A Guide to Choosing the Right Supplement

Dr. Jones: Right, and I usually recommend taking some time out for each other. I ask them, what kind of pattern of intimacy do you have when you and your partner go on vacation? "Oh yeah, when we're away we have great hotel sex." Well, there are no kids around, there are no dishes, and definitely no bills, you're in a brand new bed, it's a new place.

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Addyi proponents see a seriously stubborn double standard. There are 26 drugs approved for male sexual dysfunction, Chin-Yee noted, in part because no drug fits all. “That’s obvious, but for this drug and for women, it’s like, ‘well, if this could be a potential side effect, then the risk isn’t worth the benefit,’” she said. But if women say, "I don't want to do all that thing," it's like dieting and exercise, "Just give me a pill doctor so I can lose weight, just give me a pill." What I am afraid of is that I will get calls from husbands, "I want you to fix my wife. I want you to give her that pill." So if this is being driven by the partner, I need to get buy-in by my patient that she's really interested, because she may have some side effects. And if she's really not interested in becoming interested, then this is not for her. If she's interested in becoming interested, I think it's worth a try for a couple of weeks. And if she doesn't have significant side effects and it improves her intimate life, just thinking about sex makes people have sex more often, so the placebo effect can be significant. Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Barbara Gattuso had been happily married for decades when she signed up, in the late 2000s, for a clinical trial involving a potentially revolutionary new drug. She and her husband had once had a fulfilling sex life, both pre- and post-children. But at some point during her perimenopausal years, her desire disappeared. It wasn’t stress, fatigue or relationship issues, though her lack of sex for man tablet libido certainly contributed to those. It was more like a mysterious evaporation – like “somebody pulled the plug”, as she recalls in a new documentary on flibanserin, the experimental drug that proffered potential relief. Originally developed as an anti-depressant by the German company Boehringer Ingelheim, flibanserin had instead shown promise as a treatment for low female libido, working on neurotransmitters in the so-called “sex center” of the brain. In a video from that trial filmed by Dr Irwin Goldstein, the “godfather of sexual medicine” and a key consultant on Viagra – that revolutionary blue pill for men with erectile dysfunction – Gattuso appears nearly giddy. She was chasing her husband around again, she said.

Benefit	Description	Evidence Level	Popularity Rank
Skin Glow	Improves skin radiance	High	1
Increased Energy	Boosts daily vitality	Medium	3
Hormonal Balance	Regulates hormone levels	High	2
Appetite Suppression	Helps control cravings	Low	4

She felt “phenomenal”, like a “new woman on this drug”.

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It is shocking how quaint this footage looks and feels now, as it seems like this should have been an obvious breakthrough with cascading results. But as the Paramount+ documentary The Pink Pill: Sex, Drugs & Who Has Control demonstrates, the road to get flibanserin – often called, somewhat derisively, “the female Viagra” – to women struggling with their libido was anything but obvious, strewn with regulatory roadblocks, pharmaceutical price-gouging, sexist double standards and a profound societal disinterest in female choice, pleasure and experience. Though the US Food and Drug Administration (FDA) approved flibanserin, sold under the name Addyi, for premenopausal women suffering from Hypoactive Sexual Desire Disorder (HSDD) back in August 2015 (and, as of last December, for women post menopause) most women are not aware that a drug for female sexual desire exists, let alone that it’s available.

What women are saying

It was more like a mysterious evaporation – like “somebody pulled the plug”, as she recalls in a new documentary on flibanserin, the experimental drug that proffered potential relief. Originally developed as an anti-depressant by the German company Boehringer Ingelheim, flibanserin had instead shown promise as a treatment for low female libido, working on neurotransmitters in the so-called “sex center” of the brain. In a video from that trial filmed by Dr Irwin Goldstein, the “godfather of sexual medicine” and a key consultant on Viagra – that revolutionary blue pill for men with erectile dysfunction – Gattuso appears nearly giddy. She was chasing her husband around again, she said. She felt “phenomenal”, like a “new woman on this drug”.

120 Count

It is shocking how quaint this footage looks and feels now, as it seems like this should have been an obvious breakthrough with cascading results. But as the Paramount+ documentary The Pink Pill: Sex, Drugs & Who Has Control demonstrates, the road to get flibanserin – often called, somewhat derisively, “the female Viagra” – to women struggling with their libido was anything but obvious, strewn with regulatory roadblocks, pharmaceutical price-gouging, sexist double standards and a profound societal disinterest in female choice, pleasure and experience. Though the US Food and Drug Administration (FDA) approved flibanserin, sold under the name Addyi, for premenopausal women suffering from Hypoactive Sexual Desire Disorder (HSDD) back in August 2015 (and, as of last December, for women post menopause) most women are not aware that a drug for female sexual desire exists, let alone that it’s available. Until she was approached about making the film, “I had never heard of this drug,” Aisling Chin-Yee, the director, said. “I had never even thought about going in and talking to my doctor about my sex life.

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The only thing I’ve ever been asked by a doctor is, am I having sex or am I not having sex? And whatever answer I gave always seemed like the wrong answer.” The Pink Pill examines just how persistent that disinterest in female sexuality, beyond reproduction, runs throughout the US medical establishment. As several sexual health doctors, gynecologists and urologists attest, most medical school curricula do not include sections on female sexual health, libido or clitoral anatomy. When Viagra was introduced in 1998, the medical establishment quickly adopted a drug that was seen as a breakthrough treatment for a physical issue in men. But the conversation around female libido and orgasm remained stagnant, often starting and ending with “it’s complicated”. Until she was approached about making the film, “I had never heard of this drug,” Aisling Chin-Yee, the director, said.

Before Using

What had once been the promising frontier in female sexual health was now essentially locked away. “How can you possibly pass something that is so wonderful for women and then have it ripped out?” says Gattuso in the film. “After all of this work, all of this emotion, we’re down to square one again. Eckert managed to buy Addyi back from Valeant and start over. The drug is back on the market – though, if you google it, the first thing you will read is still a bold warning about side effects. “I had never even thought about going in and talking to my doctor about my sex life. The only thing I’ve ever been asked by a doctor is, am I having sex or am I not having sex? And whatever answer I gave always seemed like the wrong answer.” The Pink Pill examines just how persistent that disinterest in female sexuality, beyond reproduction, runs throughout the US medical establishment. As several sexual health doctors, gynecologists and urologists attest, most medical school curricula do not include sections on female sexual health, libido or clitoral anatomy.

Addyi is the #1 Prescribed Treatment for HSDD.1

Frustration with this apathy and her own disappeared desire led Cindy Eckert, a pharmaceutical entrepreneur based in Raleigh, North Carolina, to buy flibanserin for $5m in 2011, after Boehringer Ingelheim decided not to fight for FDA approval. A hyper-feminine, distinctly 2010s entrepreneur with a fondness for everything magenta, Eckert renamed the drug Addyi after Dr Addison Grey, Kate Walsh’s character on the popular medical drama Grey’s Anatomy who represented the drug’s ethos of, as she says, “women living life on their own terms”. Her company, Sprout Pharmaceuticals, completed the necessary trials, demonstrating that Addyi improved the sexual drive and experiences of women struggling with HSDD. By October 2013, it was ready to go to market, subject to FDA approval. Though Addyi works on neurotransmitters in the brain, akin to an antidepressant, the FDA assigned its review to its urology division – a better fit for Viagra, which relaxes muscles and increases blood flow to the male genitalia.

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The FDA rejected it, claiming that the side effects – namely dizziness, nausea, fatigue and low blood pressure – did not outweigh the benefits. The question of side effects – essentially, why would desire be worth it for women? – continued to dog the medication as it sought regulatory. The Pink Pill amasses a significant recent history archive of the “female Viagra’s” role in the culture wars of the 2010s, as Sprout mounted an aggressive lobbying campaign ahead of its 2015 hearing. Some of the backlash was predictably patronizing: “You might know [flibanserin] by its old name – wine,” joked Jimmy Fallon on The Tonight Show.

Do you think a pill alone can solve low sexual desire in women?

Some was more grounded, such as pushback from those who believed HSDD to be a fictional condition to guilt premature ejaculation treatment women for their lack of sex drive, low libido medicalized in the name of pharmaceutical profit, with no medical consensus on what constitutes “normal” sexual desire. The FDA questioned the potential for sedative effects, wondering if “a woman might take flibanserin the night before and get up the next morning and fall asleep taking her kids to school”, recalls Dr Anita Clayton, a University of Virginia psychiatrist and consultant to Addyi, in the film. “There was a very paternalistic attitude.” Data showing an increase of one “successful sexual event” per month was dismissed as ineffective – even though women with untreated HSDD experienced maybe one or two such events a year. The bias showing through the FDA approval process boiled down to “well, we just don’t know if [Addyi] is necessary’”, said Chin-Yee. “But that’s not a question that has ever come up when it comes to male sexual dysfunction. When Viagra was introduced in 1998, the medical establishment quickly adopted a drug that was seen as a breakthrough treatment for a physical issue in men. But the conversation around female libido and orgasm remained stagnant, often starting and ending with “it’s complicated”. Frustration with this apathy and her own disappeared desire led Cindy Eckert, a pharmaceutical entrepreneur based in Raleigh, North Carolina, to buy flibanserin for $5m in 2011, after Boehringer Ingelheim decided not to fight for FDA approval. A hyper-feminine, distinctly 2010s entrepreneur with a fondness for everything magenta, Eckert renamed the drug Addyi after Dr Addison Grey, Kate Walsh’s character on the popular medical drama Grey’s Anatomy who represented the drug’s ethos of, as she says, “women living life on their own terms”. Her company, Sprout Pharmaceuticals, completed the necessary trials, demonstrating that Addyi improved the sexual drive and experiences of women struggling with HSDD.

INDICATION AND IMPORTANT SAFETY INFORMATION INCLUDING BOXED WARNING

It is absolutely imperative that if you are a man with a penis, you should be able to do whatever you want with it. And those were not the same considerations for women.” (The FDA, which denied any accusations of gender bias, did not respond to the film-makers’ interview requests. “I will give the benefit of the doubt to the FDA that they were in the midst of like getting Doge-ed,” Chin-Yee said, referring to the Elon Musk-led consolidation that gutted the department.) Never mind that many women wanted their desire back, and felt less whole without it. “I thought ‘well, after you have kids, that goes away …’” says one HSDD patient in the film, frustrated by her lack of options and a prevailing narrative that “you’re a mother now and you focus on these things. That’s behind you.” The loss of sexual desire was “devastating”, says another whose menopause torched her formerly steady libido.

What is Addyi used for?

“I felt like someone had slayed me.” Both Gattuso and her daughter testified at the FDA’s public hearing on the drug’s approval, speaking emotionally about the toll their diminished libido had taken on their lives. Opponents of the drug put the onus back on them; one recommended they instead try what worked for her: “switching boyfriends, chocolate, coffee, certain episodes of Grey’s Anatomy, pornography, upgrading my vibrator, read Fifty Shades of Grey, a removable shower-head and an acceptance of myself and the libido I came with”. After much heated back and forth, the FDA approved Addyi in 2015. Eckert subsequently sold Sprout to pharma giant Valeant for $1bn. But the victory came with a major caveat: a black box warning, the most serious level available, for side effects such as dizziness, nausea and headache.

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Doctors had to take a test to prescribe it. Pharmacists had to take a test to fill it. Women prescribed Addyi had to sign a blue 100 pill pledge that they would not drink alcohol. (Viagra, on the other hand, came with a recommendation that one merely should avoid alcohol.) Faced with declining sales, Valeant more than doubled the price of Addyi, to $800 a prescription, making the drug cost-prohibitive. Then, in 2017, they shelved it altogether. By October 2013, it was ready to go to market, subject to FDA approval. Though Addyi works on neurotransmitters in the brain, akin to an antidepressant, the FDA assigned its review to its urology division – a better fit for Viagra, which relaxes muscles and increases blood flow to the male genitalia. The FDA rejected it, claiming that the side effects – namely dizziness, nausea, fatigue and low blood pressure – did not outweigh the benefits. The question of side effects – essentially, why would desire be worth it for women? – continued to dog the medication as it sought regulatory. The Pink Pill amasses a significant recent history archive of the “female Viagra’s” role in the culture wars of the 2010s, as Sprout mounted an aggressive lobbying campaign ahead of its 2015 hearing. Some of the backlash was predictably patronizing: “You might know [flibanserin] by its old name – wine,” joked Jimmy Fallon on The Tonight Show. Some was more grounded, such as pushback from those who believed HSDD to be a fictional condition to guilt premature ejaculation treatment women for their lack of sex drive, low libido medicalized in the name of pharmaceutical profit, with no medical consensus on what constitutes “normal” sexual desire. The FDA questioned the potential for sedative effects, wondering if “a woman might take flibanserin the night before and get up the next morning and fall asleep taking her kids to school”, recalls Dr Anita Clayton, a University of Virginia psychiatrist and consultant to Addyi, in the film. “There was a very paternalistic attitude.” Data showing an increase of one “successful sexual event” per month was dismissed as ineffective – even though women with untreated HSDD experienced maybe one or two such events a year. The bias showing through the FDA approval process boiled down to “well, we just don’t know if [Addyi] is necessary’”, said Chin-Yee. “But that’s not a question that has ever come up when it comes to male sexual dysfunction.

if she’s saying these things, it may be hsdd

Dr. Jones: Right, and I usually recommend taking some time out for each other. I ask them, what kind of pattern of intimacy do you have when you and your partner go on vacation? "Oh yeah, when we're away we have great hotel sex." Well, there are no kids around, there are no dishes, and definitely no bills, you're in a brand new bed, it's a new place. But if women say, "I don't want to do all that thing," it's like dieting and exercise, "Just give me a pill doctor so I can lose weight, just give me a pill." What I am afraid of is that I will get calls from husbands, "I want you to fix my wife.

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I want you to give her that pill." So if this is being driven by the partner, I need to get buy-in by my patient that she's really interested, because she may have some side effects. And if she's really not interested in becoming interested, then this is not for her. If she's interested in becoming interested, I think it's worth a try for a couple of weeks. And if she doesn't have significant side effects and it improves her intimate life, just thinking about sex makes people have sex more often, so the placebo effect can be significant. Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio.

What should I do if I miss a dose of Addyi?

If you like what you heard, be sure to get our latest content by following us on Facebook. Barbara Gattuso had been happily married for decades when she signed up, in the late 2000s, for a clinical trial involving a potentially revolutionary new drug. She and her husband had once had a fulfilling sex life, both pre- and post-children. But at some point during her perimenopausal years, her desire disappeared. It wasn’t stress, fatigue or relationship issues, though her lack of sex for man tablet libido certainly contributed to those. It is absolutely imperative that if you are a man with a penis, you should be able to do whatever you want with it.

dopamine, norepinephrine, and serotonin3

And those were not the same considerations for women.” (The FDA, which denied any accusations of gender bias, did not respond to the film-makers’ interview requests. “I will give the benefit of the doubt to the FDA that they were in the midst of like getting Doge-ed,” Chin-Yee said, referring to the Elon Musk-led consolidation that gutted the department.) Never mind that many women wanted their desire back, and felt less whole without it. “I thought ‘well, after you have kids, that goes away …’” says one HSDD patient in the film, frustrated by her lack of options and a prevailing narrative that “you’re a mother now and you focus on these things.

• Pink pills may contain amino acids aiding mental clarity.
• They are sometimes used as part of female fitness supplements.
• The color pink is chosen for branding targeting women.
• Some pink supplements include ingredients for hair growth.
• They are marketed as mood boosters for emotional balance.
• Placebo effects may influence perceived benefits.
• Proper dosage instructions are essential for safety.
• Some products are combined with other health supplements.
• Pink pills are sometimes used in beauty routines.
• The market for such pills is rapidly expanding.
• Regulatory standards for pink pills vary by country.

That’s behind you.” The loss of sexual desire was “devastating”, says another whose menopause torched her formerly steady libido. “I felt like someone had slayed me.” Both Gattuso and her daughter testified at the FDA’s public hearing on the drug’s approval, speaking emotionally about the toll their diminished libido had taken on their lives. Opponents of the drug put the onus back on them; one recommended they instead try what worked for her: “switching boyfriends, chocolate, coffee, certain episodes of Grey’s Anatomy, pornography, upgrading my vibrator, read Fifty Shades of Grey, a removable shower-head and an acceptance of myself and the libido I came with”. After much heated back and forth, the FDA approved Addyi in 2015. Eckert subsequently sold Sprout to pharma giant Valeant for $1bn. But the victory came with a major caveat: a black box warning, the most serious level available, for side effects such as dizziness, nausea and headache. Doctors had to take a test to prescribe it. Pharmacists had to take a test to fill it. Women prescribed Addyi had to sign a blue 100 pill pledge that they would not drink alcohol. (Viagra, on the other hand, came with a recommendation that one merely should avoid alcohol.) Faced with declining sales, Valeant more than doubled the price of Addyi, to $800 a prescription, making the drug cost-prohibitive.

• The market offers various formulations including vegan options.
• Some pink pills include calcium and magnesium for bone health.
• They are often endorsed by health influencers online.
• Beware of exaggerated claims and false advertising.
• Pink pills can be used to enhance mood and reduce stress.
• They are generally taken once daily with water.
• Non-prescription pink pills are accessible without a prescription.
• Testimonies often report improved energy levels.
• Women should avoid combining multiple supplements without advice.
• Look for transparent ingredient lists when purchasing.
• Pink pills are part of a broader trend in women’s wellness.

Then, in 2017, they shelved it altogether. What had once been the promising frontier in female sexual health was now essentially locked away.

Tip	Explanation	Frequency	Additional Notes
Follow recommended dosage	Avoid overdose, which can cause side effects	As per product instructions	Consult a healthcare provider if unsure
Maintain a balanced diet	Supplements work best with proper nutrition	Daily	Incorporate fruits, vegetables
Stay hydrated	Water helps absorb active ingredients	Throughout the day	Aim for 8 glasses per day
Use consistently	Results appear with regular use over time	Daily or as advised	Patience is key

“How can you possibly pass something that is so wonderful for women and then have it ripped out?” says Gattuso in the film. “After all of this work, all of this emotion, we’re down to square one again. Eckert managed to buy Addyi back from Valeant and start over. The drug is back on the market – though, if you google it, the first thing you will read is still a bold warning about side effects. Addyi proponents see a seriously stubborn double standard. There are 26 drugs approved for male sexual dysfunction, Chin-Yee noted, in part because no drug fits all. “That’s obvious, but for this drug and for women, it’s like, ‘well, if this could be a potential side effect, then the risk isn’t worth the benefit,’” she said.