Here’s How That New Sex Pill for Women Actually Works

Yesterday , the FDA voted to approve flibanserin , a new drug to do by woman withhypoactive intimate desire disorder , or lack of desire for sexual practice . The drug , marketed as Addyi , has been swash as “ distaff Viagra , ” in the gumption that it help bring sexuality back into these women ’s life . But flibanserin does n’t in reality work like Viagra .

Viagra , and drugs like it , act as on the erectile tissue paper inside the penis , to increase roue catamenia in men with circulatory system problems . adult male who use erectile disfunction drug do n’t have a problem desire sex ; their organic structure just do n’t answer to that desire .

Women with HSDD – about 8 - 9 % of women between the age of 30 and 60 – have a very different problem . There ’s nothing physically awry with their crotch : they can become awaken and have intercourse , even orgasm , but they feel no motivation to have sex . For some cause scientist still do n’t understand , the “ desire circuits ” inside their psyche are n’t turning on , either for their partner or even for their own fantasies . Flibanserin , spring up by Sprout Pharmaceuticals , acts on the brain , and claim to help some women wrench those circuits back on . Here ’s how it do work .

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The Neuroscience of Desire

Women with HSDD seem to experience titillating post other than than women with normal intimate function .

Some researchers think this happens because they ca n’t well dial down the activeness of certain part of the brain . One 2009 study of women with HSDD found that the office of their brain that were responsible for monitor internal worked up states were hyperactive when they watched erotic video – as if their brains were focalise on judging whether their reaction were appropriate , or else of living in the titillating moment . Flibanserin helps to change the balance of participating tour in the mastermind by play on the neurons that are commonly controlled by two neurotransmitters : serotonin and dopamine .

Neurotransmitters are the chemical that neurons utilize to send signals to other neurons . They ’re put out after an electric signal move through a neuron : When the sign reaches the ending of a neuron ’s axon , it release the chemicals into a lilliputian gap between neurons call in the synaptic cleft . neurotransmitter diffuse across the gap and latch onto specific receptors on the neighboring neuron . When neurotransmitters dock into sense organ , they start out chains of chemic reactions that can facilitate get an electrical signal moving through the fresh nerve cell .

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Or not . Neurons are n’t simple on / off switches . Some neurotransmitters arouse the neurons they dock to and push them toward ignition , but others damp down electrical reactions . Every neuron is constantly receiving both type of signal from its neighbors — and the pith of the signal decide whether the neuron flame or not . The interplay between excitatory and inhibitory signals is one of the things that makes mind function so complex , because it allow the same circle to react differently to a variety of different situations .

Neurons can even deepen how they respond to the neurotransmitters that are released by their neighbors , by adding or removing receptors for specific chemical to their surface . A nerve cell can become more sensible to dopamine , for object lesson , by tot up more dopamine receptor to its surface .

What ’s more , each neurotransmitter can obligate to a family of related receptors , and each one can be tied to a different set of chemical substance reactions . A neurotransmitter on one type of sense organ can excite or depress the electric cell a unlike amount than if it was docked at a different receptor .

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That distinction is important , because this new drug , flibanserin , can play on two dissimilar types of serotonin receptor . When it binds to a 5 - HT1a receptor , it has the same affect as a serotonin mote . But when it latches onto a 5 - HT2a receptor , it blocks the normal core of 5-hydroxytryptamine . 5-hydroxytryptamine unremarkably inhibit nerve cell , which mean flibanserin tends to deoxidize neuron activity in areas rich in 5 - HT1a receptor and increase it in neurons that have 5 - HT2a receptor . Researchers sham that women with HSDD are n’t making enough 5-hydroxytryptamine in their mastermind in general , but flibanserin only mime the neurotransmitter ’s event on one subset of neurons — the ones that have 5 - HT1a receptors .

So Does It Really Work?

The net result ? Flibanserin quiets nerve cell in a part of the brainstem called the dorsal rhaphe nucleus and the memory - and - emotion hippocampus — but it seems to have its strong quieting effect on the cerebral lens cortex , where all that ‘ ego - judging ’ bodily process is shoot space .

And because the brain is a web , convert the body process of one set of neurons can also deepen the behavior of the neurons in the residuum of their electrical circuit . The downstream effects of flibanserin are n’t entirely clear , but one study in stinkpot showed that it can make neurons in the cortex release both noradrenaline and Intropin , neurotransmitter that typically kick motivation into gear . It ’s possible that a rise in uncommitted dopamine , paired with the drug ’s mild effect on one eccentric of Dopastat receptor , bumps up the action of the learning ability ’s payoff circuits and makes the prospect of sexuality more exciting .

But the drug ’s core are elusive . This is not a miracle sex activity drug that constitute women pant for more . In fact , because the drug ’s independent effect is to doctor the brain ’s ability to suppress the piece of the wit that normally suppress ‘ desire ’ circuit , it wo n’t even work on most cleaning woman — their repressing circuits make just fine , thank you . Flibanserin only work on HSDD sufferer who have small serotonin stratum . And even for those women , Sprout Pharmaceuticals ’ clinical trials have record a complex and pretty small effect .

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And like any other drug that affects brain use , flibanserin can have side effects . According to Sprout Pharmaceuticals ’ FDA briefing document , 9 to 11 % of women ingest the drug in the clinical tryout feel dizziness , tiredness , and sickness ( as opposed to 2 to 5 % of the women on a placebo ) . The drug can also interact with other substances that have a depressive issue on the brain , such as inebriant , and amplify their effect .

Earlier this yr , the FDA ’s consultatory committee recommend approval of the drug , so long as it is marry to arisk rating and mitigation strategy ( REMS)that helps doctors order it correctly , and keep a close eye on any side consequence . The FDA has now decide that flibanserin ’s benefit for the subset of woman it works on outweighs its side burden . It remains to be see whether that group of cleaning lady is heavy enough to recoup Sprout ’s 50 million dollar investment in the drug .

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