Microblog Memes

On a somewhat less severe side of things, lack of libido in women is still considered a jokey non-issue by most doctors but viagra has been on the market for decades for men.

Viagra doesn't treat a lack of libido, it treats a lack of blood flow to the relevant anatomy. And it was discovered by accident - a drug meant to treat high blood pressure and angina that was more effective at doing something else to blood flow. In other words it's not that men use viagra to have the desire, but rather to get the equipment to play along. Lack of libido in men is often a symptom of low testosterone, so they check for that and prescribe testosterone if that's the issue but that's really the entire toolbox on that front.

Lack of libido in women is a much harder problem to solve, and the first attempt at it that ever made it to market barely worked, had to be taken daily, and went horribly wrong if you consume any alcohol at all. There's a second that hit market a few years later that's supposedly more effective and isn't a daily regimen but is also an injection, has significant potential side effects and can't be mixed with naltrexone (a drug used to treat opioid addiction) because it will cause naltrexone not to work.

Compare to contraception, where there are tons of options available to women and basically all insurance is legally required to cover at least one brand of each type, including barrier methods, with a prescription. The options available to men are condoms or being surgically sterilized, and there's no requirement to cover either at all.

It's harder to get contraceptives for men approved because it doesn't prevent a medical condition for the user and so the bar for what is acceptable as a side effect is really low. You may have seen news stories about a male pill and men chickening out over the side effects (what wimps!) but the problem wasn't men backing out of the study, but that the acceptable side effects for a treatment that prevents a different person from developing a condition are so restrictive that they killed the study because it was already never going to be approved.

There is another male contraceptive that's been in development in India since the 80s, and as of 2022 has still not been approved - RISUG. Phase 3 clinical trials for RISUG were published more than twenty years ago. There's a variation of RISUG that's in development in the US called Vasalgel, and it's been in development here for over a decade. RISUG and Vasalgel are long term reversible contraceptives - think like an IUD - that consist of an injection in each of the vas deferens and lasts up to a decade, but can be removed earlier if needed by another set of injections in the vas deferens. Should it get approved in the US, there's no legal requirement that any insurance cover it, let alone without copay because the ACA specifically only requires coverage for contraceptive options for women.