• Sex Medicine

Taking sex medicine or drugs to treat sexual dysfunction may or may not be the solution to a reduced desire or inability to engage in sexual activity.

For men there are several medicinal options for erectile dysfunction, but erectile dysfunction in itself may be the sign of another issue that may need to be resolved. Women also have options, and pills or creams may or not be a solution to regaining sexual desire or more comfortable sexual activity.

Age, anxiety, stress, diet, disease, and prescribed medicines themselves may be some underlying reasons for the inability to get an erection or have interest in or desire for sexual activity. Some people may have misconceptions about what “normal” sexual response and interest are, which may lead to the belief sex medicine can make them “normal” sexually.

There are FDA-approved drugs and generics, and there are over-the-counter drugs, supplements, and herbal aphrodisiacs, with some being unsafe and making fraudulent claims of effectiveness. Some people may have financial barriers to obtaining sexual enhancement drugs.

All drugs or medicines carry certain risks and a doctor or healthcare provider should be consulted before any drug or medicine is taken.

The sourced articles below should provide more information on sex medicines and drugs.

  1. A New ‘Female Viagra’ Approved By FDA Despite Skepticism [female]

    “The drug is intended to be a treatment for hypoactive sexual desire disorder, or HSDD, which the medical community recognizes can be a serious issue. The FDA acknowledged that it’s not clear how Vyleesi acts in the brain to affect sexual desire or distress. It advises women to use no more than one dose in 24 hours or eight a month.”

    Ariana Eunjung Cha and Laurie McGinley, washingtonpost.com, 6/21/2019

  2. Female Sexual Dysfunction: Talk About It And Get Help [female]

    “Treatments for female sexual dysfunction include a combination of nonmedical and medical approaches designed to address your mental and physical well-being. …
    Medical approaches include:
    – Estrogen therapy
    – Testosterone therapy (this is controversial)
    – Treatment for depression or anxiety
    – Treatment for any medical condition that may be contributing to your sexual dysfunction
    – Changing a medication that may be causing the problem
    Talking about your sexual dysfunction is the first step in getting help for this stigmatized yet common disorder. You have the right to an enjoyable sex life.”

    HealthyWomen, healthywomen.org, accessed on 3/2/2019

  3. Health Insurance Often Skips Coverage For Sex-Related Prescriptions [male/female]

    “For some older people, the joy of sex may be tempered by financial concerns: Can they afford the medications they need to improve their experience between the sheets? Medicare and many private insurers don’t cover drugs that are prescribed to treat problems people have engaging in sex. Recent developments, including the approval of generic versions of popular drugs Viagra and Cialis, help consumers afford the treatments. Still, for many people, paying for pricey medications may be their only option.”

    Michelle Andrews, Kaiser Health News, abcnews.go.com, 2/24/2019

  4. Medicines And Sex: Not Always A Good Mix [male/female]

    “Medicines often work by altering blood flow and brain chemistry, so its no surprise that they can affect sexual function, and not always for the better. Medications can shut down a person’s sex drive, delay orgasms, or prevent orgasms entirely. Medications are also a leading cause of erectile dysfunction in men. If you’ve noticed a drop in your ability to have or enjoy sex, talk to your doctor about possible causes. Be sure to bring a list of every medication you’re taking. A simple change of drugs or doses could be all it takes. But never stop taking a prescription drug or change dosages on your own. Your doctor can help you determine if a drug you’re taking is the problem — and help you switch to another medication safely.”

    Chris Woolston, MS, healthday.com, last updated 1/1/2019

  5. FDA: Don’t Vape Prescription Erectile Dysfunction Drugs [male]

    “The U.S. Food and Drug Administration is urging men who use e-cigarettes to avoid vaping liquids containing prescription drugs used to treat erectile dysfunction.”

    Jonathan Ng, bostonherald.com, 12/12/2018

  6. Improve Sexual Dysfunction—Without Drugs [male]

    “Mention erectile dysfunction (ED) treatment, and most people say Viagra. And no wonder. Since its 1998 approval, Viagra has become one of the world’s best-known brands, up there with Coca-Cola and McDonald’s.
    Unfortunately, few people can name the many possible contributors to erection impairment. University of Zurich urologists asked 81 ED sufferers to list its risk factors. Half the men (51 percent) could not name a single one, and only three (2 percent) could name three.
    Can you name any? Here’s the list:
    [1.] Aging …
    [2.] Medical issues …
    [3.] Smoking …
    [4.] Prostate cancer treatment …
    [5.] Alcohol …
    [6.] Other drugs …
    [7.] Prolonged bicycling on a narrow seat …
    [8.] Emotional stress …
    [9.] Obstructive sleep apnea …”

    Michael Castleman MA, psychologytoday.com, 11/1/2018

  7. Erectile Dysfunction Or Performance Anxiety? This Is Not About Sex, It Is About Shame [male]

    “However, Nicole Prause, a neuroscientist who specialises in sexual behaviour, says there is little scientific and statistical evidence of a growth in the prevalence of ED. ‘When you look representatively, there has not been an increase in erectile dysfunction. I see stats all the time reading, *It’s increased 1,000 per cent in young men*. But there’s no paper that says that.’ What does seem to have increased is young men’s performance anxiety. More men believe themselves to have ED, when they are actually anxious about their sexual performance. Under enormous social pressure to be smooth sexual performers, they are mistakenly self-diagnosing with ED after a few failed attempts to have sex. ‘If you look at the rise of easily accessible pornography, people have an expectation that men are going to be great performers,’ says Raymond Francis, a psychotherapist.”

    Sirin Kale, irishtimes.com, 10/18/2018

  8. Sex Drugs For Women: Myths And Marketing Messages [female]

    “Myth: Addyi is female Viagra
    Headline writers like cute titles, so ‘female Viagra’ was an inevitable nickname for a women’s sex drug. And Addyi pills are pink, sending a not-so-subtle message that women have a pink pill for sex, just like men have a blue pill for sex. But that’s where the similarities end.
    Viagra (chemical name: sildenafil) helps people who want to have sex, but who can’t maintain an erection, by increasing blood flow to the penis. Viagra is taken only when needed, usually 30-60 minutes before sex.
    Addyi (chemical name: flibanserin) helps cisgender, heterosexual women (the only group tested in clinical trials) feel more interested in sex roughly 10% more frequently than they would otherwise. It affects naturally occurring chemicals in the brain and is taken every day.”

    National Women’s Health Network (NWHN), nwhn.org, 10/2018

  9. Which Drug For Erectile Dysfunction? [male]

    “But the main challenge to finding the best ED [erectile dysfunction] drug for you may turn out to be health insurance rules—not biochemistry. It’s a common practice among insurers to limit the number of pills you can obtain per month. After you hit your limit, the out-of-pocket cost for a single pill can be as high as $20. ‘The main obstacle in my practice is the cost,’ Dr. Liou says. You’ll need to work with your doctor to get the pill you need at a price you can afford.”

    Harvard Men’s Health Watch, health.harvard.edu, 8/22/2018

  10. What’s Wrong With Therapies For Female Sexual Dysfunction? [female]

    “The study found that the placebo effect in these studies accounted for 67.7% of the treatment effect for the agents used to treat sexual dysfunction. Using the Female Sexual Function Index, a 19-item tool that assesses six domains of sexual functioning, the study showed that sexual dysfunction in women receiving placebo improved 3.62 (95% CI, 3.29-3.94) compared to 5.35 (95% CI, 3.29-3.94) in women receiving a pharmacologic treatment. Dr. Weinberger reiterated that these results underscore the limitations of current pharmacologic agents to treat female sexual dysfunction. Specifically, the strong placebo effect shows that current treatment approaches to female sexual dysfunction fail to address the multifactorial nature of the disorder and instead treat only a single aspect of it.”

    Mary Beth Nierengarten, contemporaryobgyn.net, 8/9/2018

  11. The Women’s Libido Pill Is Back, And So Is The Controversy [female]

    “The counterattack against the drug has been furious, and in many instances led by women. These forces contend that one woman’s sexual abnormal is another woman’s normal, and it’s not uncommon for a woman’s desire to wax and wane throughout her life. They say it’s more typical for women to respond to their partners’ overtures rather than spontaneously feel desire for sex—and that these women shouldn’t be shamed by drugmakers into thinking there’s something wrong with them.
    ‘It’s the story of disease mongering. The creation of a condition that’s really not a condition,’ says Leonore Tiefer, a sex therapist and former co-director of the Sex and Gender Clinic in the department of psychiatry at New York’s Montefiore Medical Center. Tiefer has spent much of the past decade arguing at regulatory meetings and with op-ed pieces that there’s a wide spectrum of normal sexuality. A woman with a low libido, she argues, doesn’t need medication. ‘What’s been going on for the past 10 years is a campaign on the part of Big Pharma to recruit doctors as front people and spokespeople to promote a condition that doesn’t exist,’ she says.”

    Cynthia Koons, bloomberg.com, 6/13/2018

  12. After 20 Years, Viagra Has Impacted So Much More Than Just Sex [male]

    “In October 2015, Sprout pharmaceuticals got clearance from the FDA to start selling Addyi, which reportedly increased women’s libido. Unfortunately, it was a flop—doctors had written only 4,000 prescriptions for it by the following April. Why? For one thing, unlike Viagra, Addyi, the pill needed to be taken daily, as opposed to when a woman was planning on having sex—yet each pill cost the same as a dose of Viagra. Additionally, physicians had to be ‘certified’ to prescribe Addyi. (it was just a 10-minute online course, but…doctors.) And finally, Addyi only worked ‘modestly,’ even for women who took it daily as recommended.
    ‘The recent history of the study of female sexual dysfunction is a classic example of starting with some preconceived, and non-evidence based diagnostic categorisation for women’s sexual dysfunctions, based on the male model, and then requiring further research to be based on that structure,’ John Bancroft, director of the Kinsey Institute at Indiana University, told the medical journal BMJ. ‘Increasingly it is becoming evident that women’s sexual problems are not usefully conceptualised in that way.'”

    Quartz Staff, qz.com, 3/27/2018

  13. The Little Pink Pill That Boosts Female Sex Drive [female]

    “To its detractors, flibanserin, a pink pill targeting female libido and made by Sprout Pharmaceuticals, is just another example of disease mongering. Disease mongering refers to the practice of pharmaceutical companies and others ‘pathologizing’ aspects of the human condition in order to make a buck. For example, halitosis or bad breath only became a condition that needed treatment after Listerine was developed to ‘treat’ it. However, to its supporters, female sexual interest/arousal disorder is a very real disease, and flibanserin can help. These supporters cite the distress caused by a diminished or nonexistent sex drive.”

    Naveed Saleh, MD, MS, Medically reviewed by Meredith Shur, MD, verywellhealth.com, 3/23/2018

  14. DISEASES AND CONDITIONS: Erectile dysfunction [male]

    “Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor’s OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:
    – Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Minitran, Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR, Isordil)
    – Have heart disease or heart failure
    – Have very low blood pressure (hypotension)”

    Mayo Foundation for Medical Education and Research (MFMER), nchmd.org, 3/9/2018

  15. WTF Is In Those Gas Station Penis Pills? [male]   

    “On Wednesday, the FDA issued six alerts for male sexual enhancement products that contained potentially harmful ingredients, with no mention of them on the actual product. These alerts were added to the list of many, many other sexual enhancement products that contain hidden prescription drug ingredients. Some of the products they analyzed actually contained tadalafil, the active ingredient in Cialis. Other products contained drugs that were structurally similar to tadalafil or sildenafil, the active ingredient in Viagra. Not to mention all those ‘natural’ ingredients on the label, which are untested, unstudied, and definitely not FDA-approved.
    ‘It’s been known for quite a number of years that male supplements have included chemicals within them that are either normally prescription medicines like generic forms of Viagra or Cialis or [are] tainted in some cases with things that don’t belong there, like heavy metals and things like that,’ Dr. Abraham Morgentaler, director of Men’s Health Boston, clinical professor at Harvard Medical School, tells BuzzFeed Health.”

    Casey Gueren, buzzfeed.com, 5/4/2017

  16. Controversies of Women’s Sexual Arousal and Desire [female]

    “Abstract. The past three decades have seen an unprecedented increase in empirical research on women’s sexual response. In this review, we critically examine current controversies and assumptions associated with the nature of women’s sexual arousal and desire. We focus specifically on four assumptions: (1) the assumption that women should be aroused by stimuli that align with their stated preferences, (2) the assumption that women’s physiological and self-reported arousal should perfectly align, (3) the assumption that sexual desire precedes sexual arousal, and (4) the assumption that a single pharmaceutical compound will adequately restore women’s sexual response to her level of satisfaction. Engaging a gendered psychological framework for conceptualizing women’s sexuality, we emphasize the need for models of women’s sexual response to be sensitive to the sexed biological processes and gendered psychosocial factors that contribute to a woman’s unique sexual experience.”

    Meredith L. Chivers, Lori A. Brotto, Used with permission from European Psychologist (2017),22(1), 5–26, Copyright 2017 by Hogrefe Publishing, hogrefe.com, 2017

  17. Attitudes About Sexuality And Aging [male/female]

    “The myth: Men and women lose their ability to perform sexually after a certain age.
    Vaginal dryness and erectile difficulties loom large as you hurtle past 50. You may be feeling that you should just listen to what your body is trying to tell you: Sex is a thing of the past.
    The reality: You can still have a satisfying sex life.
    While a certain degree of physical change is unavoidable, this fact of life doesn’t necessarily translate into insurmountable sexual problems. For men, the Viagra revolution means most erection problems can be corrected with little medical intervention. For women, high-tech vaginal lubricants and hormone creams and rings are viable substitutes for what nature no longer supplies. What’s important for both sexes to remember, though, is that a softer erection, reduced natural lubrication, or a less intense orgasm doesn’t mean you’re no longer interested in your partner or in sex itself. For many couples, these kinds of changes provide an impetus for developing a new, rich, and satisfying style of lovemaking — one that’s based more on extended foreplay and less on intercourse and orgasm.”

    Special Health Report, Sexuality in Midlife and Beyond, health.harvard.edu, updated 3/17/2017

  18. FDA Approves First Generic Version of ED Drug [male]   

    “The Food and Drug Administration (FDA) has approved the first generic version of Viagra (sildenafil citrate; Pfizer) for the treatment of erectile dysfunction[.] Teva has been granted approval to market generic Sildenafil Citrate Tablets with 180-day exclusivity. Generic drugs have the same quality and strength as brand-name drugs. For FDA approval, generic manufacturing and packaging sites must pass the same quality standards as brand-name drugs.”

    Da Hee Han, PharmD, empr.com, 3/10/2016

  19. Do You Need Erectile Dysfunction Drugs? [male]

    “How Do Erectile Dysfunction Drugs Work?
    The class of drugs that Levitra, Viagra, Stendra, and Cialis belong to are called PDE5 inhibitors. They work by relaxing tight blood vessels, allowing more blood to surge into the penis and cause an erection, says Gregory Bales, M.D., an associate professor of urology at the University of Chicago.”

    Karen Springen, menshealth.com, 2/19/2013