Look Out, Viagra

After years of hearing that midlife equaled sexual death, I finally found the pill that changed the game.

Why Women’s Sexual Health Is Overlooked

It took me four gynecologists to find one who didn’t think my sex life was over. Only one was male. That means that 50 percent of the medical experts I saw either had gone through midlife sexual adjustments or would at some point in time—yet still told me that it was just the way of the world.

Um, no.

How is this possibly okay? Well, it’s not, but the thinking stems from a combination of factors. Medical research on women is notoriously lesser than what’s available on men. According to Theara Coleman for The Week, the policy of excluding women from medical research followed the 1960s trials of thalidomide, which resulted in thousands of birth defects. That pattern has persisted, however, despite efforts to change policy in the ‘80s and ‘90s, even up to then-First Lady Jill Biden’s comment at the unveiling of the 2023 White House Initiative on Women’s Health that “Research on women’s health has been underfunded for decades, and many conditions that mostly or only affect women, or affect women differently, have received little to no attention.” The initiative included $100 million in women’s health funding and an additional $200 million toward research at the National Institutes of Health (NIH).

Why Isn’t There More Research on Women’s Libido?

There’s a particular paucity of research on women in midlife, however. According to Julie Miller from the Society of Women’s Health Research, “Research gaps are especially acute for diseases and conditions that are more associated with women’s midlife and later years, including perimenopause and menopause. Gaps are often even more significant for those who have been historically underrepresented in, or excluded from research, such as women of color.”

This is even more true regarding sexual health and well-being. Whether that’s due to societal discomfort with sex past youth or with women’s sexual appetites in general, the end result is a topic largely avoided in social discourse, research, and even medical training. How wild is it that menopause is often an optional course of study in medical school?

A 2021 British study found that 41 percent of UK medical schools offered zero instruction regarding menopause, despite the fact that about 13 million of the nation’s women were experiencing some stage of the menopausal process. Forbes already ran a list this year, ranking the top six erectile dysfunction (ED) treatments. Of course, that’s way past the old standards of Viagra and Cialis. Limited research now exists on whether these basics are helpful for women as well, and the marketplace is finally catching up, pushing hormone replacement therapy (HRT) far more vigorously and even coming around to one or two medications that go right to the heart of the matter.

How Addyi Changed My Sex Life

Gyno number four listened to my concerns and put me on hormone replacement therapy and testosterone, first gel that didn’t work, then a patch. That mostly leveled my mood swings, but my sex drive was still AWOL. This is the key part, one I want to shout from the rooftops: I can’t express enough how important it is to get over any embarrassment and say exactly what you need. For me, I needed to regain my sex drive and function.

Enter the little pink pill. Yes, it’s ridiculous that this is the counterpart to the guys’ little blue one—how have we not moved past pink and blue yet?—but I wasn’t going to let old school gendering get in the way of something this important. It was expensive and it didn’t work immediately. But eventually? Yeah, it really did.

Addyi (also known as flibanserin, which isn’t nearly as adorable) is, according to its manufacturers’ own website, still a bit of a mystery even to them. They don’t entirely know how it works, although they suspect that it “[increases] dopamine and norepinephrine, and transiently [decreases] serotonin, to restore the appropriate balance of excitatory and inhibitory activity of brain reward centers to the prefrontal cortex.” In other words, it gets your brain back in the zone for desire.

Final Thoughts: Is Addyi Worth It?

My personal experience was exactly that. It did take about two months to really kick in, which was frustrating because I worried I was paying for snake oil. Why not just spend that money on a massage and hope for the best once I relaxed? But I stuck with it (mostly with my partner’s encouragement, in all honesty) and right around six or seven weeks, I found myself initiating sex. Fantasizing. Having sexy dreams. All those delicious demonstrations of happily functioning desire were firing back up.

I’m still looking for the sensitivity and response I once enjoyed without even noticing it, and investigating what else is out there to replace that last piece of the puzzle. But where I once felt reluctant or avoidant, just not in the mood and pissed off about it, that’s no longer the case. Last weekend I had sex seven times. I definitely thought those days were done—I’m so very glad they’re not.

Mariah Douglas loves to write about nerdery and nudity. Bylines include Playboy, Men’s Health, Fodor’s, Vacationer, and others. She is working on a novel about the wilds of polyamory. Find her on Bluesky at @halfbuttoned1.bsky.social.

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