidently, millions of American women, suffering from low libido (some of them even in their twenties as shown last night and this morning on the news) can't wait to be able to buy what is being marketed as "female Viagra" which is nothing of the sort. Ladies, if you are counting on this pink pill to boost your sex drive you may be sadly disappointed, and before you buy it  (est. $75/month) you need to separate marketing BS from scientific reality.

Viagra, like Cialis,  belongs to a drug class known as PDE5 inhibitors.  Recall the chemical pathways here: the cavernous nerves close to the prostate gland secrete nitric oxide which stimulates release of an enzyme (cyclic GMP) inside the penile smooth muscle cells. This promotes relaxation of smooth muscles and erection. An enzyme known as PDE5 prevents this, since else there may be a prolonged erection. Hence, a PDE5 inhibitor works to suppress secretion of the PDE5 enzyme.

Men use it to get a "boost" before sexual contact, and it generally takes from 1-2 hrs. to work. The experience and effects are entirely "below the belt", i.e. in the genital region. Most males are good for several hours after taking the blue pill because the blood flow assures good connection. Male prostate cancer survivors are also asked to take it - if only to prevent deformation of the penis (say after radical prostatectomy) to enable O2 to get into the tissues.

Indeed, the pre-op use of PDE5 inhibitors is now widely indicated by oncologists for endothelial preconditioning, whereby the endothelium (the lining of the erection spaces) is in some way protected by pre-treatment. Typically, the patient then gets a prescription for a PDE5 inhibitor the day the Foley catheter is removed post-surgery/.  He is then "told to take a full dose of Viagra (100 mg) or Levitra (20 mg) once per week with adequate accompanying stimulation.

These genital mechanics and chemical aspects have not one iota to do with the "little pink pill" called Addyi now on offer to women suffering from low libido. And to believe so is to delude oneself, and hence Addyi is NOT "female Viagra". Moreover, there are more significant side effects while the main one for Viagra may be some indigestion and temporarily blurry vision and higher blood pressure.

The main difference from Viagra is that Addyi works on specific hormones in the woman's brain such as dopamine, serotonin. The increase in libido arrives after the relative strengths of these brain chemicals are "adjusted" by Addyi. There is NO concomitant blood flow to the genital region as there is for males. Also it can take much longer for the effect to kick in. As One Dr. Berman put it this morning on CBS Early Show, "the drug's risks are greater than its benefits" and also:

"It increased the number of sexually satisfying events by less than one event per month".

So, if a woman suffering from hypoactive sexual desire disorder now has sex once a month, Addyi can expect to help her increase that to twice a month. Also,  she can't take it just before a planned encounter like a man can take Viagra. No, she needs to take it "weeks or months" before the effects kick in, according to sex therapist Leonore Tiefler quoted in today's Denver Post.

Meanwhile, she will have to be on guard for the most common side effects, including:

- Dizziness
- Nausea
-Fatigue

And when combined with alcohol, it can cause fainting. Thus the FDA is also requiring a strong warning to women that they should never drink alcohol while taking the drug and stressing the risk that it can cause sudden fainting - a special danger for drivers.

 Fortunately, this pink pill  which goes by the name flibanserin, is only supposed to be issued to specially trained doctors and pharmacists to dispense it. They are also  to keep track of any problems with women taking the drug. Only trained physicians will be allowed to write prescriptions for the pill.              
                     
Alarmist? Hardly. Dr. Susan Wood, a former FDA official now at George Washington University, said she was disappointed by the approval.  She said:

"This is a product that is neither very effective nor particularly. safe. It won't benefit many women and at the same time the approval comes with a lot of restrictions, setting a precedent that a drug for women's sexual health has to be treated in a very special way."

Women desperate for a low libido "cure" would be well advised to take notice. When will this sexual salvation be ready? Sprout Pharmaceuticals' CEO Cindy Whitehead said this morning the planned roll out date is October 17th.

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