Fatal Aphrodisiacs

One of my editorial standards is that I don’t accept advertising for penis pills. As a category, these products are at best fraudulent, and at worst, deadly. Safety aside, there’s no such thing as a penis pill that’s (a) legal for sale over the internet and (b) proven effective. But even if there were such a mythical pill, how would you know if its mythical active ingredient was actually in the pill that arrived in your mailbox?

Plus, don’t let’s put safety aside as I just rhetorically did. A lot of stuff sold for boner-stiffening is actively dangerous. Last month Slate printed a nice article about the “cane toad” products that were in vogue for awhile:

Please don’t eat toad toxins to get an erection.

Toad poisonings are rare but life-threatening. Men and women have died from heart attacks after eating herbal supplements called Chan Su, or aphrodisiacs called Rockhard or Love Stone. These products all contain the dried, toxic secretions of Asiatic or cane toads. Similarly, people have been sickened and even died after drinking toad soup, eating toad eggs, or swallowing live toads to win a bet.

…

Poisoning and death probably weren’t on the minds of the men who bought “hard, dark brown” squares of aphrodisiacs from New York City street vendors. Between 1993 and 1995, at least six men fell ill and four died from heart failure caused by the aphrodisiacs’ active ingredients: toxic bufadienolides. These toad toxins were also responsible for the death of a middle-aged American in 2003 after he consumed three “sex pills.” And they were the same toxins that led to an Indian man’s weeklong hospitalization in 2011, after he ate five to six toads over the course of “an eventful morning.”

It’s hard to blame the toads for these casualties. To protect themselves against predators like dogs and snakes, the cane toad has evolved the ability to secrete toxins from its skin and the parotid gland behind its ears. This “viscous white fluid” is a stew of chemicals that induces convulsions, vomiting, and even death in would-be predators. Even though this chemical stew can reportedly cause priapism — a painful, persistent erection — it also contains toxic bufadienolides, which poison the heart.

There’s no boner-killer that kills boners as thoroughly as a heart attack. Verbum sapienti satis.

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Aphrodisiacs Closer?

As I headed into the office on the morning of this recent Friday the 13th I had an intuition that interesting news would await me. It did, in the form of a headline on Bloomberg: “Desire Drug May Prove Sex Really Is All in Her Head.” Sometimes the news gods are kind.

The gist of this story is that the German pharmaceutical firm of Boehringer Ingelheim GmbH, needing a new revenue source to make up for those which is likely to lose when its patents expire on Mirapex and Flomax, surveyed a large number of women over 18 and discovered that among many of them, ebbing sexual desire was seen as significant cause of distress. Boehringer’s answer has been to begin trials of a new drug called flibanserin, which by blocking serotonin and triggering dopamine production is supposed to amp up the libido. Boehringer is supposed to be presenting results at the upcoming meeting of the European Society for Sexual Medicine, starting Monday.

A big win, perhaps? Humanity has sought aphrodisiacs since it climbed down from the trees. The big difference is that we might just be closing in on ones which can be clinically proven to work, with all the fun that might entail.

But of course, these moves are controversial. The problem seems to really stem from an annoying distinction between therapy and enhancement uses for drugs. Many people believe that it’s okay to use drugs to treat “illnesses” or restore “normality,” but not to use them to just enjoy yourself (or make yourself smarter, stronger, etc.) So advocates of drugs like these are forced into the dodge of claiming that they exist to treat something called “Hypoactive Sexual Desire Disorder.” Critics can then point out that there is no universally (or perhaps even generally) accepted standard for what the “right” level of sexual desire is, and further that there’s something a little nasty about stigmatizing people with the “wrong” level as somehow pathological and in need of treatment. On one version of this view, hypoactive sexual desire disorder is just a made-up condition to allow Boehringer to sell drugs and make money.

My own view, for what it’s worth, is to acknowledge that the critics may have a point but then to ask whether we should care that much. Why should we rely on men in white coats to tell us what the “right” level of sexual desire for us. Shouldn’t we deliberate for ourselves and make our own judgments about what degree of sexual desire will make our lives go well and, having so deliberated, aren’t we entitled to have our judgment respected? (Reflections like this one show just how coercive and illiberal the therapy/enhancement distinction potentially is.) Shouldn’t we decide for ourselves whether our sexual desire should be enhanced or, for that matter, reduced if it so suits us, without having to pretend we’re suffering from some sort of disease?

Of course, I would also offer a caution here, to the effect that perhaps what we really want to enhance is not desire but pleasure. If you think about it enough, enhancing just desire by itself is a peculiar goal. Wanting is not the same thing as liking, even if the two are often intimately connected. Having stronger desires could be a positive problem if you lack the means to satisfy them — you might just be letting yourself in for a more frustrating life rather than a more fulfilled one. And perhaps satisfaction of desire isn’t really all that great just by itself and unaccompanied by the right hedonic state. Haven’t you ever fulfilled a great desire in your life only to feel at least somewhat disappointed in the end? It seems more plausible to think that it’s the hedonic state itself that matters: isn’t it wonderful when something happens to us for which we had no antecedent desire (perhaps because we did not even know it existed before experiencing it) but which was a source of joy when it happened (a major point in favor of skilled lovers, yes?).

Though of course, I see no reason to think that flibanserin or other future additions to the pharmacopoeia won’t also enhance pleasure. If so, good times ahead.