Category: Addyi

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What Causes Low Sex Drive In Women?

And How Can I Increase Mine?

There are real treatments available.

By Alyssa Dweck, M.D.

Not in the mood to get busy tonight? Don’t panic just yet. Libido in women is complicated. There are a whole host of factors that influence sex drive and affect why you might not want to have sex (tonight, this week, or even for the last several months).

But if it’s more of a persistent concern and it’s causing you distress, it’s worth looking into further and discussing with a trusted medical professional; the gyno is the first stop for most women. Your libido could be falling flat from something as common as stress or the birth control you’re taking, or it could be a sign of a bigger health issue. But you won’t know the underlying cause or how to solve it until you bring the issue to your doc’s attention. Okay, now let’s dive deeper.

Libido can ebb and flow for all sorts of reasons.

First, I want to remind you that there’s no such thing as a “normal” sex drive. Take the stats out there about how often other people typically have sex with a grain of salt; it varies for everyone (and, hey, people lie!). Female sex drive is nuanced, and your libido rises and falls naturally.

For example, you might have a higher sex drive around the time of ovulation (the body’s way of telling you to get frisky during your fertile time, even if you’re not actively trying to become pregnant). Or, you may not feel like being sexually active during other times of the month, like when you’re on your period (though if you’re into period sex, it can be enjoyable too).

You can also experience changes in your hormones or neurotransmitter levels from certain medications you’re taking (antidepressants, for example, could lower your drive or alter your ability to orgasm), which, in turn, can mess with your sex urge. The same can happen if you have an underlying hormonal condition like a thyroid disorder or polycystic ovary syndrome (PCOS).

Another player when it comes to sex drive that you might not necessarily expect is hormonal birth control. Most BC pills (or patches and rings) contain the hormones estrogen and progesterone, which are necessary for regulating your cycle. What the pill is doing is preventing ovulation. And as a result, the typical peaks and dips of those hormone levels don’t occur, so you’re not experiencing that surge of estrogen during ovulation, which is typically what makes women want to have sex during that fertile period.

Plus, the amount of testosterone you produce also naturally decreases significantly if you’re on the Pill, which also might make your drive slip a bit. For other women, though, feeling confident and secure in their method of birth control could make them feel more like having sex. It really depends on the person and their particular hormone levels.

Or, major life changes may impact your sex drive, like if you’ve had a death in the family, recently lost a job, or are going through a bout of depression. If your mental health or emotional circumstances could have something to do with it, you may just need to be gentle with yourself and work with a mental health pro to address the issue.

It’s also totally possible that you’re just in a self-esteem rut and aren’t feeling as sexual. The bottom line is, it’s important to be honest with your gyno and/or therapist about alllll of these factors so that they can consider all possible factors that could be affecting your libido.

Or, you may actually have hypoactive sexual desire disorder.

Beyond the typical contributing factors to low libido, you might be showing signs of a well-recognized medical condition called hypoactive sexual desire disorder, or HSDD. It presents as low sex drive, but to the maximum extent. HSDD is characterized by having a pretty much completely absent sexual drive and lack of fantasizing about sex in general.
Most patients who struggle with HSDD compare it to a light switch—they used to have regular sexual desire, but for no identifiable reason, they all of a sudden have *zero* sex drive, no matter the partner or the situation. In cases of HSDD, there’s also always distress associated with low libido, meaning an emotional component of being upset or distraught over the fact that you’re not thinking about sex.

It’s a little bit tricky to diagnose HSDD. Patients fill out a brief questionnaire about their low sex drive and how it’s affecting them emotionally, and doctors screen their responses to diagnose the disorder. If, when docs assess a patient’s answers, it seems the cause of low drive could be related to something like relationship or marital problems, or a different medical or medication issue, your MD will work on addressing and treating that with you first.
But if you do get a HSDD diagnosis, don’t panic. Believe it or not, HSDD is common among young women—one in 10 premenopausal women suffer from it—and it’s not something to be ashamed of at all.

To treat low sex drive, you have a few different options.

Treatment, as you can probably guess, depends on the underlying cause. But your doctor will likely recommend one (or more) of the following courses of action.
1. Consider seeing a sex therapist.2. Revisit books and movies that might help light your flame.
This practitioner will manage the emotional and psychological components of low sex drive and will also address how your drop in libido might be affecting your relationship, or your desire to form a new relationship.

When I work with people suffering from HSDD or low libido in general, I notice that some have a fear that this may cause their partner, if they have one, to stray or leave them. This is also something you can delve into further with a sex therapist, if your low libido is bringing up intrusive thoughts like this. In my practice, I often recommend reconnecting with your partner with a regular date night. Basically, it’s a “prescription” for intimacy.

To find a mental health practitioner with expertise in sexual health in your area, check out Aasect.org.

2. Revisit books and movies that might help light your flame.
You may simply need to do some solo homework to get back in your groove. This can include a variety of different tasks (that you’re comfortable with, of course). For some patients, watching porn or reading erotica does the trick for getting sexual thoughts back on the brain. You can incorporate this during solo time so that you can start fantasizing on your own, and then you can involve your partner in the scenario.

Another thing that helps sometimes is going out on a limb with sexual activity. That could mean a fun role play scenario for some people. For others, that could mean having sex in another room of the house besides the bedroom to keep things interesting.

3. Talk to your doc about medications and supplements that can boost your drive.

If you have HSDD, medication might be necessary to treat the condition. In 2015, a drug called Flibanserin was approved by the FDA to treat HSDD in pre-menopausal women. It’s a daily pill that may have some side effects, like dizziness, nausea, and fatigue, according to the drug’s website.

More recently, another drug called Vyleesi got approved. It is uniquely administered with an auto-injector (it’s like an Epipen) that you can take on demand to get you prepped for sex. Vyleesi works on melanocortin receptors, or energy regulators, in the brain. Studies showed increased desire and decreased distress in those taking Vyleesi. One common side effect is nausea. [Ed note: Dr. Dweck has worked as an HSDD educator with the parent company of Vyleesi.]

Other options include off-label use of testosterone supplementation via prescription or over-the-counter herbal supplements to enhance sex drive.

If months go by and you’re not able to get back to your normal level of sexual desire, that could be the right time to also alert your health-care provider that you’re not feeling like yourself.

But the main red flag is not how long your drive is low (for some people it’s weeks, months, or longer)—it’s the question of whether your low libido is distressing to you. That’s when you should bring it to your gyno’s attention.

Complete Article ↪HERE↩!

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Sex Drug for Women Stirs Up Controversy in Medical Community

Just don’t call the new medication for women’s low desire for sex ‘female Viagra.’

Vyleesi acts on neurochemicals in a woman’s brain to help her feel desire.

By

There is some good news out about how women’s sexuality, long overlooked in the medical community, is treated now. Amid much hype and interest, the U.S. Food and Drug Administration (FDA) approved Vyleesi (bremelanotide), an injection designed to improve female sexual interest arousal disorder (FSIAD) — also known as hypoactive sexual desire disorder — in premenopausal women, in June 2019.

Is Sexual Interest Arousal Disorder the Same as Sexual Desire Disorder?

Formerly called hypoactive sexual desire disorder (HSDD), the term for a lack of desire for sexual activity was recently updated in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). The disorder is when women are distressed by the fact that they have little to no desire for sexual acts and the lack isn’t due to medication, disease, relationship problems, or psychological issues. The low desire is chronic (six months or longer), present at all times (not just during certain situations), and is associated with personal distress. (The distress must be the woman’s, and not the partner’s. There is nothing wrong with a woman with low desire who isn’t upset with the status. There is a difference between dysfunction and disinterest.)

New Drug Helps Validate Women’s Sexual Experiences

“The whole concept of minimizing women’s sexual health issues is important. In the past, if women had sexual problems, they were just told they were hysterical. Now their issues are coming to the forefront, and at least the release of Vyleesi may indicate that women’s sexual health is becoming more of a priority. It’s empowerment for women that they now have choices and options,” says Michael Krychman, MD, executive director of the Southern California Center for Sexual Health in Newport Beach.

Leah Millheiser, MD, director of the female sexual medicine program at Stanford Health Care in California, adds, “It is a coup for women that the FDA is recognizing chronically low libido as an important health issue.”

New Libido Drug Is Not a Cure for All Sexual Problems

There has been some controversy, however, over the release of Vyleesi, in that it may promise more than it can deliver. First, to be clear, the injections are not a silver bullet. Women’s sexuality is a complex interplay of medical, psychological, situational, and relationship status.

“Female sexual health and wellness are multifactorial. Vyleesi provides one facet to help but it’s important to appropriately assess the woman first. If the woman has complaints, she needs to be offered an intervention: Not just medical, but sometimes also psychological input and counseling are also very appropriate. In my clinical experience, women can benefit from medical intervention and some sort of counseling as well,” says Dr. Krychman.

You May Still Need Sex Counseling to Get Back on Track

Reality check: You will still have to work on your relationship. Women and their partners have to remember that if they have had long-term concerns with desire, they may need help via sex therapy on getting back to intimacy. “It’s challenging to go from 0 to 10. You have to relearn sexual trust and intimacy. Simply giving yourself a shot is not necessarily going to be a panacea. Vyleesi improves desire, but don’t expect to feel like you’re in your sexual prime again. It’s a subtle improvement, but that might be enough to improve intimacy and sexual self-esteem,” says Dr. Millheiser.

Vyleesi Is Not Appropriate for Women With Low Libido Who Do Not Have Arousal Disorder

Vyleesi is only for premenopausal women with female sexual interest arousal disorder. For women who have low sexual desire — and would like to have more — their first stop should be to a clinician who can assess where the issue is. If sexual dysfunction is ruled out, making behavioral changes is more effective than medication. “As you age, spontaneous sex is harder to come by. Making time, relationship and sex counseling, finding private time, getting into a new environment, sex toys, and working on body image can all help. Women may not start out with spontaneous desire, but can develop responsive desire in the act,” says Millheiser, who also recommends “pregaming.” Self-stimulate, or read or watch something arousing, so you can develop responsive desire prior to engaging with your partner.

Not Female Viagra: Vyleesi Does Not Work the Way Viagra Does

There is also a prevalent misconception that Vyleesi, the second medication of its kind to come to market following the release of Addyi (flibanserin), is a female Viagra (sildenafil), referring to the male medication for erectile dysfunction. Vyleesi works on desire, while Viagra works on arousal. “Clinicians really want to move away from comparing women’s drugs with men’s. Viagra increases blood flow to the penis but men have to have desire in order for it to work. Vyleesi alters neurochemicals in the brain so women can feel desire,” says Millheiser.

Has the Public Been Provided Enough Information About the Drug?

The National Women’s Health Network, a consumer activist group, says that the FDA rushed Vyleesi to market too soon. In a statement about the approval, Cynthia Pearson, executive director, said, “The National Women’s Health Network is disappointed in the U.S. Food and Drug Administration’s (FDA) decision to approve the drug bremelanotide (brand name: Vyleesi) and urges women to avoid using the drug until more is known about its safety and effectiveness. Women simply do not have enough information to make an informed decision about whether the drug is safe and effective. The FDA did not call on their advisers to review the drug publicly, and the sponsor has not yet published full clinical trial results. The limited data that has been published leaves many important questions unanswered. For example, it appears that hundreds of women enrolled in the pivotal trials were not included in the company’s presentation of the results. What happened to those women?”

The organization also points out the potential side effects: severe nausea, and skin and gum darkening, which did not go away after stopping treatment in about one-half of cases.

There Are Concerns About Side Effects, Safety, and Effectiveness

“We respect the ability of women to make good decisions if they have good information. We are not saying side effects are a reason why women shouldn’t use it; the issue is how much do we know? Can you get enough information to make an informed decision? A very determined person could get more info by reading the detailed label on the FDA website, but it still feels like the FDA didn’t do women good service here by the rush,” says Pearson, adding, “I’ll be surprised if it takes a very big place in the arsenal. It is not very effective and makes a lot of women very uncomfortable. My prediction is it is going to be something of a flop.”

Krychman disagrees with this assessment: “The product has been extensively studied. I think it’s appropriate for the FDA to make its own judgment. They evaluated and assessed the clinical program, which was very robust, and they have a competent group of advisors.”

Millheiser concurs, “The drug company behind Vyleesi has provided sufficient data on safety and efficacy. If there hadn’t been, the FDA would not have approved it.”

Complete Article ↪HERE↩!

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Is there such a thing as ‘normal’ libido for women?

Drug companies say they can “fix” low sex drive in women.

By Caroline Zielinski

Ever wished you could reciprocate your partner’s hopeful gaze in the evening instead of losing your desire under layers of anxiety and to-do lists? Or to enthusiastically agree with your friends when they talk about how great it is to have sex six times a week?

Perhaps you just need to find that “switch” that will turn your desire on – big pharma has been trying for years to medicalise women’s sex drive, and to “solve” low libido.

One US company has just released a self-administered injection that promises to stimulate desire 45 minutes after use.

In late June, the US Food and Drugs Administration (FDA) approved Vyleesi (known scientifically as bremelanotide), the second drug of its kind targeting hypoactive sexual desire disorder (HSDD), a medical condition characterised by ongoing low sexual desire.

Vyleesi will soon be available on the market, and women will now have two drugs to choose from, the other being flibanserin (sold under the name Addyi), which comes in pill form.

Many experts are sceptical of medication being marketed as treatment for HSDD and the constructs underpinning research into the condition.

Yet many experts are highly sceptical of medication being marketed as treatment for HSDD, and also of the scientific constructs underpinning the research into the condition.

What is female hypo-active sexual desire disorder?

Hypo-active sexual desire disorder (or HSDD) was listed in the DSM-4, and relates to persistently deficient (or absent) sexual fantasies and desire for sexual activity, which causes marked distress and relationship problems.

“The problem is, it is very hard to describe what this medical condition actually is, because its construction is too entangled with the marketing of the drugs to treat it,” says Bond University academic Dr Ray Moynihan, a former investigate journalist, now researcher.

His 2003 paper, and book, The making of a disease: female sexual dysfunction,  evaluates the methods used by pharmaceutical companies in the US to pathologise sexuality in women, focussing on the marketing campaign of Sprout Pharmaceuticals’ drug flibanserin, an antidepressant eventually approved by the US Food and Drug Administration (FDA) as a treatment for women experiencing sexual difficulties.

“This campaign, called Even the Score, was happening in real time as I was working as an investigative journalist and author.

“I got to see and document the way in which the very science underpinning this construct called FSD – or a disorder of low desire – was being constructed with money from the companies which would directly benefit from those constructs.”

The campaign was heavily criticised, mainly for co-opting  language of rights, choice and sex equality to pressure the FDA to approve a controversial female “Viagra” drug.

During his research, Dr Moynihan says he found “blatant connections between the researchers who were constructing the science, and the companies who would benefit from this science”.

“The basic structures of the science surrounding this condition were being funded by industry,” he says.

What does the science say?

The biological causes of the condition have been widely researched. A quick search comes up with more than 13,000 results for HSDD, and a whooping 700,000 for what the condition used to be called (female sexual dysfunction).

Some of these studies show that women with the condition experience changes in brain activity that are independent of lifestyle factors, and other research has found that oestrogen-only therapies can increase sexual desire in postmenopausal women.

Others look into the effectiveness of a testosterone patch increasing sexual activity and desire in surgically menopausal women. Most say there is little substantive research in the field, and even less conclusive evidence.

“Oh, there are … studies galore, but mostly they are done by the industry or industry supporters – that’s one problem,” says Leonore Tiefer, US author, researcher and educator who has written widely about the medicalisation of men’s and women’s sexuality.

“There is no such thing as ‘normal’ sexual function in women,” says Jayne Lucke, Professor at the Australian Research Centre in Sex, Health and Society at La Trobe University.

“Sexual function and desire changes across the lifespan, and is influenced by factors such as different partners, life experiences, having children, going through menopause.”

Using the word ‘normal’ is very powerful, because it puts pressure on women about our idea of what is a ‘normal’ woman’.
Professor Jayne Lucke

Professor Lucke has studied women’s health and public health policy for years, and believes our need to understand female sexuality and its triggers has created a rush to medicalise a condition which may not even exist.

“Using the word ‘normal’ is very powerful, because it puts pressure on women about our idea of what is a ‘normal’ woman’,” she says.

The studies submitted by AMAG (Vyleesi) and flibanserin (Sprout Pharmaceuticals) for approval from FSD have been criticised for their connection to industry, as well as the small differences between the drugs effects and those of the placebo.

For example, Vyleesi was found to increase desire marginally (scoring 1.2 on a range out of 6) in only a quarter of women, compared to 17 per cent of those taking a placebo. A review of flibanserin studies, including five published and three unpublished randomised clinical trials involving 5,914 women concluded the overall quality of the evidence for both efficacy and safety outcomes was very low.

Side effects were also an issue with both medications.

Flibanserin never sold well, partly due to problems with its manufacturer and partly due to its use terms: that women would have to take it daily and avoid alcohol to experience a marginal increase in their sexual experiences.

“I’m just unsure of the mechanism of action with these drugs – they seem to be using the model of male sexual desire as a baseline,” Professor Lucke says.

“In the heterosexual male model of sexuality, the man has the erection, then there is penetration, hopefully an orgasm for both: that’s the model this is targeting”.

That said, it doesn’t mean that women don’t suffer from authentic sexual difficulties – the preferred term by many physicians, including the head of Sexual Medicine and Therapy Clinic at Monash Health and a sex counsellor at The Royal Women’s Hospital, Dr Anita Elias.

“I don’t use terms like ‘dysfunction’, or worry about the DSM’s classification system,” she says.

“Clinically, I wouldn’t waste too much time reading the DSM: we’re dealing with a person, not a classification.”

She says she prefers to talk about “sexual difficulties” rather than sexual “dysfunction” because often a sexual problem or difficulty is not a dysfunction, but just a symptom of what is going on in a woman’s life (involving her physical and emotional health, relationship or circumstances, or in her beliefs or expectations around sex).

She prefers ‘sexual difficulties’ rather than ‘dysfunction’ because often … (it) is a symptom of what is going on in a woman’s life.

“It’s the reason you don’t feel like having sex that needs to be addressed rather than just taking medication,” she says.

Dr Elias believes silence and shame that surrounds the topic of female sexuality is impacting how these conditions are being dealt with at a medical and societal level.

“Sexual pain and issues just don’t get talked about: if you had back pain, you’d be telling everyone –but anything to do with sex and women is still taboo”.

Dr Amy Moten, a GP based in South Australia who specialises in sexual health, says sexual difficulties are not covered well enough during medical training.

“While training will include a component of women’s sexual health, this tends to refer to gynaecological conditions (such as STIs) rather than sexual function and wellbeing.”

She says many GPs won’t think to ask a woman about sexual issues unless it’s part of a cervical screen or conversation about contraception, and that many women are reluctant to have such an intimate conversation unless they trust their GP.

“We need to think more about how to have these conversations in the future, as we’re living at a time of general increased anxiety, a lot of which can relate to sexual health.”

As for medication? It may be available in the US, but the Australian Therapeutic Goods Administration (TGA) has confirmed no drug under that name has been approved for registration in Australia – yet.

Complete Article ↪HERE↩!

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For elders and others, drugs are available that aid sexual experience.

But insurers and Medicare won’t pay for them.

A tablet of Pfizer’s Viagra, left, and the company’s generic version, sildenafil citrate.

By Michelle Andrews

For some older people, the joy of sex may be tempered by financial concerns: Can they afford the medications they need to improve their experience in bed?

Medicare and many private insurers don’t cover drugs that are prescribed to treat problems people have engaging in sex. Recent developments, including the approval of generic versions of popular drugs Viagra and Cialis, have helped consumers afford the treatments. Still, for many people, paying for pricey medications may be their only option.

At 68, like many postmenopausal women, Kris Wieland, of Plano, Tex., experiences vaginal dryness that can make intercourse painful. Her symptoms are amplified by Sjogren’s syndrome, an immune system disorder that typically causes dry eyes and mouth, and can affect other tissues.

Before Wieland became eligible for Medicare, her gynecologist prescribed Vagifem, a suppository that replenishes vaginal estrogen, a hormone that declines during menopause. That enabled her to have sex without pain. Her husband’s employer plan covered the medication, and her co-payment was about $100 every other month.

After she enrolled in Medicare, however, her Part D plan denied coverage for the drug.

“I find it very discriminatory that they will not pay for any medication that will enable you to have sexual activity,” Wieland said. She plans to appeal.

Under the law, drugs used to treat erectile or sexual dysfunction are excluded from Part D coverage unless they are used as part of a treatment approved by the Food and Drug Administration for a different condition. Private insurers often take a similar approach, reasoning that drugs to treat sexual dysfunction are lifestyle-related rather than medically necessary, said Brian Marcotte, chief executive of the National Business Group on Health, which represents large employers.

So, for example, Medicare may pay if someone is prescribed sildenafil, the generic name for Viagra and another branded drug called Revatio, to treat pulmonary arterial hypertension, a type of high blood pressure in the lungs. But it typically won’t cover the same drug if prescribed for erectile dysfunction.

Women such as Wieland may encounter a similar problem. A variety of creams, suppositories and hormonal rings increase vaginal estrogen after menopause so that women can have intercourse without pain. But drugs that are prescribed to address that problem haven’t generally been covered by Medicare.

Sexual-medicine experts say such exclusions are unreasonable.

“Sexual dysfunction is not just a lifestyle issue,” said Sheryl Kingsberg, a clinical psychologist who is the chief of behavioral medicine at University Hospitals MacDonald Women’s Hospital in Cleveland. She is the immediate past president of the North American Menopause Society (NAMS), an organization for professionals who treat women with these problems. “For women, this is about postmenopausal symptoms.”

Relief may be in sight for some women.

Last spring, the federal Centers for Medicare and Medicaid Services sent guidance to Part D plans that they could cover drugs to treat moderate to severe “dyspareunia,” or painful intercourse, caused by menopause. Plans aren’t required to offer this coverage, but they may do so, according to CMS officials.

The NAMS applauded the change.

“Dyspareunia is a medical symptom associated with the loss of estrogen,” Kingsberg said. “They had associated it with sexual dysfunction, but it’s a menopause-related issue.”

For men who suffer from erectile dysfunction, treatment can confer both physical and emotional benefits, sexual health experts said.

“In my clinical work, I see a lot of older couples,” said Sandra Lindholm, a clinical psychologist and sex therapist who is also a nurse practitioner in Walnut Creek, Calif. “They are very interested in sex, and they feel like they’re able to embrace their erotic lives. But there may be medical issues that need to be addressed.”

About 40 percent of men over age 40 have difficulty getting or maintaining an erection, studies show, and the problem increases with age. A similar percentage of postmenopausal women experience genitourinary syndrome of menopause, a term used to describe a host of symptoms related to declining levels of estrogen, including vaginal dryness, itching, soreness and pain during intercourse, as well as increased risk of urinary tract infections.

Low sexual desire is another common complaint among women and men. A drug called Addyi was approved in 2015 to treat low sexual desire disorder in premenopausal women. But many insurers don’t cover it.

Unfortunately, medications that treat these conditions may cost people hundreds of dollars a month if their insurance doesn’t pick up any of the tab. A 10-tablet prescription for Viagra in a typical 50-milligram dose may cost more than $600, for example, while the price of eight Vagifem tablets may exceed $200, according to GoodRx, a website that publishes current drug prices and discounts.

In recent years, much more affordable generic versions of some of these medications have gone on the market.

Generic versions of Viagra and Cialis, another popular erectile dysfunction drug, may be available for just a few dollars a pill.

“I never write a prescription for Viagra anymore,” said Elizabeth Kavaler, a urogynecologist at Lenox Hill Hospital in New York City. “These generics are inexpensive solutions for men.”

There are generic versions of some women’s products as well, including yuvafem vaginal inserts and estradiol vaginal cream.

But even those generic options are often relatively pricey.

Some patients cannot afford $100 for a tube of generic estradiol vaginal cream, said Mary Jane Minkin, a clinical professor of obstetrics, gynecology and reproductive medicine at Yale School of Medicine.

“I’ve asked, ‘Did you try any of the creams?’ And they say they used up the sample I gave them. But they didn’t buy the prescription because it was too expensive,” she said.

— Kaiser Health News

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Viagra rising: How the little blue pill revolutionized sex

[T]wenty years ago, a little blue pill called Viagra unleashed a cultural shift in America, making sex possible again for millions of older men and bringing the once-taboo topic of impotence into daily conversation.

While the sexual improvement revolution it sparked brightened up the sex lives of many couples, it largely left out women still struggling with dysfunction and loss of libido over time. They have yet to benefit from a magic bullet to bring it all back, experts say.

About 65 million prescriptions have been filled worldwide for the blockbuster Pfizer drug approved by the US Food and Drug Administration on March 27, 1998.

It was the first pill aimed at helping men get erections.

Suddenly, talk of an amazing drug that could make an older man’s penis hard again was all over television and magazines.

The Viagra boom also coincided with the rise of the internet, and the explosion of online pornography.

Ads for Viagra were designed to reframe what had been known as “male impotence” as “erectile dysfunction” or ED, a medical condition that could finally be fixed.

Republican senator, military veteran and one-time presidential candidate Bob Dole became the first television spokesman for Viagra, admitting his own fears about erectile dysfunction to the masses.

“It’s a little embarrassing to talk about ED, but it is so important for millions of men and their partners,” he said.

The strategy worked.

Before Viagra, men wanted to talk about their erectile problems, and did, but the conversations were awkward and difficult, recalled Elizabeth Kavaler, a urology specialist at Lenox Hill Hospital in New York.

“Now, sexuality in general is very out there,” she added.

“Sex has become an expected part of our lives as we age. And I am sure Viagra has been a big part of that.”

MISUNDERSTOOD DRUG

Viagra has had a “major impact” — on a par with the way antibiotics changed the way infections are treated, and how statins became ubiquitous in the fight against heart disease, said Louis Kavoussi, chairman of urology at Northwell Health, a New York-area hospital network.

Viagra’s release also came amid a “sort of a clampdown on physicians interacting with companies,” he said.

“So this was a perfect medicine to advertise to consumers. It was a lifestyle type of medicine.”

Viagra, or sildenafil citrate, was first developed as a drug meant to treat high blood pressure and angina.

But by 1990, men who took part in early clinical trials discovered its main effect was improving their erections, by boosting blood flow to the penis.

For all its popularity, Viagra is still often misunderstood.

“It isn’t an aphrodisiac,” said Kavoussi.

“A lot of men who ask about it say, ‘My wife isn’t very interested in relations,” he added.

“And I say, ‘Viagra is not going to change that.'”

SEXUAL REVOLUTION

In 2000, the comedy show “Saturday Night Live” featured a spoof on ads that showed sexually satisfied men saying, “Thanks, Viagra.”

In it, one eye-rolling actress after another was featured groaning “Thanks, Viagra,” as a horny male partner groped her from behind or gripped her in a slow-dance.

The skit was funny because it reflected a reality few people were talking about.

“We are a very puritanical society, and I think Viagra has loosened us up,” said Nachum Katlowitz, director of urology and fertility at Staten Island University Hospital.

“But for the most part, the women have been left out of the sexual improvement revolution.”

Pfizer finally did include women in its marketing for Viagra, in 2014. The commercials featured sultry women, including at least one with a foreign accent, speaking directly to the camera, telling men to get themselves a prescription.

‘FEMALE VIAGRA’

In 2015, the FDA approved a pill called Addyi (flibanserin), which was cast in the media as the “female Viagra,” and was touted as the first libido-enhancing pill for women who experienced a loss of interest in sex.

The pill was controversial from the start.

A kind of anti-depressant, women were warned not to drink alcohol with it. It also cost hundreds of dollars and came with the risk of major side effects like nausea, vomiting and thoughts of suicide.

“It didn’t go over too big,” said Katlowitz.

Valeant Pharmaceuticals bought Addyi for $1 billion in 2015, but sold it back to the developer, Sprout Pharmaceuticals, at a steep discount last year.

Older women’s main problem when it comes to sex is vaginal dryness that accompanies menopause, and can make sex painful.

Solutions tend to include hormones, or laser treatments that revitalize the vagina. They are just beginning to grow in popularity, but still cost hundreds to thousands of dollars, said Kavaler.

“We are at least 20 years behind men,” she said.

For Katlowitz, Viagra was a prime example of “the greed of the pharmaceutical industry.”

Viagra cost about $15 per pill when it first came out, and rose to more than $50. It finally went generic last year, lowering the price per pill to less than $1.

“There was absolutely no reason to charge $50 a pill,” said Katlowitz.

“It was just that they could, so they did.”

Complete Article ↪HERE↩!

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Following in the footsteps of Viagra, female libido booster Addyi shows up in supplements

By Megan Thielking

[F]ollowing in the footsteps of its predecessor Viagra, the female libido drug Addyi has snuck into over-the-counter supplements that tout their ability to “naturally” enhance sexual desire.

The Food and Drug Administration announced a recall Wednesday of two supplements marketed to boost women’s sex drive. The supplements Zrect and LabidaMAX — both manufactured by Organic Herbal Supply — actually contained flibanserin, a medication approved by the FDA in late 2015 to treat hypoactive sexual desire disorder in women. It’s the first time federal officials have recalled a product contaminated with the drug.

“It’s the latest example of brand-new drugs being found in supplements,” said Dr. Pieter Cohen, a physician at Harvard Medical School who studies dietary supplements.

The problem has long plagued the male sexual enhancement supplement market. Viagra has turned up in dozens of over-the-counter pills that never declared they contained the drug. The FDA regularly checks supplements shipments for the presence of Viagra, and has added flibanserin into their scans since the drug was approved.

“FDA lab tests have found that hundreds of these products contain undisclosed drug ingredients,” said Lyndsay Meyer, a spokesperson for the agency.

The massive dietary supplement industry is largely unregulated. The products can be sold without a prescription in supermarkets, supplement stores, and, increasingly, online. The products currently being recalled were sold on Amazon through February.

And while supplement makers are not allowed to claim that their products cure or treat a particular condition, they are allowed to make general claims that their products support health or, in this case, promote sexual desire.

“There’s nothing that you can actually put into the pill that lives up to advertised claims, so there is this temptation to introduce a pharmaceutical drug that attempts to meet those claims,” said Cohen. Organic Herbal Supply, which is recalling its products, did not respond to a request for comment.

The FDA said it has not received any reports of adverse events tied to either of the supplements. But Cohen said they are far from safe — and argued a lack of regulation will allow those risks to remain.

“We have no idea the harms being caused by these products. As long as these products can be sold as if they improve your sexual health, there’s going to be no stopping this,” he said.

The amount of undeclared flibanserin in a supplement could vary widely from one pill to the next, as has been the case with Viagra. It’s also possible the drug could be introduced into a supplement along with other potentially libido-boosting compounds, exacerbating those effects.

“We don’t know what danger this poses because these combinations have never been studied before they’re sold to unsuspecting consumers,” Meyer said. Consumers can report adverse events tied to these or other dietary supplements to the agency online.

Cohen said the message from the recall is clear: “Consumers should just completely avoid sexual enhancement supplements. They either might be safe and don’t work, or they might work but are likely to be dangerous.”

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