Women's Sexual Dysfunction Drugs Remain Unavailable in South Korea

"Viagra works so well for men—would it work for women too?"

My cousin posed this unexpected question while peeling fruit during our Lunar New Year family gathering. I assumed she was asking about altitude sickness prevention, a known off-label use for the drug. She wasn't.

My cousin, now in her eighth year of marriage to a man five years her junior, epitomizes the "superwoman" archetype—balancing a career and two young children without family support. But chronic fatigue has taken its toll. Intimacy began feeling like another chore rather than a romantic connection, and the frequency dropped dramatically. Her libido had simply vanished, straining the relationship despite unchanged affection for her husband.

The short answer: women should not take Viagra for sexual dysfunction. Sildenafil, Viagra's active ingredient, inhibits the PDE-5 enzyme to increase blood flow to the penis, enhancing erection. It improves "mechanical response" through vasodilation but does not boost desire itself. While the drug increases genital blood flow in women similarly, it fails to trigger sexual arousal. Female sexual dysfunction is far more complex than its male counterpart and cannot be resolved through improved blood flow alone. This explains why treatments for women lagged far behind the flood of erectile dysfunction drugs following Viagra's 1998 blockbuster launch. Studies have shown Viagra prescribed to women with sexual dysfunction caused only side effects like headaches with no therapeutic benefit.

Options do exist, however. Sprout Pharmaceuticals' Addyi (flibanserin) received FDA approval in 2015. Originally developed as an antidepressant, researchers discovered it increased female libido as a side effect. Marketed as a pink oval pill—earning the nickname "pink Viagra" in contrast to the "blue diamond"—Addyi works entirely differently from Viagra, inhibiting certain serotonin receptors while activating dopamine pathways. However, side effects including nausea, drowsiness, and dizziness proved significant, and dangerous blood pressure drops can occur when combined with alcohol or antifungal medications, generating ongoing controversy.

In 2019, Palatin Technologies' Vyleesi (bremelanotide) won FDA approval for treating hypoactive sexual desire disorder in premenopausal women. The drug activates melanocortin receptors in the central nervous system to improve sexual response and desire. Unlike pill-form Addyi, Vyleesi comes as a single-use, self-administered subcutaneous injection pen used as needed under physician guidance. More recently, U.S. biotech firm Dare Bioscience launched "Dare to Play," a topical cream containing sildenafil applied to the vulva 10-15 minutes before intercourse—though it has not yet received final FDA approval.

Unfortunately, none of these three products appear headed for the South Korean market anytime soon. Kwangdong Pharmaceutical secured exclusive Korean rights to Vyleesi in 2017 and filed for regulatory approval following bridging studies, but voluntarily withdrew its application in the second half of last year. "Approval-related matters are confidential," a company spokesperson said. "We are in discussions with the original developer regarding domestic introduction."

Separately, Chong Kun Dang acquired Korean rights in 2015 to Lorexys, a female hypoactive sexual desire disorder treatment under development by U.S.-based S1 Biopharma. Clinical development by the original developer has stalled, leaving approval prospects unclear nearly a decade later.

The treatment gap persists. While men have abundant options for sexual dysfunction, Korean women continue to face severely limited choices.