June 18, 2010

Food and Drug Administration Readies for Fight Over 'Female Viagra'

CRITICS SAY FLIBANSERIN, AN ANTIDEPRESSANT, HAS LIMITED EFFECTIVENESS AND MEDICALIZES WOMEN'S SEXUALITY

A German drug company is ready to market a pill for premenopausal women who are distressed by low sexual desire, and is prepared to fight for Food and Drug Administration approval at a hearing Friday.

Pharmaceutical companies have been on an endless quest for a female equivalent to Viagra, which launched in 1998, and many believe flibanserin holds promise for women who believe they've been left behind.

Boehringer Ingelheim came upon the possibilities of flibanserin when it was tested as an antidepressant and yielded some desirable side effects -- it made sex more pleasurable for women and seemed to increase their libido.

If the FDA's panel of experts approves flibanserin Friday, the drug company gets some fringe benefits too -- an estimated $2 billion in profits, equal or greater than annual sales of the three top men's sex drugs, Viagra, Levitra and Cialis, according to a story in The New York Times.

Boehringer has already begun online promotions with celebrity spokeswoman Lisa Rinna, a former Playboy model and soap opera actress, who says she suffers from female sexual dysfunction.

In fact, Boehringer has "quietly persuaded" the Discovery Channel to keep running a documentary about female sexual dysfunction that comes across like advertising for flibanserin, according to a blog on Pharmalot. The film notes in its introduction that the company provided funding for the project.

Many existing studies, financed by Boehringer, show that as many as 10 percent of all women live with this disorder.

Critics, however, argue that drug companies have essentially created a disease -- hypoactive sexual desire disorder -- for the natural ebbs and flows of a woman's sexuality to market a drug. (The American Psychiatric Association classified it as a disorder in 2002.)

They say the pharmaceutical industry is putting women at risk for side effects that come from taking this pill daily.

Liz Canner, a documentary filmmaker who followed the drug company Vivus as it carried out its own search for a female sex drug after Viagra hit the market in 1998, argued that clinical trials for flibanserin revealed a statistically insignificant improvement in the level of desire for as yet underdetermined risks.

"I can't see why it will be approved," said Canner, whose film "Orgasm Inc." premiered this spring. "I am really shocked the drug has gone this far."

"Most women are healthy, and it's not so much that their testosterone levels or serotonin levels or genital engorgement is a problem, it really is that a lot of women are in poor relationships and stressed out due to overwork," she said.

Although she understands women who have had radical hysterectomies and are on libido-inhibiting serotonin-specific reuptake inhibitor antidepressants, or SSRIs, may need medical intervention, most women do not.

"They are just exhausted, doing all the domestic work and working 40 hours a week," said Canner. "And a lot of women have been sexually abused, and that also affects desire. The idea that we are supposed to be desiring sex every minute of the day is a complete fantasy, science fiction, and who would want [that] anyway? What a pain!"

Earlier this year, an FDA staff report recommended against approving flibanersin as a sex drug, saying the company had not made a strong enough argument that the benefits outweighed such side effects as dizziness, nausea and fatigue.

Dr. Peter J. Piliero, Boehringer's director of medical affairs in the United States, has called hypoactive sexual desire disorder "a real disease."

In a multi-nation study made public last year, flibanserin appeared to increase desire and sexual satisfaction in women by several measures by modulating serotonin and other neurotransmitters.

Unlike Viagra, which is used to treat male erectile dysfunction by increasing blood flow to the genitals, this drug acts on the woman's brain to enhance mood.

Lead researchers from University of Ottawa -- whose work is underwritten by Boehringer Ingelheim Pharmaceuticals -- said the drug is effective in treating hypoactive sexual desire disorder or lack of libido.

The drug acts on the central nervous system, keeping serotonin, norepinephrine and dopamine "in balance," she told ABCNews.com.

"The pharmaceutical industry has come up with Viagra to solve a major concern that men have had since the beginning of time," June Reinisch, senior research fellow at the Kinsey Institute for Research in Sex, Gender and Reproduction told ABCNews.com when the first studies were publicized.

"But until now, nobody has seemed that concerned about resolving what women might like."

Reinisch said while the study was "interesting," there were more questions about the data -- women surveyed were 18 to 50, a wide age range, and from different countries.

There was also a very strong placebo effect among the women.

"We ladies are complicated, and this study is only looking at one thing," she said. "It may be a first step in something interesting, but to call it a female Viagra, we are getting way ahead of ourselves."

"Women are not interested in getting a hard on, they want to have desire and arousal," said Reinisch, who is also a consultant to New York's Museum of Sex.

The randomized, double-blind study on flibanserin was carried out at Canada's Women's Health Center of the Ottawa Hospital, as well as at University of Virginia, University of North Carolina Chapel Hill and Italy's University of Pavia.

Related: Healthy Diet - Basic Principles and Practical Advice for Daily Living

SOURCE: ABCNews.com - Available here: http://abcnews.go.com/Health/ReproductiveHealth/food-drug-administration-considers-approval-female-viagra-flibanserin/story?id=10940368

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