Understanding Female Libido and Medication Options

While currently marketed testosterone gels are designed to treat low hormone levels in men, doctors are free to prescribe them for alternate uses. "That shows you doctors are willing to write prescriptions for testosterone off-label and women are willing to take it," said BioSante Chief Financial Officer Phil Donenberg. But FDA approval of the company's LibiGel is far from certain. After lengthy discussions with the agency, the company has agreed to track over 3,000 women for more than a year to detect potential side effects. Even if the gel turns out to be safe, Emory University Professor Kim Wallen said it's unlikely to prove effective. "There have probably now been 50 studies on different kinds of testosterone regimens, and they all produce minimal or no effect" on sexual desire, according to Wallen. "This is a case where the pharmaceutical industry is looking in the wrong place." Wallen still believes there could be pharmaceutical solutions to low sexual desire, possibly with other hormones like estrogen. But he says the industry's search for a magic pill oversimplifies the problem. Sexuality is influenced by so many factors — including physical health, quality of relationships and lifestyle — that it's unrealistic to assume a drug could address millions of different cases of low libido. "There are lots of reasons that people, both men and women, experience low sexual desire," Wallen said.

Risk	Explanation	Recommendations
Heart Problems	Can stress cardiovascular system	Consult doctor if cardiac issues
Drug Interactions	Interacts with nitrates, certain antihypertensives	Avoid concurrent use
Overdose	Can cause severe hypotension, priapism	Follow prescribed dosage
Allergic Reactions	Rash, swelling, difficulty breathing	Seek medical help immediately
Age Restrictions	Not recommended for under 18	Use only as prescribed

"And to lump every individual into this group as potentially being amenable to drug therapy seems ill-advised." Some call it "female Viagra", a little pink pill meant to help some women awaken their sex drive.

• Pink Viagra is often used as a trendy marketing term for supplements.
• It may be promoted as a natural alternative to prescription Viagra.
• The packaging of pink Viagra products is usually colorful and attractive.
• The claims include increased stamina, stronger erections, and enhanced pleasure.
• Due to unregulated markets, quality control is inconsistent for pink Viagra.
• Side effects can include headaches, dizziness, or allergic reactions.
• Legal issues surround many pink Viagra products due to unapproved ingredients.
• Some users report no effect after taking pink Viagra supplements.
• Always research and seek medical advice before trying pink Viagra products.

Health reporter Erin Billups takes a look at the medication and what it may mean for the future and filed the following report. Sexual dysfunction is a favorite topic of comedians, but for most women dealing viagra medicine with sexual desire disorders it's no laughing matter. For the first time, there is a new drug on the market for these women - Flibanserin - from Valeant Pharmaceuticals. "This is for the patient who has all the, what we call the right kind of formula for being in a healthy sexual relationship and just doesn’t want to have sex and is bothered by that," explains Dr. Elizabeth Kavaler, a urologist at Lenox Hill Hospital. Some have dubbed it the "female Viagra" but it works differently than the little blue pill.

Side Effects and Risks

U.S. government advisers said in June that Boehringer's pink pill, based on the active ingredient flibanserin, offered little help to women and had unacceptable risks -- nearly 15 percent of women stopped taking a pill before a study ended due to side effects including depression, fainting and fatigue. That led the U.S. Food and Drug Administration to ask unlisted Boehringer in August for more information on flibanserin, which would have been marketed as Girosa. "The response of the authorities and the complexity and extent of further questions that would need to be addressed to potentially obtain registration for flibanserin have impacted the company's decision to focus on other pipeline projects," Boehringer said.

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Drugmakers have been searching for a medicine to improve women's sex lives since Viagra's debut 12 years ago. The market for a "pink Viagra" could stretch into the billions of dollars. Originally developed as an antidepressant, flibanserin was believed to act on brain chemicals that play a role in sexual response. But, in trials, women on the once-a-day pill, taken at bedtime reported unwanted side effects. An FDA advisory committee voted 11-0 in June that the drug's risks and benefits were unacceptable and 10-1 that effectiveness data was lacking. "Flibanserin is a medication that works on the brain, on the neurotransmitters of the brain. And it modulates the serotonin and the dopamine levels in the brain so that there is a sense of good feeling," says Kavaler. It's approved for women 50 or younger, but most experts like Kavaler agree, female sexuality and desire is complex and in most cases can't be fixed outright with a pill. Which is why the treatment is seen as controversial.

Product	Dosage	Quantity + Bonus	Price
Viagra Generic	200mg	90 + 6 Pills	170.79€ 162.66€	Buy
Viagra Original	100mg	120 + 8 Pills	470.39€ 447.99€	Buy
Viagra Generic	200mg	30 + 2 Pills	83.07€ 79.11€	Buy
Viagra Oral Jelly	100mg	220 + 18 Sachets	562.28€ 535.50€	Buy
Viagra Super Active	100mg	180 + 20 Pills	280.97€ 267.59€	Buy
Viagra Original	100mg	92 + 4 Pills	362.88€ 345.60€	Buy
Viagra Generic	150mg	30 + 2 Pills	72.32€ 68.88€	Buy
Viagra Original	100mg	12 Pills	72.54€ 69.09€	Buy
Viagra Generic	100mg	10 Pills	28.91€ 27.53€	Buy
Viagra Generic	150mg	120 + 8 Pills	177.58€ 169.12€	Buy
Viagra Oral Jelly	100mg	110 + 9 Sachets	284.63€ 271.08€	Buy
Viagra Generic	200mg	60 + 4 Pills	125.19€ 119.23€	Buy
Viagra Generic	150mg	180 + 10 Pills	236.46€ 225.20€	Buy
Viagra Original	100mg	34 + 2 Pills	163.67€ 155.88€	Buy
Viagra Soft Tabs	100mg	30 + 4 Pills	83.06€ 79.10€	Buy

"The idea that you’re going to give a woman a drug so she wants to have sex with you is disturbing to a lot of women," Kavaler points out.

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Will search be called to a halt?Decision Resources analyst Alasdair Milton says that after year of disappointing results, the search for "female Viagra" may be winding down. "In this day and age, are you really going to spend a significant amount of money developing these compounds if you're not going to get a return on your investment?" But experts who have watched the drug industry's dogged pursuit of a female dysfunction drug are not convinced the end is in sight. Dr. Leonore Tiefer, a psychiatry professor at New York University who runs a private sex therapy practice, said drug companies may target narrower groups of women to find an effective therapy, but won't give up the search anytime soon. "I don't see that there's any incentive for the companies to stop, the market is just too big," said Tiefer.

May 24, 2014

43 percent of women experience sexual dysfunctionDrug companies frequently cite a 1999 survey in the Journal of American Medical Association that found 43 percent of U.S. women had some type of sexual dysfunction, though more rigorous, in-depth surveys have put the figure closer to 10 percent. The field of potential competitors in the market has narrowed considerably over the years. Currently the only company with a drug in late-stage development is BioSante Pharmaceuticals Inc., a small specialty drugmaker developing a testosterone gel called LibiGel. According to company executives, more than 1.8 million women received prescriptions for men's testosterone gel last year, suggesting a significant market. Medical ethicist Arthur Kaplan says it's just the latest trend in pharmaceutical innovation - medication that affects the brain. "We have pills that are obviously starting to do that. That's what a lot of the things that are calming you down do and I think we'll see more of that. It has its own risk, you're mucking around in the brain, you're changing the chemistry like sex. Obviously we could try for this with appetite in obesity and things like that," says Caplan. Little more than a third of women in clinical trials saw an increase in sexual desire.

• Pink Viagra's appeal lies in its perception as a quick fix.
• Its availability online makes it accessible in many countries.
• Many pink Viagra products come with a risk of fake or expired supplies.
• The unregulated status heightens health conditions associated with use.
• Official health organizations warn against using unverified pink Viagra.
• Some pink Viagra products contain drugs banned in certain countries.
• Consumers are encouraged to read labels and seek professional advice.
• Legal action is taken against sellers of illegal pink Viagra.
• Better options include physician-prescribed, approved medications.

Still, Kavaler says it's better than nothing. "It’s refreshing that we can have these conversations and that women can start to talk about their sexuality and their concerns. Even if they are not necessarily candidate for this medication," she says.

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Boehringer, a 125-year-old company controlled by great-grandchildren of the company's founder, said it would now merely complete the two most advanced drug trials. Male impotence pills including Viagra work by widening blood vessels to increase the blood flow needed for an erection. Pfizer dropped tests of Viagra in females in 2004 after studies failed to show it helped women. The flibanserin setback was in contrast to Boehringer's success in pioneering a new blood thinning pill for a market that rival Bayer said could be worth $15 billion. A U.S.

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advisory panel last month recommend clearance of Boehringer's Pradaxa pill for preventing strokes in patients with a type of irregular heart beat. Reporting by Ludwig Burger; Editing by Dan Lalor Our Standards: The Thomson Reuters Trust Principles. A "pink pill" to boost women's sex drive remains elusive after a decade of searching by some of the world's biggest drugmakers. A panel of health experts on Friday rejected the latest offering submitted for federal approval to treat lack of female libido: an antidepressant drug that failed to increase sexual desire in two studies. The Food and Drug Administration's panel of reproductive advisers voted unanimously that the benefits of the pill from Boehringer Ingelheim did not outweigh side effects, including fatigue, depression and fainting spells. Flibanserin is approved for use for those diagnosed with hypoactive sexual desire disorder (HSDD) or inhibited sexual desire (ISD) is considered a sexual dysfunction and is characterized as a lack or absence of sexual fantasies and desire for sexual activity.

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"I am convinced that women's sexual health is important and that many women suffer from sexual dysfunction, but I'm not convinced of a clinically meaningful benefit for this drug," said panelist Paula Hillard, a gynecologist from Stanford University School of Medicine. The FDA will make its own decision on the drug in coming months, though it usually follows the advice of its panelists. The drug flibanerin, which acts on serotonin and other brain chemicals, was originally studied as a depression therapy, but then repurposed as a libido pill after women reported unusually high levels of sexual satisfaction. Despite a modest uptick in sexually satisfying events reported in the studies, panelists said the drug's benefits were not strong enough to warrant approval as a daily pill for women. The attempt to trigger sexual interest through brain chemistry is the drug industry's latest approach to find a female equivalent to the blockbuster success of Pfizer's erectile dysfunction drug, Viagra.

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Since that drug's 1998 launch, more than two dozen experimental therapies have been studied for so-called "female sexual dysfunction," a market worth an estimated $2 billion. Initially, Pfizer tested Viagra on women, hoping that the viagra black drug's ability to increase blood flow to the genitals would increase libido. When that didn't work, drugmakers turned to hormones, including testosterone. In 2004, an FDA panel rejected Procter & Gamble's testosterone patch, Intrinsa, due to unknown risks from long-term use. Two years earlier a massive government study found that hormone replacement therapy in postmenopausal women increased heart disease and breast cancer, raising concerns about the safety of all hormones. HSDD is characterized by low sexual desire that causes marked distress or interpersonal difficulty and is not due to a co-existing medical or psychiatric condition, problems within the relationship, or the effects of a medication or other drug substance.

• Pink Viagra is sometimes used as a slang term for recreational drugs.
• It may be associated with party scenes or nightlife culture.
• These substances can have stimulant effects or cause hallucinations.
• Mixing pink Viagra with recreational drugs can be particularly dangerous.
• They are often sold under the guise of sexual enhancement products.
• Legal consequences may arise from possession or sale of these substances.
• Users often underestimate the health risks involved.
• Prevention campaigns target misuse of pink Viagra and related drugs.
• Education on safe recreational drug use is crucial for public health.