When should Viagra be available for women?

 Since its popularization in early aughts, female sexual dysfunction (FSD) has been a troubled problem, with pharmaceutical companies and some health professionals (Sister Berman thinks) predicting and monetizing its cause. All this interest makes sense; back in 2005, the FSD product market was valued at $ 1.7 billion dollars. So its preferable to 비아그라 

To date, no pills have been approved by the FDA for the treatment of FSD.

But believe me, no FDA approval is not for lack of attempts. First, Pfizer tried to prove that its ruthless drug Viagra could help with FSD. Second, in 2004, P&G tried to sell the FDA on its testosterone patch, Intrinsa. Time could not be worse. Fresh from the Vioxx strike, the more cautious FDA has expressed concern about Intrinsa’s clinical significance and safety. Most recently - and not avail-- Seedling Pharmaceuticals tried to get its neurotransmitter drug, Flibanserin, approved.

In an attempt to give a complete overview of the proposed FSD treatments, I need to consider three interventions addressing this condition in 3 separate articles. This article discusses the use of Viagra in women, the second article examines the testosterone patch, and the third article examines Flibanserin . It should be noted that despite P&G discontinuing its Viagra trials in women in 2004, and the FDA excluding Intrinsa in the same year, some doctors still prescribe Viagra off-label and testosterone treatments for women with FSD .

Flibanserin, however, has not yet been approved.

How does Viagra work?

Viagra is a phosphodiesterase type 5 (PDE - 5) inhibitor.which enhances the production of guanosine monophosphate. Guanosine monophosphate relaxes smooth muscle cells and vasodilates and increases blood flow to the genitals. As we all know, in men, the effect of Viagra is an erection.

However, PDE5 is also expressed in the smooth muscles of the vagina, clitoris, and labia, leading to vaginal stagnation and clitoral erections. It is believed that in women with an organic cause of FSD, blood flow to the genitals is reduced. On a corresponding note, studies show that in some women with atherosclerosis, blood flow to the genitals is reduced.

Like all medications, Viagra has adverse effects including headaches, hot flashes, nausea, visual disturbances and so on. In addition, people taking nitrates to treat angina should avoid Viagra for fear of hypotension or dangerously low blood pressure.

Female Sexual Dysfunction (FSD) Definitions

Currently, any woman using Viagra includes a woman with a certain type of FSD called female sexual interest disorder / arousal. This terminology is relatively new and introduced in the DSM-5. Female sexual interest / arousal disorder can be defined as:

An ominous lack (or greatly reduced) of sexual interest and arousal of sensation associated with sexual fantasy. sexual thoughts, interest in sex, physiological arousal, sex initiation and so on;

Long six or more months;

Not better explained by other diseases or conditions;

Either lifelong or acquired;

Either generalized or situational;

With mild, moderate or severe severity.

As is sometimes the case with the evolving field of research, earlier discrepancies in definitions of sexual conditions confuse the results of the study. In particular, earlier studies involving sex drugs have gone from earlier terminology, which breaks down arousal problems and problems with desire into two groups: female sexual arousal disorder and hypolibidemia, respectively.

On appropriate note, other types of FSD include female orgasmic disorder, genito-pelvic pain / penetration disorder, and substance / drug-induced sexual dysfunction.

(Obviously, DSM loves slashes.)