Sildenafil citrate, flibanserin, what gives?
TW: Sexual assault
Viagra is cool if you have a penis or if you’re on the receiving end of one, but I gotta be honest– I’ve always been jealous that there isn’t a version for women. Obviously, there are different physiological factors that go into sexual experiences for people with penises or vaginas, but I’d be lying if I said I wasn’t a bit salty about the dichotomy. I would love to be able to take a pill and have better sex or be able to give better sex.
A few years ago when I was having pelvic floor issues following a sexual assault, I was expressing to my gynecologist that I was sad about my lowered sex drive and that on the rare occasion that I would feel comfortable enough to approach my partner for sex, it was often painful. My gynecologist recommended Addyi, which is culturally referred to as a “Viagra for women,” but I soon realized that wasn’t exactly the case. It is worth mentioning, though, that as annoying as it is that there’s no perfect equivalent for people with vaginas, it’s not like there were scientists working day in and day out to find a solution for erectile dysfunction. Turns out the creation and discovery of Viagra were a very happy accident and since then, scientists have been working hard to make sex a joyous and simple experience for all.
During trials for an experimental drug meant to treat angina, the subjects reported a peculiar side effect– persistent erections. The specific drug in question is sildenafil citrate, which was tested for angina in the early 90s. Angina is a symptom of coronary artery disease, and it creates severe chest pain due to the contraction of the heart muscles and restricted blood flow to the heart. In order to combat this, the sildenafil citrate compound was created to relax the arteries and relieve pain. It worked…sort of.
While the drug ultimately proved minimally efficient in the fight against angina, the result was the discovery of a safe and effective way to induce erections due to its artery-relaxing properties.
People with vaginas don’t have the same issues. While proper blood flow is vital to a person’s sexual arousal, the anatomy of the vagina is a bit more complicated and therefore can’t be targeted by the same chemical compound as sildenafil citrate.
Addyi is a drug that contains the active ingredient flibanserin and was developed to treat women’s desire. That struck me as fascinating. Viagra doesn’t target men’s desire, it specifically targets the blood flow to the penis. Have scientists determined that the way to increase a person with a vagina’s performance in bed is to target their sexual desires? Are people with penises more likely to experience desire if they are able to achieve and maintain an erection?
It’s worth noting that Addyi is specifically designed for people who have not entered menopause. I find that especially interesting, as a common complaint of people who have entered menopause is a decrease in sexual desire. On the other end, most Viagra users are men in their 50s, with the average user around 53 years old. Although, Pfizer records also indicate that 8% of the prescriptions written are for men aged 34-40. They don’t even keep track of the prescriptions written for users under 33. Why is that? Unfortunately, I haven’t yet been able to find out.
Another big difference between flibanserin and sildenafil citrate is that the latter works within hours, and the former must be taken nightly for a minimum of 3 weeks before the user can begin to experience its effects. That’s definitely a testament to the psychoactive properties of the drug, of which there are none in Viagra, contrary to popular belief. Perhaps the biggest and most unfair gap in these treatments is that people with vaginas should be able to experience the same quick-and-easy user experience from their sexual experience augmentation drug that people with penises are able to take advantage of. It sucks to have to start a drug and wait three weeks before sex *might* get good for you again.
It seems that there’s more than meets the eye when it comes to sex science. While it’s commonly perceived that “science only cares about men,” it seems that we have the right people on the case. The anatomy of our bodies is complicated and widely varying among the sexes, so while people with vaginas aren’t quite able to take a one-and-done pill to make their evenings exciting, we could be on our way to that solution sooner rather than later. For now, ladies, unfortunately, we’re still looking at the glass-of-wine-at-the-end-of-the-day method. Hang in there.