Vyleesi: Poor Fix for the “Disease” of Low Sexual Desire

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The FDA has approved a new drug for premenopausal women who want to feel more sexual desire. Called Vyleesi, a woman injects herself with it 45 minutes before she anticipates having sex.

It doesn’t seem to work very well. In trials it improved some women’s self-reported feelings of desire, but it did not increase the number of “sexually satisfying events” in a statistically significant way.

But the FDA approved it because the FDA is controlled by drug corporations. The alleged politics of male-vs-female healthcare is small potatoes. This is money-vs-public interest. And regardless of drug or disease, that’s no contest.

Comparisons of Vyleesi with Viagra are inevitable, and pointless.

Viagra doesn’t increase desire, it helps blood get to and stay in the penis, helping men get and stay erect. But it’s no aphrodisiac—after taking it, angry men are still angry, guilt-ridden men still feel guilty, and men frightened by closeness are still frightened. A few men who withdraw from sex for fear of erectile “failure” respond to Viagra with renewed interest in sex. Whether they stay interested is another story entirely. And how their partner feels about the possibility of more erections is never discussed.


There are plenty of reasons that some women want a drug like Vyleesi. Their busy lives exhaust them. Their partners frustrate them. They don’t like their bodies. Their partner pressures them for more enthusiasm. TV shows and ads suggest that everyone’s having a ton of sex. Some women feel obligated to have sex whether they want it or not, and wouldn’t mind if they actually wanted it a bit more.

But there are plenty of reasons most women won’t use Vyleesi. If invited to speak honestly, most women who wish they had more desire can tell you why they don’t. They don’t want a drug to make them desire sex more, they want a change in their sexual circumstances.

Besides, a lot of women with allegedly low desire will say they have a half-dozen more pressing issues—like a husband who sides with his parents instead of with her, or a boyfriend who drinks too much.

The need to inject it into the belly or thigh (there’s no oral version of the drug) will be a huge turn-off. And before anyone gets gender-huffy about this (“only a male scientist would invent a sex drug that women have to inject”), note the number of men who inject a drug directly into their penis to get an erection when Viagra doesn’t work.

So we’re back to the reality that lots of people don’t want sex as much as they want to, or think they should, or their partners want to. That’s been true for as long as humans have been writing history—from Saturday Night Live to Borscht Belt comics back through the Bronte sisters, Shakespeare, the Bible, and the Greeks (I’d instinctively include the Egyptians, but I don’t read hieroglyphics).

It’s easy to imagine that while Neanderthal men were out hunting for dinner, Neanderthal women were sitting around discussing how “some men” just weren’t interested enough in sex.

Yes, the lower-desire partner in about half of these cases are men. They’re often embarrassed and apologetic. And Viagra won’t work in a man who doesn’t want sex in the first place, even if he wants to want sex.

I see desire discrepancies in my office every single week. Every therapist who treats these cases says the same thing: that when there’s a big difference in how much sex two partners want, it’s almost impossible to resolve. When I get a new couple with this complaint I secretly hope they have a terrible relationship, because that’s something I know how to fix.

But what many people don’t know is that even repairing a bad relationship doesn’t necessarily fix the desire discrepancy. The old myth that “sex is a reflection of the relationship” is only partly true. Desire problems in a bad relationship are easy to explain—and almost impossible to fix. Desire problems in a good relationship are much harder to explain—and also hard or impossible to fix.

So enter a new drug. Or expensive jewelry or another child or a new BMW. Historically, none of these is very effective.

And indeed, just as Flibanserin didn’t catch on a few years ago, neither will Vyleesi. Mostly because it won’t work, or will only work under unrealistic conditions: forty percent of the women in clinical trials experienced nausea after taking it. And it simply doesn’t make women really horny. A tiny bit more desire simply doesn’t have impact in the real world.

And Vyleesi can’t overcome the most common reasons that anyone has low desire:

~ The sex is boring
~ The sex is painful
~ Past trauma
~ Chronic relationship conflict
~ I’m expected to have sex when I don’t want it
~ Refusing sex is the only relationship power I have

Finally, there’s always the possibility that each partner’s desire is “normal,” but very different. Indeed, there are very few things in relationships that both partners desire the same—whether it’s Chinese food, CSI Miami, or Beyonce albums.

It’s only our culture’s sexual exceptionalism that makes us think that two people should desire sex the same—and that if they don’t, the relationship is doomed. That just isn’t very sophisticated thinking. Most adults learn the skill of accepting that they won’t get every single thing they want in life. Successful couples learn this skill together.

If a drug can help a woman feel more desire when she wants to, let her have the drug, of course. But some otherwise-smart investors and a lot of news writers touting Vyleesi as a great breakthrough in human sexual relationships don’t know enough about humans, sex, or relationships.
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If you liked this, you’ll enjoy my post at www.MartyKlein.com/shaving-waxing-or-bushy-letting-women-be-women/

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