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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:01,502 --> 00:00:03,937 [door clacking open] 2 00:00:02,000 --> 00:00:07,000 Downloaded from YTS.BZ 3 00:00:03,971 --> 00:00:09,943 [soft footsteps plodding] 4 00:00:08,000 --> 00:00:13,000 Official YIFY movies site: YTS.BZ 5 00:00:14,215 --> 00:00:17,218 [soft footsteps plodding] 6 00:00:21,255 --> 00:00:22,690 Okay. [softly mumbling] 7 00:00:33,033 --> 00:00:34,502 Oh, that's so good. 8 00:00:34,535 --> 00:00:37,905 [director]. Um, one more time. 9 00:00:37,971 --> 00:00:39,540 Look towards me. 10 00:00:40,374 --> 00:00:44,212 And action, Cindy. 11 00:00:44,278 --> 00:00:47,481 I took on the government for women's sexual pleasure, 12 00:00:47,515 --> 00:00:49,217 and I won. 13 00:00:49,283 --> 00:00:50,684 Let me tell you why I did it. 14 00:00:50,718 --> 00:00:53,020 [upbeat dramatic music] 15 00:00:53,053 --> 00:00:56,290 The single biggest crisis in women's health is 16 00:00:56,324 --> 00:00:59,393 that you are not taken seriously. 17 00:00:59,460 --> 00:01:03,397 Why at your age should you still be concerned about sex? 18 00:01:06,066 --> 00:01:08,202 [announcer]. Ladies and gentlemen, stand up on your feet 19 00:01:08,236 --> 00:01:10,471 and give a wild 10X welcome 20 00:01:10,504 --> 00:01:12,072 to Cindy Eckert! 21 00:01:12,140 --> 00:01:13,341 [crowd cheering] 22 00:01:13,374 --> 00:01:15,743 How many of you, before this very moment, 23 00:01:15,776 --> 00:01:18,045 knew there was a little pink pill for women? 24 00:01:18,078 --> 00:01:19,147 Not so many of you. 25 00:01:19,180 --> 00:01:21,215 So I have to ask the obvious question: 26 00:01:21,249 --> 00:01:23,384 How many of you knew there was a little blue pill for men? 27 00:01:23,417 --> 00:01:25,953 [crowd applauding] 28 00:01:26,019 --> 00:01:27,054 [Cindy]. Oh, all of you know that. 29 00:01:27,087 --> 00:01:28,356 Okay. 30 00:01:28,389 --> 00:01:31,024 [female reporter]. It's known as Viagra for women, 31 00:01:31,058 --> 00:01:34,695 a tiny tablet that could have a huge impact in the bedroom. 32 00:01:34,728 --> 00:01:38,065 [Drew]. This quest to get a female sex pill 33 00:01:38,098 --> 00:01:39,233 has been going on 34 00:01:39,267 --> 00:01:41,068 for years and years and years. 35 00:01:41,101 --> 00:01:42,236 The drug comes with side effects. 36 00:01:42,270 --> 00:01:44,905 The FDA has rejected it twice. 37 00:01:44,938 --> 00:01:47,275 This whole fight has been about 38 00:01:47,341 --> 00:01:49,310 getting women what we deserve. 39 00:01:49,377 --> 00:01:52,280 Addressing low desire and sexual health in women 40 00:01:52,346 --> 00:01:54,215 is very similar to the fight that's happening 41 00:01:54,248 --> 00:01:56,150 in reproductive health. 42 00:01:56,217 --> 00:01:58,419 It's all the same message: 43 00:01:58,452 --> 00:02:01,189 We don't deserve to control our own bodies. 44 00:02:01,222 --> 00:02:03,291 [female reporter]. A new study released today raises big questions 45 00:02:03,324 --> 00:02:06,093 about whether or not it should have been approved for women 46 00:02:06,126 --> 00:02:07,695 to use at all. 47 00:02:17,171 --> 00:02:18,772 [Cindy]. I've heard every single thing. 48 00:02:18,806 --> 00:02:21,342 I've been told not to wear pink, 49 00:02:21,409 --> 00:02:22,943 pull your hair back, take the makeup off. 50 00:02:22,976 --> 00:02:24,812 No one will take you seriously. 51 00:02:24,845 --> 00:02:26,314 [female reporter]. Will the FDA approve 52 00:02:26,380 --> 00:02:29,250 the so-called female Viagra drug for women 53 00:02:29,283 --> 00:02:31,785 with unhappy sex lives? 54 00:02:31,819 --> 00:02:33,954 Our very first meeting with the FDA, 55 00:02:33,987 --> 00:02:36,790 a gentleman in the room said, 56 00:02:36,824 --> 00:02:39,660 "What do we need a bunch of horny women running around for?" 57 00:02:39,693 --> 00:02:41,061 What? 58 00:02:41,094 --> 00:02:44,131 If there were clear evidence of a clinically meaningful benefit, 59 00:02:44,164 --> 00:02:45,799 which I don't believe there is, 60 00:02:45,833 --> 00:02:47,501 approval might be appropriate. 61 00:02:47,568 --> 00:02:50,103 [Cindy]. All of that fed the frenzy. 62 00:02:50,137 --> 00:02:54,342 But at the heart of that is really our bias. 63 00:02:54,375 --> 00:02:58,346 In every scenario we're gonna talk about here today, 64 00:02:58,379 --> 00:02:59,647 you can just think to yourself, 65 00:02:59,680 --> 00:03:01,815 but what if the pill had been blue? 66 00:03:01,849 --> 00:03:04,318 [upbeat alt music] 67 00:03:04,352 --> 00:03:06,287 [male reporter]. Clamour for Viagra worldwide. 68 00:03:08,055 --> 00:03:09,523 [female reporter]. For men suffering from impotence 69 00:03:09,590 --> 00:03:11,158 Viagra has been hailed 70 00:03:11,191 --> 00:03:12,760 as a miracle drug. 71 00:03:15,563 --> 00:03:17,331 [reporter]. It's the first pill ever developed 72 00:03:17,365 --> 00:03:18,399 to treat impotence. 73 00:03:18,466 --> 00:03:19,467 Pfizer estimates 74 00:03:19,500 --> 00:03:21,869 there are 140 million men worldwide 75 00:03:21,935 --> 00:03:23,837 who have trouble achieving erection. 76 00:03:23,871 --> 00:03:25,339 [man]. Understand that we're really dealing with 77 00:03:25,373 --> 00:03:28,342 a worldwide medical problem. 78 00:03:28,376 --> 00:03:29,443 This has been of interest to men, 79 00:03:29,477 --> 00:03:31,479 you know, from time immemorial. 80 00:03:31,545 --> 00:03:38,386 ["Fuck The Pain Away" by Peaches] 81 00:03:38,452 --> 00:03:40,488 [male reporter]. As fast as pharmacists count them, 82 00:03:41,455 --> 00:03:42,923 men are buying them. 83 00:03:42,990 --> 00:03:45,192 [female reporter]. After two weeks on pharmacy shelves, 84 00:03:45,225 --> 00:03:47,561 this little blue diamond is the fastest selling 85 00:03:47,595 --> 00:03:49,430 prescription pill ever. 86 00:03:49,497 --> 00:03:51,899 [male reporter]. A US internet provider can hardly keep up. 87 00:03:51,965 --> 00:03:56,370 In Saudi Arabia, men pay as much as $100 for a single pill. 88 00:03:56,404 --> 00:03:58,439 But in Japan where it's not approved yet, 89 00:03:58,506 --> 00:04:01,875 a travel agency offers four day tours to Hawaii to get it. 90 00:04:01,909 --> 00:04:03,544 Airfare, hotel and prescription 91 00:04:03,577 --> 00:04:04,578 all included. 92 00:04:04,612 --> 00:04:06,414 [Larry]. We're discussing the treatment of impotence 93 00:04:06,480 --> 00:04:07,448 and the use of Viagra. 94 00:04:07,515 --> 00:04:08,516 In Washington, 95 00:04:08,549 --> 00:04:09,417 we have former presidential nominee, 96 00:04:09,483 --> 00:04:11,118 Bob Dole. 97 00:04:11,184 --> 00:04:13,921 [Bill]. I did not have sexual relations 98 00:04:13,954 --> 00:04:15,222 with that woman. 99 00:04:15,255 --> 00:04:16,690 I mean, President Clinton's cock, 100 00:04:16,724 --> 00:04:18,091 Bob Dole's cock. 101 00:04:18,125 --> 00:04:20,428 Now you know you don't want to hear about Bob Dole's cock, 102 00:04:20,494 --> 00:04:21,529 you know? 103 00:04:21,562 --> 00:04:22,763 [audience laughing] 104 00:04:22,796 --> 00:04:28,369 ["Fuck The Pain Away" continues] 105 00:04:28,402 --> 00:04:34,775 * Huh? What? Right Uh 106 00:04:35,409 --> 00:04:37,411 * Huh? Right 107 00:04:37,445 --> 00:04:40,914 Viagra may wind up creating a sexual revolution for men, 108 00:04:40,948 --> 00:04:42,450 but what about women? 109 00:04:47,287 --> 00:04:48,589 - [male crew] Camera's rolling. - [female crew 2] Mark it. 110 00:04:48,622 --> 00:04:49,757 [male crew 2] Alpha roll. Colour mark. 111 00:04:49,790 --> 00:04:51,492 [clacking] 112 00:04:53,994 --> 00:04:57,498 [interviewer]. Okay, so first question, 113 00:04:57,565 --> 00:05:00,434 can you tell me what you learned in medical school 114 00:05:00,468 --> 00:05:03,471 about women's sexual health? 115 00:05:03,504 --> 00:05:05,606 So when I was a medical student, 116 00:05:05,639 --> 00:05:07,941 we had pretty robust 117 00:05:07,975 --> 00:05:10,444 sexual health lectures, 118 00:05:10,478 --> 00:05:13,614 but mainly centred around male sexual health. 119 00:05:13,647 --> 00:05:17,785 And I realized very quickly the gaps that existed, 120 00:05:17,818 --> 00:05:20,253 including simple as, 121 00:05:20,287 --> 00:05:22,490 learning how to examine a clitoris. 122 00:05:22,523 --> 00:05:23,524 So you learn absolutely nothing 123 00:05:23,591 --> 00:05:24,758 in medical school 124 00:05:24,792 --> 00:05:25,659 about sexual medicine 125 00:05:25,726 --> 00:05:27,495 at all for anybody. 126 00:05:27,561 --> 00:05:30,130 In fact, in the OBGYN residency, 127 00:05:30,163 --> 00:05:31,799 the word clitoris doesn't appear anywhere 128 00:05:31,832 --> 00:05:33,667 in what they have to learn. 129 00:05:33,734 --> 00:05:36,036 In fact, they tell you don't touch the clitoris 130 00:05:36,103 --> 00:05:38,406 as to not make the patient uncomfortable. 131 00:05:40,040 --> 00:05:42,643 Can you imagine me as a urologist if I was taught 132 00:05:42,676 --> 00:05:44,144 don't touch the penis 133 00:05:44,177 --> 00:05:46,480 'cause you would make the man uncomfortable? 134 00:05:46,514 --> 00:05:47,581 In my experience, 135 00:05:47,615 --> 00:05:49,182 unfortunately female sexual health 136 00:05:49,216 --> 00:05:51,552 was all about delivering babies, 137 00:05:51,619 --> 00:05:54,321 doing women's well visits, 138 00:05:54,354 --> 00:05:56,657 a little bit on gynaecological cancers, 139 00:05:56,690 --> 00:05:57,658 but that's really it. 140 00:05:57,691 --> 00:05:58,859 And I went to Columbia. 141 00:05:58,926 --> 00:06:01,061 I mean, that's one of the best medical schools in the country. 142 00:06:01,128 --> 00:06:02,630 What I didn't learn about sexual medicine 143 00:06:02,663 --> 00:06:04,465 is pretty much everything. 144 00:06:04,498 --> 00:06:05,699 The only memory I have 145 00:06:05,766 --> 00:06:08,536 of sexual medicine coming up in medical school 146 00:06:08,602 --> 00:06:11,672 was this like weird film they showed 147 00:06:11,705 --> 00:06:14,207 of like, hippies having sex. 148 00:06:14,241 --> 00:06:16,209 It was really cringey, 149 00:06:16,243 --> 00:06:19,179 and a lot of people just like kind of walked out. 150 00:06:19,212 --> 00:06:21,682 [Francisco]. We often will define sex 151 00:06:21,715 --> 00:06:24,217 really in terms of 152 00:06:24,251 --> 00:06:26,520 how the male engages in sex. 153 00:06:29,222 --> 00:06:31,492 Men get an erection, 154 00:06:31,525 --> 00:06:35,529 ejaculate, feel pleasure. 155 00:06:35,563 --> 00:06:37,898 But unfortunately, a much larger number of women 156 00:06:37,931 --> 00:06:39,667 don't experience that. 157 00:06:39,700 --> 00:06:41,602 That's the orgasm gap. 158 00:06:41,669 --> 00:06:43,704 The orgasm gap is, 159 00:06:43,737 --> 00:06:47,675 it's maddening because in order to have an orgasm, 160 00:06:47,708 --> 00:06:49,877 there are a number of different parts of the vulva 161 00:06:49,910 --> 00:06:51,378 that need to be stimulated. 162 00:06:51,411 --> 00:06:53,246 The brain needs to be stimulated. 163 00:06:53,280 --> 00:06:55,248 There's a lot of pieces that go into it 164 00:06:55,282 --> 00:06:57,518 and people then suddenly say it's complex 165 00:06:57,551 --> 00:06:59,587 and that it's unattainable. 166 00:06:59,653 --> 00:07:01,088 But when it comes to a penis, 167 00:07:01,121 --> 00:07:04,057 it's just assumed that if that penis can't have an orgasm, 168 00:07:04,091 --> 00:07:06,193 there's a serious problem with that individual. 169 00:07:07,060 --> 00:07:09,697 The gap starts when we realize 170 00:07:09,730 --> 00:07:12,533 that society doesn't really care whether or not 171 00:07:12,566 --> 00:07:15,035 someone with a clitoris has an orgasm. 172 00:07:15,068 --> 00:07:16,704 And once you realize that, 173 00:07:16,737 --> 00:07:19,940 you recognize where all these balls get dropped. 174 00:07:20,541 --> 00:07:23,611 [Rachel]. No one is talking about pleasure and orgasms. 175 00:07:23,677 --> 00:07:26,614 No one is talking about libido at all. 176 00:07:26,647 --> 00:07:28,415 It really doesn't matter to our society 177 00:07:28,448 --> 00:07:30,350 whether people like sex or don't like sex 178 00:07:30,383 --> 00:07:32,085 as long as they have sex to make babies 179 00:07:32,119 --> 00:07:34,254 and we procreate as a society. 180 00:07:34,287 --> 00:07:36,123 And so we've ignored it completely. 181 00:07:36,657 --> 00:07:39,927 [rhythmic dance music] 182 00:07:39,960 --> 00:07:41,995 * One thing on my mind 183 00:07:43,764 --> 00:07:45,966 [Cindy]. When Viagra was approved in 1998, 184 00:07:45,999 --> 00:07:49,603 it was deemed to meet such an important unmet medical need, 185 00:07:49,637 --> 00:07:52,172 it was literally fast tracked for approval. 186 00:07:52,239 --> 00:07:54,942 It received the kind of rare status we reserve 187 00:07:54,975 --> 00:07:57,845 for lifesaving cancer drugs or rare diseases. 188 00:07:57,911 --> 00:07:59,780 So literally a national emergency 189 00:07:59,813 --> 00:08:00,814 if men can't get it up. 190 00:08:00,881 --> 00:08:02,983 This is a subject you will not see discussed much 191 00:08:03,016 --> 00:08:03,984 on television. 192 00:08:04,017 --> 00:08:04,985 Were you embarrassed? 193 00:08:05,018 --> 00:08:06,419 Yeah, I was- still am. 194 00:08:06,453 --> 00:08:07,988 I mean, it's something you don't run around, you know, 195 00:08:08,021 --> 00:08:10,290 sit around talking about in a coffee shop 196 00:08:10,323 --> 00:08:13,326 or particularly in a public television program. 197 00:08:13,360 --> 00:08:16,864 I just really have to comment on to Dr, uh, to Senator Dole. 198 00:08:16,930 --> 00:08:18,999 What he just did was just truly amazing to, 199 00:08:19,032 --> 00:08:20,467 to discuss in-in public, 200 00:08:20,500 --> 00:08:23,637 in a public forum what it's like to have this problem. 201 00:08:23,671 --> 00:08:24,738 The-the humiliation, 202 00:08:24,772 --> 00:08:26,640 the embarrassment, the frustration. 203 00:08:26,674 --> 00:08:31,344 My name is Irwin Goldstein and, uh, I love sexual medicine. 204 00:08:31,378 --> 00:08:34,748 There are so many sufferers with this condition. 205 00:08:34,782 --> 00:08:36,149 They stay in closets. 206 00:08:36,183 --> 00:08:38,652 They do not talk about this and it's just wonderful. 207 00:08:38,686 --> 00:08:40,688 Okay, let me answer your question. 208 00:08:40,721 --> 00:08:42,455 Impotence means you're not a man. 209 00:08:42,489 --> 00:08:43,691 Being a male, 210 00:08:43,757 --> 00:08:45,693 you're supposed to have an erection, 211 00:08:45,726 --> 00:08:47,494 uh, on demand. 212 00:08:47,527 --> 00:08:50,964 So in the days prior to the oral pill, 213 00:08:50,998 --> 00:08:52,733 it was considered, 214 00:08:52,800 --> 00:08:54,134 I don't want to talk about it. 215 00:08:54,167 --> 00:08:55,836 Divorce happened commonly, 216 00:08:55,869 --> 00:08:57,871 uh, depression happened. 217 00:08:57,905 --> 00:08:59,673 [gentle music] 218 00:08:59,707 --> 00:09:03,343 [Cindy]. Irwin Goldstein is the godfather of sexual medicine. 219 00:09:03,376 --> 00:09:07,347 I mean, he was the key investigator on the trial 220 00:09:07,380 --> 00:09:08,849 that got Viagra approved. 221 00:09:08,882 --> 00:09:13,621 Irwin really did something spectacular, um, with Viagra. 222 00:09:13,654 --> 00:09:16,256 And I think once he solved that problem for men, 223 00:09:16,323 --> 00:09:17,691 he said... 224 00:09:17,891 --> 00:09:19,359 women. 225 00:09:19,392 --> 00:09:21,361 [Irwin]. May 14th, 1998, 226 00:09:21,394 --> 00:09:22,730 a day I will never forget. 227 00:09:22,763 --> 00:09:24,497 The New England Journal of Medicine 228 00:09:24,531 --> 00:09:27,668 published finally all the data on Viagra. 229 00:09:27,701 --> 00:09:29,402 I was the first author 230 00:09:29,469 --> 00:09:30,704 and all the phone calls 231 00:09:30,738 --> 00:09:33,406 from people who had any concerns, 232 00:09:33,440 --> 00:09:34,875 came to our office. 233 00:09:34,908 --> 00:09:36,744 And guess what the gender was? 234 00:09:38,278 --> 00:09:39,379 [female voicemail message]. Hi Dr. Goldstein, 235 00:09:39,412 --> 00:09:42,783 happily married lady here for over ten years. 236 00:09:42,850 --> 00:09:43,951 My husband's not the issue. 237 00:09:44,017 --> 00:09:45,919 And we used to have a great love life, 238 00:09:45,953 --> 00:09:48,055 but I just don't find myself wanting to have sex. 239 00:09:48,088 --> 00:09:49,222 [female voicemail message #2]. Dr. Goldstein, 240 00:09:49,256 --> 00:09:50,824 calling about this Viagra pill, 241 00:09:50,858 --> 00:09:52,425 not for my boyfriend. 242 00:09:52,459 --> 00:09:54,061 He's got no problem. 243 00:09:54,361 --> 00:09:56,429 [female voicemail message #3]. Congratulations on getting my husband a boner. 244 00:09:56,463 --> 00:09:57,965 What do you have for me? 245 00:09:58,031 --> 00:09:59,199 [female voicemail message #4]. They're off the planet! 246 00:09:59,232 --> 00:10:01,101 I don't know where they think these men on Viagra 247 00:10:01,134 --> 00:10:03,136 are gonna stick all those erections. 248 00:10:04,304 --> 00:10:06,874 [Irwin]. I said, Hey, we're very busy. 249 00:10:06,907 --> 00:10:07,908 I'm a urologist. 250 00:10:07,941 --> 00:10:10,577 I do the men's sexual problems. 251 00:10:10,610 --> 00:10:12,913 There's gynecologist, they deal with women. 252 00:10:12,946 --> 00:10:15,683 And I said, "If you have any, any issues, come back to me 253 00:10:15,716 --> 00:10:16,784 "and let me tell you what's going. 254 00:10:16,850 --> 00:10:18,118 "You know, tell me what's going on." 255 00:10:18,151 --> 00:10:19,452 And to a T, 256 00:10:19,486 --> 00:10:20,721 everyone called back. 257 00:10:20,754 --> 00:10:22,422 "Gynecologists aren't doing this. 258 00:10:22,455 --> 00:10:25,592 "The gynecologist said, 'Go see Dr. Goldstein.'" 259 00:10:25,625 --> 00:10:27,294 So I was like, okay. 260 00:10:27,360 --> 00:10:30,998 I finally learn that we need to take care of women 261 00:10:31,064 --> 00:10:32,800 with sexual health problems. 262 00:10:33,901 --> 00:10:36,436 [Sarah]. I first learned about sexual medicine as a career 263 00:10:36,469 --> 00:10:37,938 when I was in medical school. 264 00:10:37,971 --> 00:10:39,773 And realized 265 00:10:39,807 --> 00:10:41,641 that there was this whole world of information 266 00:10:41,675 --> 00:10:44,845 that I did not know even existed about sexual health, 267 00:10:44,912 --> 00:10:48,615 about pain, about orgasm, arousal, 268 00:10:48,648 --> 00:10:52,285 and realized I wanted it to be a part of my practice. 269 00:10:52,319 --> 00:10:53,286 Women's sexual health, 270 00:10:53,320 --> 00:10:54,254 and vulvas in general, 271 00:10:54,287 --> 00:10:57,124 have never been a priority of our society. 272 00:10:57,157 --> 00:11:00,360 We can see that as deep as the terminology used 273 00:11:00,427 --> 00:11:02,462 for the innervation of the vulva. 274 00:11:02,495 --> 00:11:03,630 The pudendal nerve 275 00:11:03,663 --> 00:11:06,834 is the nerve that provides most of the sensation, 276 00:11:06,900 --> 00:11:08,936 particularly in regards to sexual function, 277 00:11:08,969 --> 00:11:10,470 to the vulva, the clitoris, 278 00:11:10,503 --> 00:11:12,672 the labia, the vestibule. 279 00:11:12,740 --> 00:11:15,976 And pudendal literally means "shame." 280 00:11:16,009 --> 00:11:18,812 Often patients don't feel like they deserve sex, 281 00:11:18,846 --> 00:11:19,980 they don't deserve intimacy, 282 00:11:20,013 --> 00:11:22,282 they don't deserve pleasure or connection. 283 00:11:22,315 --> 00:11:24,617 And when that is lost, 284 00:11:24,651 --> 00:11:28,355 I think that a piece of them is really broken. 285 00:11:28,421 --> 00:11:29,356 More often than not, 286 00:11:29,422 --> 00:11:30,690 women will just say, 287 00:11:30,758 --> 00:11:32,192 "Oh yeah, I, you know, 288 00:11:32,225 --> 00:11:33,660 "I haven't orgasmed in years, 289 00:11:33,693 --> 00:11:34,895 "but it's fine, whatever. 290 00:11:34,962 --> 00:11:35,829 "I mean, I just gave up." 291 00:11:35,863 --> 00:11:37,530 Not that it's someone who's like okay 292 00:11:37,564 --> 00:11:38,899 with not having sexual pleasure, 293 00:11:38,966 --> 00:11:41,168 it's just that they didn't think that they deserved it. 294 00:11:41,201 --> 00:11:45,705 And a lot of my job is actually normalizing 295 00:11:45,739 --> 00:11:48,075 that it's okay to want more for yourself 296 00:11:48,141 --> 00:11:49,910 when it comes to sexual pleasure and desire, 297 00:11:49,977 --> 00:11:54,181 which is very different than society's approach to men, 298 00:11:54,214 --> 00:11:55,749 where it is a right. 299 00:11:56,583 --> 00:11:58,185 Your genitalia affects 300 00:11:58,218 --> 00:11:59,853 how you're treated in the healthcare system. 301 00:11:59,887 --> 00:12:01,889 You know, I trained as a urologist 302 00:12:01,922 --> 00:12:06,226 and I was very used to objective data, 303 00:12:06,259 --> 00:12:07,360 and objective evidence, 304 00:12:07,394 --> 00:12:09,830 and really listening to our patients. 305 00:12:09,863 --> 00:12:10,898 And I didn't realize 306 00:12:10,931 --> 00:12:14,001 that was something very unique to the fact that 307 00:12:14,034 --> 00:12:16,469 I was working with predominantly men, 308 00:12:16,503 --> 00:12:19,572 'cause when I started working in the women's health space, 309 00:12:19,606 --> 00:12:23,243 I was oftentimes listening to my patients 310 00:12:23,276 --> 00:12:26,213 telling me the consistent medical gaslighting 311 00:12:26,246 --> 00:12:27,247 that they were experiencing 312 00:12:27,314 --> 00:12:29,749 when it came to their vulva, vaginal healthcare. 313 00:12:29,817 --> 00:12:31,952 A lot of times when people come in with problems 314 00:12:32,019 --> 00:12:35,088 and are previously told, "It's all in your head," 315 00:12:35,155 --> 00:12:37,224 okay, basically getting medically gaslit, 316 00:12:37,257 --> 00:12:39,426 the default sometimes is to blame the patient 317 00:12:39,492 --> 00:12:42,729 when you as the provider don't know how to help them. 318 00:12:42,762 --> 00:12:44,264 Uh, your name, uh, is Mrs. Martin, 319 00:12:44,297 --> 00:12:45,265 is that right? 320 00:12:45,298 --> 00:12:46,566 That's correct. 321 00:12:46,599 --> 00:12:48,468 [interviewer]. Well try and tell me for starters if you can, 322 00:12:48,535 --> 00:12:50,570 what is the current dilemma? 323 00:12:50,603 --> 00:12:52,405 What's going on that troubles? 324 00:12:52,439 --> 00:12:53,706 [Rachel]. The idea of it's all in your head 325 00:12:53,740 --> 00:12:55,843 is a tale as old as time. 326 00:12:55,876 --> 00:12:58,078 "Have a date night, drink a glass of wine, 327 00:12:58,111 --> 00:12:59,913 "read Fifty Shades of Grey. 328 00:12:59,947 --> 00:13:02,049 "Here's a good therapist, go to this therapist. 329 00:13:02,082 --> 00:13:03,416 "It's all trauma." 330 00:13:03,450 --> 00:13:08,455 Well, I-I don't have climaxes anymore at all. 331 00:13:08,488 --> 00:13:10,090 And I feel like I'm just submitting now, 332 00:13:10,123 --> 00:13:12,926 that I'm not, I'm not giving anything or getting anything. 333 00:13:12,960 --> 00:13:14,127 [Irwin]. In general, 334 00:13:14,194 --> 00:13:17,064 people don't like talking about sexual problems. 335 00:13:17,097 --> 00:13:21,835 Um, most providers don't do sexual medicine. 336 00:13:21,902 --> 00:13:24,804 Have you ever been to a doctor who does sexual medicine? 337 00:13:24,838 --> 00:13:25,906 There's so few of them. 338 00:13:25,939 --> 00:13:27,975 Your sexual experiences, 339 00:13:28,008 --> 00:13:29,476 which are very important to you, 340 00:13:29,542 --> 00:13:32,245 you're not willing to share and they're not willing to hear, 341 00:13:32,279 --> 00:13:34,281 [chuckles] but they should be. 342 00:13:34,314 --> 00:13:36,016 They should be as, 343 00:13:36,083 --> 00:13:39,119 if they're bothering you and it's affecting your, 344 00:13:39,152 --> 00:13:43,423 your yourself, your, your, your relationship with someone else, 345 00:13:43,456 --> 00:13:44,824 your ability to be a parent, 346 00:13:44,892 --> 00:13:47,494 your ability to be a good worker at work, 347 00:13:47,527 --> 00:13:49,963 uh, you should have the opportunity to discuss this. 348 00:13:50,663 --> 00:13:54,001 [Cindy]. Irwin Goldstein is a mad scientist 349 00:13:54,067 --> 00:13:56,103 who loves discovery 350 00:13:56,136 --> 00:14:00,807 and does it for the care of his patients 351 00:14:00,840 --> 00:14:02,342 through and through. 352 00:14:02,375 --> 00:14:04,644 [rhythmic music] 353 00:14:04,677 --> 00:14:06,846 [Cindy]. I'll take you back to 2010. 354 00:14:06,914 --> 00:14:08,115 I'm in Miami 355 00:14:08,148 --> 00:14:10,984 at the Sexual Medicine Society Conference, 356 00:14:11,018 --> 00:14:13,586 and it's the best researchers in the world on sex. 357 00:14:15,155 --> 00:14:17,925 So here's Irwin chasing me around with his MacBook 358 00:14:17,958 --> 00:14:19,893 and he said, "You have to watch these, 359 00:14:19,960 --> 00:14:22,495 "you have to watch these, you have to watch these." 360 00:14:22,529 --> 00:14:25,999 So today is 10 21 10. 361 00:14:26,033 --> 00:14:28,201 It's, uh, Thursday. 362 00:14:29,269 --> 00:14:31,538 There was a drug company in Germany 363 00:14:31,571 --> 00:14:36,176 that was studying an alternative drug for depression. 364 00:14:36,209 --> 00:14:38,545 And of course, just like Viagra, 365 00:14:38,578 --> 00:14:40,480 it was found to be amazingly successful 366 00:14:40,513 --> 00:14:44,717 in helping women who had low libido or low desire. 367 00:14:44,751 --> 00:14:48,021 We have patient 24163 368 00:14:48,055 --> 00:14:49,889 of the flibanserin open label trial. 369 00:14:49,957 --> 00:14:51,558 I had patients on this. 370 00:14:51,624 --> 00:14:54,094 I filmed them saying, "Oh my God, 371 00:14:54,161 --> 00:14:57,064 "after taking flibanserin I'm smiling and I'm happy 372 00:14:57,130 --> 00:15:00,167 "and I stare at my partner and I just want to be with them." 373 00:15:00,200 --> 00:15:01,401 And why we're filming this? 374 00:15:01,434 --> 00:15:03,070 This is really cool, her results. 375 00:15:03,103 --> 00:15:07,407 So I'm gonna turn this around and patient 24163. 376 00:15:07,440 --> 00:15:08,408 How are ya? [chuckles] 377 00:15:08,441 --> 00:15:09,742 [chuckling] I'm fine. 378 00:15:09,776 --> 00:15:11,878 [Irwin]. So this is a little weird, but you know, I, you know, 379 00:15:11,911 --> 00:15:13,213 this is your really last chance to, 380 00:15:13,246 --> 00:15:15,415 to document this to humanity. 381 00:15:15,448 --> 00:15:19,186 So you're on, tell us side effects, benefits. 382 00:15:19,219 --> 00:15:20,587 How did you do with this drug? 383 00:15:20,653 --> 00:15:23,223 I did phenomenal on this drug. 384 00:15:23,256 --> 00:15:24,992 I feel like a new woman on this drug. 385 00:15:25,925 --> 00:15:27,260 [machine whirring] 386 00:15:27,294 --> 00:15:28,595 [Cindy]. At that conference, 387 00:15:28,628 --> 00:15:31,131 this company presented this brain scan imaging 388 00:15:31,198 --> 00:15:33,000 of a women struggling with their libido. 389 00:15:34,067 --> 00:15:38,071 And it was like lightning struck! 390 00:15:38,105 --> 00:15:39,139 Holy shit! 391 00:15:39,206 --> 00:15:41,241 [snaps fingers] It's biology! 392 00:15:41,274 --> 00:15:45,145 [soft dramatic music] 393 00:15:45,212 --> 00:15:48,781 [Cindy]. HSDD or Hypoactive Sexual Desire Disorder 394 00:15:48,848 --> 00:15:50,050 is the name. 395 00:15:50,083 --> 00:15:53,886 It was first characterized in the literature in 1977. 396 00:15:53,920 --> 00:15:57,057 And it basically is this like absence of spontaneous thoughts 397 00:15:57,090 --> 00:15:59,059 or interest. 398 00:15:59,092 --> 00:16:01,995 And we realize it's in the sex centre of the brain. 399 00:16:03,663 --> 00:16:06,466 You know, we're hardwired to procreate 400 00:16:06,499 --> 00:16:09,069 and for, you know, millions of people, 401 00:16:09,102 --> 00:16:11,171 something goes off kilter in that wiring. 402 00:16:12,005 --> 00:16:14,241 I had no sexual desire. 403 00:16:14,274 --> 00:16:16,309 Libido was almost zero. 404 00:16:16,376 --> 00:16:18,278 [Cindy]. It was such a common thread. 405 00:16:18,311 --> 00:16:22,182 And, you know, what happened is I saw those videos, 406 00:16:22,249 --> 00:16:25,285 I completely saw myself in those videos. 407 00:16:26,386 --> 00:16:27,954 I was in a place in a relationship 408 00:16:27,987 --> 00:16:29,789 where I was deeply disconnected. 409 00:16:31,124 --> 00:16:33,360 I was in the exact same place, 410 00:16:33,426 --> 00:16:35,428 really struggling with this issue. 411 00:16:37,264 --> 00:16:38,831 I just never think about it, 412 00:16:38,898 --> 00:16:40,367 like it's gone. 413 00:16:40,433 --> 00:16:42,469 It used to be there, but it's gone. 414 00:16:43,336 --> 00:16:45,805 Go talk to hundreds of women 415 00:16:45,838 --> 00:16:49,176 who have nothing in common other than this one issue, 416 00:16:49,242 --> 00:16:53,012 and listen to them all give you the exact same words: 417 00:16:53,046 --> 00:16:54,181 It's gone. 418 00:16:54,247 --> 00:16:56,983 And they had been conditioned to not even 419 00:16:57,016 --> 00:16:58,051 sort of fight for it 420 00:16:58,118 --> 00:17:01,688 because, well, your pleasure doesn't matter. 421 00:17:01,721 --> 00:17:03,223 "Just go along. 422 00:17:03,290 --> 00:17:04,224 "This is what it is. 423 00:17:04,291 --> 00:17:05,858 "Relax, honey, have a bath. 424 00:17:05,892 --> 00:17:06,926 "Schedule date night. 425 00:17:06,959 --> 00:17:08,161 "Buy sexier lingerie. 426 00:17:08,195 --> 00:17:09,529 "Do better." 427 00:17:09,562 --> 00:17:11,164 You do better. 428 00:17:11,198 --> 00:17:12,332 Fuck you. 429 00:17:12,365 --> 00:17:14,000 [clacking] 430 00:17:15,868 --> 00:17:17,504 [Gina]. I had never talked about libido. 431 00:17:18,705 --> 00:17:21,074 I think that's another thing where I thought, 432 00:17:21,141 --> 00:17:23,676 after you have a kid that goes away, you know? 433 00:17:23,710 --> 00:17:26,146 That was kind of the narrative from 434 00:17:26,179 --> 00:17:27,747 my elders, right? 435 00:17:27,814 --> 00:17:28,881 And the women around me, 436 00:17:28,948 --> 00:17:30,517 that you're a mother now 437 00:17:30,550 --> 00:17:33,186 and you focus on these things and that's behind you. 438 00:17:33,220 --> 00:17:35,922 So no discussion about it. 439 00:17:38,591 --> 00:17:43,230 [Susan]. I went from a scale of one to ten on the libido, 440 00:17:43,263 --> 00:17:45,498 I was eleven. 441 00:17:45,532 --> 00:17:48,368 Uh, and then when menopause hit, 442 00:17:48,401 --> 00:17:51,171 I [stutters] became a negative three. 443 00:17:52,139 --> 00:17:54,174 Um, it was devastating. 444 00:17:54,207 --> 00:17:59,346 As a woman, we, we love to feel desirable 445 00:17:59,379 --> 00:18:01,080 and happy with their relationships 446 00:18:01,148 --> 00:18:02,915 and things like that. 447 00:18:02,949 --> 00:18:03,916 And for me, 448 00:18:03,950 --> 00:18:06,886 I felt like someone had just slayed me. 449 00:18:06,919 --> 00:18:12,058 I, I tell people I, I lost touch with my inner goddess. 450 00:18:12,091 --> 00:18:13,460 [clacking] 451 00:18:14,294 --> 00:18:17,164 [Sue]. My husband likes to practice what he preaches. 452 00:18:17,197 --> 00:18:19,532 And one day he came home from work and he said, 453 00:18:19,566 --> 00:18:22,435 we've just developed a new questionnaire. 454 00:18:22,502 --> 00:18:24,237 It was basically the beginning of testing 455 00:18:24,271 --> 00:18:26,273 for Addyi. 456 00:18:26,306 --> 00:18:28,275 And he says, just take the test for fun. 457 00:18:28,308 --> 00:18:31,544 And I took it and he goes, holy, you've got HSD! 458 00:18:32,412 --> 00:18:34,914 When you have Hypoactive Sexual Desire Disorder, 459 00:18:34,947 --> 00:18:36,249 which is what I had, 460 00:18:36,283 --> 00:18:37,817 you're not aware that it's in your cognition. 461 00:18:37,884 --> 00:18:39,386 Well, everybody has it differently. 462 00:18:39,419 --> 00:18:40,787 It may mean that, you know, 463 00:18:40,820 --> 00:18:42,389 when your partner walks through the door, 464 00:18:42,422 --> 00:18:44,824 you used to wanna jump his bones or her bones 465 00:18:44,891 --> 00:18:46,426 and that's not of interest anymore. 466 00:18:46,459 --> 00:18:48,828 It may be that while you're in bed having sex, 467 00:18:48,895 --> 00:18:49,896 you're thinking about, ugh, 468 00:18:49,929 --> 00:18:51,231 I have to put the wash in the dryer, 469 00:18:51,264 --> 00:18:53,633 I have to buy milk for the kids before school tomorrow. 470 00:18:53,666 --> 00:18:55,602 Or it may be that you don't want your partner to touch you 471 00:18:55,635 --> 00:18:56,769 because you have, 472 00:18:56,803 --> 00:18:58,305 you've developed, you know, aversion. 473 00:18:58,371 --> 00:18:59,839 It couldn't mean a lot of things. 474 00:18:59,906 --> 00:19:03,109 But for me, I was having essentially duty sex. 475 00:19:03,142 --> 00:19:05,512 When I had sex, it was good, 476 00:19:05,578 --> 00:19:08,415 but I had no reason to want to have sex again. 477 00:19:08,448 --> 00:19:09,816 [clacking] 478 00:19:11,484 --> 00:19:14,821 [Barbara]. I met my husband at a party at his uncle's house 479 00:19:17,424 --> 00:19:22,329 and in our early relationship there was no problem 480 00:19:22,362 --> 00:19:25,765 with desire with sex. 481 00:19:25,798 --> 00:19:27,800 One time there was a construction site 482 00:19:27,834 --> 00:19:29,802 and we decided that 483 00:19:29,836 --> 00:19:32,405 this would be a great opportunity. 484 00:19:32,439 --> 00:19:35,007 I mean, it was just spur of the moment all the time. 485 00:19:35,041 --> 00:19:37,644 Spur of the moment, just boom, we're ready to go. 486 00:19:37,677 --> 00:19:41,448 Um, and then we had children 487 00:19:41,481 --> 00:19:45,084 and there was absolutely no problem whatsoever. 488 00:19:45,117 --> 00:19:46,152 And then all of a sudden, 489 00:19:46,185 --> 00:19:48,888 it was like somebody pulled the plug. 490 00:19:48,955 --> 00:19:50,523 I had zero desire. 491 00:19:52,425 --> 00:19:53,660 [Gregg]. When I first met her I, 492 00:19:53,693 --> 00:19:57,497 I thought she was a, a real hottie. 493 00:19:57,530 --> 00:20:00,032 No, we were a young, healthy, 494 00:20:00,066 --> 00:20:01,434 - sexually active- - Amorous. 495 00:20:01,468 --> 00:20:04,471 Couple. Yeah, and, uh, yeah, 496 00:20:04,504 --> 00:20:07,307 and it, it was, it was good for a long time. 497 00:20:07,340 --> 00:20:11,043 When it became evident that she wasn't responding, 498 00:20:11,110 --> 00:20:13,413 I almost got angry. 499 00:20:13,480 --> 00:20:14,547 Is she mad at me about something? 500 00:20:14,614 --> 00:20:16,148 Did I do something? 501 00:20:16,182 --> 00:20:17,717 Uh, does she think I'm cheating? 502 00:20:17,750 --> 00:20:18,718 I never did. 503 00:20:18,751 --> 00:20:20,820 Never have, never will. 504 00:20:20,853 --> 00:20:25,925 Um, so yeah, it was tough. 505 00:20:25,992 --> 00:20:27,360 [Barbara]. So that's why I decided 506 00:20:27,394 --> 00:20:29,596 that when I heard of this clinical trial, 507 00:20:29,662 --> 00:20:32,365 I would definitely give that a try. 508 00:20:32,399 --> 00:20:36,836 And oh my gosh, it was just amazing. 509 00:20:36,869 --> 00:20:38,571 Your whole relationship with your, 510 00:20:38,638 --> 00:20:40,340 or at least mine with my husband, 511 00:20:40,373 --> 00:20:43,410 was stressed or strained. 512 00:20:43,476 --> 00:20:44,577 [Irwin]. And on the medication? 513 00:20:44,611 --> 00:20:48,715 On the medication [chuckles] I chase him. [laughs] 514 00:20:48,748 --> 00:20:49,749 [Irwin]. Awesome. 515 00:20:49,782 --> 00:20:52,452 It is, it is unbelievable. 516 00:20:52,519 --> 00:20:55,388 I love my husband tremendously, 517 00:20:55,422 --> 00:20:58,891 but with this drug I love him even more. 518 00:20:58,925 --> 00:21:02,261 And our, our sexual experiences were, 519 00:21:02,295 --> 00:21:04,230 were incredible. 520 00:21:04,263 --> 00:21:06,599 It was, it was like I was a new woman. 521 00:21:10,437 --> 00:21:14,273 [reporter]. Will the FDA approve the so-called female Viagra? 522 00:21:14,341 --> 00:21:16,709 A drug for women with unhappy sex lives. 523 00:21:16,743 --> 00:21:18,745 I'm at the FDA meeting right now. 524 00:21:18,778 --> 00:21:20,647 I'll have more in this hour. 525 00:21:20,713 --> 00:21:24,384 Boehringer Ingelheim be applied for approval by the FDA. 526 00:21:24,417 --> 00:21:26,285 Today's agenda involves discussion related 527 00:21:26,319 --> 00:21:27,454 to new drug application. 528 00:21:27,520 --> 00:21:31,891 NDA 22526 Flibanserin hundred milligrams tablets. 529 00:21:31,924 --> 00:21:33,460 Because I was doing a lot of work 530 00:21:33,526 --> 00:21:36,929 with antidepressant associated sexual dysfunction, 531 00:21:36,963 --> 00:21:39,432 I was an advisor. 532 00:21:39,466 --> 00:21:42,735 I appreciate the opportunity to be able to speak with you today. 533 00:21:42,769 --> 00:21:45,171 For male erectile dysfunction, 534 00:21:45,237 --> 00:21:47,273 and what they had used a measure, 535 00:21:47,306 --> 00:21:51,478 was this sexual event successful for you? 536 00:21:51,511 --> 00:21:55,448 Meaning the penis was rigid enough to penetrate a vagina. 537 00:21:55,482 --> 00:21:58,150 They decided to try to apply that to women. 538 00:21:58,184 --> 00:21:59,151 And we said, 539 00:21:59,185 --> 00:22:02,288 what is a successful sexual event in women? 540 00:22:02,321 --> 00:22:04,824 Do you think that it might be having an orgasm 541 00:22:04,857 --> 00:22:07,293 'cause that's really not related to desire. 542 00:22:07,326 --> 00:22:10,663 And that was the sort of first real foray 543 00:22:10,697 --> 00:22:16,302 into them not really understanding women's sexuality. 544 00:22:16,335 --> 00:22:17,937 These are the numbers that you see, 545 00:22:17,970 --> 00:22:20,707 so these are women who have HSDD. 546 00:22:20,773 --> 00:22:23,510 They do not have depression. 547 00:22:23,543 --> 00:22:27,547 You can see that HSDD is the most common 548 00:22:27,614 --> 00:22:29,816 sexual dysfunction 549 00:22:29,849 --> 00:22:34,153 as compared to effects on arousal or orgasm. 550 00:22:34,186 --> 00:22:36,022 The studies were positive 551 00:22:36,055 --> 00:22:40,326 and it showed that people's sexual functioning improved 552 00:22:40,359 --> 00:22:42,495 over time when they were on this drug. 553 00:22:42,529 --> 00:22:47,534 But ultimately Boehringer Ingelheim had it turned down 554 00:22:47,567 --> 00:22:49,436 for approval by the FDA. 555 00:22:51,504 --> 00:22:53,806 [Cindy]. At that meeting in Miami, 556 00:22:53,840 --> 00:22:57,844 the German company went to all the researchers in the world 557 00:22:57,877 --> 00:23:00,312 and said, we're not gonna develop it. 558 00:23:01,681 --> 00:23:04,517 And you could feel the air leave the room. 559 00:23:04,551 --> 00:23:09,556 [Barbara]. I am so, so upset that this is terminating 560 00:23:09,589 --> 00:23:15,027 because this Flibanserin can change people's lives, 561 00:23:15,061 --> 00:23:16,563 they can change relationships, 562 00:23:16,596 --> 00:23:20,900 they can, um, make a person whole again. 563 00:23:20,933 --> 00:23:24,437 And she is patient 24174. 564 00:23:24,471 --> 00:23:25,772 And she, uh, 565 00:23:25,838 --> 00:23:29,241 because [indistinct] closed up, we had to close out the trial. 566 00:23:29,275 --> 00:23:31,277 [Cindy]. What was surprising is that a company 567 00:23:31,343 --> 00:23:34,481 that had found this kind of spectacular discovery 568 00:23:34,547 --> 00:23:36,583 was not going to pursue it 569 00:23:36,616 --> 00:23:39,118 'cause they didn't want to take on women and sex, right? 570 00:23:39,185 --> 00:23:40,219 No thank you, 571 00:23:40,252 --> 00:23:41,921 we're not getting into this debate. 572 00:23:41,954 --> 00:23:44,256 And I think Irwin knew that too, 573 00:23:44,290 --> 00:23:46,759 which is why he said you need to do something about this. 574 00:23:46,793 --> 00:23:50,797 The science was there, it required a champion. 575 00:23:50,863 --> 00:23:53,099 I said, please just get on an airplane, 576 00:23:53,132 --> 00:23:54,233 fly to this place. 577 00:23:54,266 --> 00:23:56,636 For one dollar they'll probably give you the medicine. 578 00:23:56,669 --> 00:23:58,605 I sort of almost begged. 579 00:23:58,638 --> 00:24:00,306 I mean, you have to develop it. 580 00:24:00,372 --> 00:24:02,408 Irwin chose me, it spoke to me, 581 00:24:02,441 --> 00:24:03,876 this is what I was struggling with 582 00:24:03,910 --> 00:24:06,646 and I was gonna fight for what I deserved 583 00:24:06,679 --> 00:24:08,581 and I was determined. 584 00:24:08,615 --> 00:24:10,449 And so I bought the drug. 585 00:24:12,451 --> 00:24:14,320 * Gimme what I want, what I want, what I want * 586 00:24:14,386 --> 00:24:15,822 * want, want, want, what I want * 587 00:24:15,855 --> 00:24:17,957 [Cindy]. And so, what do you do when you get a drug through the FDA? 588 00:24:17,990 --> 00:24:19,492 You sit down with the FDA 589 00:24:19,526 --> 00:24:22,361 and you say, okay, here's this product, 590 00:24:22,428 --> 00:24:23,462 what is the roadmap? 591 00:24:23,496 --> 00:24:24,797 * Gimme what I want, what I want, what I want 592 00:24:24,831 --> 00:24:25,865 * what I want, what I want 593 00:24:25,932 --> 00:24:27,133 * Like a Spice Girl * 594 00:24:27,166 --> 00:24:28,835 [Cindy]. They tell you what endpoints you have to meet 595 00:24:28,868 --> 00:24:29,869 in clinical trials. 596 00:24:29,936 --> 00:24:31,638 They define success for you 597 00:24:31,671 --> 00:24:34,507 and you have to prove it with statistical significance. 598 00:24:35,374 --> 00:24:38,177 So that's what we really spent our first year doing 599 00:24:38,210 --> 00:24:40,647 is all the things that the FDA had asked of us, 600 00:24:40,680 --> 00:24:41,814 good stewards of science, 601 00:24:41,848 --> 00:24:44,383 we went out, we did all that work. 602 00:24:44,450 --> 00:24:47,186 And I remember being just so excited. 603 00:24:47,219 --> 00:24:48,821 Like we've done it, we did it, 604 00:24:48,855 --> 00:24:50,022 it works! 605 00:24:50,056 --> 00:24:54,661 This drug was about women living life on their own terms, 606 00:24:54,694 --> 00:24:57,564 so I wanted a woman's name. 607 00:24:57,630 --> 00:25:01,167 A character that I loved was actually Addison 608 00:25:01,200 --> 00:25:02,669 on Grey's Anatomy. 609 00:25:02,702 --> 00:25:05,371 I like that she lives life on her own terms, 610 00:25:05,404 --> 00:25:07,239 so we called it Addyi. 611 00:25:14,213 --> 00:25:16,382 Our very first meeting with the FDA, 612 00:25:16,415 --> 00:25:18,685 there was a tension in that room. 613 00:25:18,718 --> 00:25:22,822 You can imagine you walk in like company sits on one side, 614 00:25:22,855 --> 00:25:24,857 FDA sits on the other side, 615 00:25:24,891 --> 00:25:26,726 it's like a face off. 616 00:25:26,793 --> 00:25:30,730 And there was just this sense 617 00:25:30,763 --> 00:25:34,734 that this was not gonna be a straightforward conversation. 618 00:25:35,668 --> 00:25:37,837 Here I am running a company, 619 00:25:37,870 --> 00:25:39,606 totally a woman in a man's world. 620 00:25:41,340 --> 00:25:45,578 When I left college I worked for Fortune's most admired company, 621 00:25:45,645 --> 00:25:49,749 but I left Big Pharma because it wasn't the fit for me. 622 00:25:49,816 --> 00:25:53,753 And I found this incredible testosterone product for men 623 00:25:53,820 --> 00:25:56,756 and built my first business out of that called Slate. 624 00:25:56,823 --> 00:26:00,760 And so, I had brought a product to market for men 625 00:26:00,793 --> 00:26:02,094 that was FDA approved. 626 00:26:02,128 --> 00:26:03,896 So when all the questions were different 627 00:26:03,930 --> 00:26:05,732 on a product for women, 628 00:26:05,765 --> 00:26:08,234 I knew something was up. 629 00:26:08,267 --> 00:26:09,869 And I asked this question, 630 00:26:09,902 --> 00:26:11,270 why are we being reviewed 631 00:26:11,303 --> 00:26:14,440 by the urology division of the FDA 632 00:26:14,473 --> 00:26:18,745 when this is a drug that works on neurotransmitters? 633 00:26:18,778 --> 00:26:19,746 And the answer was, 634 00:26:19,779 --> 00:26:22,514 "We review all the sex drugs." 635 00:26:22,548 --> 00:26:25,251 I said, "Yeah because they've all been for men." 636 00:26:25,284 --> 00:26:28,087 And that was it, like I stepped in it. 637 00:26:28,120 --> 00:26:29,789 I knew it as soon as I said it, 638 00:26:29,856 --> 00:26:32,324 I could feel that tension in the room, 639 00:26:32,391 --> 00:26:33,760 like how dare you, 640 00:26:33,793 --> 00:26:38,064 we are the experts on sex, and yet they weren't. 641 00:26:38,097 --> 00:26:41,567 I walked out of that meeting and I thought, 642 00:26:41,600 --> 00:26:43,803 science cures bias, right? 643 00:26:43,870 --> 00:26:46,138 Science always knows the answer. 644 00:26:46,172 --> 00:26:49,008 I knew we'd actually achieved all the results 645 00:26:49,075 --> 00:26:50,777 that they'd asked us to achieve. 646 00:26:50,810 --> 00:26:53,445 And so, I was getting ready to launch, 647 00:26:53,479 --> 00:26:55,247 and I had been in New York 648 00:26:55,281 --> 00:26:57,784 and I flew back to Raleigh where I'm based. 649 00:26:58,617 --> 00:27:00,619 The whole company is like waiting 650 00:27:00,653 --> 00:27:02,221 with the champagne chilling. 651 00:27:03,923 --> 00:27:06,926 The minute the plane landed, my phone's blowing up. 652 00:27:06,959 --> 00:27:08,795 I got a call from my assistant. 653 00:27:08,828 --> 00:27:11,463 She's like, Hey, we heard from the FDA, 654 00:27:11,497 --> 00:27:14,166 they came back and said no. 655 00:27:14,200 --> 00:27:17,169 And it was just like, pow! 656 00:27:17,203 --> 00:27:19,638 I thought, oh my God. 657 00:27:19,672 --> 00:27:22,041 I didn't know what I was gonna say. 658 00:27:22,108 --> 00:27:23,810 My board knew this was the day, 659 00:27:23,843 --> 00:27:25,812 my shareholders knew this was the day, 660 00:27:25,845 --> 00:27:27,714 the patients knew this was the day, 661 00:27:27,780 --> 00:27:29,816 Irwin knew this was the day. 662 00:27:30,717 --> 00:27:32,752 I'm like, gotta go in, gotta face the music. 663 00:27:35,554 --> 00:27:38,324 I got everybody around the table and I said, 664 00:27:38,357 --> 00:27:41,694 "We just heard from the FDA and we were turned down." 665 00:27:41,728 --> 00:27:43,763 And it was silence. 666 00:27:47,233 --> 00:27:51,170 I remember sitting in the office until the last person left. 667 00:27:51,203 --> 00:27:53,873 I was looking out the window until I started to cry 668 00:27:54,974 --> 00:27:57,176 and I'm like, what the hell are you doing? 669 00:27:57,209 --> 00:28:00,980 Like pick yourself back up, we're going back into battle. 670 00:28:01,013 --> 00:28:05,251 And I thought not on my fucking watch, no way. 671 00:28:06,185 --> 00:28:08,888 It was time to take 'em on. 672 00:28:08,955 --> 00:28:10,056 [soft dramatic music] 673 00:28:10,122 --> 00:28:11,390 [reporter]. Viagra for women. 674 00:28:11,423 --> 00:28:12,591 It's a little pink pill 675 00:28:12,658 --> 00:28:14,861 that's supposed to increase a woman's desire. 676 00:28:14,894 --> 00:28:18,164 And the FDA has already said no to the drug. 677 00:28:18,197 --> 00:28:20,432 But the company is appealing that decision. 678 00:28:22,401 --> 00:28:24,370 [Josephine]. I had never heard of HSDD. 679 00:28:24,403 --> 00:28:26,405 I had never heard of Flibanserin. 680 00:28:26,438 --> 00:28:28,707 There was a meeting on my calendar, um, 681 00:28:28,741 --> 00:28:30,576 to meet with a company called Sprout 682 00:28:30,609 --> 00:28:32,011 who was coming to us for help. 683 00:28:32,044 --> 00:28:34,046 And so I went to the meeting 684 00:28:34,080 --> 00:28:35,915 and I met Cindy who was a very, 685 00:28:35,948 --> 00:28:37,784 very different from most of my clients. 686 00:28:39,251 --> 00:28:42,755 Ooh, what's coming? 687 00:28:42,822 --> 00:28:43,790 Hey, hey, hey. 688 00:28:43,856 --> 00:28:46,392 I remember that first meeting, you know, 689 00:28:46,425 --> 00:28:49,728 this spectacular woman came into the room. 690 00:28:49,762 --> 00:28:51,630 I was watching her body language 691 00:28:51,697 --> 00:28:54,867 and I thought, I think this is my soulmate. 692 00:28:54,901 --> 00:28:55,768 Theodore, I can't believe you're not even 693 00:28:55,835 --> 00:28:57,669 paying attention, buddy. 694 00:28:58,437 --> 00:29:00,572 The plan is to make a plan. 695 00:29:00,606 --> 00:29:02,909 So how do you take on the government 696 00:29:02,942 --> 00:29:05,577 for women's sexual pleasure? 697 00:29:05,611 --> 00:29:07,379 I was working primarily in oncology, 698 00:29:07,413 --> 00:29:09,949 so trying to get cancer drugs through the FDA, 699 00:29:10,016 --> 00:29:13,219 and I hadn't done much in the reproductive health space. 700 00:29:13,252 --> 00:29:15,888 And Cindy walked in with so much energy 701 00:29:15,922 --> 00:29:18,925 and started telling me about HSDD and Flibanserin 702 00:29:18,958 --> 00:29:21,994 and the challenges that FDA had given them. 703 00:29:22,061 --> 00:29:25,798 My first reaction honestly in that moment was, oh these, 704 00:29:25,832 --> 00:29:28,134 these seem like great people and an energized team, 705 00:29:28,200 --> 00:29:30,269 but I don't think I'm gonna be able to help them. 706 00:29:34,173 --> 00:29:36,275 I didn't understand the condition. 707 00:29:36,308 --> 00:29:38,978 You know, I thought of it's, it's a sex drug, 708 00:29:39,011 --> 00:29:41,981 that sounds like something that's not necessary. 709 00:29:42,014 --> 00:29:44,650 Oncology drugs are saving people's lives 710 00:29:44,683 --> 00:29:47,186 and I didn't think it was as important. 711 00:29:49,255 --> 00:29:54,060 The reason I decided to take the case was Cindy showed me 712 00:29:54,093 --> 00:29:55,794 some real documented evidence 713 00:29:55,828 --> 00:29:58,130 of things FDA was saying and asking for 714 00:29:58,164 --> 00:30:02,301 that pointed out to me that FDA had a real bias 715 00:30:02,334 --> 00:30:06,839 rooted in maybe hangups about women and sex and, 716 00:30:06,873 --> 00:30:09,208 and that FDA wasn't thinking about this, um, 717 00:30:09,275 --> 00:30:10,943 in a truly scientific way. 718 00:30:10,977 --> 00:30:13,579 And I decided to take it because as a lawyer 719 00:30:13,612 --> 00:30:16,448 it sort of rubbed my fairness button the wrong way. 720 00:30:17,516 --> 00:30:22,054 [Stacey]. When the drug first went up for FDA review in 2010, 721 00:30:22,121 --> 00:30:25,657 the FDA did not feel that there was enough data 722 00:30:25,691 --> 00:30:28,460 to support its effectiveness. 723 00:30:28,494 --> 00:30:31,230 [reporter]. The FDA advisory panel voted ten to one, 724 00:30:31,297 --> 00:30:33,966 that flibanserin was not significantly better 725 00:30:34,000 --> 00:30:35,067 than a placebo, 726 00:30:35,134 --> 00:30:37,003 and unanimously that the benefits 727 00:30:37,036 --> 00:30:40,206 did not outweigh side effects like dizziness, nausea, 728 00:30:40,239 --> 00:30:42,208 and fatigue. 729 00:30:42,274 --> 00:30:44,010 [Josephine]. When the German company took it forward, 730 00:30:44,043 --> 00:30:47,146 they got a list of issues that said go do one more study 731 00:30:47,179 --> 00:30:48,514 where you show desire 732 00:30:48,547 --> 00:30:51,550 and then also go do a number of studies 733 00:30:51,583 --> 00:30:54,086 on healthy volunteers looking at interactions 734 00:30:54,153 --> 00:30:55,254 with other drugs. 735 00:30:55,321 --> 00:30:58,090 And that's when Sprout took it and did all that work. 736 00:30:58,157 --> 00:30:59,558 Then they brought that back to FDA 737 00:30:59,625 --> 00:31:02,028 and now they get rejected again, 738 00:31:02,061 --> 00:31:04,030 having done everything FDA asked for. 739 00:31:04,063 --> 00:31:05,564 [reporter]. The FDA gave a red light 740 00:31:05,597 --> 00:31:08,734 to a drug meant to rev up a woman's sex drive. 741 00:31:08,767 --> 00:31:12,038 The agency rejected a little pink pill called Flibanserin 742 00:31:12,071 --> 00:31:14,140 saying it had modest effectiveness. 743 00:31:14,173 --> 00:31:18,010 We've had biological solutions and treatments for men. 744 00:31:18,044 --> 00:31:19,912 I think it's time for women. 745 00:31:19,979 --> 00:31:25,251 [Stacey]. Erectile dysfunction was seen as an unmet physical ailment. 746 00:31:25,284 --> 00:31:31,523 Addyi was evaluated as an unmet psychological ailment, 747 00:31:31,557 --> 00:31:35,561 which immediately triggers a higher standard of review 748 00:31:35,594 --> 00:31:37,563 and additional safety measures. 749 00:31:38,430 --> 00:31:40,866 [Anita]. They said it had to be ultra safe 750 00:31:40,899 --> 00:31:44,003 because women were taking it every day. 751 00:31:44,036 --> 00:31:49,308 And so, they generated a lot of concerns about things like 752 00:31:49,375 --> 00:31:51,077 use with alcohol. 753 00:31:51,110 --> 00:31:54,947 Addyi is alleged to have this shocking alcohol interaction 754 00:31:55,014 --> 00:31:56,615 that we can't accept, 755 00:31:56,648 --> 00:32:00,252 when the data are almost exactly the data of Cialis. 756 00:32:00,286 --> 00:32:01,620 And when you look at Cialis, 757 00:32:01,687 --> 00:32:04,390 it essentially says men should not binge drink. 758 00:32:04,423 --> 00:32:08,560 [Anita]. "You shouldn't consume if you've had more than five 759 00:32:08,594 --> 00:32:10,229 "alcoholic beverages." 760 00:32:10,262 --> 00:32:13,432 So women can't have any and men can have five 761 00:32:13,465 --> 00:32:15,134 and still take it. 762 00:32:15,167 --> 00:32:16,935 Well it's probably not gonna work very well 763 00:32:16,969 --> 00:32:20,772 in that circumstance for an erection, but okay. 764 00:32:20,806 --> 00:32:24,110 [Josephine]. Another example is that flibanserin makes you sleepy. 765 00:32:24,143 --> 00:32:26,112 That is a labelled side effect, 766 00:32:26,145 --> 00:32:29,148 we know that that's why you take it right before bed. 767 00:32:29,215 --> 00:32:31,183 And we had shown 768 00:32:31,250 --> 00:32:32,318 that there were more sex, 769 00:32:32,351 --> 00:32:34,153 satisfying sexual events when you were on flibanserin 770 00:32:34,220 --> 00:32:35,187 than when you weren't. 771 00:32:35,254 --> 00:32:36,822 And one of the FDA reviewers said, 772 00:32:36,888 --> 00:32:40,092 "Well couldn't that be because the women are just too sleepy 773 00:32:40,126 --> 00:32:42,194 "to fight off their husbands?" 774 00:32:42,261 --> 00:32:44,363 First of all, I don't believe we have husband rapists 775 00:32:44,430 --> 00:32:45,331 at large in this country. 776 00:32:45,397 --> 00:32:46,798 But, but beyond that, 777 00:32:46,832 --> 00:32:48,234 you know, I just thought, 778 00:32:48,267 --> 00:32:50,269 if everybody could just think about their personal situation 779 00:32:50,302 --> 00:32:51,470 for a moment, 780 00:32:51,503 --> 00:32:53,205 the wife is sleepy, 781 00:32:53,272 --> 00:32:55,041 are we having more sex or less sex? 782 00:32:55,107 --> 00:32:57,176 The notion that the wife is sleepy 783 00:32:57,243 --> 00:32:58,644 so we must be having more sex, 784 00:32:58,677 --> 00:33:03,049 like you're refusing to accept that this is real data. 785 00:33:03,115 --> 00:33:05,817 Like so when you see data that answers the question, 786 00:33:05,851 --> 00:33:07,386 yes, they're having more sex, 787 00:33:07,453 --> 00:33:10,189 you immediately are looking for a way to discount it. 788 00:33:10,222 --> 00:33:13,159 Their concern with sedation was, 789 00:33:13,192 --> 00:33:15,194 and they literally said this, 790 00:33:15,261 --> 00:33:19,265 that a woman might take flibanserin the night before 791 00:33:19,298 --> 00:33:20,399 and get up in the morning 792 00:33:20,466 --> 00:33:23,502 and fall asleep driving her kids to school. 793 00:33:24,770 --> 00:33:26,172 It was very much like, 794 00:33:26,205 --> 00:33:28,640 well, we need to sort of protect women 795 00:33:28,674 --> 00:33:30,709 because they might not remember, 796 00:33:30,742 --> 00:33:34,180 they might not make good choices about taking this, 797 00:33:34,213 --> 00:33:36,048 and it's so dangerous. 798 00:33:36,082 --> 00:33:39,017 So we did a driving study and lo and behold, 799 00:33:39,051 --> 00:33:43,422 women drove better taking Addyi than placebo. 800 00:33:43,489 --> 00:33:45,091 And that's not surprising 801 00:33:45,157 --> 00:33:48,860 'cause if you have a better deeper night's sleep, um, 802 00:33:48,894 --> 00:33:51,363 your reaction time in the morning is improved. 803 00:33:51,397 --> 00:33:54,766 You know, the driving study was over a million dollars, 804 00:33:54,833 --> 00:33:56,502 which we have so many drugs, 805 00:33:56,535 --> 00:33:58,604 all the anti-depressants cause sedation. 806 00:33:59,505 --> 00:34:00,739 And no one said, 807 00:34:00,772 --> 00:34:02,408 go make sure, you know, you're, 808 00:34:02,474 --> 00:34:04,410 you're not gonna be impaired the next morning. 809 00:34:04,476 --> 00:34:06,678 The reason here was, well these are women 810 00:34:06,712 --> 00:34:08,547 who could be driving their kids to school. 811 00:34:08,580 --> 00:34:13,119 And it's that paternalistic lens over women's health, right? 812 00:34:13,185 --> 00:34:15,053 That it's, it's not about the woman, 813 00:34:15,087 --> 00:34:17,356 it's about the people she touches in her life 814 00:34:17,389 --> 00:34:19,057 and also protecting them. 815 00:34:19,091 --> 00:34:20,459 And that's inappropriate, right? 816 00:34:20,526 --> 00:34:22,894 A drug is, is approved as safe and effective 817 00:34:22,928 --> 00:34:24,963 for the people who take it. 818 00:34:25,597 --> 00:34:27,333 [reporter]. It's the little pink pill. 819 00:34:27,366 --> 00:34:29,235 And this one is for the ladies. 820 00:34:29,268 --> 00:34:33,205 It works on key chemicals in the brain to increase desire. 821 00:34:33,239 --> 00:34:36,942 They, they had a desire before and they've lost that 822 00:34:36,975 --> 00:34:39,945 and it's really causing pretty profound distress, 823 00:34:39,978 --> 00:34:43,215 either for them personally or in their relationship dynamic. 824 00:34:43,249 --> 00:34:46,118 [reporter]. Enter the pink pill known as flibanserin. 825 00:34:46,152 --> 00:34:47,953 Cindy Whitehead bought the rights to it 826 00:34:47,986 --> 00:34:51,290 and has been working for three years to get FDA approval. 827 00:34:51,357 --> 00:34:54,560 The last trial of a thousand women showed promising results. 828 00:34:55,794 --> 00:34:59,465 [Josephine]. FDA insisted that we measure satisfying sexual events. 829 00:34:59,498 --> 00:35:01,333 We had to show an improvement 830 00:35:01,400 --> 00:35:03,469 in how many satisfying sexual events we were having, 831 00:35:03,535 --> 00:35:05,070 and we showed it, right? 832 00:35:05,103 --> 00:35:06,972 That was, I think it was one more per month 833 00:35:07,038 --> 00:35:09,408 and FDA's like oh, one more per month. 834 00:35:09,441 --> 00:35:11,310 And in essence, the FDA had said to us, 835 00:35:11,343 --> 00:35:14,480 well, we feel the effect is only modest 836 00:35:14,513 --> 00:35:17,316 and therefore no risk would be worth it. 837 00:35:17,383 --> 00:35:19,418 So we said to the FDA, hold on, 838 00:35:19,451 --> 00:35:22,288 what do you mean that the effect is modest? 839 00:35:22,321 --> 00:35:23,322 It is true 840 00:35:23,389 --> 00:35:26,325 that Addyi doesn't take you from being having no sex 841 00:35:26,392 --> 00:35:27,959 to being a nymphomaniac. 842 00:35:27,993 --> 00:35:29,127 Actually, that would be bad. 843 00:35:29,161 --> 00:35:31,197 We have to measure for that in clinical trials, right? 844 00:35:31,263 --> 00:35:33,299 It takes you from a place in which 845 00:35:33,332 --> 00:35:34,366 you're not thinking about sex 846 00:35:34,433 --> 00:35:36,435 to where you are thinking about sex. 847 00:35:36,468 --> 00:35:39,338 Society thinks of sex as a performative act, 848 00:35:39,371 --> 00:35:40,872 there's a destination. 849 00:35:40,939 --> 00:35:42,841 And really what this was addressing 850 00:35:42,874 --> 00:35:47,112 was the brain being in the right place 851 00:35:47,145 --> 00:35:48,414 to have spontaneous interest 852 00:35:48,447 --> 00:35:51,217 to respond to a partner's advance, 853 00:35:51,283 --> 00:35:53,552 to want to initiate something. 854 00:35:53,619 --> 00:35:57,423 So like everything being so performance driven 855 00:35:57,456 --> 00:35:59,157 was really a male metric. 856 00:35:59,191 --> 00:36:02,228 [Francisco]. The studies show that there's an increase in, on average, 857 00:36:02,294 --> 00:36:04,863 one sexually satisfying encounter a month. 858 00:36:04,896 --> 00:36:06,398 And a lot of folks will hear that and say, 859 00:36:06,465 --> 00:36:08,300 one encounter a month, that's very little, 860 00:36:08,334 --> 00:36:10,402 but how is that even worth it? 861 00:36:10,469 --> 00:36:13,305 And my response to that typically is, 862 00:36:13,339 --> 00:36:15,374 when we're treating somebody who has HSDD, 863 00:36:15,407 --> 00:36:17,042 they'll be lucky if they have sex 864 00:36:17,075 --> 00:36:18,844 once or twice a year typically. 865 00:36:18,877 --> 00:36:23,215 Once a month is a monstrous change for some of these, uh, 866 00:36:23,249 --> 00:36:24,182 these couples. 867 00:36:24,216 --> 00:36:25,651 [clacking] 868 00:36:26,184 --> 00:36:28,554 [Stacey]. We've always prioritized our sex life 869 00:36:28,587 --> 00:36:31,056 and it's something we don't wanna lose. 870 00:36:31,122 --> 00:36:32,558 - We met in college. - Yeah. 871 00:36:32,591 --> 00:36:34,393 - Um... - Grad school. 872 00:36:34,460 --> 00:36:35,861 Grad school. 873 00:36:35,894 --> 00:36:38,897 Both studying the same subject, 874 00:36:38,964 --> 00:36:42,668 and we didn't hit it off right away, 875 00:36:42,701 --> 00:36:46,672 but, um, once we, uh, got together we've been inseparable 876 00:36:47,573 --> 00:36:52,411 and, um, well our relationship was fine, um, 877 00:36:52,478 --> 00:36:58,617 but our sex life had, had dwindled, um, 878 00:36:58,684 --> 00:37:00,252 and it was frustrating of course, 879 00:37:00,319 --> 00:37:02,621 but then, um, you know, 880 00:37:02,688 --> 00:37:04,390 I was going through a change too. 881 00:37:04,423 --> 00:37:07,225 And so, every month I was going and getting tested, 882 00:37:07,259 --> 00:37:09,461 um, for testosterone levels. 883 00:37:09,528 --> 00:37:12,298 And I think we were both experiencing our own versions 884 00:37:12,364 --> 00:37:13,899 of menopause, um, 885 00:37:13,932 --> 00:37:17,736 and our libidos seemed to be out of sync. 886 00:37:17,769 --> 00:37:23,275 Um, David got involved in some treatment that increased his, 887 00:37:23,342 --> 00:37:26,378 and mine was still laxing there behind. 888 00:37:26,412 --> 00:37:31,049 And, um, I had one, um, gynecologist, um, 889 00:37:31,082 --> 00:37:37,489 but she didn't try to educate me beyond, um, 890 00:37:37,556 --> 00:37:40,492 I think she said something to the effect of, 891 00:37:40,559 --> 00:37:42,561 um, you're at a approaching a period of time 892 00:37:42,594 --> 00:37:45,431 where hormones probably wouldn't make more sense for you. 893 00:37:47,198 --> 00:37:48,434 [Sue]. So clearly you can see, 894 00:37:48,467 --> 00:37:50,168 despite the wonderful job with my makeup, 895 00:37:50,235 --> 00:37:52,304 that I'm a menopausal woman. 896 00:37:52,338 --> 00:37:53,339 And for those who think 897 00:37:53,405 --> 00:37:54,506 that after your hot flashes are gone 898 00:37:54,573 --> 00:37:55,941 menopause is over, 899 00:37:55,974 --> 00:37:57,476 no, you're in menopause for the rest of your life 900 00:37:57,543 --> 00:37:59,511 until you die. 901 00:37:59,578 --> 00:38:00,946 But just because you're menopausal 902 00:38:00,979 --> 00:38:03,482 doesn't mean you don't have a right to great sex. 903 00:38:04,383 --> 00:38:05,317 My whole life and my whole training 904 00:38:05,384 --> 00:38:07,819 menopause was treated as a footnote. 905 00:38:07,853 --> 00:38:09,120 In my field it was like, 906 00:38:09,154 --> 00:38:12,257 use lube as though that would solve all the solutions 907 00:38:12,290 --> 00:38:13,559 to do with your shoulder, 908 00:38:13,592 --> 00:38:14,660 to do with your brain fog, 909 00:38:14,693 --> 00:38:16,995 to do with the way alcohol affects you, 910 00:38:17,028 --> 00:38:18,964 the fact that you can't sleep at night. 911 00:38:18,997 --> 00:38:21,132 And now we're in this moment 912 00:38:21,166 --> 00:38:23,569 where we're talking about perimenopause and menopause 913 00:38:23,602 --> 00:38:25,604 and it's pissing some people off. 914 00:38:25,637 --> 00:38:27,606 They're wondering why are you being so loud about it? 915 00:38:27,639 --> 00:38:28,807 Well, the real question is, 916 00:38:28,840 --> 00:38:31,677 why were we forced to be so quiet about it for so long? 917 00:38:32,378 --> 00:38:36,047 Postmenopausal patients are considered irrelevant 918 00:38:36,114 --> 00:38:39,317 when it comes to sexual health in our society. 919 00:38:39,351 --> 00:38:41,987 It is not only by our society, 920 00:38:42,020 --> 00:38:43,254 but patients within themselves 921 00:38:43,288 --> 00:38:45,290 don't feel like they deserve sex. 922 00:38:45,323 --> 00:38:46,358 They don't deserve intimacy. 923 00:38:46,425 --> 00:38:48,494 They don't deserve pleasure, connection. 924 00:38:48,527 --> 00:38:51,863 I had a patient come in just the other day who said, 925 00:38:51,897 --> 00:38:54,966 "I shouldn't even be having sex anymore, right?" 926 00:38:55,000 --> 00:38:58,537 And I mean, my, my mouth is open for them 927 00:38:58,604 --> 00:38:59,638 because I'm just like, 928 00:38:59,671 --> 00:39:03,542 I don't understand how this can be so ingrained 929 00:39:03,575 --> 00:39:04,676 in everything that we do 930 00:39:04,710 --> 00:39:07,212 that even patients feel that they don't deserve it. 931 00:39:07,278 --> 00:39:10,682 And I think that's what's so heartbreaking, um, 932 00:39:10,716 --> 00:39:14,553 is to see that people don't even value themselves 933 00:39:14,586 --> 00:39:17,856 because our society has so clearly told them 934 00:39:17,889 --> 00:39:20,926 that they are no longer a valued part of the society. 935 00:39:23,228 --> 00:39:24,863 [Stacey]. When you look at women: 936 00:39:24,896 --> 00:39:27,633 premenopausal, postmenopausal, 937 00:39:27,666 --> 00:39:29,535 transgender individuals, 938 00:39:29,568 --> 00:39:33,238 the conversation of what is available for you 939 00:39:33,271 --> 00:39:36,207 is not dictated by you. 940 00:39:36,241 --> 00:39:39,244 If you are a cisgendered white male, 941 00:39:39,310 --> 00:39:40,546 the healthcare in the United States 942 00:39:40,579 --> 00:39:42,714 is pretty darn good 943 00:39:42,748 --> 00:39:48,053 and your healthcare experience can be a uniquely personal one. 944 00:39:48,086 --> 00:39:49,721 [reporter]. Twenty-six to zero, 945 00:39:49,755 --> 00:39:51,923 that represents how many drugs are available 946 00:39:51,957 --> 00:39:53,925 to treat male sexual dysfunction, 947 00:39:53,959 --> 00:39:55,961 compared to those that treat women's. 948 00:39:57,128 --> 00:40:00,932 [Cindy]. When I started, there were 25 FDA approved drugs for men. 949 00:40:00,966 --> 00:40:03,735 When we were going through this, and in our appeal, 950 00:40:03,769 --> 00:40:06,805 the 26th drug for men came to market 951 00:40:06,872 --> 00:40:09,074 and it's for curvature of the penis 952 00:40:09,107 --> 00:40:11,877 that interferes with your enjoyment of sex. 953 00:40:11,910 --> 00:40:15,113 Okay, so that typically had to be corrected surgically 954 00:40:15,146 --> 00:40:17,048 and now there was a different and simpler option. 955 00:40:17,082 --> 00:40:18,116 Great. 956 00:40:18,183 --> 00:40:22,420 So the studies were on around a thousand or so men 957 00:40:22,454 --> 00:40:26,658 and it had a pretty important but rare side effect, 958 00:40:26,725 --> 00:40:29,160 and that was penile rupture. 959 00:40:29,227 --> 00:40:31,497 So let me get this straight, 960 00:40:31,563 --> 00:40:34,132 we can give men a product and their dick can explode, 961 00:40:34,165 --> 00:40:36,502 but women can't have the seven dwarfs of side effects 962 00:40:36,568 --> 00:40:38,570 like sleepy, dizzy, nausea. 963 00:40:38,604 --> 00:40:42,307 Twenty-six times we had done that for men. 964 00:40:42,373 --> 00:40:46,612 So guys, it's just you and your honey. 965 00:40:46,645 --> 00:40:48,747 Setting is perfect. 966 00:40:48,780 --> 00:40:52,484 But then erectile dysfunction happens again. 967 00:40:52,551 --> 00:40:55,320 [Cindy]. Viagra at that point had done so many commercials 968 00:40:55,353 --> 00:40:58,590 and, you know, we laughed about the Viagra ads at the time 969 00:40:58,624 --> 00:41:01,326 that were basically conditioning women 970 00:41:01,359 --> 00:41:03,695 to let men know all their choices, um, 971 00:41:03,762 --> 00:41:05,831 while not asking the question, where's mine? 972 00:41:05,897 --> 00:41:06,832 You know what? 973 00:41:06,898 --> 00:41:08,266 Plenty of guys have this issue, 974 00:41:08,299 --> 00:41:09,668 not just getting an erection, 975 00:41:09,735 --> 00:41:10,936 but keeping it. 976 00:41:10,969 --> 00:41:14,840 Well Viagra helps guys with ED get and keep an erection. 977 00:41:16,808 --> 00:41:21,847 I'm a beautiful woman laying in a bed talking about 978 00:41:21,913 --> 00:41:23,582 your erection. 979 00:41:24,516 --> 00:41:25,884 Erection. 980 00:41:29,354 --> 00:41:30,689 Now that they're distracted, 981 00:41:30,722 --> 00:41:33,024 let's do something to change this. 982 00:41:33,058 --> 00:41:34,693 Women deserve better. 983 00:41:34,726 --> 00:41:36,261 Let's even the score. 984 00:41:37,563 --> 00:41:38,830 Stop! 985 00:41:38,864 --> 00:41:42,000 Sprout initiated something called "even the score." 986 00:41:42,033 --> 00:41:44,670 This was a advocacy campaign 987 00:41:44,703 --> 00:41:47,338 to try to get people to understand 988 00:41:47,372 --> 00:41:52,377 that this is a critical issue for 10% or more of women. 989 00:41:52,443 --> 00:41:54,379 Are we really so behind 990 00:41:54,412 --> 00:41:57,549 that we don't think women have the right to sexual desire? 991 00:41:57,583 --> 00:42:00,619 Yet again we come second. 992 00:42:01,920 --> 00:42:03,922 [ad voice]. Men who take erectile dysfunction medication 993 00:42:03,989 --> 00:42:05,490 may find it entirely useless 994 00:42:05,523 --> 00:42:08,193 if their partner does not have any sexual desire. 995 00:42:08,226 --> 00:42:10,729 Options for women have been through rigorous trials 996 00:42:10,762 --> 00:42:12,931 and show less serious side effects. 997 00:42:12,998 --> 00:42:14,700 Safe and effective sexual health medication 998 00:42:14,733 --> 00:42:16,768 could help thousands of women and their partners 999 00:42:16,835 --> 00:42:18,837 enjoy a healthy sex life. 1000 00:42:20,238 --> 00:42:21,707 Men have a little blue pill, 1001 00:42:21,740 --> 00:42:24,375 so why not a little pink pill for the ladies? 1002 00:42:24,409 --> 00:42:28,213 [Stacey]. Sprout really helped in bringing the conversation 1003 00:42:28,246 --> 00:42:30,181 into the media 1004 00:42:30,215 --> 00:42:34,886 and into the living rooms and awareness of people. 1005 00:42:34,920 --> 00:42:36,588 - Flibanserin. - Flibanserin. 1006 00:42:36,622 --> 00:42:37,889 Flibanserin. 1007 00:42:37,923 --> 00:42:39,725 [reporter]. Now it is expected to be marketed under the name, 1008 00:42:39,758 --> 00:42:41,092 Addyi-1. 1009 00:42:41,126 --> 00:42:43,629 [Cindy]. It became a very public conversation. 1010 00:42:43,695 --> 00:42:45,563 Here's this little private company 1011 00:42:45,597 --> 00:42:46,932 in Raleigh, North Carolina, 1012 00:42:46,998 --> 00:42:49,701 and all of a sudden Nightline shows up at my door. 1013 00:42:49,735 --> 00:42:52,337 They're like, who are you and what's happening here? 1014 00:42:52,370 --> 00:42:54,740 [reporter]. It's known as Viagra for women, 1015 00:42:54,773 --> 00:42:58,744 a tiny tablet that could have a huge impact in the bedroom. 1016 00:42:58,777 --> 00:43:01,046 I think this is absolutely an evolution 1017 00:43:01,079 --> 00:43:03,114 in the female sexual revolution. 1018 00:43:03,148 --> 00:43:06,618 [reporter]. But you won't be able to get the pink pill just yet 1019 00:43:06,685 --> 00:43:08,754 because the drug is locked in a heated battle 1020 00:43:08,787 --> 00:43:10,756 for FDA approval. 1021 00:43:10,789 --> 00:43:11,857 [Cindy]. Once that happened, you know, 1022 00:43:11,890 --> 00:43:13,792 the public was all weighing in. 1023 00:43:13,859 --> 00:43:15,260 [reporter]. There's a pill that's in development 1024 00:43:15,293 --> 00:43:16,427 not FDA approved yet. 1025 00:43:16,461 --> 00:43:18,063 Woo! For women? Like Viagra? 1026 00:43:18,096 --> 00:43:19,597 There you go. 1027 00:43:19,631 --> 00:43:22,267 People are like, aw, the little pink pill. 1028 00:43:22,300 --> 00:43:23,301 So it's the little pink pill. 1029 00:43:23,368 --> 00:43:24,803 That little pink pill. 1030 00:43:24,870 --> 00:43:26,137 It's a little pink pill. 1031 00:43:26,171 --> 00:43:27,773 Oh the little pink pill. 1032 00:43:27,806 --> 00:43:29,775 It is the sing song in their voice 1033 00:43:29,808 --> 00:43:30,776 and the pat on the shoulders. 1034 00:43:30,809 --> 00:43:32,310 It assumed weakness. 1035 00:43:32,343 --> 00:43:34,345 It assumed that it was trivial. 1036 00:43:34,412 --> 00:43:35,647 Is there something to fix? 1037 00:43:35,714 --> 00:43:37,448 No, not at all. 1038 00:43:37,482 --> 00:43:39,851 [Cindy]. And it was so dismissive. 1039 00:43:39,918 --> 00:43:42,020 [reporter]. Some doctors say flibanserin was rejected 1040 00:43:42,087 --> 00:43:43,755 for a very simple reason, 1041 00:43:43,789 --> 00:43:47,125 it's an ineffective drug for a non-existent problem. 1042 00:43:47,158 --> 00:43:49,127 It's a classic marketing technique 1043 00:43:49,160 --> 00:43:52,630 to first create a problem and then sell the solution. 1044 00:43:52,664 --> 00:43:54,365 And that's what's going on here. 1045 00:43:54,432 --> 00:43:56,134 What is this advocacy group? 1046 00:43:56,167 --> 00:43:58,503 Is it a Sprout PR campaign? 1047 00:43:58,536 --> 00:44:00,071 [reporter]. It looks like a Viagra ad, 1048 00:44:00,105 --> 00:44:02,841 but this parody is mocking all those male pills 1049 00:44:02,908 --> 00:44:04,676 and their big budget commercials. 1050 00:44:04,743 --> 00:44:06,511 Even the Score made the video, 1051 00:44:06,544 --> 00:44:09,480 a group backed by nonprofits and pharmaceutical companies, 1052 00:44:09,514 --> 00:44:11,750 including the one that makes Flibanserin, 1053 00:44:11,783 --> 00:44:13,819 the so-called "Little Pink Pill." 1054 00:44:15,754 --> 00:44:21,159 [gentle piano music] 1055 00:44:21,192 --> 00:44:23,361 [Cindy]. You can make two choices in that moment, right? 1056 00:44:23,428 --> 00:44:27,165 You either let it set you back and you lean back from it 1057 00:44:27,198 --> 00:44:28,700 or you lean right into it 1058 00:44:28,734 --> 00:44:30,769 and say, this is the conversation we're gonna have. 1059 00:44:32,704 --> 00:44:35,606 I took my pink stilettos and I started going to DC. 1060 00:44:36,975 --> 00:44:39,644 And I was knocking on the doors of these giants 1061 00:44:39,677 --> 00:44:41,546 in women's rights and women's health 1062 00:44:41,612 --> 00:44:44,215 and I was like, hi, I'm Cindy, 1063 00:44:44,249 --> 00:44:48,019 I have this company and here's what this condition is. 1064 00:44:48,053 --> 00:44:50,121 And I went with Dr. Goldstein 1065 00:44:50,155 --> 00:44:54,225 so that they could ask an expert any questions they might have. 1066 00:44:54,259 --> 00:44:57,362 And at the end of this meeting a woman named Susan Scanlon 1067 00:44:57,395 --> 00:44:59,898 who ran the National Council of Women's Organizations, 1068 00:44:59,931 --> 00:45:03,401 came over and she's like, we're gonna fight this. 1069 00:45:07,739 --> 00:45:10,909 When we called it on a double standard, 1070 00:45:10,976 --> 00:45:13,879 this group started to come together. 1071 00:45:13,912 --> 00:45:17,615 Here were giants of Women's Health and Rights, 1072 00:45:17,682 --> 00:45:19,217 Black Women's Health Imperative, 1073 00:45:19,250 --> 00:45:20,919 Nurse Practitioners in Women's Health, 1074 00:45:20,952 --> 00:45:22,620 Nurse-Midwives, 1075 00:45:22,687 --> 00:45:23,855 National Organization for Women, 1076 00:45:23,889 --> 00:45:25,223 National Council of Women's Organizations, 1077 00:45:25,256 --> 00:45:26,391 National Consumers League, 1078 00:45:26,424 --> 00:45:30,695 incredible like women that were my heroes. 1079 00:45:33,264 --> 00:45:35,266 The FDA themselves had deemed this 1080 00:45:35,300 --> 00:45:39,537 one of their top ten areas of unmet need. 1081 00:45:39,570 --> 00:45:41,907 This issue is so prevalent it affects so many women 1082 00:45:41,940 --> 00:45:44,575 that it was on their top ten list, 1083 00:45:44,609 --> 00:45:46,845 and yet here we were in this conversation. 1084 00:45:46,878 --> 00:45:49,614 So for all these women's rights groups, 1085 00:45:49,647 --> 00:45:51,416 with Dr. Goldstein, 1086 00:45:51,449 --> 00:45:55,320 chartered a bus and demanded a meeting with the FDA, 1087 00:45:59,124 --> 00:46:00,826 [reporter]. An FDA advisory panel today 1088 00:46:00,892 --> 00:46:03,261 hearing the pros and cons of Flibanserin, 1089 00:46:03,294 --> 00:46:05,363 also known as the female Viagra. 1090 00:46:06,965 --> 00:46:10,135 [Cindy]. When we fought, other women fought. 1091 00:46:10,201 --> 00:46:12,637 [Susan]. Good morning, thank you for letting me speak. 1092 00:46:12,670 --> 00:46:14,772 I'm Susan Scanlon, I'm Chair Emerita 1093 00:46:14,806 --> 00:46:17,943 of the National Council of Women's Organizations. 1094 00:46:17,976 --> 00:46:20,178 I'm also chair of Even The Score. 1095 00:46:21,980 --> 00:46:23,982 [Cindy]. You know, I give all credit to Susan Scanlon, 1096 00:46:24,015 --> 00:46:26,952 who I'm so sad is no longer with us. 1097 00:46:26,985 --> 00:46:30,621 She was larger than life, with a voice to match, 1098 00:46:30,655 --> 00:46:35,827 and, you know, also a huge mentor of mine in that she said, 1099 00:46:35,861 --> 00:46:38,663 "We're gonna call a spade a spade here." 1100 00:46:38,696 --> 00:46:42,133 [Susan]. We're tired of hearing that female sexual health is complex 1101 00:46:42,167 --> 00:46:45,503 as if there would be no answer if we didn't study it. 1102 00:46:45,536 --> 00:46:46,671 Make no mistake, 1103 00:46:46,704 --> 00:46:48,306 men are equally complex 1104 00:46:48,339 --> 00:46:50,775 and there's been no shortage of medications 1105 00:46:50,808 --> 00:46:53,111 to address their sexual dysfunction. 1106 00:46:53,144 --> 00:46:54,312 In 1960, 1107 00:46:54,345 --> 00:46:57,448 the birth control pill precipitated a societal shift 1108 00:46:57,482 --> 00:47:01,019 to recognize women's rights as reproductive beings. 1109 00:47:01,086 --> 00:47:04,990 In 2014, let's shift to recognize women's rights 1110 00:47:05,023 --> 00:47:06,691 as sexual beings. 1111 00:47:06,724 --> 00:47:08,059 Thank you very much. 1112 00:47:08,126 --> 00:47:10,661 [crowd applauding] 1113 00:47:10,695 --> 00:47:12,230 [Cindy]. I would challenge anybody, 1114 00:47:12,297 --> 00:47:15,533 what is better than to have advocacy? 1115 00:47:15,566 --> 00:47:16,534 The best things have happened 1116 00:47:16,601 --> 00:47:18,569 when patients have taken the mic 1117 00:47:18,636 --> 00:47:20,638 and demanded what they deserve. 1118 00:47:20,671 --> 00:47:22,740 My name is Judith, I'm 66 years old 1119 00:47:22,807 --> 00:47:24,709 and I've been dealing with FSD 1120 00:47:24,775 --> 00:47:27,012 on and off for 17 years. 1121 00:47:27,045 --> 00:47:30,481 Hi, I'm Katherine, I'm from Indianapolis, Indiana. 1122 00:47:30,515 --> 00:47:34,019 I learned in high school sex ed that a woman's sexual prime, 1123 00:47:34,052 --> 00:47:36,021 so to speak, is in her thirties, 1124 00:47:36,054 --> 00:47:37,555 yet here I am. 1125 00:47:37,588 --> 00:47:40,725 [Barbara]. It is amazing how many women of all ages I talked to 1126 00:47:40,758 --> 00:47:43,194 that have some degree of HSDD, 1127 00:47:43,228 --> 00:47:47,832 this disorder is real and we need a solution. 1128 00:47:47,865 --> 00:47:51,869 At that time, there was a lot of feeling that 1129 00:47:51,903 --> 00:47:55,106 we were medicalizing HSDD. 1130 00:47:55,173 --> 00:47:56,975 And finally we have Susan. 1131 00:47:58,009 --> 00:47:59,077 Hi, I'm Susan. 1132 00:47:59,110 --> 00:48:02,280 I stopped having desire for sex about two years 1133 00:48:02,347 --> 00:48:05,550 into my now 11-year partnership with my husband. 1134 00:48:05,583 --> 00:48:07,385 My partner and I had done work on ourselves 1135 00:48:07,418 --> 00:48:08,886 in a therapeutic setting. 1136 00:48:08,920 --> 00:48:11,556 We learned that our sexual problems were a co-created 1137 00:48:11,589 --> 00:48:13,724 problem in our relationship. 1138 00:48:13,758 --> 00:48:15,560 [Anita]. Their idea was really that 1139 00:48:15,593 --> 00:48:17,895 it was saying you have a condition 1140 00:48:17,929 --> 00:48:21,066 that they didn't have because they were normal. 1141 00:48:21,099 --> 00:48:22,833 [reporter]. Clinical psychologist Leonore Tiefer 1142 00:48:22,867 --> 00:48:24,235 says Sprout has concocted a women's rights issue 1143 00:48:24,269 --> 00:48:28,406 to guilt the FDA into approving flibanserin. 1144 00:48:28,439 --> 00:48:32,877 It's just a mishmash of politics and science 1145 00:48:32,910 --> 00:48:35,113 and sex and money. 1146 00:48:35,180 --> 00:48:36,414 Money, money, money. 1147 00:48:36,447 --> 00:48:38,916 [reporter]. The FDA's ruling is due later this month. 1148 00:48:38,950 --> 00:48:42,954 [Joshua]. Some people felt like women's desire was more complicated 1149 00:48:43,021 --> 00:48:45,756 and we shouldn't be medicating women 1150 00:48:45,790 --> 00:48:48,159 because oftentimes their desire can get better 1151 00:48:48,226 --> 00:48:50,228 if they're working with a therapist 1152 00:48:50,261 --> 00:48:52,597 or you know, seeing a couple's therapist with their partner. 1153 00:48:52,630 --> 00:48:54,632 [reporter]. This busy mom of four, Amanda Parrish, 1154 00:48:54,665 --> 00:48:57,602 says she used to have a smouldering sex life 1155 00:48:57,635 --> 00:48:59,037 with her husband. 1156 00:48:59,070 --> 00:49:01,806 [doctor]. This drug isn't necessarily going to treat the fatigue 1157 00:49:01,872 --> 00:49:03,641 that might be giving you a low sex drive 1158 00:49:03,674 --> 00:49:06,311 or you know, the kids that you have running around 1159 00:49:06,377 --> 00:49:08,579 or the partner who isn't helping you out 1160 00:49:08,613 --> 00:49:09,814 with the chores around the house. 1161 00:49:09,847 --> 00:49:11,082 [Joshua]. That's totally true. 1162 00:49:11,116 --> 00:49:16,154 But why shouldn't we offer a medication 1163 00:49:16,221 --> 00:49:18,823 that has been shown, clinically proven, 1164 00:49:18,856 --> 00:49:20,158 to help increase desire? 1165 00:49:20,191 --> 00:49:22,327 Not to say that it's one or the other. 1166 00:49:22,360 --> 00:49:24,462 In fact, I think most people that prescribe this medication 1167 00:49:24,495 --> 00:49:25,663 would say, 1168 00:49:25,696 --> 00:49:27,632 keeping that therapy stuff around 1169 00:49:27,665 --> 00:49:29,634 is really important, right? 1170 00:49:29,667 --> 00:49:33,238 But if you can provide a medical solution 1171 00:49:33,271 --> 00:49:37,008 in conjunction with psychological treatments, 1172 00:49:37,075 --> 00:49:39,344 why would we deny women that? 1173 00:49:39,377 --> 00:49:41,646 Women don't need treatments with real side effects 1174 00:49:41,679 --> 00:49:44,349 for imaginary diseases invented by marketers. 1175 00:49:44,415 --> 00:49:47,185 [Sue]. If you've never experienced HSDD, 1176 00:49:47,218 --> 00:49:48,686 you don't understand what it is. 1177 00:49:48,719 --> 00:49:49,987 [Thea]. It is a thinly veiled, 1178 00:49:50,021 --> 00:49:53,191 profit-driven marketing campaign filled with bias, 1179 00:49:53,258 --> 00:49:56,161 misleading, unsubstantiated information. 1180 00:49:56,194 --> 00:49:58,096 I think it's a scam. 1181 00:49:58,129 --> 00:50:02,300 To have a community fighting and saying we were medicalizing 1182 00:50:02,333 --> 00:50:04,202 and claiming this wasn't a biologic problem. 1183 00:50:04,235 --> 00:50:07,138 Well I will tell you it's a, it's in your brain. 1184 00:50:07,172 --> 00:50:10,308 The language I like to use when they say it's all in your head, 1185 00:50:10,341 --> 00:50:12,710 well, your brain is up in your head. 1186 00:50:12,777 --> 00:50:13,744 This is your brain. 1187 00:50:13,811 --> 00:50:14,745 We live in a world 1188 00:50:14,812 --> 00:50:16,747 where women should have a choice for their body 1189 00:50:16,814 --> 00:50:18,149 and they should be able to choose 1190 00:50:18,183 --> 00:50:20,318 if they wanna take a a pill, 1191 00:50:20,351 --> 00:50:23,054 an injection, sex therapy, 1192 00:50:23,121 --> 00:50:24,255 or all of them. 1193 00:50:24,322 --> 00:50:25,923 But who is anyone else to tell me? 1194 00:50:25,990 --> 00:50:27,225 And that's what angered me. 1195 00:50:27,258 --> 00:50:31,028 Who is that anyone else to tell me I have a biologic problem? 1196 00:50:31,062 --> 00:50:32,563 I know that I was functional before. 1197 00:50:32,597 --> 00:50:34,265 I know it's not in my relationship. 1198 00:50:34,332 --> 00:50:36,067 I know something's changed. 1199 00:50:36,101 --> 00:50:38,736 Who is gonna tell me I can't do something about it? 1200 00:50:38,769 --> 00:50:44,008 So the mood of the FDA was very much a combative 1201 00:50:44,041 --> 00:50:47,678 that either you believed in a biologic treatment 1202 00:50:47,712 --> 00:50:48,713 or you believed 1203 00:50:48,746 --> 00:50:51,382 that you shouldn't have a biologic treatment. 1204 00:50:51,416 --> 00:50:53,551 [male reporter]. A major medical headline tonight involving women, 1205 00:50:53,584 --> 00:50:55,920 the drug nicknamed the Little Pink Pill. 1206 00:50:55,986 --> 00:50:58,022 A key decision today. 1207 00:50:58,055 --> 00:51:00,091 [female reporter]. FDA advisors will once again consider 1208 00:51:00,158 --> 00:51:04,395 whether to approve a drug that's already been rejected twice. 1209 00:51:04,429 --> 00:51:06,063 [female reporter 2]. Women now once step closer 1210 00:51:06,097 --> 00:51:08,299 with joining their frisky male counterparts 1211 00:51:08,366 --> 00:51:10,935 who've enjoyed the benefits of pills to help their sex lives 1212 00:51:10,968 --> 00:51:12,370 for years. 1213 00:51:13,003 --> 00:51:15,306 [Josephine]. I arrived at FDA when the doors opened 1214 00:51:15,373 --> 00:51:17,275 and then as people started to come, they were like, 1215 00:51:17,342 --> 00:51:20,411 you know, there's people on the road, um, leading into the FDA 1216 00:51:20,445 --> 00:51:22,079 with signs and banners 1217 00:51:22,113 --> 00:51:24,449 and like, I think it's gonna be a tough day. 1218 00:51:27,418 --> 00:51:29,954 I was in my urology training at Georgetown 1219 00:51:29,987 --> 00:51:32,757 and so I was in the Washington DC area 1220 00:51:32,790 --> 00:51:35,092 and it just felt important. 1221 00:51:35,126 --> 00:51:37,595 I can't describe it, but it felt historical. 1222 00:51:38,363 --> 00:51:39,764 [Vivian]. Good morning. 1223 00:51:39,797 --> 00:51:42,400 We have a very full agenda. 1224 00:51:42,433 --> 00:51:45,002 Welcome to the Drugs Advisory Committee. 1225 00:51:45,803 --> 00:51:47,205 [Cindy]. It was straight out of a movie. 1226 00:51:47,238 --> 00:51:49,274 FDA's never seen crowds like this. 1227 00:51:49,307 --> 00:51:52,510 The press were showing up, everybody was in this room 1228 00:51:52,577 --> 00:51:55,646 and it feels a little bit like you're at the Supreme Court. 1229 00:51:57,081 --> 00:51:59,317 [Josephine]. The first FDA meeting I went to with Cindy, 1230 00:51:59,350 --> 00:52:01,952 you know, I had at that point met her a number of times 1231 00:52:01,986 --> 00:52:03,120 in person. 1232 00:52:03,154 --> 00:52:05,356 She was oddly always wearing pink. 1233 00:52:05,423 --> 00:52:06,257 And so I had this concern 1234 00:52:06,291 --> 00:52:08,259 that she was gonna wear pink to FDA, 1235 00:52:08,293 --> 00:52:11,296 and so I got up my nerve to tell her, so don't, 1236 00:52:11,329 --> 00:52:14,865 don't wear pink to FDA because you won't be credible. 1237 00:52:14,932 --> 00:52:18,002 And she really didn't say yes or no, 1238 00:52:18,035 --> 00:52:19,870 but she showed up the next day in pink. 1239 00:52:21,172 --> 00:52:22,773 [Cindy]. When I showed up at FDA meetings 1240 00:52:22,807 --> 00:52:25,176 and my pink got brighter and brighter and brighter 1241 00:52:25,243 --> 00:52:27,011 until you could see it from outer space. 1242 00:52:27,044 --> 00:52:29,780 To me it was about being unapologetic 1243 00:52:29,814 --> 00:52:31,782 and actually what was at the root of that 1244 00:52:31,816 --> 00:52:34,285 was the conversation we needed to have. 1245 00:52:34,319 --> 00:52:36,221 [Josephine]. I will tell you that the morning of the advisory committee, 1246 00:52:36,287 --> 00:52:37,455 I mean, it was very tense 1247 00:52:37,488 --> 00:52:39,857 and I was in my black suit and my beige shirt, 1248 00:52:39,890 --> 00:52:43,361 and I just went up to her and I knelt down right next to her 1249 00:52:43,394 --> 00:52:44,395 and I just said, 1250 00:52:44,462 --> 00:52:46,464 "I'm wearing pink underwear." 1251 00:52:46,497 --> 00:52:48,533 Like just to like, lighten the mood, 1252 00:52:48,599 --> 00:52:50,835 which was like also happened to be true. 1253 00:52:50,868 --> 00:52:53,371 Thank you Dr. Lewis and good morning. 1254 00:52:53,404 --> 00:52:55,440 I'd like to take a moment. I'm Josephine Torrente, 1255 00:52:55,473 --> 00:52:56,507 Executive Vice President 1256 00:52:56,541 --> 00:52:58,676 of Corporate and Regulatory Affairs 1257 00:52:58,709 --> 00:53:00,578 at Sprout Pharmaceuticals. 1258 00:53:00,645 --> 00:53:04,815 The first statement by FDA was a defence 1259 00:53:04,849 --> 00:53:06,451 that they are not in fact biassed. 1260 00:53:07,385 --> 00:53:11,622 So, uh, some have claimed gender bias on the part of FDA 1261 00:53:11,656 --> 00:53:15,893 when it comes to treatments for female sexual dysfunction. 1262 00:53:15,926 --> 00:53:19,430 The FDA firmly rejects this assertion. 1263 00:53:19,497 --> 00:53:22,066 FDA is always concerned with unmet needs, 1264 00:53:22,132 --> 00:53:25,836 whether this is in women, men or in children. 1265 00:53:25,870 --> 00:53:29,874 [Josephine]. The fact that FDA felt the pressure to say, 1266 00:53:29,907 --> 00:53:32,610 "We are not biassed against women's health," 1267 00:53:32,677 --> 00:53:36,414 just tells you the impact that these women were having 1268 00:53:36,447 --> 00:53:39,384 by going to FDA and saying, we need a drug for this. 1269 00:53:39,417 --> 00:53:41,252 Don't diminish the benefit. 1270 00:53:43,120 --> 00:53:50,227 [soft dramatic music] 1271 00:53:50,261 --> 00:53:51,429 Good afternoon. My name is Barbara. 1272 00:53:51,496 --> 00:53:52,463 I'm a nurse. 1273 00:53:52,530 --> 00:53:53,564 This is my daughter Vicky, 1274 00:53:53,598 --> 00:53:56,467 and we are patients of Dr. Goldstein 1275 00:53:56,534 --> 00:54:00,438 and we have no interest in the outcome of this meeting. 1276 00:54:00,505 --> 00:54:02,072 I'm Amanda Parrish. 1277 00:54:02,106 --> 00:54:04,942 I am one of the lucky 11,000 women 1278 00:54:04,975 --> 00:54:07,745 that was a patient on the Flibanserin clinical trial. 1279 00:54:07,778 --> 00:54:09,980 I'm here with my husband Ben. 1280 00:54:10,047 --> 00:54:13,250 We funded our own trip and we have no financial stake 1281 00:54:13,284 --> 00:54:14,885 at the outcome of this meeting. 1282 00:54:14,919 --> 00:54:17,121 Hi, my name is Katherine Campbell. 1283 00:54:17,154 --> 00:54:20,257 My travel expenses are being reimbursed by Sprout. 1284 00:54:20,291 --> 00:54:22,427 I hope everyone understands that my husband and I 1285 00:54:22,460 --> 00:54:25,730 do not have money set aside to fly back and forth to DC 1286 00:54:25,763 --> 00:54:28,799 so that I can talk about how much sex we're not having. 1287 00:54:29,467 --> 00:54:34,104 [Cindy]. Here you are with women who've taken time off work, 1288 00:54:34,138 --> 00:54:35,773 had somebody babysit the kids, 1289 00:54:35,806 --> 00:54:38,309 potentially fly across country 1290 00:54:38,343 --> 00:54:41,312 to reveal their most private struggle 1291 00:54:41,346 --> 00:54:45,483 behind the closed doors of their bedroom at a federal agency. 1292 00:54:45,550 --> 00:54:46,451 My name is Kelly Stapp 1293 00:54:46,484 --> 00:54:48,653 and I have no financial things to disclose, 1294 00:54:48,686 --> 00:54:51,456 but I will disclose the fact that I'm a bit scared to death 1295 00:54:51,489 --> 00:54:53,958 to stand up here and talk about this. 1296 00:54:53,991 --> 00:54:57,795 [Cindy]. Can you imagine like how just awkward, uncomfortable, 1297 00:54:57,828 --> 00:55:00,698 brave it was for them to do that? 1298 00:55:00,765 --> 00:55:02,467 They're the heroes of this story. 1299 00:55:02,500 --> 00:55:04,369 Hello, my name is Erica [indistinct] 1300 00:55:04,435 --> 00:55:05,803 and I hate public speaking, 1301 00:55:05,836 --> 00:55:07,438 but I'm here anyway. 1302 00:55:07,472 --> 00:55:10,775 I am here today to tell you HSDD is not a figment 1303 00:55:10,808 --> 00:55:12,309 of a woman's imagination. 1304 00:55:12,343 --> 00:55:14,479 It's not a fiction invented by the drug companies 1305 00:55:14,512 --> 00:55:16,481 and it's not a disease forced upon women 1306 00:55:16,514 --> 00:55:17,948 by the medical community. 1307 00:55:17,982 --> 00:55:19,517 HSDD is real. 1308 00:55:19,550 --> 00:55:21,352 I know because I had it 1309 00:55:21,386 --> 00:55:22,820 When I was 24 years old 1310 00:55:22,853 --> 00:55:24,855 I was diagnosed with breast cancer. 1311 00:55:24,889 --> 00:55:25,956 I was clearly informed 1312 00:55:25,990 --> 00:55:28,359 of many of the potential negative consequences 1313 00:55:28,426 --> 00:55:29,827 of surgical menopause. 1314 00:55:29,860 --> 00:55:32,997 But no one ever advised me that I was at an increased risk 1315 00:55:33,030 --> 00:55:34,599 for HSDD. 1316 00:55:34,632 --> 00:55:37,368 There was so much emotion in the room. 1317 00:55:37,402 --> 00:55:40,971 A television doctor suggested on an interview just last night 1318 00:55:41,005 --> 00:55:43,307 that maybe my libido is low sometimes 1319 00:55:43,340 --> 00:55:45,209 because I've had a bad day. 1320 00:55:45,242 --> 00:55:47,578 An anchor on a morning show yesterday said 1321 00:55:47,645 --> 00:55:49,547 that she doesn't need treatment because a housekeeper 1322 00:55:49,614 --> 00:55:53,017 and time away from the kids would solve her desire issues. 1323 00:55:53,050 --> 00:55:56,654 If your sexual desire issues can be cured with a good day 1324 00:55:56,687 --> 00:55:59,056 and a babysitter, then congratulations, 1325 00:55:59,089 --> 00:56:01,559 you do not have HSDD, 1326 00:56:01,592 --> 00:56:03,561 but the rest of us would sure appreciate it 1327 00:56:03,594 --> 00:56:05,596 if you would stop dismissing our concerns 1328 00:56:05,663 --> 00:56:08,132 and making a complete mockery of the issue. 1329 00:56:10,167 --> 00:56:12,236 Hi, my name is Vicky Loftus. 1330 00:56:12,269 --> 00:56:15,272 I was on the patient panel in October, 2014 1331 00:56:15,339 --> 00:56:17,675 and told my story about how HSDD 1332 00:56:17,708 --> 00:56:20,377 has negatively affected my life. 1333 00:56:20,411 --> 00:56:22,847 My mother was on the panel as well. 1334 00:56:22,880 --> 00:56:24,682 We both shared our individual struggles, 1335 00:56:24,715 --> 00:56:26,584 which were sadly very similar. 1336 00:56:26,651 --> 00:56:28,519 Since my appearance on the panel, 1337 00:56:28,553 --> 00:56:30,254 my marriage has suffered greatly. 1338 00:56:30,287 --> 00:56:32,723 So much so that the conversation of divorce 1339 00:56:32,757 --> 00:56:36,627 is on the table stemming from my low sexual desire. 1340 00:56:36,694 --> 00:56:38,563 My husband has a difficult time understanding 1341 00:56:38,596 --> 00:56:40,631 my struggle with this disorder. 1342 00:56:40,698 --> 00:56:42,900 He still takes my avoidance of sex personally 1343 00:56:42,933 --> 00:56:45,402 thinking I don't love him anymore 1344 00:56:45,436 --> 00:56:46,604 and there is something wrong with him, 1345 00:56:46,637 --> 00:56:48,439 which is farthest from the truth. 1346 00:56:51,141 --> 00:56:53,444 [Barbara]. As a mom standing next to your daughter 1347 00:56:53,511 --> 00:56:56,481 who is going through a divorce at that time, 1348 00:56:56,547 --> 00:57:00,117 for her to get in front of an FDA panel, 1349 00:57:00,184 --> 00:57:02,720 it took a lot of courage on her part. 1350 00:57:02,753 --> 00:57:06,791 It was a very traumatic thing for her. 1351 00:57:06,857 --> 00:57:11,596 So to listen to those hecklers it, 1352 00:57:11,629 --> 00:57:15,432 it was heartbreaking to watch that. 1353 00:57:15,466 --> 00:57:16,934 It was just heartbreaking. 1354 00:57:16,967 --> 00:57:18,636 [audience clapping] 1355 00:57:18,669 --> 00:57:21,138 Thank you. Speaker 31, please. 1356 00:57:21,205 --> 00:57:22,773 There was a woman who stood up and said, 1357 00:57:22,807 --> 00:57:24,642 let me give you some options: 1358 00:57:26,511 --> 00:57:27,745 read erotica, 1359 00:57:27,778 --> 00:57:29,947 find a different partner, 1360 00:57:29,980 --> 00:57:32,316 get a better shower head. 1361 00:57:32,349 --> 00:57:34,084 [woman]. Here are some things that have helped me with periods 1362 00:57:34,118 --> 00:57:35,653 of low libido: 1363 00:57:37,187 --> 00:57:38,523 switching boyfriends, 1364 00:57:38,589 --> 00:57:40,625 chocolate, coffee, 1365 00:57:40,658 --> 00:57:42,993 certain episodes of Grey's Anatomy 1366 00:57:43,027 --> 00:57:44,161 pornography, 1367 00:57:44,228 --> 00:57:45,963 upgrading my vibrator, 1368 00:57:45,996 --> 00:57:47,164 reading 50 Shades of Grey, 1369 00:57:47,197 --> 00:57:49,099 a removable shower head, 1370 00:57:49,133 --> 00:57:52,136 and an acceptance of myself and the libido I came with. 1371 00:57:52,169 --> 00:57:55,172 [woman 2]. Excuse me, Alexandra, sorry, your two minutes is up. 1372 00:57:56,574 --> 00:57:58,843 [Cindy]. That's all saying you're doing something wrong 1373 00:57:58,876 --> 00:58:00,645 and it's your fault. 1374 00:58:01,245 --> 00:58:04,148 And you just watched the faces of women 1375 00:58:04,181 --> 00:58:05,950 who were brave enough to say the thing 1376 00:58:05,983 --> 00:58:06,984 they were struggling with 1377 00:58:07,017 --> 00:58:11,722 and then others mock them, be cruel to them. 1378 00:58:11,789 --> 00:58:14,158 And that was hard to watch. 1379 00:58:14,191 --> 00:58:17,595 Sprout's lobbying effort called Even The Score 1380 00:58:17,628 --> 00:58:22,833 has used deception to mobilize women with real sexual concerns 1381 00:58:22,867 --> 00:58:25,369 to lobby for their questionable product. 1382 00:58:25,435 --> 00:58:27,337 They've tried to distract the public, 1383 00:58:27,371 --> 00:58:28,706 bully the FDA, 1384 00:58:28,773 --> 00:58:32,710 and they have hampered real sex research. 1385 00:58:32,777 --> 00:58:34,378 But make no mistake, 1386 00:58:34,411 --> 00:58:37,682 Even The Score reveals the methods and values 1387 00:58:37,715 --> 00:58:39,750 of Sprout Pharmaceuticals. 1388 00:58:39,817 --> 00:58:42,352 Reject this drug once and for all 1389 00:58:42,386 --> 00:58:44,589 and let's move on to really help women. 1390 00:58:45,556 --> 00:58:46,523 Thank you. 1391 00:58:46,557 --> 00:58:48,993 Speaker 32, please. 1392 00:58:49,026 --> 00:58:51,729 There was so much politics. 1393 00:58:51,796 --> 00:58:55,165 There was so many people there angry about the idea 1394 00:58:55,199 --> 00:58:57,835 that a medicine could help with sexual health. 1395 00:58:57,868 --> 00:58:58,836 If there were clear evidence 1396 00:58:58,869 --> 00:59:00,805 of a clinically meaningful benefit, 1397 00:59:00,838 --> 00:59:02,740 which I don't believe there is, 1398 00:59:02,773 --> 00:59:05,275 significant but not clinically meaningful, 1399 00:59:05,342 --> 00:59:07,712 accompanied by manageable risks, 1400 00:59:07,745 --> 00:59:09,614 approval might be appropriate. 1401 00:59:09,680 --> 00:59:11,749 Flibanserin is a mediocre aphrodisiac 1402 00:59:11,782 --> 00:59:13,250 with scary side effects. 1403 00:59:13,317 --> 00:59:16,420 Its effects may be due to non-specific sedating effects, 1404 00:59:16,453 --> 00:59:19,023 apparently equivalent to four drinks. 1405 00:59:19,056 --> 00:59:21,258 One of the fears the FDA had 1406 00:59:21,291 --> 00:59:23,728 was that this was like an aphrodisiac 1407 00:59:23,761 --> 00:59:26,964 and it might be slipped into somebody's drink in a bar 1408 00:59:27,031 --> 00:59:29,734 and then they'd have sex with some stranger. 1409 00:59:29,767 --> 00:59:30,901 One thing I worry about is 1410 00:59:30,935 --> 00:59:33,771 because of the indication of this drug, 1411 00:59:33,838 --> 00:59:40,577 could it be thought of as like a date rape drug? 1412 00:59:40,611 --> 00:59:43,080 I think that's an excellent point 1413 00:59:43,113 --> 00:59:47,918 and that is something certainly that we have thought about. 1414 00:59:47,952 --> 00:59:49,954 But it doesn't work like that at all. 1415 00:59:50,020 --> 00:59:51,889 Anything that you have to take daily, 1416 00:59:51,922 --> 00:59:53,724 I will tell you that 1417 00:59:53,758 --> 00:59:56,293 you have to have taken it for a certain number of days 1418 00:59:56,360 --> 00:59:58,595 before it really has an effect. 1419 00:59:58,629 --> 01:00:00,130 My name is Dr. Irwin Goldstein. 1420 01:00:00,164 --> 01:00:01,866 I serve on Sprouts Advisory Board. 1421 01:00:01,899 --> 01:00:03,100 And I'm Sue Goldstein. 1422 01:00:03,133 --> 01:00:04,969 We're here for San Diego Sexual Medicine today, 1423 01:00:05,002 --> 01:00:07,638 and we have no financial interest in today's outcome. 1424 01:00:07,672 --> 01:00:09,874 [Irwin]. It was very distressing 1425 01:00:09,907 --> 01:00:12,777 that colleagues would take this view 1426 01:00:12,810 --> 01:00:14,812 that we were harming people, 1427 01:00:14,879 --> 01:00:17,281 and we had a lot of evidence that wasn't true. 1428 01:00:17,314 --> 01:00:19,016 It's an embarrassment, it's a humiliation. 1429 01:00:19,083 --> 01:00:20,918 It's a evil against women. 1430 01:00:20,951 --> 01:00:23,320 It's crazy. It's just crazy. 1431 01:00:23,387 --> 01:00:26,456 To the experts who do not manage women 1432 01:00:26,490 --> 01:00:27,858 with sexual health problems, 1433 01:00:27,925 --> 01:00:30,661 give these women the right to choose, 1434 01:00:30,728 --> 01:00:32,963 vote yes to approve, and thank you. 1435 01:00:32,997 --> 01:00:34,665 [Sue]. Thank you. 1436 01:00:34,732 --> 01:00:36,100 [Anita]. Some of this, I think, 1437 01:00:36,133 --> 01:00:38,502 is an attempt to control women, 1438 01:00:38,535 --> 01:00:42,039 and that's been going on for millennia. 1439 01:00:42,106 --> 01:00:44,141 It's going on now. 1440 01:00:44,174 --> 01:00:47,511 There really is a whole sense 1441 01:00:47,544 --> 01:00:51,048 of not hearing women and not trying to help them, 1442 01:00:51,115 --> 01:00:54,885 or trying to block something when help is available. 1443 01:00:54,952 --> 01:00:57,221 And that's unconscionable to me. 1444 01:01:01,558 --> 01:01:02,827 I'm Dr. Anita Clayton. 1445 01:01:02,860 --> 01:01:05,062 I'm gonna get straight to the point. 1446 01:01:05,129 --> 01:01:07,998 Stop moving the goalposts. 1447 01:01:08,032 --> 01:01:09,666 The efficacy, safety, 1448 01:01:09,700 --> 01:01:11,836 and clinically meaningful effects of Flibanserin 1449 01:01:11,869 --> 01:01:13,370 are clear. 1450 01:01:13,403 --> 01:01:16,941 Maybe the message is that you don't trust women with HSDD, 1451 01:01:18,042 --> 01:01:20,911 or you just don't trust women. 1452 01:01:20,978 --> 01:01:23,714 At the core of this whole thing was really, 1453 01:01:23,748 --> 01:01:25,282 does it matter? 1454 01:01:25,615 --> 01:01:27,417 And do women deserve. 1455 01:01:27,484 --> 01:01:28,819 I think that's really what it was. 1456 01:01:28,853 --> 01:01:31,055 Like all this other was just noise. 1457 01:01:31,121 --> 01:01:34,024 It was just noise to distract 1458 01:01:34,058 --> 01:01:36,226 from the bias at the centre of it, 1459 01:01:36,260 --> 01:01:37,895 which is, we don't think it really matters 1460 01:01:37,928 --> 01:01:39,696 if women have a more satisfying sex life. 1461 01:01:39,730 --> 01:01:41,198 That's the truth. 1462 01:01:41,231 --> 01:01:44,869 We literally heard this from the FDA 1463 01:01:44,902 --> 01:01:48,906 is that women do not have to desire sex 1464 01:01:48,939 --> 01:01:50,474 to have sex. 1465 01:01:53,243 --> 01:01:55,179 Yeah. 1466 01:01:55,212 --> 01:01:57,181 [Vivian]. So with that said, 1467 01:01:57,214 --> 01:02:01,085 we will now turn to the voting process. 1468 01:02:01,118 --> 01:02:02,987 [Cindy]. I think about the stakes 1469 01:02:03,020 --> 01:02:05,055 because I knew what we were up against. 1470 01:02:07,224 --> 01:02:10,727 Ooh. Because we had done everything we could 1471 01:02:10,761 --> 01:02:12,897 and the team was nervous. 1472 01:02:12,930 --> 01:02:15,933 We felt immense pressure to win it for women. 1473 01:02:16,000 --> 01:02:17,768 All the women that showed up, 1474 01:02:17,802 --> 01:02:20,037 all the women's health and rights advocates, 1475 01:02:20,070 --> 01:02:22,773 all the doctors, 1476 01:02:22,807 --> 01:02:24,842 Okay, we ready? 1477 01:02:25,843 --> 01:02:27,878 Okay, let's go. 1478 01:02:30,047 --> 01:02:31,982 [Josephine]. The emotions are just up and down all day, 1479 01:02:32,049 --> 01:02:35,285 and then they vote sort of secretly, right? 1480 01:02:35,319 --> 01:02:36,921 They all press a button 1481 01:02:36,954 --> 01:02:39,089 so that they can't influence each other, 1482 01:02:39,123 --> 01:02:41,158 and the number just comes up on the screen. 1483 01:02:42,793 --> 01:02:46,897 That process probably took a minute and a half, 1484 01:02:46,931 --> 01:02:49,733 it felt like twenty minutes 1485 01:02:49,766 --> 01:02:51,902 before that number came up on the screen, 1486 01:02:51,936 --> 01:02:53,971 and then the room just erupted. 1487 01:02:54,038 --> 01:02:55,139 [cheering] 1488 01:02:55,172 --> 01:02:59,076 [upbeat music] 1489 01:02:59,109 --> 01:03:01,278 * Never believed I could feel like this 1490 01:03:01,311 --> 01:03:02,980 * Got me feeling so high 1491 01:03:03,047 --> 01:03:07,317 [female reporter]. The FDA approving the controversial Little Pink Pill. 1492 01:03:07,351 --> 01:03:08,953 [male reporter]. The FDA approved the new drug 1493 01:03:08,986 --> 01:03:11,421 designed to boost the female libido. 1494 01:03:11,455 --> 01:03:13,190 * And there ain't nobody can blame me 1495 01:03:13,257 --> 01:03:15,292 * They can't blame me now 1496 01:03:15,325 --> 01:03:17,494 * 'Cause everything you doing, yeah that's how I like it 1497 01:03:17,561 --> 01:03:18,695 * You know what you're doing, yeah * 1498 01:03:18,762 --> 01:03:21,298 [Josephine]. We got an 18 to six positive vote. 1499 01:03:21,331 --> 01:03:24,034 It just tells you the strength of the data 1500 01:03:24,101 --> 01:03:26,971 and also the strength of the people who spoke to say, 1501 01:03:27,004 --> 01:03:29,773 this is meaningful and I do need this drug. 1502 01:03:33,110 --> 01:03:35,980 [Cindy]. That day in the room when my hand was shaking 1503 01:03:36,013 --> 01:03:38,148 as the score went up, 1504 01:03:38,182 --> 01:03:39,984 I don't know that the FDA's ever had a whole room 1505 01:03:40,017 --> 01:03:44,188 erupt into cheers over an approval of a medication. 1506 01:03:44,221 --> 01:03:46,323 It was so validating. 1507 01:03:46,356 --> 01:03:48,225 And I was on the last flight out to New York 1508 01:03:48,292 --> 01:03:50,160 to do press the next morning. 1509 01:03:50,194 --> 01:03:53,864 * I hope that you, you were talkin' 'bout me * 1510 01:03:53,898 --> 01:03:56,500 [Cindy]. Yesterday science won and so too did women. 1511 01:03:56,533 --> 01:03:58,368 Finally, women have the ability 1512 01:03:58,402 --> 01:04:00,971 to make the choice with their healthcare providers 1513 01:04:01,005 --> 01:04:02,139 whether or not they want treatment 1514 01:04:02,172 --> 01:04:05,042 for the most common form of female sexual dysfunction. 1515 01:04:05,109 --> 01:04:07,978 And it's been a long time to get to this moment. 1516 01:04:08,012 --> 01:04:10,514 What about the reality of money raising 1517 01:04:10,547 --> 01:04:13,017 when it comes to now marketing this, 1518 01:04:13,050 --> 01:04:14,985 and Cind, you're a small company, privately held. 1519 01:04:15,019 --> 01:04:16,853 We are small, yes. 1520 01:04:16,887 --> 01:04:18,688 How are you going to pay for all this? 1521 01:04:21,558 --> 01:04:23,327 [Cindy]. We were the largest news story in the world. 1522 01:04:24,161 --> 01:04:27,898 And then the phone started ringing. 1523 01:04:27,965 --> 01:04:30,034 In August 2015, we got the approval. 1524 01:04:31,401 --> 01:04:34,404 Two days later, we sold the company for a billion dollars. 1525 01:04:34,438 --> 01:04:41,411 [upbeat dramatic music] 1526 01:04:41,445 --> 01:04:43,147 * 1527 01:04:43,180 --> 01:04:46,583 [Cindy]. Up until about 4:00 AM in the morning the night before, 1528 01:04:46,650 --> 01:04:48,385 we were still going back and forth. 1529 01:04:48,418 --> 01:04:50,587 And I can remember sitting in the seat at Squawk Box 1530 01:04:50,620 --> 01:04:52,322 next to the CEO, 1531 01:04:52,356 --> 01:04:55,292 and they wanted confirmation of the signature. 1532 01:04:55,359 --> 01:04:57,561 And they were like 5, 4, 3. 1533 01:04:57,594 --> 01:04:58,662 We got it! 1534 01:04:58,695 --> 01:05:00,897 And it just happened right there on air. 1535 01:05:00,931 --> 01:05:03,100 To be sure, science has won the day here. 1536 01:05:03,167 --> 01:05:05,235 So this is a condition that we've known about medically 1537 01:05:05,269 --> 01:05:06,937 since 1977. 1538 01:05:06,971 --> 01:05:09,106 We have four decades of medical literature on it. 1539 01:05:09,173 --> 01:05:10,407 The opportunity's quite large. 1540 01:05:10,440 --> 01:05:12,742 You know, and certainly in the hundreds of millions for us. 1541 01:05:12,776 --> 01:05:14,778 But we're hope, hopefully it's in the billions 1542 01:05:14,811 --> 01:05:16,580 in terms of, uh, what this could do 1543 01:05:16,613 --> 01:05:18,782 from a, from a revenue standpoint, 1544 01:05:18,815 --> 01:05:21,986 [Cindy]. This whole fight has been about getting women, 1545 01:05:22,052 --> 01:05:22,953 myself included, 1546 01:05:23,020 --> 01:05:26,456 what we deserve and knowing our worth. 1547 01:05:26,490 --> 01:05:27,624 And I wasn't gonna take something 1548 01:05:27,657 --> 01:05:29,059 that wasn't what this was worth. 1549 01:05:29,093 --> 01:05:30,961 Let me ask you about the Valeant acquisition 1550 01:05:31,028 --> 01:05:33,063 and sort of what that did for you 1551 01:05:33,097 --> 01:05:36,100 because you've got a lot more marketing muscle, 1552 01:05:36,133 --> 01:05:38,602 a lot more oomph behind this product now. 1553 01:05:38,635 --> 01:05:40,470 What kind of a game changer was that for you? 1554 01:05:40,504 --> 01:05:41,438 Game changer. 1555 01:05:41,471 --> 01:05:43,173 We're a 34 person company 1556 01:05:43,240 --> 01:05:45,475 who managed to get this across the finish line. 1557 01:05:45,509 --> 01:05:48,412 So this is the ability to make good on the mission, right? 1558 01:05:48,445 --> 01:05:50,280 This is gonna be accessible to women 1559 01:05:50,314 --> 01:05:52,782 every corner of the globe 1560 01:05:52,816 --> 01:05:54,784 because we needed a global player 1561 01:05:54,818 --> 01:05:57,354 to be able to do that in a way this tiny little company 1562 01:05:57,421 --> 01:05:59,689 with 35 people couldn't do. 1563 01:05:59,756 --> 01:06:02,626 But again, no one takes you seriously. 1564 01:06:02,659 --> 01:06:05,462 I think this sounds like a great holiday gift. 1565 01:06:05,495 --> 01:06:08,665 [laughing] 1566 01:06:08,732 --> 01:06:10,134 Tonight we'll take a look at the pros and cons 1567 01:06:10,167 --> 01:06:12,169 of female Viagra. 1568 01:06:12,236 --> 01:06:13,803 [audience laughing] 1569 01:06:13,837 --> 01:06:15,139 [Jimmy]. Pro: When ingested 1570 01:06:15,172 --> 01:06:18,108 Flibanserin increases a woman's sex drive. 1571 01:06:18,142 --> 01:06:19,809 Con: you might know it by its old name- 1572 01:06:19,843 --> 01:06:21,311 "wine." Yeah. 1573 01:06:21,345 --> 01:06:23,147 [audience laughing] 1574 01:06:23,180 --> 01:06:25,315 [audience cheering] 1575 01:06:25,349 --> 01:06:27,217 [Anita]. The media, 1576 01:06:27,284 --> 01:06:30,154 they picked up on the people saying "this is dangerous." 1577 01:06:30,187 --> 01:06:31,688 This pill is not for everyone. 1578 01:06:31,721 --> 01:06:33,157 Dizziness four times greater, 1579 01:06:33,190 --> 01:06:35,525 sleepiness, nausea, fatigue. 1580 01:06:35,559 --> 01:06:37,161 There's an interaction with alcohol. 1581 01:06:37,194 --> 01:06:39,229 [Anita]. They splashed it all over 1582 01:06:39,296 --> 01:06:42,699 because they like a story, they like a conflict 1583 01:06:42,732 --> 01:06:45,169 and it was detrimental. 1584 01:06:45,202 --> 01:06:46,870 But your critics remain this morning. 1585 01:06:46,903 --> 01:06:48,472 The critics have not gone away. 1586 01:06:48,505 --> 01:06:50,340 Charlie Rose asked me like, "Hey Cindy, 1587 01:06:50,374 --> 01:06:52,209 "could you not have invented a drug with no side effects?" 1588 01:06:52,276 --> 01:06:54,544 [Charlie]. Is there no way to have created a drug 1589 01:06:54,578 --> 01:06:56,113 without the side effects? 1590 01:06:57,314 --> 01:06:58,715 Uh, no. 1591 01:07:00,217 --> 01:07:02,018 No drug comes without side effects. 1592 01:07:02,052 --> 01:07:03,887 I think that's very important, right? 1593 01:07:03,920 --> 01:07:06,256 Addyi is no different than countless other drugs. 1594 01:07:06,323 --> 01:07:09,025 It was so obtuse. 1595 01:07:09,059 --> 01:07:11,228 Again, you can't have any risk 1596 01:07:11,261 --> 01:07:13,097 'cause this thing doesn't really matter. 1597 01:07:13,563 --> 01:07:16,866 The challenge with this drug is that it is limited 1598 01:07:16,900 --> 01:07:20,870 to a very strict subpopulation of women 1599 01:07:20,904 --> 01:07:24,674 who have a sudden or new onset of low desire 1600 01:07:24,708 --> 01:07:26,510 and no other explanations. 1601 01:07:26,543 --> 01:07:29,146 And it's a reproductive age population too, 1602 01:07:29,179 --> 01:07:31,348 and we should be thinking about and concerned about 1603 01:07:31,381 --> 01:07:34,017 the reproductive safety of this drug. 1604 01:07:34,050 --> 01:07:37,354 It just shows up over and over and over again. 1605 01:07:37,387 --> 01:07:40,257 [reporter]. The Addyi comes with a black box warning from the FDA, 1606 01:07:40,324 --> 01:07:41,758 the strongest warning it can give 1607 01:07:41,791 --> 01:07:44,094 because it's loaded with side effects. 1608 01:07:44,128 --> 01:07:50,234 A box warning literally is a box in the medical information. 1609 01:07:50,267 --> 01:07:53,103 They said you couldn't drink alcohol at all. 1610 01:07:53,137 --> 01:07:57,607 And their warning for Viagra was you shouldn't take it, 1611 01:07:57,641 --> 01:08:00,110 not that you couldn't, but you shouldn't take it. 1612 01:08:00,177 --> 01:08:03,380 So putting something in a boxed warning 1613 01:08:03,413 --> 01:08:07,417 that is not a legitimate safety issue is a real problem. 1614 01:08:08,885 --> 01:08:11,421 [Cindy]. Doctors had to take a test to write it. 1615 01:08:11,455 --> 01:08:13,290 Pharmacists had to take a test to dispense it 1616 01:08:13,357 --> 01:08:14,958 and women had to sign a piece of paper 1617 01:08:15,024 --> 01:08:17,794 promising they wouldn't drink if they were on it. 1618 01:08:17,827 --> 01:08:21,131 [Barbara]. They put it in a classification with things 1619 01:08:21,165 --> 01:08:23,099 that are very harmful, 1620 01:08:23,133 --> 01:08:25,602 and Addyi is not harmful. 1621 01:08:25,635 --> 01:08:26,770 I took alcohol, 1622 01:08:26,803 --> 01:08:28,472 I didn't, I wasn't even told 1623 01:08:28,538 --> 01:08:30,407 that I couldn't take alcohol. 1624 01:08:30,440 --> 01:08:34,110 And everybody that I know had a drink before dinner. 1625 01:08:34,144 --> 01:08:36,012 You take this medication at night, 1626 01:08:36,079 --> 01:08:38,282 you're not supposed to get behind the wheel of a car 1627 01:08:38,315 --> 01:08:39,883 or take it in the morning. 1628 01:08:40,484 --> 01:08:43,287 [Anita]. The other thing is that men can take it from 1629 01:08:43,320 --> 01:08:45,322 basically any age, 1630 01:08:45,355 --> 01:08:49,993 and that includes people up to 70, 80, or whatever. 1631 01:08:50,026 --> 01:08:53,363 Women though had to be between 18 1632 01:08:53,430 --> 01:08:56,633 and where they entered the perimenopause. 1633 01:08:56,666 --> 01:09:01,171 So there's real problems there in a discrepancy 1634 01:09:01,238 --> 01:09:03,873 between men and women. 1635 01:09:03,940 --> 01:09:06,776 And there was a very paternalistic attitude. 1636 01:09:06,810 --> 01:09:09,979 [reporter]. Addyi is not approved for use in postmenopausal women. 1637 01:09:10,013 --> 01:09:11,781 The FDA says more studies are needed 1638 01:09:11,815 --> 01:09:14,484 to determine whether it's safe and effective for them. 1639 01:09:14,518 --> 01:09:18,988 [Barbara]. They just made it impossible to get the drug. 1640 01:09:19,022 --> 01:09:22,359 And with all the restrictions on the pharmacists, 1641 01:09:22,426 --> 01:09:23,960 they weren't selling it. 1642 01:09:24,661 --> 01:09:27,197 [reporter]. It's been on the market now for three or four weeks 1643 01:09:27,231 --> 01:09:31,535 and the demands so far has been really, really, really low. 1644 01:09:31,601 --> 01:09:32,669 And frankly, you know, 1645 01:09:32,702 --> 01:09:34,704 Valeant been in the news for a lot of other reasons 1646 01:09:34,738 --> 01:09:36,573 for some of the troubles that they've had. 1647 01:09:38,208 --> 01:09:43,012 [Barbara]. For Valeant to jack the price up the way they did 1648 01:09:43,046 --> 01:09:45,249 is I think criminal for women. 1649 01:09:46,383 --> 01:09:48,518 [reporter]. Valeant's a very controversial company. 1650 01:09:48,552 --> 01:09:50,587 A lot of stuff came out about its business model, 1651 01:09:50,654 --> 01:09:53,490 particularly the business model of buying other drug companies 1652 01:09:53,523 --> 01:09:56,360 then jacking up the prices of those drugs. 1653 01:09:56,393 --> 01:09:58,662 Well then it was cost prohibitive, 1654 01:09:58,695 --> 01:10:00,497 so they stopped taking it. 1655 01:10:02,165 --> 01:10:03,733 And that was the end of it. 1656 01:10:07,103 --> 01:10:08,338 [Cindy]. And then, of course, 1657 01:10:08,372 --> 01:10:10,407 the next thing that happened is they shelved it. 1658 01:10:18,448 --> 01:10:20,917 The intention was I was gonna stay. 1659 01:10:20,984 --> 01:10:22,252 You know, that was part of the deal. 1660 01:10:22,286 --> 01:10:25,589 I would stay and build their entire women's health franchise, 1661 01:10:25,655 --> 01:10:28,558 and within three months of that deal closing, 1662 01:10:28,592 --> 01:10:31,595 I got a phone call that invited me to leave. 1663 01:10:31,661 --> 01:10:32,962 And not long after that, 1664 01:10:33,029 --> 01:10:34,831 they got rid of the entire team. 1665 01:10:37,133 --> 01:10:39,969 I've never been more depressed in my life than that period. 1666 01:10:41,505 --> 01:10:45,642 To have won one and then them to not launch it, 1667 01:10:45,709 --> 01:10:48,612 and the women who had shown up at those meetings 1668 01:10:48,645 --> 01:10:50,447 to not be able to get it. 1669 01:10:51,415 --> 01:10:56,085 That felt the worst of anything. 1670 01:10:56,119 --> 01:10:58,955 It was, it was, that was brutal for me. 1671 01:10:58,988 --> 01:11:02,392 [Vicky]. Women that are struggling with HSDD should have the option 1672 01:11:02,426 --> 01:11:04,093 to choose a safe and approved treatment 1673 01:11:04,127 --> 01:11:06,296 with guidance from their healthcare provider. 1674 01:11:06,330 --> 01:11:07,731 Thank you. 1675 01:11:08,131 --> 01:11:11,501 [Barbara]. How can you possibly pass something 1676 01:11:11,568 --> 01:11:13,937 that is so wonderful for women 1677 01:11:13,970 --> 01:11:16,139 and then have it ripped out? 1678 01:11:16,172 --> 01:11:18,274 After all of this work, 1679 01:11:18,308 --> 01:11:23,112 and after all of this emotion, 1680 01:11:23,146 --> 01:11:26,950 we're down to square one again and we still are. 1681 01:11:26,983 --> 01:11:28,352 [helicopter whirring] 1682 01:11:28,418 --> 01:11:29,686 [people cheering] 1683 01:11:29,753 --> 01:11:32,021 [reporter]. We just got new metrics in, 1684 01:11:32,088 --> 01:11:33,790 Donald J. Trump 1685 01:11:33,823 --> 01:11:38,328 is the President of the United States Elect. 1686 01:11:38,362 --> 01:11:42,332 [Stacey]. The past five to ten years really calls into question 1687 01:11:42,366 --> 01:11:45,201 where the state of women's health is going. 1688 01:11:49,205 --> 01:11:51,708 [reporter]. The last year has been incredibly difficult for women. 1689 01:11:51,775 --> 01:11:54,478 We have seen major attacks on Obamacare, 1690 01:11:54,511 --> 01:11:55,979 protections for birth control. 1691 01:11:56,012 --> 01:11:57,647 And we know that on the state level 1692 01:11:57,681 --> 01:11:58,748 there are a number of courts 1693 01:11:58,782 --> 01:12:01,385 that are working to roll back our right to choose. 1694 01:12:01,451 --> 01:12:03,720 [voices chanting] 1695 01:12:03,787 --> 01:12:06,656 [female reporter]. Tonight we remember an American icon, 1696 01:12:06,690 --> 01:12:08,692 Supreme Court Justice Ruth Bader Ginsburg 1697 01:12:08,758 --> 01:12:10,394 died today. 1698 01:12:10,460 --> 01:12:12,696 [male reporter]. Ginsburg was seen as a champion of women's rights. 1699 01:12:12,762 --> 01:12:14,564 Her passing now gives President Donald Trump 1700 01:12:14,631 --> 01:12:17,501 the chance to shore up the conservative majority 1701 01:12:17,534 --> 01:12:19,135 when choosing a replacement. 1702 01:12:19,736 --> 01:12:21,871 [male reporter 2]. Confirmation brings a major shift to the court 1703 01:12:21,905 --> 01:12:24,408 and it will have an impact for years to come. 1704 01:12:25,074 --> 01:12:27,176 [indistinct chanting] 1705 01:12:27,210 --> 01:12:30,647 [Stacey]. One of the tipping points in the conversation that we're having 1706 01:12:30,680 --> 01:12:35,752 requires us to look back to what happened just a few years ago 1707 01:12:35,819 --> 01:12:38,522 with the overturning of Roe v. Wade. 1708 01:12:38,555 --> 01:12:41,691 I don't accept this ruling! We're not going to go back! 1709 01:12:41,725 --> 01:12:43,560 What changed since 1973? 1710 01:12:43,593 --> 01:12:45,261 What changed? 1711 01:12:46,229 --> 01:12:48,197 [Sue]. To be at a time in my life 1712 01:12:48,231 --> 01:12:49,899 that the rights that my generation 1713 01:12:49,933 --> 01:12:52,068 fought so hard to have 1714 01:12:52,101 --> 01:12:54,638 see them taken away. 1715 01:12:54,671 --> 01:12:59,242 What right does anybody have to say what I do with my body? 1716 01:12:59,308 --> 01:13:02,512 Why does any right and men have a right to, 1717 01:13:02,546 --> 01:13:04,414 to, to control any of that, 1718 01:13:04,448 --> 01:13:06,883 whether it's sexual health, reproductive rights, uh, 1719 01:13:06,916 --> 01:13:09,453 who, who you're married to, 1720 01:13:09,519 --> 01:13:11,387 none of that is anybody's business 1721 01:13:11,421 --> 01:13:12,889 if you're not harming anybody else, 1722 01:13:12,922 --> 01:13:14,591 and I will stand up and support and hope to God, 1723 01:13:14,658 --> 01:13:17,594 like I have two granddaughters, teenagers. 1724 01:13:17,627 --> 01:13:19,262 I hope that they live in a world better 1725 01:13:19,328 --> 01:13:21,197 than the world we're looking at today. 1726 01:13:22,165 --> 01:13:24,734 [female reporter]. Today the story of Josseli Barnica, 1727 01:13:24,768 --> 01:13:27,571 a young mother pregnant with her second child 1728 01:13:27,604 --> 01:13:30,607 who died of sepsis just one week 1729 01:13:30,640 --> 01:13:33,610 after Texas's abortion ban went into effect. 1730 01:13:33,643 --> 01:13:37,714 Despite being diagnosed with a miscarriage in progress, 1731 01:13:37,747 --> 01:13:39,583 doctors said they could not treat her, 1732 01:13:39,616 --> 01:13:41,485 meaning provide an abortion, 1733 01:13:41,551 --> 01:13:44,488 until her fetus no longer had a heartbeat. 1734 01:13:44,554 --> 01:13:46,289 [Irwin]. People are literally dying 1735 01:13:46,322 --> 01:13:49,559 as a result of these horrible political changes. 1736 01:13:49,593 --> 01:13:51,394 We have to get all of this reversed back 1737 01:13:51,427 --> 01:13:53,062 to the where it once was, 1738 01:13:53,096 --> 01:13:54,631 where-where people have rights. 1739 01:13:54,698 --> 01:13:56,132 And-and reproductive and sexual rights 1740 01:13:56,165 --> 01:13:58,735 are just as important as cardiac rights, 1741 01:13:58,768 --> 01:14:01,471 as orthopedic rights, as any other right. 1742 01:14:01,538 --> 01:14:02,939 I'm scared to have a daughter 1743 01:14:02,972 --> 01:14:06,943 because I don't know how the world is going to treat her, 1744 01:14:06,976 --> 01:14:08,645 'cause you could be the best parent in the world 1745 01:14:08,712 --> 01:14:10,514 and you could teach that girl 1746 01:14:10,580 --> 01:14:14,283 to be the strongest possible person, 1747 01:14:14,317 --> 01:14:17,186 but you have no idea when she goes out into the world 1748 01:14:17,253 --> 01:14:19,656 how the world is gonna receive and treat her. 1749 01:14:19,723 --> 01:14:23,493 It's also a scary time with what is happening 1750 01:14:23,560 --> 01:14:26,630 to traditionally marginalized groups. 1751 01:14:27,497 --> 01:14:30,333 Trans people are the most marginalized in our society 1752 01:14:30,399 --> 01:14:34,671 and they've been scapegoated in a way that 1753 01:14:34,704 --> 01:14:38,608 they are sort of being used as this smoke and mirrors vehicle 1754 01:14:38,642 --> 01:14:41,611 in this all out assault on personal autonomy. 1755 01:14:41,645 --> 01:14:43,980 And it's scary how quickly that has escalated. 1756 01:14:44,013 --> 01:14:46,783 You know, back in the twenty late teens, 1757 01:14:46,816 --> 01:14:49,152 it was this discussion around bathrooms 1758 01:14:49,185 --> 01:14:52,021 and then very quickly it was trans people in sports. 1759 01:14:52,055 --> 01:14:54,223 It is a hot topic in American politics, 1760 01:14:54,290 --> 01:14:55,859 whether or not transgender people 1761 01:14:55,892 --> 01:14:58,862 can compete in categories in which they identify. 1762 01:14:58,928 --> 01:15:00,797 [Blair]. And then very quickly it was 1763 01:15:00,830 --> 01:15:02,465 trying to ban care for trans youth, 1764 01:15:02,498 --> 01:15:04,000 and now there's multiple states actually trying to 1765 01:15:04,033 --> 01:15:06,536 limit care for trans adults. 1766 01:15:06,570 --> 01:15:09,739 So what happened with Roe is a direct extension 1767 01:15:09,806 --> 01:15:12,709 of what's been happening with trans rights. 1768 01:15:12,776 --> 01:15:13,843 At the end of the day, 1769 01:15:13,877 --> 01:15:16,179 if like we collectively as-as a society 1770 01:15:16,212 --> 01:15:19,182 are not standing up and protecting trans rights, 1771 01:15:19,215 --> 01:15:21,184 then we're not protecting our rights. 1772 01:15:21,217 --> 01:15:25,989 Regardless of what's going on in Washington politically, 1773 01:15:26,022 --> 01:15:27,791 people are still suffering. 1774 01:15:27,824 --> 01:15:29,726 So all the games that people are playing, 1775 01:15:29,793 --> 01:15:32,696 all the rights that are being stripped from people 1776 01:15:32,729 --> 01:15:34,898 regardless of who they are, 1777 01:15:34,964 --> 01:15:36,532 at the end of the day, 1778 01:15:36,566 --> 01:15:38,735 my patient in my room is still suffering 1779 01:15:38,802 --> 01:15:41,537 because I will be honest right now as a gynecologist, 1780 01:15:41,571 --> 01:15:43,039 it's a little bleak. 1781 01:15:43,072 --> 01:15:44,373 Patients are feeling it too 1782 01:15:44,407 --> 01:15:46,776 when they come into the exam room as well. 1783 01:15:46,843 --> 01:15:48,745 If our reproductive rights, 1784 01:15:48,778 --> 01:15:51,547 our rights to bodily autonomy are threatened, 1785 01:15:51,581 --> 01:15:54,383 we almost can't even get to the conversation of pleasure 1786 01:15:54,417 --> 01:15:57,721 because we're fighting for basic human rights, 1787 01:15:57,754 --> 01:15:59,989 those fundamental rights to exist 1788 01:16:00,023 --> 01:16:01,758 to have control over our bodies. 1789 01:16:01,791 --> 01:16:03,593 And that's very scary. 1790 01:16:03,827 --> 01:16:07,363 But I don't wanna lose the conversation around pleasure 1791 01:16:07,396 --> 01:16:09,933 as we focus on rights itself 1792 01:16:09,999 --> 01:16:11,234 because pleasure is a part of that. 1793 01:16:11,267 --> 01:16:15,404 And in fact, if we focus on everybody's right to pleasure, 1794 01:16:15,438 --> 01:16:17,306 men, women, folks of all genders, 1795 01:16:17,373 --> 01:16:19,275 if we talk about pleasure, 1796 01:16:19,308 --> 01:16:24,247 then we have more support to talk about rights. 1797 01:16:24,280 --> 01:16:26,215 And I think that they go hand in hand. 1798 01:16:26,249 --> 01:16:27,450 [Rachel]. You need people yelling and screaming, 1799 01:16:27,516 --> 01:16:28,752 and you need coalitions, 1800 01:16:28,785 --> 01:16:30,319 and you need people getting loud. 1801 01:16:30,386 --> 01:16:31,287 You need advocacy, 1802 01:16:31,354 --> 01:16:33,122 you need research, you need mentorship, 1803 01:16:33,156 --> 01:16:34,824 you need awareness, you need communicat- 1804 01:16:34,891 --> 01:16:36,125 You need all of those things. 1805 01:16:36,159 --> 01:16:38,928 [Anita]. We need a seat at the medical school tables. 1806 01:16:38,962 --> 01:16:40,229 Who's coming up with the curriculum? 1807 01:16:40,263 --> 01:16:43,266 How many hours need to be devoted to this subject? 1808 01:16:43,299 --> 01:16:45,769 We need a seat at the FDA in terms of 1809 01:16:45,802 --> 01:16:47,837 what medications are getting FDA approved. 1810 01:16:47,904 --> 01:16:50,473 What roadblocks are they putting up in place 1811 01:16:50,539 --> 01:16:52,809 trying to protect women and keep us safe, 1812 01:16:52,842 --> 01:16:55,679 which actually just create huge barriers to care. 1813 01:16:55,745 --> 01:16:58,815 We need to hold insurance companies responsible. 1814 01:16:58,848 --> 01:17:00,616 And our patients need to speak up 1815 01:17:00,650 --> 01:17:02,919 and demand from their congressmen, 1816 01:17:02,952 --> 01:17:04,053 from their legislators 1817 01:17:04,087 --> 01:17:06,222 that these are important issues that they deserve. 1818 01:17:07,556 --> 01:17:09,926 [Sarah]. The most important way 1819 01:17:09,959 --> 01:17:11,494 in which any individual 1820 01:17:11,527 --> 01:17:16,132 could make an impact on this fight for bodily autonomy 1821 01:17:16,165 --> 01:17:18,835 and the right to equal amounts of care, 1822 01:17:18,868 --> 01:17:22,672 would be to educate ourselves and to remain curious. 1823 01:17:22,706 --> 01:17:26,475 And when we hear something that doesn't quite seem the same 1824 01:17:26,509 --> 01:17:28,611 as what we were trained to think, 1825 01:17:28,644 --> 01:17:30,814 to push back a little bit 1826 01:17:30,847 --> 01:17:33,950 and realize that the truth is actually something 1827 01:17:33,983 --> 01:17:36,485 that's been hidden from us for a very long time. 1828 01:17:36,519 --> 01:17:38,922 [Josephine]. I think the key is to not be discouraged by the losses. 1829 01:17:39,923 --> 01:17:43,359 There will be losses and you can't just take that and go, 1830 01:17:43,426 --> 01:17:45,328 well there's no point in fighting this fight 1831 01:17:45,361 --> 01:17:46,830 'cause we just lost that fight. 1832 01:17:46,863 --> 01:17:48,497 And I think right now that's what we have to do, 1833 01:17:48,531 --> 01:17:51,701 is we keep having to push for the right answer. 1834 01:17:53,036 --> 01:18:00,009 [bright music] 1835 01:18:00,043 --> 01:18:07,917 * 1836 01:18:07,984 --> 01:18:10,920 [Cindy]. In the dark days after the CEO fired me, 1837 01:18:10,987 --> 01:18:12,856 no one was feeling sorry for me, right? 1838 01:18:12,889 --> 01:18:15,358 I had really the entrepreneur's dream come true. 1839 01:18:15,391 --> 01:18:16,692 I exited the business. 1840 01:18:16,726 --> 01:18:19,228 It was an incredible outcome for all the shareholders, 1841 01:18:19,262 --> 01:18:23,232 and yet I found myself really unfulfilled 1842 01:18:23,266 --> 01:18:25,334 because it's not what I'd set out to do. 1843 01:18:25,368 --> 01:18:27,403 [reporter]. Well the drama isn't over for the drug maker, 1844 01:18:27,436 --> 01:18:28,704 Valeant Pharmaceuticals, 1845 01:18:28,738 --> 01:18:33,042 the CEO just recently back from medical leave is now out. 1846 01:18:33,076 --> 01:18:34,543 [Cindy]. So when the new CEO came, 1847 01:18:34,577 --> 01:18:36,913 I asked him if he'd have breakfast with me in New York 1848 01:18:36,980 --> 01:18:39,348 and I sat down with him and I said, "Give it back." 1849 01:18:39,382 --> 01:18:41,184 He said, "No thank you. Go away." 1850 01:18:42,819 --> 01:18:45,388 So I issued a lawsuit. 1851 01:18:45,421 --> 01:18:47,891 They'd made commitments to me on what they would do. 1852 01:18:47,924 --> 01:18:50,960 You know, how much they would put toward the marketing, 1853 01:18:51,027 --> 01:18:52,929 the education of physicians on it. 1854 01:18:52,996 --> 01:18:55,899 And they were in breach of all those obligations. 1855 01:18:55,932 --> 01:18:58,902 And ultimately in exchange for dropping the lawsuit, 1856 01:18:58,935 --> 01:19:00,469 they gave the product back. 1857 01:19:00,503 --> 01:19:04,407 Just give us the history of this female Viagra drug 1858 01:19:04,440 --> 01:19:05,474 because it was bought, wasn't it, 1859 01:19:05,508 --> 01:19:07,777 by Valeant and went nowhere fast. 1860 01:19:07,811 --> 01:19:09,278 And now she's bought it back. 1861 01:19:09,312 --> 01:19:12,782 [Cynthia]. Yeah, Cindy successfully settled with Valeant a lawsuit 1862 01:19:12,816 --> 01:19:15,318 that allowed them to get the drug back at no cost to them. 1863 01:19:15,351 --> 01:19:17,286 And they're taking this back to the market 1864 01:19:17,320 --> 01:19:18,822 for the second time. 1865 01:19:18,855 --> 01:19:21,858 And so it's basically the, the drug's second shot. 1866 01:19:25,594 --> 01:19:26,762 [Cindy]. The minute we got it back, 1867 01:19:26,796 --> 01:19:27,997 we went to back to work 1868 01:19:28,064 --> 01:19:30,499 and we invested all of these dollars back into 1869 01:19:30,566 --> 01:19:32,335 all the scenarios that we could show back up to the FDA 1870 01:19:32,368 --> 01:19:35,638 and actually got that black box warning contraindication 1871 01:19:35,671 --> 01:19:36,806 removed. 1872 01:19:36,840 --> 01:19:39,108 It has an entirely different label today. 1873 01:19:39,142 --> 01:19:42,178 No doctor has to take a test to prescribe it. 1874 01:19:42,211 --> 01:19:46,349 Eli does what he calls pharma or farm P-H-A-R-M to table. 1875 01:19:46,382 --> 01:19:47,483 That's right. 1876 01:19:47,516 --> 01:19:49,986 So he's making sure all these pills are coming off 1877 01:19:50,019 --> 01:19:52,655 the manufacturing line. 1878 01:19:52,688 --> 01:19:54,323 Kristen, our chief of staff, 1879 01:19:54,357 --> 01:19:57,493 Margaret in finance here. 1880 01:19:57,526 --> 01:20:01,831 Chrissy Newbauer, who runs customer service for us. 1881 01:20:01,865 --> 01:20:05,034 Michelle, who's working in customer service as well. 1882 01:20:05,068 --> 01:20:06,002 When we got approved, 1883 01:20:06,035 --> 01:20:09,005 we were confined to only premenopausal women. 1884 01:20:09,038 --> 01:20:14,143 So we've submitted for our postmenopausal expansion of use. 1885 01:20:14,543 --> 01:20:15,478 [Josephine]. I don't even like to say 1886 01:20:15,511 --> 01:20:17,881 that we've submitted for postmenopausal. 1887 01:20:17,914 --> 01:20:21,851 We've submitted for approval in women with HSDD. 1888 01:20:21,885 --> 01:20:24,687 It, it's not for approval of postmenopausal women, right? 1889 01:20:24,720 --> 01:20:25,889 It's women with HSDD 1890 01:20:25,955 --> 01:20:27,823 'cause that's who it should always have been approved for. 1891 01:20:27,857 --> 01:20:29,058 And so, 1892 01:20:29,092 --> 01:20:32,361 after we disprove the alcohol contraindication, 1893 01:20:32,395 --> 01:20:35,031 if you Google Addyi and alcohol, 1894 01:20:35,064 --> 01:20:39,202 what comes up is Addyi is contraindicated with alcohol. 1895 01:20:39,235 --> 01:20:41,570 That's still out there, that narrative. 1896 01:20:41,637 --> 01:20:44,373 Like even though we proved it, 1897 01:20:44,407 --> 01:20:47,210 that narrative, six years, is still out there, 1898 01:20:47,243 --> 01:20:48,844 and it's still out there in part 1899 01:20:48,878 --> 01:20:50,880 because FDA keeps it out there. 1900 01:20:50,914 --> 01:20:53,249 So the first order of business was science, 1901 01:20:53,282 --> 01:20:55,418 and then I think the second order of business 1902 01:20:55,451 --> 01:20:59,522 has been demystifying all of the garbage 1903 01:20:59,555 --> 01:21:01,524 that's been out there about this. 1904 01:21:01,557 --> 01:21:02,525 Women are like, 1905 01:21:02,558 --> 01:21:04,393 what do you mean there's a pink pill for me? 1906 01:21:04,427 --> 01:21:05,561 I've never heard of it. 1907 01:21:05,594 --> 01:21:08,431 And that is now the real problem. 1908 01:21:08,464 --> 01:21:09,398 You guys know 1909 01:21:09,432 --> 01:21:11,600 that I've been fighting for years on this issue, 1910 01:21:11,634 --> 01:21:15,404 that I fought to get the first FDA approved treatment option 1911 01:21:15,438 --> 01:21:16,739 for women's libido. 1912 01:21:16,772 --> 01:21:18,975 All the while hearing the same excuse, 1913 01:21:19,042 --> 01:21:21,744 "Mmm, women's libido is complicated." 1914 01:21:21,777 --> 01:21:24,613 Is it complicated or is it just not prioritized? 1915 01:21:24,647 --> 01:21:26,415 I had nothing on social media, 1916 01:21:26,449 --> 01:21:27,450 but you know what? 1917 01:21:27,483 --> 01:21:29,252 Somebody had to speak up 1918 01:21:29,285 --> 01:21:32,555 and once I spoke up, it just never stopped. 1919 01:21:32,588 --> 01:21:34,790 When doctors dismiss our pain, 1920 01:21:34,857 --> 01:21:35,925 downplay our symptoms, 1921 01:21:35,959 --> 01:21:38,161 or essentially tell us it's all in your head, 1922 01:21:38,227 --> 01:21:40,229 we learn to be our own advocates. 1923 01:21:40,263 --> 01:21:42,765 That's not empowerment, that's survival. 1924 01:21:42,798 --> 01:21:43,799 Cindy, welcome to the show. 1925 01:21:43,832 --> 01:21:44,968 Thanks for having me. 1926 01:21:45,001 --> 01:21:46,469 The truth is, I knew that you were gonna be wearing 1927 01:21:46,502 --> 01:21:47,470 pink today. 1928 01:21:47,503 --> 01:21:48,737 I know, it's shocking. 1929 01:21:48,771 --> 01:21:51,474 I think Addyi has parallels to all of these other conversations 1930 01:21:51,507 --> 01:21:53,109 we're having right now 1931 01:21:53,142 --> 01:21:55,611 that I'd like to think we've had a hand in 1932 01:21:55,644 --> 01:21:58,414 because when you fight back, you can win. 1933 01:21:58,447 --> 01:22:02,285 [upbeat music] 1934 01:22:02,318 --> 01:22:03,419 Dr. Blair Peters here, 1935 01:22:03,452 --> 01:22:04,620 full-time gender affirming surgeon. 1936 01:22:04,653 --> 01:22:05,754 Hi everybody, uh, 1937 01:22:05,788 --> 01:22:07,957 Rachel Rubin, urologist and sexual medicine specialist. 1938 01:22:07,991 --> 01:22:09,658 We're live on Instagram right now. 1939 01:22:09,725 --> 01:22:11,827 * I don't want to want when I wanna 1940 01:22:11,894 --> 01:22:14,330 * Anything I want cuz I like it like that * 1941 01:22:14,397 --> 01:22:15,464 [Maria]. So this person asked, 1942 01:22:15,498 --> 01:22:18,667 I pee after sex and yet I'm still getting UTIs. 1943 01:22:18,701 --> 01:22:19,902 What am I doing wrong? 1944 01:22:19,935 --> 01:22:21,971 Just wanted to give you guys a walkthrough to this device. 1945 01:22:22,005 --> 01:22:24,173 Um, it is for erectile dysfunction. 1946 01:22:24,207 --> 01:22:26,509 Here are things I would do to have a better sex life. 1947 01:22:26,542 --> 01:22:27,710 [Cindy]. It is so fun 1948 01:22:27,776 --> 01:22:32,348 to watch these badass younger physicians. 1949 01:22:32,415 --> 01:22:34,350 Hi everybody, it's your education share, 1950 01:22:34,417 --> 01:22:35,851 Sarah Cigna. 1951 01:22:35,884 --> 01:22:38,487 [Cindy]. Whether they're on Instagram breaking barriers 1952 01:22:38,521 --> 01:22:42,825 or they're in the room challenging conventional wisdom, 1953 01:22:42,858 --> 01:22:43,892 I love it. 1954 01:22:43,959 --> 01:22:45,761 * I'm a rebel * 1955 01:22:46,229 --> 01:22:48,831 * I'm a rebel 1956 01:22:48,864 --> 01:22:50,399 I am not a magician, 1957 01:22:50,466 --> 01:22:53,702 but my batting average is really fricking good. 1958 01:22:53,736 --> 01:22:56,505 And in our practice we take a lot of time 1959 01:22:56,539 --> 01:22:57,673 to get to know you, 1960 01:22:57,706 --> 01:22:59,542 to figure out what's bothering you, 1961 01:22:59,575 --> 01:23:02,378 and to figure out how do we optimize your quality of life. 1962 01:23:02,445 --> 01:23:04,547 Stacey, David, it's great to see ya! 1963 01:23:04,580 --> 01:23:05,514 Good to see you. 1964 01:23:05,548 --> 01:23:07,783 One of the things we often ask people is, 1965 01:23:07,816 --> 01:23:10,219 what does sex look like for you right now? 1966 01:23:10,253 --> 01:23:12,721 And compare that to what you want it to look like. 1967 01:23:12,755 --> 01:23:13,856 Why is that important? 1968 01:23:13,889 --> 01:23:17,026 Because I can't assume what kind of sex you're having 1969 01:23:17,060 --> 01:23:19,028 or even what you want it to look like, 1970 01:23:19,062 --> 01:23:22,031 and the more I understand you and what your goals are, 1971 01:23:22,065 --> 01:23:23,266 then we see magic. 1972 01:23:23,332 --> 01:23:25,534 When you really take the time with people, 1973 01:23:25,568 --> 01:23:27,203 that's when the magic happens. 1974 01:23:27,236 --> 01:23:29,004 That's why I think it is so important 1975 01:23:29,038 --> 01:23:31,407 during an annual exam to encourage women 1976 01:23:31,440 --> 01:23:33,109 to hold a hand mirror 1977 01:23:33,176 --> 01:23:35,278 while I go through their external vulvar exam. 1978 01:23:35,344 --> 01:23:36,912 I feel like most of the time when I do that 1979 01:23:36,945 --> 01:23:39,582 women are so shocked and happy 1980 01:23:39,615 --> 01:23:41,084 that somebody took the time to show them 1981 01:23:41,150 --> 01:23:43,419 really who they are down there. 1982 01:23:43,486 --> 01:23:47,356 And that's just one step in the process of empowering women 1983 01:23:47,390 --> 01:23:50,526 to take more ownership over their own sexual function. 1984 01:23:50,559 --> 01:23:52,928 [Sarah]. Patients and we as clinicians, 1985 01:23:52,961 --> 01:23:54,697 need some sense of community, 1986 01:23:54,730 --> 01:23:57,266 especially in the current political climate. 1987 01:23:57,333 --> 01:23:59,735 Without people who are banding together, 1988 01:23:59,768 --> 01:24:00,936 creating community, 1989 01:24:01,003 --> 01:24:02,905 creating safe spaces, 1990 01:24:02,938 --> 01:24:05,908 and pushing the needle forward, 1991 01:24:05,941 --> 01:24:08,277 we're never gonna get anywhere. 1992 01:24:08,344 --> 01:24:11,114 [Sue]. We should be able to stand up for our rights 1993 01:24:11,147 --> 01:24:12,348 and say, "I want more." 1994 01:24:12,381 --> 01:24:14,250 I want something better out of this relationship. 1995 01:24:14,283 --> 01:24:15,751 I want something better outta sex. 1996 01:24:15,784 --> 01:24:17,953 I want something better out of my job. 1997 01:24:17,986 --> 01:24:19,322 [stammers] I want something better from, you know, 1998 01:24:19,388 --> 01:24:21,290 from the, from my family, 1999 01:24:21,357 --> 01:24:24,593 but you, but if you don't tell somebody, 2000 01:24:24,627 --> 01:24:27,230 then how can you expect somebody else to help you? 2001 01:24:27,263 --> 01:24:30,433 [Maria]. The underlying theme of whether it's sexual health 2002 01:24:30,466 --> 01:24:32,735 to reproductive health is choice. 2003 01:24:32,768 --> 01:24:34,303 So whether it's having an orgasm 2004 01:24:34,337 --> 01:24:35,638 or having an abortion, 2005 01:24:35,671 --> 01:24:37,640 women should have the ability to choose 2006 01:24:37,673 --> 01:24:40,443 what is the best thing for them. 2007 01:24:40,476 --> 01:24:41,944 [Blair]. A lot of the culture in medicine 2008 01:24:41,977 --> 01:24:43,812 is still very anti speaking out 2009 01:24:43,879 --> 01:24:47,616 and it's because we don't speak up for things 2010 01:24:47,650 --> 01:24:50,153 that the narrative has become very warped 2011 01:24:50,186 --> 01:24:53,156 and very much straight away from science. 2012 01:24:53,222 --> 01:24:55,458 So I think there's a huge need more than ever 2013 01:24:55,491 --> 01:24:58,161 for a lot of us to really be out there. 2014 01:24:58,227 --> 01:25:02,965 [Joshua]. I'm hopeful because I'm seeing more women come into this field. 2015 01:25:02,998 --> 01:25:05,334 I'm seeing more queer people enter this space 2016 01:25:05,401 --> 01:25:06,602 and saying like, 2017 01:25:06,635 --> 01:25:09,004 we need to really rethink how we talk to people about sex 2018 01:25:09,071 --> 01:25:12,308 so that we include all types of people. 2019 01:25:12,341 --> 01:25:16,011 I think that the more pleasure and orgasms 2020 01:25:16,078 --> 01:25:18,481 and fun people can have that is safe, 2021 01:25:18,514 --> 01:25:19,782 that is consensual, 2022 01:25:19,815 --> 01:25:22,185 I think when we focus on pleasure and joy, 2023 01:25:22,251 --> 01:25:27,055 then the hatred and the trolling and the nastiness 2024 01:25:27,122 --> 01:25:28,624 and the focus on all the negative, 2025 01:25:28,657 --> 01:25:30,826 I think it kind of starts to go away. 2026 01:25:30,859 --> 01:25:33,362 So I think by focusing on joy, 2027 01:25:33,396 --> 01:25:35,364 I think we can make a lot of progress. 2028 01:25:35,398 --> 01:25:40,203 The magic that happens after someone reclaims their sexuality 2029 01:25:40,269 --> 01:25:41,870 just knows who they are, 2030 01:25:41,937 --> 01:25:44,207 takes full ownership of their existence, 2031 01:25:44,240 --> 01:25:45,174 their bodies, 2032 01:25:45,208 --> 01:25:47,876 their birthright of pleasure. 2033 01:25:47,943 --> 01:25:50,879 You get to literally witness this person 2034 01:25:50,913 --> 01:25:52,415 step into their power. 2035 01:25:52,481 --> 01:25:54,517 I have seen so many of my patients 2036 01:25:54,550 --> 01:25:55,851 go on to sign a book deal, 2037 01:25:55,884 --> 01:25:58,354 go on to like run for office, 2038 01:25:58,387 --> 01:26:01,190 to go on to do so many things 2039 01:26:01,224 --> 01:26:03,091 because they had the audacity 2040 01:26:03,158 --> 01:26:06,061 and the audaciousness to chase their pleasure, 2041 01:26:06,094 --> 01:26:08,931 which then opened up doors to chase all their other dreams, 2042 01:26:08,997 --> 01:26:11,200 and it is so fun. 2043 01:26:11,234 --> 01:26:13,536 Story alert. I have a story alert. 2044 01:26:13,569 --> 01:26:15,371 I saw a patient very recently, 2045 01:26:15,404 --> 01:26:16,339 she's in her sixties, 2046 01:26:16,372 --> 01:26:18,607 twenty-five years ago in her late thirties 2047 01:26:18,674 --> 01:26:22,445 she lost her ability to have her three magical orgasms. 2048 01:26:22,511 --> 01:26:25,448 She used to orgasm three powerful magical times. 2049 01:26:25,514 --> 01:26:29,252 Well, I just saw her and she said, "Dr. Rubin, 2050 01:26:29,285 --> 01:26:31,354 "they're back!" 2051 01:26:31,454 --> 01:26:34,056 * Love heavy but I gotta let you go 2052 01:26:34,089 --> 01:26:36,592 * Mind steady and I got a way to let it go 2053 01:26:36,625 --> 01:26:39,262 * Love came here but it never left so 2054 01:26:39,295 --> 01:26:41,630 * The way we look be supervised by a pen stroke 2055 01:26:41,697 --> 01:26:44,099 * In the high note crying in my throat 2056 01:26:44,132 --> 01:26:46,602 * Love heavy and I think its time to let it go * 2057 01:26:46,669 --> 01:26:49,405 * Way of love but it weighs too much and you weigh too much 2058 01:26:49,438 --> 01:26:52,408 * Staying out of touch looking suss, huh * 2059 01:26:52,775 --> 01:26:54,377 * Put our love on a layaway 2060 01:26:54,410 --> 01:26:56,612 * Paying for it every time I have a piece for you 2061 01:26:56,679 --> 01:26:57,713 * Peach that's sweet 2062 01:26:57,746 --> 01:26:59,448 * Bon appetit, bon appetit 2063 01:26:59,515 --> 01:27:02,351 * Just miss me... * 160954

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