Its name is flibanserin, but it’ll be marketed under the catchier name of Addyi. Presumably the idea is that bored, lustless women will cry “Addy-yi-yay!” for Sprout Pharmaceuticals’ achievement in developing “The female Viagra”. Sprout has just got FDA approval in America, and signed a billion-dollar takeover agreement with a bigger chemical firm, Valeant. The PR is dazzling; it is hailed as a breakthrough, a holy grail, an “enormous, enormous advance in women’s health”.
Sounds good, eh? In a world of cancers, infertilities, osteoporosis, Aids and perinatal mortality, should we not whoop for joy at the alleviation of any female problem, and hope that the NHS, too, is conned into issuing the stuff as fast as Sprout-Valeant can churn it out?
Not in this old cynic’s book. Pick the issue apart, practically and culturally, and what emerges is, even by the snake-oil standards of non-critical pharmacy, patronising codswallop. The condition that flibanserin claims to alleviate is listed in the pernicious American psychiatric-diagnostic tome Diagnostic and Statistical Manual of Mental Disorders. It is termed “hypoactive sexual desire disorder” or HSDD, and its symptom is a lack of interest in sex for “three months or more” and failure to initiate it. It was first named in 1977, unsurprisingly because between the Summer of Love and the terrors of Aids came a period when old decorums cracked, and progressive thought declared that sex-for-fun was not only good and guiltless but necessary: anyone from 18 to 80-plus without a sex life was unhealthy.
So the psychiatric profession created the diagnosis, and has fretted ever since about the deficiency of women who get bored of sex, too tired for it, or simply don’t fancy getting it on with the available partner. Oprah Winfrey fell for the claim that 43 per cent of American women were sufferers, mourning “a silent epidemic”. Interestingly, by the way, HSDD isn’t defined as an inability to reach a climax: just as a lack of motivation to start the process at all. And no doubt a few women — in this hypersexual, braggart, Fifty-Shades culture — do feel uneasy about their lack of desire. Though asThe Times reported, while national surveys suggest that 30 per cent of UK women admit lacking interest for three months or more “the proportion reporting distress was much lower”.
In other words, sex isn’t everything, not for everybody. Love, hugs, intimacy, domestic contentment, family, friendship, fascination with work or study can outrank the full act itself. But Big Pharma says that won’t do: you’re hypoactive, disordered, take the tablet! Even some US women’s groups banged the drum, saying it was unfair that men had Viagra and there was nothing for women.
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But it’s no parallel. Viagra treats impotence mechanically, increasing blood flow to the appropriate part. The man, whose desire is all there, takes it ad hoc. Side-effects are temporary and not considered dangerous. This female drug, on the other hand, must be taken every day, operates on brain chemistry like an antidepressant, and the side effects include low blood pressure, fainting and drowsiness, with “potentially dangerous” interactions with other drugs including contraceptives (oh, brilliant!). And, oh yes, you shouldn’t drink alcohol when you’re taking it. Which is every day.
And what is promised in return? Does it make you a tiger, panting for your man however unappealing or inconsiderate? Not really. Results are deemed “modest”, with a “sexually satisfying encounter” (not necessarily orgasmic) 0.5-1 more times per month than previously. Big deal. The placebo did nearly as well. No wonder the FDA rejected the drug twice.
You could mutter that it is designed for the benefit of men, making women chemically willing and relieving blokes of the tedious business of seduction, warmth, humour, gentleness and imagination that are traditionally so effective in meeting the complexities of female sexuality (and without denying a girl a drink, too). But even without such cynicism, it is troubling to see another blithe medicalisation of a temperamental phenomenon that is likely to have more to it than chemistry.
It reminds me of that other medical mantra imported from corporate industrial America, the knee-jerk diagnosis of “attention deficit hyperactivity disorder”. That gets diagnosed quite often not only in real sufferers — there are some, just as there are some depressives immensely helped by medication — but in normally rowdy children, medicated from the age of three for asking too many questions or running about more than adults want to cope with. The very word “disorder” has a nasty ring to it: suggesting a standard of orderliness, an emotional correctness that tidies away any private eccentric responses. The child is adventurous, hyped on junk food and bored in a dully taught class of 40? Drug him! The woman is tired and preoccupied and through with childbearing, and doesn’t feel like sex with an oafish husband for three whole months? Drug her!
We are assured that the new drug would only be prescribed after counselling about potential relationship or anger issues. But given the experience of antidepressants, handed out by many doctors too busy for endless talk, you have to doubt that. The best hope is that women laugh at the whole idea, and say that they’ll “initiate sexual contact” when they’re good and ready, so mind your own business. But in a culture that shrieks (inaccurately) that everyone else is at it all the time, some may fall for it. “Doctor, make me want him!” Weird. Creepy.