For nearly 20 years, men have had the little blue pill. Now women have a little pink pill. From “female Viagra” to vaginal lasers, women’s arousal is finally taking center stage in the medical community—and in the mainstream.
Experts say the FDA’s approval of what many are deeming “female Viagra,” along with a spate of new vaginal lasers and the long-anticipated arrival of the male contraceptive pill, are finally changing the landscape of how women’s sexual health is viewed and treated.
The little pink pill known as flibanserin, which was previously rejected twice by the FDA, is now FDA-approved and will be marketed under the brand name Addyi to treat low libido in women—what doctors term hypoactive sexual desire disorder (HSDD). However, that’s where the similarities between it and its blue counterpart end. “Calling it ‘female Viagra’ really isn’t accurate,” says Alyse Kelly-Jones, MD, an OB/GYN at Novant Health in Charlotte, NC, who testified before the FDA panel on flibanserin. “Viagra works on blood flow to the penis, and flibanserin works on neurochemicals in the brain,” she explains.
While Viagra increases blood flow to the genitals to help men get an erection, Addyi uses two types of serotonin to increase dopamine—the “feel good chemical”—in the brain. Men who pop a Viagra pill can expect results within the hour, while Addyi requires a commitment to be taken every day, with the peak of clinical testing results seen after eight weeks of continuous usage.
According to experts, the treatment may not be ideal, but it’s a start. Women in the flibanserin trials reported 4.4 satisfying sexual sessions a month versus 3.7 in the placebo group, with 2.7 the average for all before they took part in the study. “Honestly, the results weren’t overwhelming,” says Santa Monica, CA OB/GYN Lisa M. Masterson, MD, an expert on The Doctors television show. “Though it’s past time we recognize that women’s sexual health is as important as men’s sexual health, I think flibanserin is an exciting start that will open the door for a lot more innovation,” she adds.
What makes the pink pill a big deal is that it’s treating women’s loss of sexual desire in a new way. While men typically have cut-and-dry libido issues, women’s sexual arousal process is more complex to address, and has to do with everything from lower levels of mood chemicals to changes in vaginal function (as menopause approaches), as well as the psychological issues such as self-image, explains Masterson. “How women feel about themselves and their bodies can be very connected to libido, or lack thereof,” she says.
The pink pill functions much like an antidepressant, though possible side effects like drowsiness are more minor and manageable than commonly prescribed antidepressants like Wellbutrin, according to Newport Beach, CA OB/GYN Michael Krychman, MD, Executive Director at The Southern California Center for Sexual Health and Survivorship, who also testified on the flibanserin FDA panel. “I really think flibanserin will be a game changer,” Krychman says. “We’ve seen that it improves the satisfaction of sexual events, decreases sexual distress and improves desire days.”
While tight vaginal walls have long been ascribed to male sexual pleasure, Kelly-Jones, Masterson and Krychman all say that vaginal laxity is a true medical condition that also profoundly affects female sexual enjoyment. Friction is needed for women to feel arousal and pleasure during intercourse, and slack vaginal walls make for much less of it. It’s also this loosening that is responsible for bladder leakage, a sensitive issue many women find so irksome and embarrassing that it kills their desire to have sex. And the drop in estrogen after menopause can cause chronic vaginal dryness, making intercourse very painful.
New lasers claim to rejuvenate the vagina and consequently address issues like bladder leakage and dryness that prevent many from engaging in or enjoying intimacy. FDA-approved for vaginal resurfacing, FemiLift aims to tighten vaginal muscles to improve incontinence and dryness, while the MonaLisa Touch (FDA-approved for gynecological ablation) focuses on increasing lubrication of the vaginal walls. Both lasers work by increasing cell turnover and stimulating collagen production for better hydration. Not covered by insurance, these painless treatments are expensive, costing several hundred dollars apiece, and typically require a series of three. Even the VSPOT popped up in New York City, a first-of-its-kind medi-spa helmed by Completely Bare founder and former Real Housewives of New York star Cindy Barshop, where gynecologists perform FemiLift treatments on clients looking to treat vaginal concerns after childbirth and menopause.
According to Masterson and Kelly-Jones, the concept of non-invasive lasers that tighten and lubricate the vagina will be revolutionary if shown to do what is claimed in larger groups. “It’s exactly the same science behind facial lasers that we already know works—it slips off old cells and helps build healthier collagen so the new skin is fresh and elastic,” Masterson says. “Let me tell you, if I could afford one of those lasers, it would be in my office already,” she adds. However, Krychman says he wants to see more rigorous clinical trials with the placebo effect tested (an academic standard that doctors call “sham testing”), as well as more case studies, before he considers any credence in the claims.
Whether the pink pills and fancy lasers really make the grade is still debatable—but one thing’s for certain: The new way we’re looking at female sexual health is here to stay.