Pharmaceutical companies have long searched for a libido-enhancing pill for women, preferably one that delivered the same financial and clinical success as Viagra did for Pfizer.
Addyi, the first FDA-approved drug to boost women’s sexual desire, would ostensibly be the answer—except that the little pink pill has foundered in comparison to the little blue one since hitting shelves a month ago.
Doctors have written roughly 227 Addyi prescriptions since the drug became available, according to Bloomberg, a figure dwarfed by the 600,000 Viagra scripts filled in the first month after it hit the market.
While both drugs promise to boost libido, Addyi was never poised to take off in the same way that Viagra did.
Known generically as flibanserin, Addyi had an inauspicious relationship with the FDA, which rejected it twice—first in 2010 and again in 2013—until finally approving it in August.
The FDA’s green light divided doctors and advocates: Some hailed it as a long-overdue victory for women’s sexual health, while others thought it was scientifically irresponsible.
Critics attributed the drug’s eventual FDA approval to gender politics. In the months leading up to the FDA hearing, Sprout Pharmaceuticals, Addyi’s manufacturer, launched a “sexual health equity” campaign and accompanying website, Even the Score.
The website drew attention to the “26 drugs marketed for the treatment of male sexual dysfunctions” that have been approved by the FDA, “compared to zero to address the most common form of female sexual dysfunction,” among other politicized “facts.”
But its approval was frowned upon by many women’s health advocates.
“They were critical of flibanserin/Addyi for several reasons, including the marginal benefit and considerable side effects,” Debby Herbenick, associate professor of health and sexuality at Indiana University and author of Sex Made Easy, told The Daily Beast.
Addyi’s 10 percent efficacy rate comes with side effects like sudden drops in blood pressure, fainting, and sleepiness—all guaranteed mood-killers. Women who take the daily pill are also instructed to abstain from drinking alcohol, or face higher risk of side effects. (By contrast, Viagra has a 50 percent efficacy rate and is not meant to be consumed with large quantities of alcohol.)
“For many women, a little alcohol may be more helpful for their sexual desire or arousal than this medication,” Herbenick said of Addyi, noting that women’s health advocates also disapproved of the fact that very few women were involved in the drug’s alcohol-use trials.
Its sedative effect led one FDA committee member to ask at the trial whether the drug will “work,” according to Herbenick, since sleepiness is conducive to, well, sleep.
Addyi has long been dubbed “Viagra for women,” a misleading nickname given that the two drugs work in completely different ways.
While Viagra treats erectile dysfunction, increasing blood flow to the genitals, Addyi targets the brain, flooding it with dopamine, which controls the brain’s pleasure and reward circuits, and norepinephrine, the hormone that mediates stress. (The drug was first developed as an antidepressant.)
As the first libido-boosting drug for women, Addyi’s relative flop since entering the market is proof that a remedy for women with desiccated sexual appetites remains elusive.
“Many sexual health professionals feel that one day, there may very well be a safe and effective medication that helps to enhance women’s sexual desire or arousal, but that Addyi isn’t it,” said Herbenick.
The drug may see a boost in sales once Sprout launches direct-to-consumer advertising, but Herbenick hopes educated consumers will not be seduced by ads that suggest “a glossy, rosy picture of sex-while-medicated, and then leave the fine print and warnings at the end.”
In a statement to The Daily Beast, Sprout Pharmaceuticals stressed that the company’s “priority has been to educate healthcare providers and pharmacists about the safe use of this first-of-its-kind treatment for women.
“We are proud that Sprout has been able to launch Addyi just two months after FDA approval and we are confident in where we stand just a few short weeks after coming to the market.”