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More about Flibanserin

December 4th, 2009

Dr Petra

First off, after blogging about Flibanserin I was contacted by Boehringer Ingelheim wanting a right to reply. So their letter is now added to that blog, which you can read here.

More 4 ran a short piece about the drug, featuring the very excellent Katherine Angel. This piece ran to the standard format that many media outlets took. It was presented as the ‘fun’ piece at the end of the news, and didn’t explain the drug completely. Interestingly within the piece one interviewee (the features editor for Woman magazine) described a scenario of a wife feeling pestered into sex by a husband – an upsetting situation and one that could be addressed through better communication. But not one that a drug might fix. And yet this was presented within the report in the context of a female libido problem that scientists should be working to ‘fix’. And sadly, as with countless other reports on this issue, the More 4 piece ended with a typical jokey response, with the anchorman describing Flibanserin as ‘the cure for creeping hands’.

Christine Ottery wrote a fantastic piece for The Guardian outlining the drug but with a focus on the wider issues of women’s sexual functioning. Meanwhile blogger Laurie Penny took up the political aspects of what the drug might mean to women in her piece (simultaneously published for Morning Star and Liberal Conspiracy). Both Christine and Laurie’s pieces are well worth a read – and particularly the responses. It’s interesting to me if you frame this debate within a health or sexual rights issue people tend to listen more than if you place it within a more feminist account.

The New York Times ran two pieces about medicalising female desire generally which you can read here and here. While Cory Silverberg returned to the debate and referenced a couple of fantastic blogs he’d spotted on Flibanserin.

The San Diego Union Tribune focuses on medics involved in consulting on female sexual dysfunction products, while Scottish paper The Herald compares male and female sex drugs. I wanted to like the Herald’s piece but a quick glance suggested the writer hadn’t really researched the area and seemed to have relied on a poorly written piece about ‘what women want’ to argue sex researchers can’t agree about what excites women, and ends with the statement “comparatively little research goes into combating killers of the developing world such as malaria” – which is just not true. It’s very annoying when you’re requiring journalists to write intelligently about the marketing of drugs if they don’t get basic public health information correct.

In more helpful coverage Agony Aunt and medic Miriam Stoppard wrote a helpful lay summary of female desire problems – along with some practical solutions.

And on a similar note, today I discussed Flibanserin and more specifically issues of female desire on BBC Radio 4′s Woman’s Hour, with veteran Agony Aunt and writer Katharine Whitehorn. You can hear that discussion here.

One thing that has been brought to my attention during the period of time Flibanserin’s been in the news, is the lack of awareness about the development and marketing of the drug by many therapists or those working in sexual health. Journalists have told me they’ve had a struggle to find people who can talk about the drug in any informed way. They’ve had no shortage of therapists and others able to talk about women and desire, but they’ve noted that either therapists/educators hadn’t heard of Flibanserin, or hadn’t followed its recent progress, nor were able to interpret or understand the clinical data from the trials.

In fairness to those working in therapy/education the drug trials haven’t been reported in any peer reviewed journals, but some parts of the data were released to the public (see my original blog linked above). It is worrying that those working in this area are not keeping up to speed with the development of drugs, the debates around medicalisation, and the ability to read trial data. It’s one reason that drug companies can unduly influence practitioners – if said practitioners are not aware of wider political debates or able to critically evaluate evidence. So a big take home message from this is about better education for those involved in therapy/sexual health – and particularly those willing to talk to the media.

It’s also worth correcting a few errors that have appeared in the media following launch of the Flibanserin trial data. Flibanserin is not the ‘female Viagra’ (despite the lead researcher for the Flibanserin trials using that term). Viagra works on the circulatory system and it increases blood flow to the penis. Flibanserin works on neurotransmitters and promotes feelings of desire.

Some media reports have suggested the drug will be on sale in two years time. This is also inaccurate. At this stage the drug is still undergoing trials and has yet to be approved for safe use. So there will be a period of time (unknown) before it becomes publicly available, and we have seen other drugs fall at this point if the FDA or EMEA don’t pass them for public use. If/when Flibanserin is made available it won’t be on sale or an over the counter product, but will be on prescription only. And in the UK this will be limited based on cost.

I’ve seen media coverage stating you take the drug when you want sex. This is also incorrect. Flibanserin is an anti-depressant style drug and to get any effects you have to take it daily for a set period of time. We don’t yet know what the side effects are from withdrawing from the drug, or long term use. But we do know it’s not a ‘sex smartie’ to take when you want to have sex.

Obviously a lot of the coverage of the drug has raised concerns women have about desire and arousal. I’ve noted these worries and I’ll be creating blogs and handouts for the new year that address these issues. After all, there are many reasons women go off sex, and while a lot of them can’t be fixed overnight, many of them can be sorted effectively.

Let’s wait and see what happens with the development of Flibanserin. I’ll keep you updated on it, and I’ll be letting you know what other research on women and desire is coming out.

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