Science of Sex: Using Drugs to Raise Women’s Libido

June 29th, 2019

Raising Women's Sex Drive with Medication

This month’s Science of Sex post comes on the heels of an announcement that the FDA has approved the second drug that intended’s to treat women with low libido, also known as hypoactive sexual desire disorder and which you might remember is one of several types of female sexual dysfunction.  The new medication, called Vyleesi, works differently than the previously-released Addyi. In both cases, however, the efficacy and methods of the drugs leave us with more questions than answers.

Vyleesi binds to melanocortin receptors in the brain. Although researchers aren’t sure why that would lead to increased libido because those receptors deal with pain and food intake among other functions. The current theory is that this helps to increase dopamine. Dopamine is a chemical that functions as a hormone in the body and a neurotransmitter in the brain, sending signals to other cells. Of the dopamine pathways in the brain, one is associated with the reward center. The association with pleasure is why dopamine plays a role in addition. It also helps to regular attention, emotional response, movement, and learning.

This drug may force the brain to process erotic stimulation as rewarding, which boosts libido. Because this happens immediately, Vyleesi only needs to be taken before sexual activity and not every day like Addyi, which has been around for several years but hasn’t performed well commercially.

Furthermore, Addyi works on another brain receptor to block serotonin, a neurotransmitter that contributes to feelings of happiness among many other functions. Serotonin plays a role in reward systems and too much can dampen libido as well as curb dopamine. Taken daily, Addyi can reduce serotonin

Both drugs have their risks. Because low serotonin levels are associated with depression, Addyi may be a poor fit with women who struggle from depression. It may be negated by SSRIs, which mitigate depression by boosting serotonin levels in the body but often reduce sex drive. The drug also comes with side effects such as dizziness and “sedation.” It shouldn’t be used with alcohol.

While Vyleesi isn’t taken daily and can be used with alcohol, which might mitigate some risks, users will face a tighter schedule. The drug can be used once daily, up to eight times a month. Boosting libido twice a week is better than the one additional sack session prompted by Addyi over placebo during clinical trials, but Vyleesi comes as an injection while Addyi is a pill. Furthermore, Vyleesi’s side effects include nausea, which affected 40% of women who took it, mostly after the first injection. A small number of participants experienced changes in skin color that remained even after they stopped the drug. Consider that 90% of participants remained in the trial, however.

Before Addyi was even approved, some sex educators were wary of the drug. I imagine Vyleesi will receive some of the same critiques. Vyleesi appears to be a better deal than Addyi in some ways, but neither drug increased the number of sexually satisfying events n a statistically significant way. The FDA no longer requires companies making these drugs to count sexual sessions, and critics point out that women may simply be having more sex that they don’t enjoy. 

And this leads us to one of the main complaints. Is it really beneficial to boost a woman’s sex drive just so it’ll be closer to her partner’s? Should we make women to feel bad for having less desire than men (apparently)? It is a win to force women to sit through more bad sex? Certainly there are women who would feel just fine having less sex if society allowed them to.

The CEO of the drug company has stated “It’s not just about low sexual desire, but about how it impacts patients’ relationships and quality of life. These women are really suffering.” However, this drug doesn’t examine why women are suffering. Dr. Adriane Fugh-Berman, a professor in the department of pharmacology and physiology at Georgetown University Medical Center who studies pharmaceutical marketing has.

I think it’s worth noting what’s an acceptable level of libido is socially influenced. Making women care less about the bad sex that they’re having is a dubious goal.

And for those women who want to want more sex? There are non-drug options that are more effective than both of these options and present fewer risks. Mindfulness can increase libido and sexual satisfaction. Sex education can ensure that women know and ask for what they want in bed, that their partners are better lovers, and that people understand that responsive desire does not necessarily mean low desire. On top of this, education explains concepts such as the dual-control model, which helps explain how external factors play into libido and enables people to ditch the shackles placed on them by society in the form of (useless) sexual scripts.

Can we even diagnose low libido before tackling those issues?

Reading a book or experimenting doesn’t require a prescription, abstinence from alcohol, or perfect health to produce results that are more statistically significant than Addyi and Vyleesi have shown.

Further Reading

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Revolting Prostitutes: The Fight For Sex Workers Rights

June 6th, 2019

Not two days ago I had an elegant summary for Revolting Prostitutes bouncing around my head. It was the perfect segue into a review, and I’ve gone and lost it. That’s what I get, I suppose, for waiting to write it down. And I really waited far too long to even start writing this review because my memory is not hazy. Good thing Revolting Prostitutes leaves an impact.

Just what impact is it?

This book makes the argument that sex workers’ rights are women’ rights are sex workers’ rights and human rights by extension, and because of this should not be excluded as feminists or members of society. Juno Mac and Molly Smith do this by taking a hard look at the reality of sex work: why people do it, how it can be done safely, whether it’s feminist, how sex work and sex trafficking differ, and how society can protect some of its most at-risk members. Mac and Smith examine laws about sex work around the world to make their ultimate argument that in a world where some people must resort to sex work to make money, decriminalizing and not legalizing sex work is the only way to protect those people. Furthermore, they illustrate how pivotal sex workers have been when it comes to the fight for women’s rights and why excluding them from feminist arguments is not just unethical but grossly ignorant.

Revolting Prostitutes takes us through Nevada where just a few brothels operate legally toward Sweden where it examines the Scandinavian model of criminalization to the UK and, finally, to New Zealand. It is here where sex work has been decriminalized, and sex workers have a voice when it comes to laws that would affect them.

The feminism promoted in Revolting Prostitutes is not white feminism. Even though the authors admit to their own privilege (being cisgender, white and middle class), they examine the issues surrounding sex workers, many of whom are working class or people of color, through and intersectional lens. Among the topics addressed in these pages is immigration, which makes Revolting Prostitutes seem especially timely to this American.

Aside from teaching the reader what they don’t know about sex work, the authors smash longheld myths about sex work, including the idea that legalization is the best route. I once viewed sex work similar to marijuana and fell into the camp of “legalize sex work so it can be taxed.” But this book thoughtfully points out that legalization offers no protections for sex workers when one of the main dangers they face is from the police. In a world where that wasn’t the case, they argue, legalization may be an option. But for now, it remains out of reach.

It is far from the only myth torn apart in these pages. While so many people who argue for sex worker’s rights paint the picture of the “Happy Hooker,” you will not see that imagery in Revolting Prostitutes. This book is more frank than that. The authors would not paint with such broad strokes. Instead, they write honestly about how sex is neither good nor bad by definition, and neither is sex work or people, for that matter. These things can be positive or negative, health or otherwise. And when it comes to people, they are people who deserve our care faults and all. This is why the authors write candidly about the damage done to sex workers by so-called carceral feminists who want brothels shut down, and sex workers deported even if doing so will result in the greater abuse and potentially death of those sex workers.

When disproving these ideologies, Juno and Moll never take the easy way out by simply claiming them false. time after time they are prepared to say it’s more complicated than that and explain why. For example, when they touch on whether sex work is a bad thing because some sex works do not enjoy their jobs or because sex workers sell their bodies, the authors are quick to point out that there are many grueling jobs that do not bring joy to those who perform them. Those workers simply need the money. They trade their time and, yes, their bodies, to jobs that take a toll day in and day out. Revolting Prostitutes breaks down the issues one by one into palatable bites like that, and more.

Those people who have a strict anti-sex work stance would likely not enjoy or agree with Revolting Prostitutes. I’d hope that some people who are on the fence or who have not thought deeply about these issues might find themselves swayed by the book, however. Furthermore, the authors are clearly proponents of socialized elements of society. In this way, Revolting Prostitutes look as society as a whole using sex workers as a litmus test. A society that lacks support will surely fail this marginalized group of people. Readers who disagree with a government supporting its people through socialized healthcare and similar programs will surely balk at statements within the pages.

As for me, I am neither of those types of people. I found the arguments thoughtful and eye-opening. With the words they’ve written, Mac and Smith do an excellent job bringing sex workers, and they work they do from the other. They humanize people that are all too often written off, ignored, and otherwise erased. I am all too happy to recommend Revolting Prostitutes as long as society overlooks sex workers. I am angered that this book needs to exist but glad that it does. I hope that people and governments can learn from words like these and the people who are willing to write and speak them. Perhaps reality could be not quite so harsh for sex workers and women as a whole.

Until then, I can only lend my support to the revolt.

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