Viagra went on sale in 1998 and became a top-selling drug almost immediately.
The ‘blue pill’ accidentally discovered by the American pharmaceutical company Pfizer became a huge money-making machine for them. In the first three months alone, Americans spent an estimated $400 million on the erectile dysfunction drug.
It didn’t take long for the industry to focus on the other half of the market, women, and see an opportunity to double their profits, and they started working on that as well.
Nicole Prowse, a neuroscientist and researcher at the University of California, Los Angeles (UCLA) in the US, recalls that ‘I started studying sexual physiology around the time Viagra was introduced and realized that sexology at that time was A lot of investment is being made in research into genetics or sexuality.
“We have never seen the magnitude of this research. Our science (sexual physiology) is still quite underdeveloped, it is considered a risky area. There are many companies that don’t even want to broach the subject.’
However, after almost 25 years and spending millions of dollars, the pharmaceutical industry has not been able to develop a female version of the ‘blue pill’ for women.
It’s a failure that has given rise to a larger debate on women’s sexuality, as experts say what is generally considered a taboo area about women’s desires and the extremes of sexual pleasure (libido) and Also tells a story about misunderstandings.
The search for the ‘pink pill’
The history of viagra for men is popular. Dr Mitra Bollil, who works in Pfizer’s research department in the UK, told BBC Brazil that the drug used today to improve erectile function was discovered by chance.
“We were developing a drug for angina, which is a heart condition. Around this time, some clinical trial participants began to report more erectile dysfunction than usual. At first we didn’t pay much attention, we thought it was because the participants were young.
The decision to investigate further was made when an article published by American researchers reported that one of the ingredients of the drug they were testing (called a PDE5 inhibitor) How does the penile corpus cavernosum (arteries of the clitoris) affect tissue that increases blood circulation to the area?
“My boss asked me to do a study to find out if this really happens or if it’s just a random ‘accident,'” recalls Dr. Bouleil.
Later research on Viagra shows that it has the ability to cause increased blood circulation around the penis and keep them erect for longer.
And the pharmaceutical industry’s first approach to directing its efforts toward making Viagra for potential women was based on exactly the same principle: to create a drug that would increase blood circulation in the vagina and clitoris.
“The tissues that make up the male and female sex organs are the same in the early stages of embryonic development,” says Dr. Bouleil.
‘These tissues differ because they are produced by hormones, but the stem cells that make up the sex organs are essentially the same in males and females, and the enzyme phosphodiesterase type 5 (PDE5) is also present in these tissues. Is. We thought, ‘Well, if it works for men, it’s very likely to work for women.’
But it was not so.
Human body tissues
Physical examination even showed increased blood flow to the vagina and clitoris, but both control group participants and those taking Viagra reported no improvement in sexual function.
Other pharmaceutical manufacturers doing similar research were faced with the same problem, so it was not surprising that sexual physiologists who were already investigating how blood flow worked in the sexual gratification and pleasure system. Is.
The scientist was Nicole Prowse, who was involved in one of several ongoing projects on female Viagra in the US at the time.
Increased blood flow to the genitals is also part of the female sexual response. When a woman becomes sexually aroused, the body increases blood flow to the vaginal walls and clitoris, causing it to enlarge as does the labia majora, a process called vasocongestion. .
The problem is that many times women don’t even realize this is happening.
“We’ve studied this for years, and for women, it’s not as easy to self-diagnose vasocongestion,” Prowse says. So we knew there was an opportunity for us to do something in that direction, and women report that they don’t really feel anything.’
Most women’s sexual problems are not related to insufficient blood flow to the genital area, says Laurie Broteau, professor of gynecology at the University of British Columbia in Canada.
The most common cause of these is loss or lack of sexual desire.
Meanwhile in men Viagra does not work without desire and an erection requires brain ‘activation’. The central question in this case is that the mechanism of expression of desire is completely different between men and women.
In Prowse’s opinion, although this was already clear to many scientists involved in researching female Viagra, many pharmaceutical companies ignored the warnings because of the sales potential. “We warned them it wouldn’t work (in women),” he reiterated.
In the early 2000s, Prowse joined one of the projects to discover Viagra for women as a graduate student. In a meeting with the research team on the Viagra for Women project, Prowse was surprised to find that she was the only woman in the group, while most of the other researchers were male researchers over the age of 50.
However, she says that the research participants were there ‘with the best intentions of wanting to help women, but still, she felt there was no meaningful discussion about what and how women respond sexually. happens.
Failure in the first investigation
Dr. Bouleil agrees that the pharmaceutical industry “should have listened more to women.” In 2004, when Pfizer announced it was suspending its project, she gave interviews to explain why. Given a series of
At that time, Dr. Boll said that during sexual intercourse, there is a disconnection between the changes in the genitals and the changes in the brain in many women, while such a disconnection does not exist in men. Men are constantly attracted to the idea of penile erection in the presence of naked women and want to have sex. Dealings with women depend on many factors.
After the failure of the women’s project, pharmaceutical companies gradually stopped spending money on it, and abundant funding for research on sexual physiology ended.
Prowse, who by then was a research associate in the Department of Psychiatry at the University of California, faced internal resistance within the institution to continue her research on ‘sexuality’ and depression.
Despite securing private funding for her research through her own efforts, the university told her it could not accept the money, a position she attributes to the “controversial” nature of her research.
“There’s still a lot of stigma around anything that deals with women’s sexuality,” says Prowse. A pill is considered ‘acceptable’ but many companies have an image-damaging image of anything sexual, meaning anything that can be seen as obscene, is highly resisted.’
Antidepressants
After nearly two decades, a drugmaker didn’t abandon the female Viagra project, but instead focused on another organ, the brain.
In 2015, a company called Sprout launched the female brain drug flibanserin, a drug originally intended as an antidepressant. was developed that targets levels of the hormones dopamine and serotonin with the promise of increasing female libido.
Experts criticized this medicine. The first was that it was less effective, considered a low-grade drug. Clinical trials showed an increase in the number of sexual acts during one month between participants at a rate of 0.5 to 1 when comparing results to the placebo group.
Many believed that the benefits were not worth the money involved. Unlike Viagra, ‘flibanserin’ needed to be taken daily and could cause dizziness, fatigue and nausea and could not be used by women who drink alcohol as it is a daily meal, so whatever If he decides to take it, he should stop drinking alcohol.
The drug was even rejected twice by the US regulatory body Food and Drug Administration (FDA) before being approved. Flibanserin never went on sale. Currently, this drug has been approved in some countries.
Other pharmacological drugs, such as ‘Vyleesi’, a ‘brimelanotide’ injection which was approved in the US in 2019 for use in premenstrual days by women with low libido, have also failed. There are mills.
One reason for the failure of the female sexual desire puzzle may be related to the fact that female sexual desire has a psychological dimension. For example, this helps explain why low libido affects women more than men.
Depression, anxiety, stress, low self-esteem, relationship conflict, partner embarrassment all interfere with women’s desire more than men’s, says University of British Columbia professor Lori Brutto.
“Men also benefit from the effects of higher testosterone levels, which allow them to experience a more spontaneous form of desire,” she says.
The spontaneous urge to have sex has long been thought of as a desire, something that arises like hunger or thirst. The most advanced research theorists working in the study of female sexuality, however, call it reflexive sexual desire, which arises as a result of a stimulus.
One of the scientists who introduced this concept in the early 2000s was Canadian Rosemary Basson. For him and for a large group of scientists today, things are not as simple as they seem.
The traditional linear model, which emerged from studies in the 1960s and 1970s, ignores that ‘the key components of women’s sexual satisfaction are trust, intimacy, respect, communication, affection, and pleasure in contact. are linked to. According to them, women’s sexual response can be linear when they don’t have a stable partner, for example when they are newly engaged.
Women in long-term relationships repeatedly experience a sexual response that includes desire and excitement, thinking about sex, stages of the process that also include emotional intimacy and psychosexual motivation. This debate is important not only to better understand women, but also to distinguish between the problems that need to be addressed and the nature of women’s sexuality.
If not viagra pill, then what?
Lori Broteau, director of the Sexual Health Laboratory at the University of British Columbia, is conducting studies with positive results. With practice, she says, women have become more aware of the physiological changes that occur before and during sexual activity — sensations such as constriction of blood vessels or ‘tickling’ that normally occur. but produce sexual arousal — which can help them increase or maintain sexual desire.
“We found that mindfulness also works on a number of negative thoughts that women with sexual problems have about themselves, reducing levels of self-criticism and increasing self-compassion,” Prowse believes. That the pharmaceutical industry has given up on finding a pill that will solve women’s sexual problems.
“What I’ve seen are startups (new companies) being worked on individually by a few scientists with more innovative ideas. Do you think any medicine will solve women’s sexual problems?’
It would be sad if it was a bullet, right? I think we (women) are more than that. Nowadays people want a pill for everything: to lose weight, a pill to solve their sexual problems but the body is so much more than that. We are the result of millions of years of evolution. The human body is an incredible machine and it is narrow-minded to believe that a pill can solve all problems.