DIY Sex Drive Enhancement for Women

I suspect men have wanted to control female sexuality since the dawn of time. Certainly aphrodisiacs (named after Aphrodite, Greek goddess of love and desire) appear in the medical writings of ancient Greece, and in Chinese medicine the perfect combination of acupuncture and herbs is supposed to work wonders. Ayurvedic practitioners have suspected that chiropractic has more to do with awakening Kundalini energy than with pinched nerves. It wouldn’t surprise me to learn that Samuel Hahnemann, founder of homeopathy, toyed with a few titillating remedies, or that chiropractic founder Daniel David Palmer envisioned low libido as a spinal misalignment correctible by the appropriate manipulative therapies.

When I was a hormone-fueled 14, the hot topic in this regard was Spanish fly. We didn’t know what it meant beyond a Disney-fied housefly with a sombrero, but thought if we could just find some and sneak it into a punchbowl, we’d be able to transform all 8^th grade girls into (here’s a phrase from decades ago) “raging nymphomaniacs.” I’d later learn that Spanish fly was an actual herb–cantharides–and years later when cleaning out my father’s ancient drug store I actually found a dust-coated bottle of the stuff, its contents long since evaporated away. Staring at it, I probably fantasized about the potential power I might have had, if only. Cantharides was later shown in clinical trials to be worthless.

With these historic aphrodisiacs, predictably it’s been men prescribing to women and not women seeking treatment themselves. The intake questionnaire at WholeHealth Chicago asks “are you happy with your sex life?” As a rule, the answers are as follows: women in new relationships answer “yes” (occasionally with an exclamation mark), while those in no relationship or in a relationship that’s lasted about five years or more answer “no.” Those not in a relationship often say so, right on the form, the ubiquitous “NA.” Men almost always answer “yes,” unless they’re not in a relationship. How long they’ve been in a relationship is usually irrelevant, or some will answer a variation of “partner not interested.”

A Viagra for women?

These answers on our questionnaire pretty much parallel the data in a New York Times Magazine article last week entitled “Unexcited? There May Be a Pill for That,” an update on the pharmaceutical industry’s intense (almost libidinal) desire to develop a Viagra for women. Interestingly, because the companies involved are engaged in clinical trials that will be presented to the FDA, the word “aphrodisiac” appears not once in the text even though that’s exactly what they’re working on. Also, the clinical researchers are all men.

One sex drive killer is the SSRI group of meds, the antidepressants that raise your serotonin. Most women actually don’t have a problem with SSRIs, which may mean the medication is bringing their levels to a normal range, while those who find sexual desire has become a remote memory may not need the drug at all or are taking too high a dose.

The real novocaine of libido apparently boils down to simple boredom. Same old. The numerous women interviewed during the study usually loved their long-time partners, but couldn’t get the emotional or physical juices flowing when, after Leno, she felt her thigh squeezed or a nuzzling at her neck. Suddenly, and often unhappily, she wished he were sleepy. Then it was either, “Honey, not tonight” or she took a deep breath and performed with a diligence that would make Stanislavski proud.

To make significant progress in developing the perfect aphrodisiac, you need big bucks for research and development. Enter Big Pharma, still reeling joyously from its Viagra profits. But because Blue Cross will never fund something as banal as a sex-drive enhancer (especially for women), Big Pharma needs the enterprise cloaked in a patina of legitimacy. They do so by creating a disease. Here the psychiatric profession, historical recipients of Big Pharma largesse when it comes to new drugs, steps up and dubs lack of desire as Hypoactive Sexual Desire Disorder, HSDD for short.

“You want your effects to be good but not too good,” said Andrew Goldstein, who is conducting the US trials. “There was a lot of discussion about it by the experts in the room…the need to show that you’re not turning women into nymphomaniacs. There’s a bias against — a fear of creating the sexually aggressive woman.”

Deep down, whether we’ve read Euripides’ “The Bacchae” or not, apparently men fear female sexual aggression.

The alchemy of desire

Not that Big Pharma hasn’t tried to stoke your libido in the past. But trials using small doses of Viagra flopped, as did small doses of testosterone. Current efforts combine these drugs while simultaneously boosting dopamine, the neurotransmitter of desire, and temporarily damping down serotonin. Interestingly, it’s not that difficult to do all three of these yourself, hence the DIY reference in the title, which we’ll get to below.

With the new libido-enhancing meds, one named Lybrido and the other Lybridos, the trick is to combine two sexual chemicals into one pill. Herbalists, especially the Chinese, have always relied on combinations, and more recently so has Big Pharma. The new weight loss aid, Qsymia, combines two inexpensive generic drugs, phenteramine and topiramate. Vimovo, for arthritis pain, combines the over-the-counter anti-inflammatory naproxen with Nexium to counter the stomach side effects. Treximet for migraines is simply Imitrex (generic) plus naproxen again.

The plan is for either Lybrido and Lybridos to be taken as needed. These are not maintenance meds (no matter what you think).

The make-up of the drugs is undeniably clever. Lybrido is a tablet coated with a thin peppermint-flavored layer of testosterone. Keep it in your mouth until the flavor disappears, then swallow. The remainder of the tablet contains a Viagra-like substance to increase blood flow to your vagina and clitoris. The second drug, Lybridos, has the same testosterone-peppermint coating but contains a small dose of the anti-anxiety medication buspirone (BuSpar). Taken daily, buspirone will increase serotonin, but taken up to twice a week it actually suppresses serotonin and allows dopamine to dominate the scene.

The components of these meds have been around for years and are really quite safe. It’s by combining them creatively that Big Pharma hopes they’ll work their magic and help them secure a lucrative patent. One thing you can expect is that both medications will be expensive and possibly not covered by insurance. With Viagra (and the other erectile dysfunction pills) coming in at about $9.00 a pill, don’t expect Lybrido/Lybridos to cost any less.

But keep in mind that when the tablet contents are taken separately–the DIY idea–the price can plummet.

Examples of taking separate ingredients instead of pricey combination drugs

• You could avoid the $2.50-per-pill price of Vimovo and simply use over-the-counter naproxen (Aleve) and over-the-counter lansoprazole (Prevacid, similar to Nexium) at a fraction of the price.
• The two Qsymia ingredients (phenteramine and topiramate) require prescriptions, but both are generic and a fraction of Qsymia’s cost.
• Treximet, for migraines, is simply Imitrex (now generic) combined with the ubiquitous naproxen.

I think you’re getting my drift here.

If you want to pursue this, you’ll have to nag your primary care physician for a few prescriptions. Show your doc the NYT article and this health tip.  All we’re doing is off-label prescribing, something physicians do quite regularly. It would probably help if your doctor is a woman in her forties, partnered for a decade or longer. She may even be curious about your results.

DIY Lybrido  Ask for a low dose (say 1 mg) of orally dissolvable testosterone from a compounding pharmacy. Take with one-quarter a Viagra tablet.

DIY Lybridos  Use the same testosterone dose with BuSpar 5 mg.

Honestly, there’s no reason why all three components–testosterone, Viagra and BuSpar– can’t be taken together. Your doctor will let you know if any of your current meds will cause drug interactions, a pretty rare event with any of these three.

I can’t feel particularly guilty revealing this information. After all, everything’s there in last Sunday’s NYT.

Be well,
David Edelberg, MD

PS: Although the DIY Lybrido/Lybridos formulas may be effective if your lack of libido is due to SSRI use, pay heed to this new study showing that depression is vastly overdiagnosed and overmedicated in the US. It might be time to talk to your doctor about reducing or even eliminating your medication. Insurance companies love to keep patients on SSRIs “forever” rather than funding useful non-drug treatments like cognitive behavioral therapy, but, really, don’t capitulate your health (and sexuality) to the bottom-line numbers of the insurance industry.

PPS: For those of you that would like to try a non-prescription natural female libido enhancement aid, consider ITI Woman, a blend of several herbs historically associated with sexuality.  According to the label: “To support healthy sexual drive, function and pleasure in women.”