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Can pink pills cure her lack of sexual desire?

My dog Emma is in heat these days. She dreams about puppies and prepares a nest for them in her basket. Male dogs come galloping up to our house, tails high, owners behind them, short of breath and carrying an empty leash. Emma will mate at once, given the chance. She wants to, and she doesn’t care who the partner is, as long as he’s male. When she is not in heat, she sneers at any dog getting too curious of her behind. She does not want to mate. It’s simple.

Marianne and Svend are a couple a little over 50. Marianne’s desire for sex has disappeared completely. She never thinks of sex, has no sexual fantasies, no sudden nice feelings of warmth and heaviness in her pelvis. She and Svend have tried so many things: They have talked about what she likes and what usually turns her on, they have gone on a lover’s weekend, bought toys, watched porn. Nothing has helped. Svend doesn’t try to get close to her so much anymore and the good talks they used to have a getting more rare. Marianne is worried and sad. It’s not simple at all.

People have expectations about desire. They especially expect it to be there, ready to supply experiences, relaxation, wellness, intimacy, and happiness… Lust and a good sex life are seen as necessary ingredients in a good life.

Desire comes from many things

Words, pictures, touch, smell, thoughts and imaginations. What turns us on and how quickly and easily it happens has in part to do with where we are in life. Stress and busyness, disease, breast feeding, oral contraceptives, a partner who’s not as new and exciting as s/he used to be, pain – these are all desire killers. During puberty, when the libido hormone testosterone is high, the sex drive is intense and powerful. During old age spontaneous lust may have disappeared and can only be enticed forward by stimulation and fantasies.

Lack of desire is a widespread problem, with a negative impact on the lives of women and couples all over the world. Hence a great deal of money is at stake for a company who can bring a desire boosting pill on the market. The U.S. Food and Drug Administration has now approved Addyi (flibanserin), the first product ever to get an official stamp as a preparation strengthening sexual desire. It’s so far only tested on women prior to menopause. It’s been called “Pink Viagra” or Viagra for women, which is misleading. Viagra (for men) only works if the man already wants to have sex. Addyi is for those who have no desire for sex.

Small effect, many side effects

Dosage is one pill every day, and if you don’t have any noticeable effect after 8 weeks, you should stop the treatment. The pill can have side effects. It can make you dizzy, sleepy and nauseated. The risk is greatest if you drink alcohol, so during treatment with Addyi, you should not drink alcohol at all. A new kind of Antabus, actually. And the effect is not something that will make you see stars and fireworks. The women in treatment get a handful more sexual thoughts and fantasies, but only 10% of the women think their sex lives get better. On average, they have satisfying sex once or twice more every second month. If that makes it worth the trouble (and the side effects) taking Addyi probably depends on how often you have sex in the first place. And so far, Addyi is only approved for women who have not yet gone through menopause.

So Addyi is no miracle. Maybe it’s not at all better for Marianne than other ways of improving desire. I will come back to that later.