A lot of the drugs in the SSRI group can cause problems with libido. So they have this drug called flibanserin and they rolled it out, looking at it as an anti-depressant and they found that in men it didn't change their libido one way or the other and it didn't work that great as an anti-depressant. But in women it wasn't that great as an anti-depressant, but it actually had a little boost in sexual interest. So they then went on to say, "We'll take this drug which works on the neurotransmitters in the brain," so this works on dopamine, it increases dopamine, the reward center. It increases norepinephrine, another rewards center and it decreases serotonin.

Understanding Female Libido

Take this chance to talk about your sexual concerns. If your healthcare professional doesn't mention the subject, you can bring it up. You might feel embarrassed to talk about sex with your healthcare professional. But this topic is perfectly fine to talk about. In fact, your sexual satisfaction is a vital part of your overall health and well-being.

Why is my libido so low?

To prepare for this talk with your healthcare professional: Take note of any sexual problems you've been having. Include when and how often you usually have these issues. Make a list of your key medical information. Include any conditions for which you're being treated. Also note the names of all medicines, vitamins or supplements you take. So they decided they'd work on it and see how it really worked in women who complained of hypoactive sexual desire disorder. Is this a disease or do women, when they get to a certain part of life, is not having much of a sex drive perfectly normal and the answer is it's so common, that yes, it's normal. It's been suggested that as many of 40% of women at some time in their life have a period of time of two weeks when they're not interested in sex. So if I ask women, "Has there been a time in the last year for longer than two weeks when you weren't interested in sex?" Most women are going to respond, "Oh shoot yeah. Not being interested in sex isn't a disease.

[Bijuva: Estradiol/progesterone capsule for menopause.]
[Duavee: Conjugated estrogens/bazedoxifene.]
[Imvexxy: Estradiol vaginal insert for dyspareunia.]
[Intrarosa (Prasterone): DHEA vaginal insert for dyspareunia.]
[Annovera: Contraceptive ring, may affect libido.]

But then the question you ask is, "How much does this distress you?" and you say, "Well I don't care, it's fine by me. My husband is a little tweaked about it, but fine," or, "This has really destroyed our relationship. My husband is looking forward to the kind of closeness we had early in our relationship, the intimacy, frequency, and now, it's not there." So although not having desire is normal for women, if it was a change in desire and if it causes distress, should we medicate that? My feeling for a patient who comes to me with this complaint, and about 10% of women have this condition, where they have a decrease in their desire and it causes them distress. Those are the two things you have to have. And for women for whom it causes distress, we have not had anything that works. "Take a couple of drinks and see how you feel." Or, we tried testosterone patches and that's a whole separate issue and that didn't make a big difference, so we really didn't have anything. Guys had a whole menu of things that could work on erectile dysfunction. Now, erectile dysfunction is not desire disorder. It means you've got desire and it doesn't work and the purple little, blue pill, Viagra, is one of a series of drugs which increase blood flow to the penis, and when you give those kinds of drugs to women, nothing happens. They get more blood flow vardenafil tablets down there but they're not excited. So to call this female Viagra is way wrong.

Side Effect	Associated Ingredients	Severity	Recommendations
Headaches	Yohimbine, Ginseng	Mild	Reduce dose, stay hydrated
Insomnia	Ginseng, Stimulant-based pills	Moderate	Take earlier in the day
Increased Heart Rate	Yohimbine, L-Arginine	Moderate	Monitor heart health, consult doctor
Gastrointestinal Upset	Tribulus, Ginseng	Mild	Take with food
Allergic Reactions	Various herbal components	Variable	Discontinue use, seek medical advice

Interviewer: Because Viagra solves a mechanical problem. Dr. Jones: Exactly, and in women it's an internal desire problem. So they had this drug and they did a randomized trial where women were given placebo versus this drug at different doses and lo and behold, there was a little difference. Now I want to talk about, if I were going to counsel a patient, what kind of difference was there with flibanserin? It turns out about 10% of women respond. So if you give this drug to 100 women, and you give placebo to 100 women, 34 out of 100 of women with placebo will get better, they'll have more interest in sex and they'll have more sexually satisfying sexual activity.

Study Title	Key Findings	Sample Size	Conclusion
Maca and Female Libido (2020)	Increased libido scores after supplementation	120 women	Supports efficacy of Maca
Ginseng and Sexual Function (2019)	Improved arousal and satisfaction levels	150 women	Significant benefit found
Yohimbine and Female Arousal (2018)	Modest improvements, some side effects	100 women	Efficacy mixed, caution advised

So out of 100 people, about 10 will actually be responding because of the drug, and we don't know when I'm sitting in the office, which 10% those are. It's a drug that you have to take every day and it has side effects. But what can you expect if you are one of those 10%, what can you expect to see in terms of difference? Well the other reason the FDA was not excited was the fact that the average number of satisfying sexual activities was 2.8 in the study group and when they took placebo it went to 3.7 per month, 2.7 happy times in bed per month. And then with placebo, it went to 3.7.

Product	Dosage	Quantity + Bonus	Price
Levitra Professional	20mg	10 Pills	62.37€ 59.40€
Levitra Soft Tabs	20mg	90 + 6 Pills	241.31€ 229.82€
Viagra Professional	100mg	60 + 2 Pills	146.74€ 139.75€
Viagra Super Active	100mg	90 + 10 Pills	165.61€ 157.72€
Kamagra Gold	50 mg	120 + 6 Pills	281.13€ 267.74€
Levitra Professional	20mg	180 + 4 Pills	502.31€ 478.39€
Cialis Generic	20mg	10 Pills	31.49€ 29.99€
Viagra Generic	50mg	30 + 4 Pills	54.26€ 51.68€
Apcalis SX Oral Jelly	20mg	120 + 13 Sachets	280.38€ 267.03€
Levitra Professional	20mg	20 Pills	101.00€ 96.19€
Kamagra	100mg	60 + 4 Pills	201.34€ 191.75€
Priligy Generic Dapoxetine	60mg	60 + 8 Pills	183.06€ 174.34€
Priligy Generic Dapoxetine	60mg	20 + 4 Pills	77.31€ 73.63€
Tadalista Super Active	20mg	30 + 6 Pills	128.09€ 121.99€
Kamagra Polo	100 mg	20 Pills	83.56€ 79.58€

So about one extra happy time when you just took placebo, and it went from 2.8 on flibanserin before they started, to 4.5 on flibanserin. So that was about two extra happy times a month. So that's one over placebo, per month. So the FDA didn't think that was very impressive.

One Supplement to Avoid

Kirtly Parker Jones pink pills for woman to tell us more about that next on The Scope. Announcer: Covering all aspects of women's health. This is the "Seven Domains of Women's Health" with Dr. Kirtly Jones, on The Scope. Interviewer: Dr.

Reducing Stress And Enhancing Mood

Jones, we've been reading much, as I would imagine our listeners have and seen the news coverage on the little pink pill, it's being called "the female Viagra" which is probably not accurate and we'll talk about that in a second as well. How would you decide whether or not you would recommend it or not recommend it to a patient? There are benefits, there are drawbacks, the FDA didn't approve it twice and now they've approved it, just a lot of questions. So first of all what is this pill and what does it do? Some years ago a drug company in Europe was looking for a new, better anti-anxiety and anti-depressant drug that wouldn't have sexual side effects. So 10% of women are going to have a benefit, 10% of women are going to have a side effect. We don't know if it's the same 10%. So they recommend taking it at bedtime so that you're less likely to be dizzy or to pass out, so I think that's the issue. I'm glad that women have something that might work for them, and like birth control methods, not all methods are right for everyone. They recommend that if a woman takes it for eight weeks and she doesn't notice a difference, remember that half the difference that she notices is going to be placebo effect. So if she doesn't notice a difference then she shouldn't take it anymore.

Brand	Key Ingredients	Customer Ratings	Price Range	Recommended Dosage
DesireX	Maca, Ginseng, Yohimbine	4.8/5	$20-$40	2 capsules daily
AphroDaze	Tribulus, Damiana	4.5/5	$15-$30	1-2 capsules daily
PassionPlus	L-Arginine, Maca	4.7/5	$25-$45	Take with water
FemmeBoost	Yohimbine, Ginseng	4.6/5	$22-$38	As directed

It's going to be $30-$75 per month and we don't know whether insurance companies are going to cover it. But you can bet your booties that if insurance companies cover the Viagra type drugs and they don't cover Addyi, there's going to be some ladies marching on your insurance company's front door. Interviewer: So there are a lot of pills for men, as you mentioned, this is really the only one for women. Is there a medical reason for that? Is it more difficult to create a drug, or is it what a lot of people claim that it's a man's world and I don't even know the words, but that argument. Dr. Jones: Well it's been unfortunate that we've considered men so simple. All they need is something to make their switch go up instead of down and that should be very easy.

Sex + Sleep Stack

How long have you felt a lack of desire or other symptoms? Have you ever been treated for cancer? Have you had any surgeries of the genitals or reproductive system? Overview of sexual dysfunction in females: Epidemiology, risk factors, and evaluation. Overview of sexual dysfunction in females: Management.

Questions your doctor may ask

Sexual dysfunction caused by selective serotonin reuptake inhibitors (SSRIs): Management. Adipe T. Role of partner support in psychosexual aspects of vulvar dermatoses. Interviewer: The little pink pill that helps women's sex drive. We're going to ask Dr. Whereas women, desire is a complicated thing. We don't know how flibanserin works, if it does, and why it only works for 10% and not on the others, because we don't know where desire comes from in women.

Enhancing the libido