Last week saw the approval of Addyi, the "Female Viagra," by the Food and Drug Administration. It's proponents claim that it's a massive breakthrough for female sexual health, but many experts have come out against the drug, saying that its negatives far outweigh its benefits. I would have to agree. This drug's regulatory approval is bad news both in theory and practice.

Desire is something very personal and subjective. There is no such thing as a "normal" amount of desire. If you asked 10 random people how many orgasms they had per month on average, you'd probably get 10 different answers (or else 10 people running away from you, because you're asking randomers about their sex lives). Sprout Pharmaceuticals, the makers of the drug, don't take into consideration that desire naturally ebbs and flows at different stages of life and in different stages in relationships, or acknowledges the fact that that is ok.

I'm a huge fan of Dr. Emily Nagoski's new book Come as You Are, because it explains the research done over the past 20 years on the topic of female desire. As Dr. Nagoski explains in the video below, it was once believed that horniness worked spontaneously, and that we seek out sex based on a sudden desire to have it. It is now understood that many people, especially women have what is called "Responsive Desire;" where desire builds in response to sexual pleasure and stimuli. I think the most important point she makes in the book is that any amount of desire you have or don't have is completely normal and healthy. What matters most is whether or not you're happy with the sex you're having.

Even if we take the problematic idea that lower desire is something to be fixed out of the equation, Addyi still has major practical flaws. Firstly it must be taken every day as opposed to an hour before sex like male Viagra, and while Viagra works to treat an actual physical issue, Addyi uses testosterone to change the patient's brain chemistry, a bit like an antidepressant. While taking Addyi, the user cannot drink. At All. Not one beer or glass of wine. This is because alcohol exacerbates it's very unsexy side effects like fainting, fatigue, dizziness, and nausea. If that wasn't enough to put you off it, how about its rate of effectiveness?

The women who used it in their clinical trials found they only had one extra orgasm per month when compared to those who took a placebo, and only 10% said they felt it was even mildly effective. And it's not as if those in the trials went from having zero orgasms to 1 per month. The New York Times mentioned a trial where women averaged around 2.7 "satisfying sexual experiences" per month. With the Addyi, that increased to 4.4 per month and 3.7 with a placebo. The actual drug only gave the test subjects .7 more of a "sexually satisfying experience" than a placebo. 

So how the heck did they get F.D.A. approval? Well they didn't, not initially anyway. Addyi was rejected twice before. It was originally owned by German Pharmaceuticals company, Boehringer Ingelheim, but after being rejected unanimously in 2010, they sold the drug to Sprout who then launched an intense PR campaign. Part of that campaign involved the formation of Even the Score, a coalition of women's health groups whose sole mission seems to have been to get F.D.A. approval for Addyi. Sprout of course is listed as a supporter. One of the groups also listed is the Black Women's Health Imperative. That's right, the nice lady on the MSNBC panel discussion with Dr. Nagoski is part of that lobbying group.

Their main talking point is that men have a number of medications that they can take for erectile dysfunction, but there hasn't been a single pill on the market for women. If the F.D.A didn't approve Addyi, with it's pink-drenched marketing campaign, they'd be smelly, women-hating sexists. And while I agree that there has been a systemic focus in Western health systems on men's rights to sexual pleasure, there is a huge problem in that it's not a like-for-like comparison. 

On their website, Even the Score quote a paper where 43% of female respondents aged 18-59 reported: "lack of desire, anxiety about sexual performance, lubrication difficulties, inability to climax, or pain during intercourse." I'm sorry but if nearly half of the female population are suffering from something, the problem probably isn't with the individuals, but the culture, which brings us back to the first problem with Addyi - the idea that if someone experiences low desire (again purely subjective), there is something wrong with her.  

Interestingly, in that paper the same author stated:

"Experience of sexual dysfunction is more likely among women and men with poor physical and emotional health. Moreover, sexual dysfunction is highly associated with negative experiences in sexual relationships and overall well-being"

and concluded that their 

"results indicate that sexual dysfunction is an important public health concern, and emotional problems likely contribute to the experience of these problems". 

In a culture that spends a lot of time telling women what is desirable and normal, and given that the variance in what is normal for women is huge, maybe we should address what causes these emotional problems and discuss them before we decide to prescribe a pill to fix the the symptom.

I do understand that it's easier said than done; that saying everyone's level of desire is normal is not going to quell the fears and stress of every woman out there who thinks she may be suffering from sexual dysfunction, but there are definitely far better ways of boosting desire, many of which involve simply looking after your own health. To close, I've compiled a list of things that I've find may help and don't involve having to take a pill everyday that restricts you from drinking a glass of wine ever again:

• A glass of wine - Everything in moderation, but a small glass could help lower inhibitions.
• Plenty of sleep 
• Plenty of exercise - Exercise releases feel-good hormones in the brain and helps with anxiety and depression.
• The petrol station scene in Magic Mike XXL
• Eating lots of fruit & veg / Drinking plenty of water
• Good communication with your partner(s) - talk about sex and fantasies, what you'd like to do together. Get those creative juices flowing, even if they're not fantasies you ever intend on playing out. Just talking about them can be a big turn on. 
• The final dance scene in Magic Mike XXL