Interviewer: So there are a lot of pills for men, as you mentioned, this is really the only one for women. Is there a medical reason for that? Is it more difficult to create a drug, or is it what a lot of people claim that it's a man's world and I don't even know the words, but that argument. Dr.
| Effect | Description | Duration | Notes |
|---|---|---|---|
| Increased Blood Flow | Eases erectile dysfunction | 4-6 hours | Primary intended effect |
| Visual Disturbances | Bluish tint, blurred vision | Transient | Rare side effect |
| Headache | Throbbing headache | Usually short | Common side effect |
| Flushing | Warm sensation on face and neck | Short-term | Common, mild side effect |
| Dizziness | Lightheadedness | Transient | Use caution when standing |
Jones: Well it's been unfortunate that we've considered men so simple. All they need is something to make their switch go up instead of down and that should be very easy.
It turns out about 10% of women respond. So if you give this drug to 100 women, and you give placebo to 100 women, 34 out of 100 of women with placebo will get better, they'll have more interest in sex and they'll have more sexually satisfying sexual activity. So out of 100 people, about 10 will actually be responding because of the drug, and we don't know when I'm sitting in the office, which 10% those are. It's a drug that you have to take every day and it has side effects. But what can you expect if you are one of those 10%, what can you expect to see in terms of difference?
Well the other reason the FDA was not excited was the fact that the average number of satisfying sexual activities was 2.8 in the study group and when they took placebo it went to 3.7 per month, 2.7 happy times in bed per month. And then with placebo, it went to 3.7. So about one extra happy time when you just took placebo, and it went from 2.8 on flibanserin before they started, to 4.5 on flibanserin. So that was about two extra happy times a month. So that's one over placebo, per month.
So the FDA didn't think that was very impressive. What happened was the drug company that originally started flibanserin gave up the drug, and another small start up company called Sprout Pharmaceuticals took it on and they actually started a media campaign called Even the Score. They went to the FDA and said, "Women have nothing. Men have all these things to viagra black help them, women have nothing. So the FDA originally didn't think that one extra happy time per month was adequate given the side effects, which I'll talk about in a second. Whereas women, desire is a complicated thing. We don't know how flibanserin works, if it does, and why it only works for 10% and not on the others, because we don't dapoxetine viagra know where desire comes from in women. Why is it common, 50% of women don't have desire until they're already in the middle of being stimulated, so they only have responsive desire? So we're not very smart about where desire comes from, and there aren't very many good animal models for desire. Interviewer: What would you recommend to a patient asking you about this medication? Dr. Jones: I think I'm a fan of the 5 Ts, so when a woman says I'm just not that interested in sex anymore and this bothers me, remember those are the two things. They have to be not as interested, they have to have had interest at least once, so taking a 50-year-old who's never been interested in sex and thinking a pill is going to work, it's not going to work. "So I had interest and now I don't." I say the 5 Ts are, Time - we are over extended. If you think you're going to have fast food sex the way you did when you were 20 you're not going to. You need to go for gourmet sex which means you have to plan it, you have to think about it, you have to tell your partner what makes you get in the mood. I think touch is important, the kind of quick sex where you didn't have that much time together physically, that's not going to work as you get older, so the right kind of touch.
Women need emotional and physical tenderness before they're going to get in the boat and row with you. A lot of women say "I'm not interested but I haven't been interested since my husband had an affair with that woman down the street," well I can't blame you. Do you have some inner hostilities and you just don't want to have sex with them? So what are the reasons going on?
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Super Active | 100mg | 10 Pills | 28.76€ 27.39€ | |
| Viagra Generic | 100mg | 60 + 4 Pills | 96.36€ 91.77€ | |
| Viagra Generic | 100mg | 30 + 4 Pills | 60.91€ 58.01€ | |
| Viagra Generic | 150mg | 120 + 8 Pills | 177.58€ 169.12€ | |
| Viagra Soft Tabs | 100mg | 90 + 6 Pills | 205.31€ 195.53€ | |
| Viagra Generic | 100mg | 20 Pills | 45.58€ 43.41€ | |
| Viagra Original | 100mg | 4 Pills | 40.94€ 38.99€ | |
| Viagra Professional | 100mg | 120 + 4 Pills | 262.83€ 250.31€ | |
| Viagra Oral Jelly | 100mg | 10 Sachets | 46.36€ 44.15€ | |
| Viagra Oral Jelly | 100mg | 110 + 9 Sachets | 284.63€ 271.08€ | |
| Viagra Generic | 25mg | 180 + 6 Pills | 154.93€ 147.55€ | |
| Viagra Professional | 100mg | 20 Pills | 71.14€ 67.75€ | |
| Viagra Oral Jelly | 100mg | 30 + 5 Sachets | 115.76€ 110.25€ |
What I often hear is "I just am not that interested anymore." "Well tell me about your relationship with your husband." "Well we've been together for 20 years and he's my best friend." Well you know, you just don't have sex with your best friend. So having that kind of relationship evolve is great for the marriage, that they're now best friends, but it's not great for sex.
The sex needs something a little bit different.
I'm glad that women have something that might work for them, and like birth control methods, not all methods are right for everyone. They recommend that if a woman takes it for eight weeks and she doesn't notice a difference, remember that half the difference that she notices is going to be placebo effect. So if she doesn't notice a difference then she shouldn't take it anymore. It's going to be $30-$75 per month and we don't know whether insurance companies are going to cover it. But you can bet your booties that if insurance companies cover the Viagra type drugs and they don't cover Addyi, there's going to be some ladies marching on your insurance company's front door. Interviewer: So if it doesn't bother your patient, then there's not a problem? Interviewer: And before you would recommend this pill you might recommend the 5 Ts that you've talked about.
| Country | Regulatory Status | Notes |
|---|---|---|
| USA | Approved generics available | OTC and prescription options available |
| UK | Prescription required | Strict regulation |
| Australia | Approved for medical use | Import restrictions apply |
| India | Widely manufactured, some unregulated brands | Varies in quality |
| Canada | Prescription only | Clinical evaluation necessary |
Dr.
Then I think they got some pressure and they decided okay, we'll just put it out, and it's going to be available under the brand name Addyi, with a funny spelling A-D-D-Y-I, Addyi, on the middle of October. It should be available in drug stores. You have to take it every day, you have to take it at bedtime and so different from the Viagra style drugs for men, they only take it when they think they're going to be interested in sex. Women have to take this every day, so they're taking a pill every day for an event that might happen three or four times a month. What are the side effects and why do you take it at bedtime?
You take it at bedtime because the side effects include low blood pressure, hypotension, fainting, dizziness, headache and sleepiness. About 10% of women are going to have that effect. So 10% of women are going to have a benefit, 10% of women are going to have a side effect. We don't know if it's the same 10%. So they recommend taking it at bedtime so that you're less likely to be dizzy or to pass out, so I think that's the issue. Jones: Right, and I usually recommend taking some time out for each other. I ask them, what kind of pattern of intimacy do you have when you and your partner go on vacation? "Oh yeah, when we're away we have great hotel sex." Well, there are no kids around, there are no dishes, and definitely no bills, you're in a brand new bed, it's a new place. But if women say, "I don't want to do all that thing," it's like dieting and exercise, "Just give me a pill doctor so I can lose weight, just give me a pill." What I am afraid of is that I will get calls from husbands, "I want you to fix my wife. I want you to give her that pill." So if this is being driven by the partner, I need to get buy-in by my patient that she's really interested, because she may have some side effects. And if she's really not interested in becoming interested, then this is not for her. If she's interested in becoming interested, I think it's worth a try for a couple of weeks. And if she doesn't have significant side effects and it improves her intimate life, just thinking about sex makes people have sex more often, so the placebo effect can be significant. Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio.
So although not having desire is normal for women, if it was a change in desire and if it causes distress, should we medicate that? My feeling for a patient who comes to me with this complaint, and about 10% of women have this condition, where they have a decrease in their desire and it causes them distress. Those are the two things you have to have. And for women for whom it causes distress, we have not had anything that works. "Take a couple of drinks and see how you feel." Or, we tried testosterone patches and that's a whole separate issue and that didn't make a big difference, so we really didn't have anything.
Guys had a whole menu of things that could work on erectile dysfunction. Now, erectile dysfunction is not desire disorder. It means you've got desire and it doesn't work and the purple little, blue pill, Viagra, is one of a series of drugs which increase blood flow to the penis, and when you give those kinds of drugs to women, nothing happens. They get more blood flow down there but they're not excited. So to call this female Viagra is way wrong.
Interviewer: Because Viagra solves a mechanical problem. Dr. Jones: Exactly, and in women it's an internal desire problem. So they had this drug and they did a randomized trial where women were given placebo versus this drug at different doses and lo and behold, there was a little difference. Now I want to talk about, if I were going to counsel a patient, what kind of difference was there with flibanserin? If you like what you heard, be sure to get our latest content by following us on Facebook. When the FDA approved use of ADDYI (flibanserin) in August of 2015, it felt like the world blew up. Newspapers heralded its’ release as “female viagraâ€. Some rejoiced, “finally, gender parity in medicine for sexual dysfunction!â€, while others turned up their noses at it, questioning its necessity for women with low libido.
| Focus Area | Potential Advancements | Estimated Timeline | Remarks |
|---|---|---|---|
| Improved Bioavailability | New formulations for faster onset | 2-3 years | Enhancing user experience |
| Reduced Side Effects | Safer compounds, fewer adverse reactions | 3-5 years | Better safety profile |
| Alternative Delivery | Sublingual, transdermal patches | 4-6 years | More discreet, convenience-focused |
| Combination Therapies | Combining sildenafil with other agents | 2-4 years | Increased efficacy, tailored treatments |
| Market Expansion | Entry into emerging markets | Ongoing | Broader access globally |
There are a lot of emotions around this new drug and it has had an interesting effect of raising some very important questions about female sexuality, society’s comfort with sexuality at large, and gender equality. In this post, we will examine the black and white facts about this drug.
We will try and push past the emotion surrounding this drug to study how it works. Ultimately, you will have to decide what this drug means to you, but hopefully this post will provide you with a brief background to how the drug effects those taking it. The first and most important question to ask is, “who is this drug for?â€. ADDYI is for premenopausal women with low desire to engage in sexual activity of any kind, alone or with any partner.