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Is "Female Viagra" Right for You?

Two medications have been approved to treat female sexual dysfunction—but do they really work?

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If you're struggling with low sex drive, treatments may be able to help.

In August 2015, following a trio of clinical trials, the U.S. Food and Drug Administration (FDA) approved Addyi (flibanserin), the so-called “female Viagra.” Four years later, in June 2019, another medication called Vyleesi (bremelanotide) got the FDA’s go-ahead. These drugs purport to increase sexual desire in women and are the first FDA-approved treatments for female sexual dysfunction. Both are available only by prescription. Addyi is a once-a-day pill, while you take Vyleesi via injection as needed, with some restrictions.

Find out how these drugs work—and whether they could be right for you.

Medically reviewed in January 2020.

Do they work like Viagra?

2 / 5 Do they work like Viagra?

Though “female Viagra” is convenient shorthand, neither Addyi or Vyleesi work like Viagra for men. Viagra treats sexual performance issues by increasing blood flow to help men get and maintain erections. Addyi and Vyleesi work on brain chemicals to increase women’s sexual desire.

In a trial, women taking Addyi reported between 0.5 and 1 additional satisfying sexual events per month, and also reported better scores on a sexual distress index compared with women taking a placebo. 

In trials for Vyleesi, around 35 percent of patients taking the drug reported a significant reduction in sexual distress, versus 31 percent on a placebo. Additionally, about 25 percent of Vyleesi patients experienced improvements in sexual desire. Only 17 percent on a placebo did the same.

Who should take it?

3 / 5 Who should take it?

The drugs are approved for premenopausal women with a condition known as hypoactive sexual desire disorder, or HSDD. It's characterized by a low sex drive and accompanying personal distress that does not stem from other medical, medicinal or psychiatric reasons, or problems with a relationship. The type of sexual activity, the partner and the situation have no effect on desire in a woman with HSDD.

"We don’t know for sure, but the mechanism of action suggests Addyi would probably be effective in postmenopausal women," says Keith Roach, MD, an Associate Professor in Clinical Medicine in the division of general medicine at Weill Cornell Medical College and New York Presbyterian Hospital. Neither Addyi or Vyleesi is indicated for postmenopausal women, however, so it’s best to speak with your HCP for more information.

What are the side effects?

4 / 5 What are the side effects?

Addyi can cause low blood pressure and fainting. These effects may be magnified by alcohol, some oral contraceptives and certain antifungal medications. The medicine should be taken at bedtime in order to minimize the risk of injury associated with general sedation/sleepiness and loss of consciousness. Women taking Addyi should stop drinking alcohol two hours before a bedtime dose (or skip the dose), and then not drink again until the next day.

Dr. Roach says about 15 percent of women experience these side effects. “Dizziness, somnolence, nausea, and fatigue are all at significantly increased rates compared with placebo,” he adds.

Vyleesi may cause nausea, vomiting, redness of the face, reactions at the site of injection site and headache. Some people may experience a darkening of the skin in certain areas, such as the gums, face or breasts—and the discoloration may remain even after you come off the drug. Vyleesi can trigger a temporary bump in blood pressure, as well. People with cardiovascular disease or uncontrolled high blood pressure should not use the medication.

How safe are they?

5 / 5 How safe are they?

Some critics contend that the side effects and questionable perks of HSDD drugs outweigh the benefits. Just over half of the women in the Addyi trial said their sexual desire improved while taking the drug, but 38 percent of women taking a placebo said the same. “It’s more effective than a placebo, but not a lot,” says Roach. But he adds that a woman prescribed Addyi has a 50-50 chance of improvement, whether it’s due to the placebo effect or not.

“I’ll prescribe the drug to an appropriate female patient who is willing to accept the risks, provided she understands them,” says Roach. He adds that because there is high demand for this treatment, "you’ll find a lot of people willing to accept even high risks of side effects.” 

Sources:
U.S. Food and Drug Administration: “Drug Trials Snapshots: ADDYI,” FDA approves new treatment for hypoactive sexual desire disorder in premenopausal women,” FDA orders important safety labeling changes for Addyi.”
Medscape: FDA Approves 'Female Viagra' Flibanserin (Addyi),” “'Female Viagra' Foes Denounce PR Campaign to Win FDA Approval.”
Vyleesi.com: “Important Safety Information.”
Simon JA, Kingsberg SA, et al. Efficacy and safety of flibanserin in postmenopausal women with hypoactive sexual desire disorder: results of the SNOWDROP trial. Menopause. 2014 Jun;21(6):633-40

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