"Female Viagra" only has 227 prescriptions so far. Maybe that's because it doesn't work.

Addyi was supposed to be a popular drug. According to the marketing campaign for the women's libido enhancer, nearly half of all women suffer from sexual dysfunction, and this pill was going to help them as Viagra did for men.

But according to Bloomberg News, Addyi is no blockbuster. While half a million prescriptions were written for Viagra in its first few weeks on the market, Addyi has garnered only 227 since its October 17 debut.

So the question is why? Here are some possible reasons:

• The medication doesn't work all that well. As I described in a story, only a small subset of women who take the drug every day experience its benefits: about half an additional sexual encounter each month above those taking a placebo pill. The drug also carries serious potential side effects, including drowsiness, dizziness, nausea, and, less commonly, extremely low blood pressure and spontaneous fainting — all of which are worsened by alcohol.

• There are regulatory hurdles to prescribing and taking it. The FDA's workaround for some of the scary side effects has been to allow only health care professionals and pharmacies who have gone through special training to prescribe the drug. These health care providers also need to assess the ability of patients to stay away from alcohol while on Addyi — something many women may not want to do.
• It costs about $780 per month, according to Bloomberg, and there's only limited insurance coverage available.
• Awareness may still be limited. The drug company's marketing plans have been restricted by FDA — though given all the media buzz around Addyi, it's a little hard to believe that people haven't heard of it.

Altogether, I can't help but think that smart campaigns by consumer advocacy groups, along with skeptical media coverage about Addyi, helped raise awareness about the medication's unimpressive risk-benefit ratio. Maybe the slow uptake is also a hopeful sign of informed consumerism taking hold in this one small corner of medicine.

Related:

• What the FDA’s approval of "pink Viagra" tells us about the problems with drug regulation
• 5 reasons to be skeptical of the new "female Viagra"

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