Secrets of «female Viagra»: everything is not like men

Both men and women may face the problem of sexual desire, arousal, and intimate difficulties. For men, science has already come up with a magic pill — sildenafil. But for some reason it is not suitable for women. Moreover, it is still not clear what substance could give the same effect for the fairer sex as Viagra. MedAboutMe figured out what is the difference between men and women, why Viagra does not work for everyone, and is there a female version of it?

The mechanism of sexual desire in women

Both men and women are normally capable of experiencing sexual desire — this is the name given to the desire for intimate relationships without the goal of conceiving a child, but with the desire to exclusively enjoy and satisfy their natural sexual needs. We can say that it reflects the motivation and desire to enter into an intimate relationship and is focused on this process. Today, sex drive is also called «libido».

The role of the «main violin» in the formation of sexual desire in women is played by sex hormones:

• Estradiol (from the group of estrogens) increases the blood supply to the brain, activates the transmission of nerve impulses, increases the sensitivity of the erogenous zones located in the genital area. There is also an increase in vaginal circulation, which causes the release of vasoactive substances from the endothelial cells lining the vessels. Neurotransmitters are involved in the regulation of female sexual desire. They can reduce or increase the degree of sexual desire, and are also responsible for the emotional coloring of this condition. So, estradiol enhances the release of norepinephrine (stimulates sexual arousal), and also activates the production of dopamine by the hypothalamus, while there is an increase in the concentration of beta-endorphins and regulation of the concentration of serotonin. And these three types of hormones — dopamine, endorphins and serotonin — are also called «hormones of happiness.» As a result — complete sexual satisfaction and a vivid orgasm.
• Testosterone (belongs to androgens) acts on brain receptors, triggering erotic fantasies and increasing motivation for sexual intercourse.

But no less than hormones, the mood of a person and his mental status are also important. Moreover, the libido of a sexually healthy person is resistant to hormone surges.

It should be clarified that women are more than men dependent on psychosocial influences. A woman’s libido can change not only depending on the stage of the menstrual cycle, but also on relationships with a partner and, in general, on a specific situation.

Loss of libido in women

The very concept of «reduced libido» is very broad, especially in relation to women. According to scientists, a third of the fair sex aged 18 to 59 years is faced with a drop in libido. At the same time, due to the socio-cultural characteristics of the position of women in society, they themselves do not always pay attention to this problem, so we can certainly even talk about the underdiagnosis of this pathology — that is, in fact, the problem is even wider.

Disorder of sexual desire is expressed in the loss of interest in intimate life. For the first time this condition was officially noted in the IV edition of the Diagnostic and Statistical Manual of mental disorders — in the manual on mental disorders used in the United States. In it, the concept of «hypoactive sexual desire disorder» (HSDD) was introduced. As a pathology, this condition is considered if it causes severe distress and problems in relationships with a partner. The International Classification of Diseases (ICD-10) even distinguishes it as a separate nosology «Lack or loss of sexual desire» (with F52.0 coding).

At the same time, a significant part of the works on this topic speaks of sexual dysfunction in women, considering 4 categories of disorders:

• deterioration of libido (loss of fantasies on intimate topics, sexual desire);
• the inability to achieve orgasm (or the so-called delayed orgasm);
• dyspareunia — pain during intercourse;
• sexual arousal disorder.

One way or another, it is clear that with the problems of sexual desire in women, things are more complicated than in men. And attempts to use male drugs for treatment did not lead to anything. But why?

Viagra and the female body

First of all, it should be understood that Viagra is not a hormonal drug. Its active ingredient, sildenafil, is an inhibitor of the phosphodiesterase type 5 enzyme (PDE5). This drug was originally developed as a cardiac drug, and improved sexual function in male patients was a side effect. And it is this effect that has made sildenafil one of the most famous drugs in the world. In men, it solves the problem of achieving an erection, that is, a man has a desire, sexual arousal too, but there is no erection or it is too weak.

It is still used in cardiology, endocrinology, oncology, nephrology, and even in obstetrics and gynecology — anywhere in the course of treatment it may be necessary to control the production of PDE5. And actually, once it was the detection of PDE5 in the cells of the vagina in more than 80% of women that formed the basis for the idea to explore Viagra as a drug for the treatment of not only gynecological and urological diseases, but also sexual dysfunction in women.

As a result, numerous experiments have shown that sildenafil can be used to increase the blood circulation of the uterus and placenta during pregnancy, to prevent pulmonary hypertension and fetal lung hypoplasia, and even to protect it from the teratogenic effects of certain drugs and reduce signs of distress syndrome in newborn babies. Heart disease, kidney disease in women may also require the use of sildenafil. However, it was either not possible to obtain a significant effect in the treatment of sexual dysfunctions in women, or the degree of evidence of these studies is called into question by scientists.

The fact is that Viagra acts unambiguously on men. Regardless of the mood and psychological «troubles», the drug causes a rush of blood to the genitals, bringing the penis into a state of «combat readiness», which, ideally, for the body should end in a discharge in the form of an orgasm. In women, a rush of blood to the genitals does not mean an increase in sexual arousal.

This does not mean that Viagra is generally useless in intimate terms for women. In elderly women in the menopause, the hormonal background changes, so the natural lubrication in the vagina is not produced enough. The same problem — vaginal dryness, which makes intercourse painful, can occur in women taking hormonal contraceptives. Sildenafil, which activates the blood circulation of the genitals, contributes to the production of a sufficient amount of lubrication and effective hydration of the genital organs in anticipation of sexual intercourse.

«Women’s Viagra»: excitement and nerves

In search of a drug that would cause sexual desire in women, scientists have developed the drug flibanserin. This substance, which was called «Viagra for Women», increases the activity of neurotransmitters in the brain, and it is those that cause sexual desire.

It should be noted that this is not the first remedy for female sexual dysfunction. Back in 2005, an unsuccessful attempt was made to bring another drug to the market, but its effectiveness was minimal, and the risk of developing rather serious side effects is quite high.

Flibanserin was originally developed as an antidepressant. It leads to an increase in the level of dopamine and norepinephrine, but at the same time reduces the level of serotonin. As mentioned above, all these hormones play an important role in the formation of sexual desire and arousal. Let us emphasize the difference between sildenafil and flibanserin: the first acts on a “mechanical”, physiological level, the second on the level of the psyche, which is especially important for women.

The drug was approved by the US Food and Drug Administration (FDA) in 2015. At that time, according to the results of the studies, it was intended for the treatment of decreased sexual desire in older women.

But later it turned out that the drug should not be taken with alcohol (and at least 2 hours before and after drinking alcohol), since this causes a significant risk of a sharp drop in blood pressure up to fainting. It should also not be taken by people with liver disease. Among its other side effects are dizziness, dry mouth, nausea, insomnia, and chronic fatigue.

Finally, flibanserin should not be taken if the person is being treated:

• some means for the treatment of cardiovascular pathologies,
• some antibiotics;
• medicines to treat fungal infections;
• drugs for the treatment of HIV;
• some antidepressants;
• separate dietary supplements, for example, containing St. John’s wort.

In addition, you should not drink flibanserin with grapefruit juice.

And the last point: the effectiveness of flibanserin for women cannot be compared with the effectiveness of sildenafil for men. «Women’s Viagra» gives an effect, but not so «lethal», and it does not solve all the problems that prevent sexual arousal in such complex and sensitive natures as women.

Does the pill solve the problem of sexual desire?

Unfortunately no. Whatever the pill that leads to sexual arousal, it will not make the sexual intercourse itself better, will not teach a person the art of intimate relationships that are equally desirable for both partners and bring them satisfaction.

In addition, it is not certain that the drug will help, even if the problem is correctly identified and theoretically flibanserin is able to solve it. Sexual desire in women is a complex condition that depends on a huge number of factors.

In general, faced with the problem of sexual desire, you should first determine its true cause. This may be a feature of the physiology or biochemistry of a particular person, or a side effect of an illness or medication, or it may turn out to be a psychological task that a specialist in this field will help solve.