To its detractors, flibanserin, a pink pill targeting feminine libido and produced by Sprout Pharmaceuticals, is just another example of disease mongering. Disease mongering refers to the practice of pharmaceutical companies and others”pathologizing” facets of the human condition to be able to make a buck. By way of instance, halitosis or bad breath just became a condition that needed treatment following Listerine was designed to”treat” it.
But to its supporters, feminine sexual interest/arousal disorder is a really real disorder, also flibanserin can help. These fans cite the distress brought on by a diminished or nonexistent libido.
What’s Female Sexual Interest/Arousal Disorder?
Female sexual interest/arousal disorder identifies a decrease or absence of sexual curiosity about a girl that lasts 6 months or more months and causes distress or interpersonal difficulties. Moreover, such disinterest is unattributable to another disease (think depression or diabetes ) or medication (think antidepressants). It is significant that this loss of sexual desire causes discomfort or difficulty because, otherwise, it isn’t actually a issue. In the end, tons of folks have a longstanding disinterest in sex that does not cause personal troubles, and that is fine.
Researchers discovered that female sexual interest/arousal disease involves complicated brain circuitry controlling benefit processing.
Especially, this illness affects frontostriatal pathways and neuronal projections of this insula, amygdala, hypothalamus and ventral striatum. In girls with such sexual interest and arousal problems, sexual motivation and pleasure are adversely affected. Naturally, aberrant reward processing pieces into other psychiatric disorders including schizophrenia, depression, substance abuse, dementia, eating disorders and other sexual disorders.
Interestingly, researchers have discovered changes in functional MRI that suggest macrocircuit anomalies attributable to female sexual interest/arousal ailments. For example, women diagnosed with this disease exhibit abnormal activation in the brain’s cortical and striatal regions.
How Does Flibanserin Work?
It is really difficult (impossible) for scientists to quantify specific neurotransmitter levels in different parts of the brain. However, using microdialysis techniques and nodes inside brain networks, researchers postulate that flibanserin increases the release of both dopamine and norepinephrine and lowers the release of dopamine in women with reduced sexual interest and desire. More specifically, flibanserin can distinguish between serotonin receptors and stimulate serotonin 5HT1A receptors while blocking serotonin 5HT2A receptors in the adrenal gland consequently increasing the downstream release of dopamine and norepinephrine. Apparently, these joint neurotransmitter effects help better modulate reward processing and increase feminine libido.
Of particular note, flibanserin functions on hormones, not hormones. Though hormones have proven successful in boosting libido, unwanted effects make them overly risky as treatment.
Moreover, flibanserin isn’t”female Viagra.” Viagra works by increasing blood flow to the genitals utilizing a completely different mechanism and impacting a different site of action (genitals vs. brain).
Results from two clinical trials known as BEGONIA and DAISY (ah, titles of flowers… how cute!) Suggest that flibanserin can increase feminine libido. Combined, these randomized and placebo-controlled trials examined 3548 girls with a sexual interest and arousal disorder. Following 24 months of once-daily treatment with 100 mg flibanserin, fulfilling sexual events, sexual appetite, and distress brought on by low sexual desire had been measured using various (subjective) questionnaires.
Researchers found that in participants taking flibanserin–compared to people taking placebo–there was an increase in a number of satisfying sexual experiences and level of sexual desire and a decline in distress caused by low sexual desire.
Serious adverse events in these trials occurred in over 1 percent of participants, and none of the serious events were attributable to flibanserin treatment itself. Less severe negative effects included dizziness, nausea, fatigue, and sleepiness (most frequent ).
Another randomized and placebo-controlled trial called SNOWDROP (I am seeing a pattern, here… another blossom name!) , analyzed 949 postmenopausal women with female sexual interest/arousal disease (technically hypoactive sexual desire disorder–a DSM-IV-TR expression that has since been altered to sexual interest/arousal disorder in DSM-5). Similar to the other trials, the results imply that flibanserin enhances sexual appetite, a number of satisfying sexual events and reduces sexual distress while causing few negative outcomes. Specifically, 37.6 percent of girls on flibanserin versus 28.0 percentage of girls taking placebo reported satisfying sexual events.
Although in a number of these studies researchers attempted to include participants taking antidepressant medications, antihypertensives, triptans and a few antifungals, one big limitation of these studies would be sampling bias. To put it differently, because issues with sexual arousal and desire are pervasive and influence all types of girls, it was hard to check whether flibanserin works for everybody.
Citing concerns about safety and effectiveness, the FDA has refused to approve flibanserin twice–rejections by which its maker, Sprout Pharmaceuticals, and others take issue. From a healthcare remedies standpoint, I certainly sympathize with the FDA’s concerns. After all, flibanserin tools with several neurotransmitters and believing that several of the girls who will choose the medication will also be taking other drugs that further change neurotransmitter levels — like antidepressants and anxiolytics — it is ideal to have a cautionary stance.
Many people honestly do not know what to think about flibanserin. On the one hand, a lot of men and women are suspect of pharmaceutical companies and their intentions and forecast if approved, flibanserin may be overprescribed to certain women like those who experience no distress associated with a paucity of sexual desire or arousal. On a related note, everything about Sprout’s marketing of flibanserin screams manipulation including the pill’s pink color and floral-monikered clinical trials. On the other hand, it’s hard to understand the effects of flibanserin unless you’re a girl who uses the medicine.