Low sexual desire can be a big problem for many women. It can affect relationships and how happy you feel overall. For some, this isn’t just a passing feeling. It’s a real medical condition.
This brings us to Addyi (flibanserin). It’s a medicine approved for a specific condition. This condition is called acquired, generalized Hypoactive Sexual Desire Disorder (HSDD). It’s for women who haven’t yet gone through menopause.
So, what is Addyi exactly? How does it work? What are the real benefits and risks? This article explains Addyi clearly. We use science and expert views to help you understand this medicine.
What is Addyi (Flibanserin)?
Addyi isn’t a magic pill for anyone wanting more desire. Its use is very specific.
What is Hypoactive Sexual Desire Disorder (HSDD)?
First, let’s understand HSDD. It’s not just having less interest in sex sometimes. HSDD is different.
HSDD means you have a new and ongoing lack of sexual thoughts or desire. This happens no matter the situation or partner. It must also cause you real distress or problems in your relationships.
Other things must be ruled out first. These include other medical issues, relationship problems, or drug side effects.
“Diagnosing HSDD needs a careful check by a doctor,” says Dr. Evelyn Reed. She’s a psychologist who studies sexual health. “We need to tell the difference between a medical condition and normal changes in desire.”
Who Can Use Addyi?
The FDA approved Addyi only for certain women. They must be premenopausal and have acquired, generalized HSDD.
Addyi is not for:
- Low desire caused by relationship issues or other medical problems.
- Women who have already gone through menopause. (Doctors sometimes prescribe it ‘off-label’ for this group, but the FDA hasn’t approved it.)
- Men.
- Improving sexual performance.
How Does Addyi Work? The Science Made Simple
Addyi works very differently than drugs like Viagra for men. Viagra affects blood flow. Addyi works on brain chemicals.
Targeting Brain Chemicals, Not Blood Flow
Viagra helps men by increasing blood flow to the penis. Addyi works on the brain’s complex system for sexual desire.
“Female desire is complex. It involves hormones, feelings, relationships, and brain science,” notes Dr. Kenji Tanaka. He studies how drugs affect the brain and sexual function. “Addyi tries to help by changing signals in the brain.”
Balancing Brain Chemicals
Scientists are still learning exactly how Addyi works. They believe it adjusts certain brain chemicals called neurotransmitters.
It seems to lower serotonin (which can reduce desire). It also raises dopamine and norepinephrine (which may boost desire). The goal is to bring these chemicals back into balance.
You take Addyi every day, usually at bedtime. It works gradually over weeks, not right away.
The Story of Addyi: Getting Approved
Addyi had a long road to approval. There was a lot of debate along the way.
A Difficult Path
Scientists first tested Addyi as an antidepressant. It didn’t work well for depression. But some women in the study reported higher libido. So, research shifted to HSDD.
The FDA rejected Addyi twice (in 2010 and 2013). They worried about its small benefits compared to the risks. Key risks were fainting and low blood pressure, especially with alcohol.
Advocacy Groups Played a Role
During the third review, some groups pushed hard for approval. They argued women needed fair access to sexual health treatments. Critics felt this pressure downplayed the safety risks.
Addyi finally got approved in 2015. But it came with strong safety rules. These include a Boxed Warning (the FDA’s most serious alert) and a special safety program (REMS).
Does Addyi Work Well? What Studies Show
How well Addyi works is still discussed. Studies measured success in specific ways.
How Success Was Measured
The main goals in the big studies were:
- An increase in “satisfying sexual events” (SSEs) per month.
- An increase in desire, based on women’s own reports.
Modest Benefits, Varies by Person
The results showed women taking Addyi had about 0.5 to 1 more SSE per month than women taking a placebo (sugar pill). They also reported slightly higher desire and less distress about it.
“The average benefit in studies was small, but real,” says Dr. Lena Hanson, a researcher of HSDD treatments. “But averages don’t show everything. Some women might feel a bigger difference. Others might see none.”
It’s important to have realistic expectations. Addyi doesn’t work for everyone. Any improvement might be subtle, not dramatic.
Understanding the Risks and Side Effects
Addyi has serious safety concerns. Doctors and patients need to pay close attention.
Big Safety Worries: Fainting and Low Blood Pressure
The biggest risks with Addyi are fainting (syncope) and severe low blood pressure (hypotension). These risks go way up if you drink alcohol while taking Addyi. This is the main reason for the Boxed Warning and safety program.
The Danger with Alcohol (REMS Program)
The special safety program (REMS) means doctors and pharmacists need special training. They must tell patients about the serious risk of fainting and low blood pressure with alcohol.
At first, the advice was no alcohol at all. Now, the FDA says if you drink alcohol, stop drinking at least two hours before taking Addyi at bedtime. Or, skip your Addyi dose that night. Never take a missed dose the next morning or double the dose.
“The alcohol interaction is serious,” warns Dr. Reed. “Patients have to understand this risk and be careful.”
Other Common Side Effects
Besides fainting and low blood pressure, other common side effects are:
- Dizziness
- Nausea
- Feeling tired or sleepy
- Trouble sleeping (insomnia)
- Dry mouth
Taking Addyi at bedtime helps reduce daytime dizziness and sleepiness.
Addyi vs. “Viagra”: Don’t Get Them Confused
People often compare Addyi to Viagra. This comparison is wrong. They work in totally different ways.
- What it targets: Addyi targets brain chemicals for desire. Viagra targets blood flow for erections.
- How it works: Addyi tries to balance brain chemicals. Viagra relaxes blood vessels.
- When to take it: Take Addyi daily at bedtime (works over time). Take Viagra only when needed before sex.
- What it treats: Addyi treats HSDD (low desire). Viagra treats Erectile Dysfunction (trouble getting/keeping an erection).
Knowing this difference helps you understand what Addyi does and doesn’t do.
Practical Things to Know About Addyi
If you and your doctor are thinking about Addyi, keep these points in mind.
How to Take It
The usual dose is 100 mg once a day at bedtime. Taking it at bedtime is important because of the risks of low blood pressure, fainting, and sleepiness.
You might need weeks to see if it helps. Doctors often say if you don’t see improvement in desire or distress after 8 weeks, you should stop taking it.
Who Should Avoid Addyi?
People with liver problems should not use Addyi. It also interacts badly with certain other medicines. These include some common antibiotics and antifungals. These drugs can raise Addyi levels in your body and increase the risk of fainting and low blood pressure.
Your doctor must check all your medicines carefully. And remember the serious risk with alcohol.
Cost and Insurance
Addyi can be costly. Insurance coverage varies a lot. You might have high out-of-pocket costs. Ask about programs that might help lower the cost.
What Experts Think Now and Looking Ahead
Addyi is important because it was the first drug approved to work on brain chemistry for women’s low desire. But it’s not the right answer for everyone. This is due to its modest average results and serious safety risks, especially with alcohol.
Research continues on female sexual desire. Scientists hope to find future treatments that might work differently or have fewer risks.
Experts agree that treating low desire often needs looking at the whole picture. This might include therapy, counseling, treating other health issues, checking hormones, and lifestyle changes. Medication like Addyi is one option for the right person.
Frequently Asked Questions (FAQ) about Addyi
Q1: How fast does Addyi work?
A1: Addyi isn’t a quick fix. You take it daily at bedtime. It might take several weeks to notice changes. Doctors usually check after 8 weeks. If there’s no improvement by then, they often suggest stopping it.
Q2: Can I use Addyi after menopause?
A2: The FDA only approved Addyi for premenopausal women with HSDD. We don’t know if it’s safe or effective after menopause. Some doctors might prescribe it ‘off-label’, but this isn’t officially approved.
Q3: What if I drink alcohol while taking Addyi?
A3: Drinking alcohol with Addyi greatly increases your risk of very low blood pressure and fainting. If you drink, stop drinking at least two hours before your bedtime dose. Or, skip the Addyi dose that night. Never make up a missed dose later. Talk honestly with your doctor about alcohol use.
Q4: Is Addyi addictive?
A4: No evidence suggests Addyi is addictive. It affects brain chemicals tied to mood and desire, not the pathways usually linked to addiction.
Q5: Are there other treatments for low sexual desire in women?
A5: Yes, there are often many parts to treating low desire. Options include therapy (sex therapy, couples counseling), treating other health problems, changing other medicines, hormone therapy (especially after menopause, though effects vary), and lifestyle adjustments. Another medicine, Vyleesi (bremelanotide) injection, is also approved for HSDD in premenopausal women. Talk to your doctor about all your options.
Conclusion
Addyi (flibanserin) is a specific medicine for a specific problem. That problem is acquired, generalized HSDD in premenopausal women that causes distress. It works on brain chemicals, unlike drugs for male erection problems.
Studies show Addyi can help some women increase satisfying sexual events and desire. But the average benefit is modest, and it doesn’t work for everyone. Serious risks like fainting and low blood pressure, especially with alcohol, require great care.
Understanding Addyi means knowing its possible benefits for some, but also its limits and safety rules. It’s part of a larger effort to support women’s sexual health.