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FDA considers endorsement of drug that some call a Viagra for women

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"What we know," Sand said, "is the overall experience of the increase in satisfying sexual activity, the increase in the amount of desire and the decrease in distress that goes along with that is, in women's voices, considered meaningful."

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Exactly how the drug works is unclear, but it appears to decrease levels of one brain chemical, serotonin, while boosting levels of two others: dopamine and norepinephrine.

Although some women experienced minor side effects such as nausea, dizziness and drowsiness, no serious complications have been reported, Sand said.

Critics say that the pharmaceutical industry played a central role in defining HSDD as an official psychiatric disorder and exaggerated its scope by funding key research.

"People think they are sick when they are not. People become patients when they don't need to be," said Ray Moynihan, a lecturer at the University of Newcastle in Australia and author of the forthcoming book "Sex, Lies and Pharmaceuticals."

For many women, waning sexual desire is a normal part of aging. For others, it could be a sign of other medical problems, a dysfunctional relationship or even an abusive partner.

"Is it really a problem, or is it the societal message of what they're supposed to be experiencing, or pressure from a partner, or changes in themselves?" asked Susan Bennett, an assistant professor of medicine at Harvard Medical School.

In weighing the potential risks and benefits of making flibanserin available by prescription, the FDA committee -- its members split evenly between men and women -- will have to navigate the subtle terrain of elusive emotional concepts such as desire, arousal, satisfaction and distress.

"Women's desire for sexual emancipation is very worthy," said Leonore Tiefer, a clinical associate professor of psychiatry at the New York University School of Medicine. "I fear that it's being hijacked by a profit-oriented industry that doesn't really try to understand women and their sexuality."

In addition to potential long-term side effects that will become clear only after many more women take the drug for many years -- as with hormone replacement therapy -- some people fear flibanserin could make women vulnerable to abuse.

"Is this going to make women desire an abusive partner?" asked Liz Canner, a documentary filmmaker who produced "Orgasm Inc.," about the pharmaceutical industry's role in developing drugs for female sexual disorders. "Is it going to make us desire every guy who walks by?"

Sand disputed that concern.

"This isn't some kind of aphrodisiac that we can put in the water and have suddenly sexually interested women in our population," Sand said. "The notion that somehow this is a construct of the pharmaceutical industry is misleading. This isn't something new. This is something women have been suffering for a long time."

The FDA said it never discusses specific products awaiting approval. For her part, Lana, the Northern Virginia housewife, said she hopes the drug is available soon.

"Gradually after I started taking it, I started having thoughts about sex again. I started having dreams about sex. I hadn't had dreams about sex in years," she said. "My desire came back."


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