A Catholic Doctor's Perspective on Addyi, the "Female Viagra"

(photo: Register Files)

R. Jared Staudt raises some valid concerns about the FDA’s recent approval of Addyi, a drug that has been popularly touted as the “female Viagra.” Professor Staudt is right to be concerned that the existence of Addyi (Flibaneserin) may represent an attempt—or be used—to force female sexuality into a male pattern. But we should be careful about both the bath water and the baby in the tub: abusus non tollit usum, the abuse of a thing does not take it away its use. There is a legitimate (and moral) use for drugs like Addyi, Viagra, etc. which aim to treat sexual dysfunction.

Surprisingly, even the FDA recognizes that Addyi should not be seen as a magic pill to treat hypoactive sexual desire in women when it results from relational, medical or psychiatric illnesses or because of sexual violence. Rather, it is intended for women whose low libido is idiopathic (i.e. does not result from an identifiable cause). The medications package information explains that it is intended to treat “women with acquired, generalized hypoactive sexual desire disorder (HSDD), as characterized by low sexual desire that causes marked distress or interpersonal difficulty and not due to a coexisting medical or psychiatric condition, problems within the relationship, or the effects of a medication or other drug substance. Flibanserin [Addyi] is not indicated for the treatment of HSDD in postmenopausal women or in men, or to enhance sexual performance.” (emphasis original)

It’s not so infrequent that women will seek treatment for their hypoactive sexual desire disorder. With up to ten percent of women falling into this category, that’s not surprising. As a male, I’ve gained some valuable insight into the psychology of women on so many topics, this one included. And to be clear, although a female colleague once quipped that I have “honorary ovaries” (which I think was a compliment and in any case that’s how I took it), I would never pretend to fully understand the fullness of what St. John Paul II referred to as “feminine originality” (Mulieris Dignitatem). Nevertheless, I’ve learned that what motivates many women to seek a solution for their libido problems is that particular feminine sensitivity to what lies deeply in the nature of marital sexuality itself: namely, mutual self-gift.

It’s a very, very, very unpopular notion, but the concept of “marital duty” or “conjugal rights” (even if the formulation and terminology is imperfect) describes in moral language a reality about marriage that is experienced by the people involved as part of their love for their spouse. St. Paul observed that a “husband should fulfill his marital duty to his wife, and likewise the wife to her husband” (1 Corinthians 7:3).

It’s telling that St. Paul mentions the husband first, but I’ll explore that in another column. Yes, men have used their strength and accidents of history to dominate women. But Addyi doesn’t have to be used to perpetuate an inequity or force women to do something against their will. It goes without saying that using it for such an end would be wrong.

The market for this drug is there, at least in part, because femininity quite naturally tends toward giving and caring.  In their bodies, women bring the joy of life from a mess of pain and turmoil. As mothers, they nurture weakness into strength with tireless sacrifice. As wives, they breathe vigor into moribund dreams often at some cost to their own. And they will ignore embarrassment to ask a doctor for a prescription in hopes of responding better to their husbands physically. On the whole, a man wouldn’t do this. Sure he might seek treatment for sexual dysfunction, but let’s face it, it would be primarily because of his own concern not because of chivalry.

Most of the women whom I’ve treated for hypoactive sexual desire are in good, healthy relationships and don’t describe domineering husbands who have forced them to seek treatment or who are pressuring them into something they don’t want. Rather, they describe “wanting to want” sexual activity for the good of their marriage and out of love for their husbands as their primary concern. It proceeds from the interiority of their hearts and not from some external pressure. Yes, Addyi could be abused on many and various fronts. And yes a “female Viagra” would be a kind of Holy Grail from an economic standpoint. But just because there’s money to be made doesn’t mean there isn’t real, authentic love to be made too.