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\u2019t 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.<\/p>\n\n\n\n
When I was a hormone-fueled 14, the hot topic in this regard was Spanish fly. We didn\u2019t 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\u2019d be able to transform all 8th <\/sup>grade girls into (here\u2019s a phrase from decades ago) \u201craging nymphomaniacs.\u201d I\u2019d later learn that Spanish fly was an actual herb–cantharides–and years later when cleaning out my father\u2019s 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.<\/p>\n\n\n\n With these historic aphrodisiacs, predictably it\u2019s been men prescribing to women and not women seeking treatment themselves. The intake questionnaire at WholeHealth Chicago asks \u201care you happy with your sex life?\u201d As a rule, the answers are as follows: women in new relationships answer \u201cyes\u201d (occasionally with an exclamation mark), while those in no relationship or in a relationship that\u2019s lasted about five years or more answer \u201cno.\u201d Those not in a relationship often say so, right on the form, the ubiquitous \u201cNA.\u201d Men almost always answer \u201cyes,\u201d unless they\u2019re not in a relationship. How long they\u2019ve been in a relationship is usually irrelevant, or some will answer a variation of \u201cpartner not interested.\u201d<\/p>\n\n\n\n These answers on our questionnaire pretty much parallel the data in a New York Times Magazine<\/i> article last week entitled \u201cUnexcited? There May Be a Pill for That<\/a>,\u201d an update on the pharmaceutical industry\u2019s 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 \u201caphrodisiac\u201d appears not once in the text even though that\u2019s exactly what they\u2019re working on. Also, the clinical researchers are all men.<\/p>\n\n\n\n One sex drive<\/a> killer is the SSRI group of meds, the antidepressants that raise your serotonin. Most women actually don\u2019t 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.<\/p>\n\n\n\n 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\u2019t 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, \u201cHoney, not tonight\u201d or she took a deep breath and performed with a diligence that would make Stanislavski<\/a> proud.<\/p>\n\n\n\n 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.<\/p>\n\n\n\n “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 \u2014 a fear of creating the sexually aggressive woman.”<\/p>\n\n\n\n Deep down, whether we\u2019ve read Euripides\u2019 \u201cThe Bacchae<\/a>\u201d or not, apparently men fear female sexual aggression.<\/p>\n\n\n\n Not that Big Pharma hasn\u2019t 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\u2019s not that difficult to do all three of these yourself, hence the DIY reference in the title, which we\u2019ll get to below.<\/p>\n\n\n\n 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.<\/p>\n\n\n\n The plan is for either Lybrido and Lybridos to be taken as needed. These are not maintenance meds (no matter what you think).<\/p>\n\n\n\n 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.<\/p>\n\n\n\n The components of these meds have been around for years and are really quite safe. It\u2019s by combining them creatively that Big Pharma hopes they\u2019ll 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\u2019t expect Lybrido\/Lybridos to cost any less.<\/p>\n\n\n\n But keep in mind that when the tablet contents are taken separately–the DIY idea–the price can plummet.<\/p>\n\n\n\n I think you\u2019re getting my drift here.<\/p>\n\n\n\n If you want to pursue this, you\u2019ll have to nag your primary care physician for a few prescriptions. Show your doc the NYT article and this health tip. All we\u2019re 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.<\/p>\n\n\n\n DIY Lybrido <\/b>Ask for a low dose (say 1 mg) of orally dissolvable testosterone from a compounding pharmacy. Take with one-quarter a Viagra tablet.<\/p>\n\n\n\n DIY Lybridos<\/b> Use the same testosterone dose with BuSpar 5 mg.<\/p>\n\n\n\n Honestly, there\u2019s no reason why all three components–testosterone, Viagra and BuSpar– can\u2019t 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.<\/p>\n\n\n\n I can\u2019t feel particularly guilty revealing this information. After all, everything\u2019s there in last Sunday\u2019s NYT.<\/p>\n\n\n\n Be well, 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<\/a> 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 \u201cforever\u201d rather than funding useful non-drug treatments like cognitive behavioral therapy, but, really, don\u2019t capitulate your health (and sexuality) to the bottom-line numbers of the insurance industry.<\/p>\n\n\n\nA Viagra for women?<\/b><\/h2>\n\n\n\n
The alchemy of desire<\/b><\/h2>\n\n\n\n
Examples of taking separate ingredients instead of pricey combination drugs<\/b><\/h2>\n\n\n\n
David Edelberg, MD<\/em><\/p>\n\n\n\n