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By now I presume most everyone has heard about Lybrido and Lybridos, two drugs currently in development that promise to boost female sex drive (albeit in a different way than Viagra helps men). In this post, I want to look at two aspects of the issue, one that has been discussed quite a bit recently and another that has not: the way normal drives and behaviors are turned into illnesses in order to justify and sell “cures” for them, and the attitudes about intercourse, sex, and relationships that lie beneath the demand for the drugs themselves.
Pathologizing normal behavior in order to “cure” it
As people such as Time’s Maia Szalavitz and fellow Psychology Today blogger Christopher Lane have noted, hypoactive-sexual-desire syndrome seems to be following the same path as depression did several decades ago. There are a number of books, such as Lane’s Shyness: How Normal Behavior Became a Sickness and Gary Greenberg’s Manufacturing Depression, that accuse drug companies, in conjunction with “Big Psych” (for lack for a better term), of exaggerating the extent of depression in order to sell antidepressants. This is not to say that clinical depression does not exist or that it’s not a serious problem for those that suffer from it—far from it. Nonetheless, some people argue that depression has been defined down so that more people can be diagnosed with it and more prescriptions can be written. The same thing seems to be happening now with declining sexual desire: what used to be merely a lull in passion is now a disorder that—surprise!—can be treated with a pill, which drug companies are only too happy to provide.
But could this be a solution without a problem? I tend to think so, and the reason is based on the way we understood intercourse (in particular) and sex (in general) in our relationships and our lives.
Too much emphasis on intercourse
Drugs like Viagra and Lybrido are intended to help couples have intercourse. Intercourse is great, of course, but it isn’t the be-all, end-all of human sexual relations. It is for singles cruising for a one-night stand it is, obviously, but these are not the target consumers of these drugs—people in long-term relationships are. But it is exactly such people that I would expect to realize that intimacy and touch are more important than tab-A-in-slot-A (or same-sex couples' variant of choice). Not every sexual encounter has to end in orgasm for both partners (or even one of them) to be mutually fulfilling, especially in the context of an emotionally rich long-term relationship.
As I understand, a declining sex drive over time is completely natural. I’m not one to commit a naturalistic fallacy, in which what's natural is held automatically to be good—I’d lose my philosopher’s license for that! But just as there is no need to embrace everything natural, there is no need to resist everything natural either. Like other results of aging, it may be easier to accommodate a declining sex drive than to fight it. As people age and their sex drive declines, they can find other ways to enjoy physicality with their partners that don’t necessarily involve intercourse. For starters, they can think of foreplay as an end in itself. If it culminates in intercourse, great, but if it doesn’t, that can be great too—in the meantime, they’re enjoying getting physical with the people they love without the pressure of having to “perform” or show the same signs of arousal as when they were younger.
It’s a cliché, but for a good reason: the true sexual organ is the brain, and if a person is truly engaged with his or her partner, any intimacy can be made sexual.
Too much emphasis on sex altogether
Much has written about how unrealistic it is to expect everything—love, affection, friendship, intimacy, sex, etc.—from one person for all of our adult lives. This is often used to make a case for open relationships or serial monogamy (or an excuse for infidelity), but let’s look at it another way: maybe we should not be expecting "it all" as we get older. Or maybe we can expect "it all" over time, but what "it all" means changes as we get older (as another fellow PT blogger Heidi Grant Halvorson writes about happiness in The Atlantic). Sure, we might have had a lot of sex when we were young, but who says we have to have the same amount of sex when we’re old—especially if we just don’t want to anymore?
We know who says this, of course: the drug companies. (Marketers, pop culture, and the ubiquitous word “sexy” to denote anything good or desirable don’t help either, but that’s a subject for another time!) Drug companies want you to feel you should want sex all the time. They want to make you feel so bad about not wanting sex all the time that you’ll run to your doctor and ask for a pill. They want to make your partner whose sex drive hasn’t fallen as much as yours has to urge you to see your doctor. They want your friends who have gotten the sex-drive pill from themselves or their partners to tell you how great it is and how it saved their marriages and OH MY GOD the orgasms so you’ll go to your doctor and get it NOW.
But you don’t have to listen to them. If you don’t want sex as much as you used to, that’s fine. It may be a result of another issue, such as a physical problem with circulation or a psychological problem such as clinical depression, or it may just be stress or other problems you’re dealing with in that crazy mess we call life. If so, then your drop in libido is one of many symptoms of a larger problem that deserves to be addressed in and of itself. But even if it’s none of these things—you feel fine, you’re a happy person, and you’re the one in a million people who isn’t stressed—it’s still OK to not want sex as much as you used to. It doesn’t mean there’s something wrong with you. You may be "unusual" in purely statistical terms, but you’re not “broken” unless you start to feel like you’re broken (or let someone hocking pills make you feel like you’re broken).
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“But Mark,” you say, “isn’t a difference in sex drive between partners in a relationship bad?” Well, yes and no.
Yes
Yes
But this doesn’t mean that the lower sex-drive partner has to run to the doctor and sign up for meds. As odd as it may seem, in 2013 people are still hesitant to talk about their sexual desires and needs with their partners, but in cases like this they need to. Surely it’s better to talk about these things than for one partner to start medicating himself or herself? In addition, Daniel Bergner at The New York Times Magazine brings up a number of possible unintended consequences of taking these pills, such as the effect on the male ego of knowing his partner had to “dope” before she wanted to have sex with him. (This is been as issue with women and Viagra since its introduction, as Judith Newman explains at The Huffington Post.)
No: Differences in sex drive alone shouldn’t be enough to threaten a relationship. Remember, these are not singles looking for one-night stands we’re talking about here, or even couples in the early, most passionate stage of their relationship. These are people who have been together long enough to have gotten a little bored with each other sexually. And this is what the APA is labelling a "disorder" what the drug companies are trying to “cure”?
Sex is great, no doubt, whatever form it may take, whether intercourse or not. But I would hope that after a couple has been together long enough for things to get a little stale in the bedroom, other things would have developed to compensate, such as deep and profound affection, understanding, and intimacy, aspects of a relationship that nourish the soul as much as horizontal gymnastics used to nourish the body, if not more. Couples will still want to get physical, of course, but often less and less over time as their sex drives naturally decline. If the partners' sex drives decline at different rates and this actually endangers a couple’s relationship, I would suspect that there’s not much else of value to the relationship—and no sex-desire pill is going to patch things together for long.
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Maybe it’s just me, but I feel that drugs designed to boost arousal or libido—for women or men—are "solving" a problem that doesn’t and shouldn’t exist. It's natural for a person's sex drive to decline over time, and each of us must choose how to deal with this in a way that fits with our lives and our relatonships. It’s in the interests of the drug companies, however, to make us feel that giving in to this decline is wrong, that we should want to have sex as much as we did when we were younger, and that their pills will be the magic elixir to love and happiness in our relationships. But should we putting such a high priority on intercourse—or sex in general—that we’re willing to take yet another pill to fine-tune our aging metabolisms to achieve it?
There's an even larger issue looming here as well. Given that intercourse is just one part of a couple’s sex life, and sex is just one part of a fulfilling relationship, it strikes me as absurd that we devote so many resources to developing a drug to enhance that one aspect of our lives. The economist in me wants to know—when he’s not screaming “let me out!”—which diseases are the drug companies spending less time and money on in order to work on enhancing libido? Every dollar and every day the drug companies choose to develop drugs to make people horny represents one less dollar and one less day they’re spending try to cure cancer or Parkinson’s. I’m all for enriching the lives of everybody if we can, but surely the ill and dying have a priority on our concern, our attention, and our resources.
Hey, maybe we’ll get lucky and Lybrido will be discovered to lessen the effects of Parkinson’s—the way we’re headed, that seems to be the only way we’ll do it.
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For a select list of my previous Psychology Today posts organized by topic, see here.
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