Female Desire: What You Should Know Before Reaching for the Pink Pill

August 27, 2015 Updated: April 28, 2016

Desire depends on complex, dynamic factors, and low libido in women can often be the proverbial tip of the iceberg—the symptom that’s most noticeable, but only a small piece of the whole issue. 

Addyi (flibanserin), known as the “pink pill,” is the first-ever FDA-approved pharmaceutical for female libido. Although it’s been hailed the female version of Viagra, that comparison is not really apt: Viagra relaxes muscles and increases blood flow, whereas Addyi—which was developed from an antidepressant—acts solely on brain chemicals and is supposed to be taken daily rather than only when intimacy is wanted.

Addyi’s approval last week came after it was twice rejected by the FDA due to its limited effectiveness and side effects like low blood pressure, dizziness, fainting, nausea, sleepiness, and insomnia. Alcohol  can increase the risk of some side effects.

Dr. Jen Landa, OB-GYN, a specialist in women’s health, hormones, and functional and regenerative medicine, and chief medical officer of BodyLogicMD, a nationwide network of hormone specialists, explained some of the concerns she has about the drug and what women can do to promote intimacy.

Epoch Times: Hormones are often part of the reason for low libido. Addyi acts only on brain chemistry. Do you think it will have any effect on hormones?

Dr. Jen Landa: The pill does act on brain chemistry. Specifically, it helps to increase certain neurotransmitters—dopamine and norepinephrine, which are pro-sexual, and to inhibit serotonin, which can decrease sexuality in women. That being said, Addyi doesn’t seem to have any impact on hormones or hormone levels. I don’t see this as a good thing.  

For women, the biggest drop in testosterone they experience is not during menopause as with other hormones, like estrogen. Women have the biggest drop in testosterone between the ages of 18 and 34 years old. After that, testosterone levels continue to decrease but not as fast.  

Many women are dealing with suboptimal testosterone levels. They may still be in the “normal” range, but the normal range is [considered the same] for women from 18–80 years old.  If I’m 35 years old and my testosterone is normal for a 70-year-old, my doctor will tell me I’m still in the “normal” range, and that’s just not right.

If a 35-year-old woman has the testosterone level of a 70-year-old woman, this should be recognized as a functional testosterone deficiency. Correcting a testosterone deficiency will help to naturally raise dopamine and norepinephrine levels, which will have a positive effect on women’s sexuality.  

I believe a much better approach to our bodies is to replace what’s missing over time rather than messing with our brain chemistry. The changes in brain chemistry that happen with Addyi is the reason why the side effects of dizziness, nausea, and sleepiness are so commonly seen.

With Addyi, you aren’t correcting a deficiency, you’re throwing off brain chemistry. Who knows what else will happen over time with this intervention? 

Epoch Times: In women, low sex drive is a complex, multi-faceted issue. What are some of the other causes women should be aware of?

Dr. Landa: This is another important issue. This is the reason I don’t think we will ever find the reason for low sex drive in women in a pill, not even a hormone pill.  

Losing your sex drive is “HARSH” (habits, attitude, relationships, stress, and hormones).

Habits, healthy lifestyle habits: Women with poor lifestyle habits will tend to have multiple issues that may lead to lower sex drive. Poor eating and exercise habits can lead to feeling fat, tired, and irritable. Feeling like that is not sexy. 

Attitude: A lot of sex happens in the brain, and having a sexy attitude is super important. Many women have issues with their sexuality because of things that are happening with their moods or self-esteem. Some women get so wrapped up in being a mom that they forget to be the sexy, sensual creatures they are.

Relationships: Studies have shown that one of the main determinants of a woman’s sex life is her relationship with her partner. This one is huge. Many women I see say they have a great relationship but frequently when we dig a little bit deeper, there are some resentments they are dealing with under the surface. These resentments can leak out in places like our sex lives. 

Stress: This is the biggest sex killer I know of. The problem is that we’re all stressed. I think one of the biggest things we can all do to increase our health, happiness, and sexuality is to decrease our stress. 

Hormones: Yes, hormones are important but just one aspect of the whole puzzle. There are many hormones that interact to help women feel more sexy. While testosterone is important, several others play a role as well.  

Epoch Times: What would you recommend women try first before reaching for this “pink pill”?

Dr. Landa: First, I think we need to look at our everyday habits and whether they are adding to or detracting from our sex lives. Eating well, exercising, sleeping well, decreasing stress, and using stress-reduction practices all serve to balance our hormones.  

Balanced hormones is one of the most basic elements to a great sex life. Take a look at your relationship. If there are unresolved resentments, try to communicate with your partner about them.  

Another relationship issue that comes up a lot is boredom. Couples need to work together to find ways to shake things up in their lives and have some fun.  

Seeing your partner take on new challenges can help you to find them attractive in a whole new way. Spend time together doing something new and fun. Some women need more help and may need to see a hormone specialist for a complete hormone evaluation and possibly treatment.  

The interview has been edited for style and clarity.

For more information from Dr. Landa, see her free video series at RewireDesire.com