Often called "female Viagra," Addyi (flibanserin) and Vyleesi (bremelanotide)are medications designed to boost sexual desire in females though they do not affect physical performance. They treat a condition called hypoactive sexual desire disorder (HSDD), or female sexual interest/arousal disorder (FSIAD).
Viagra (sildenafil)is not approved for use in females.Viagra and similar drugs treat erectile dysfunction (ED). They boost sexual performance in males by improving blood flow to the penis but do not affectlibido. Addyi and Vyleesi work differently.
:max_bytes(150000):strip_icc()/GettyImages-166676237-8d589196f7a642c7a8f6c733edc1cce9.jpg "Female Viagra: Versions, Safety, Questions to Ask (1)")
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and gender are related concepts, but they are not the same:
- Sex refers to biology: chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex.
- Gender describes a person's internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics.
Research studies sometimes don't use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate.To reflect our sources accurately, this article uses terms as the sources use them.
Types of Medications
Addyi and Vyleesi are medications approved for treating HSDD, a condition in which the lack of interest in sex lasts a minimum of six months. Symptoms include a decrease or absence of sexual interest or arousal that causes significant distress and is not explained by another condition or stressor.
Neither medication is approved for use in males and neither has any effect on physical sexual performance.
Addyi
Addyi is a serotonin 5-HT-receptor agonist. It affects serotonin and other natural substances in the brain, but the exact mechanism of action is unknown. It's not a drug you take ahead of a sexual encounter that's meant to last for a few hours, like Viagra does.
Instead, a level is established in your body. Addyi is an oral medication you take once a day at bedtime, whether or not you plan to have sex. It can take several weeks to start working. You should stop taking it if there's no improvement after eight weeks.
Vyleesi
Vyleesi is a melanocortin receptor agonist. It activates certain natural substances in the brain that affect mood and thinking, but the exact mechanism of action isn't clear.
Using a prefilled syringe, you inject it just under the skin in the abdomen or thigh as needed, at least 45 minutes before sexual activity. It's unclear how long any effect may last, but the label recommends no more than one injection in 24 hours and no more than eight injections per month.
Research continues into other options for HSDD treatment, including the use of testosterone, Lorexys (a combination of bupropion and trazodone), and other potential therapies.
Who Can Benefit
For females, some providers may prescribe Viagra off-label (for uses not specifically intended or approved but that may be beneficial). Some studies suggest that a topical sildenafil cream, applied to the skin, may improve HSDD before menopause, especially in females with no other sexual dysfunction that limits orgasm.
Less is known about treatment options in postmenopausal HSDD, although hormonal therapies are sometimes used. There are studies to suggest benefits of Addyi in postmenopausal people, but more research is needed and there is yet no FDA approval for use after menopause.
Addyi and Vyleesi may offer options for people with acquired changes in sexual desire due to surgery or other factors that contributed to early menopause. Addyi is safe to use for those with HSDD who take certain medications for depression, but it's not meant as treatment for depression.
Safety and Side Effects
The most common side effects of Addyi include:
- Dizziness
- Sleepiness
- Nausea
- Fatigue
- Insomnia
- Dry mouth
Addyi has had its share of controversy; due to concerns about safety and efficacy, the Food and Drug Administration (FDA) required more clinical trials before approving the drug. Some people may experience low blood pressure and fainting. People with liver disease should not take Addyi.
The most common side effects of Vyleesi include:
- Nausea
- Flushing
- Injection site reactions
- Headache
- Vomiting
Some people may experience a temporary increase in blood pressure and a reduction in heart rate. They may developlocalized areas of hyperpigmentation (areas of darkened skin). People with uncontrolled high blood pressure should not take Vyleesi.
You also should not take these medications if you are:
- Pregnant
- Breastfeeding
- Postmenopausal
- Male
Serious Interactions
Taking Addyi and alcohol within two hours of each other raises the risk of severe low blood pressure and fainting. Do not take Addyi if you also take moderate or strong CYP3A4 inhibitors.
Vyleesi can slow absorption and make some oral medications, such as antibiotics, less effective. Do not use it if you take oral naltrexone products for alcohol or opioid addiction.
How to Get Medication
Viagra, Addyi, and Vyleesi require a prescription from a healthcare provider and should come from a reliable source.
Illegitimate online pharmacies may not comply with laws or health and safety regulations. Being able to order without a prescription is a big red flag. Check with a healthcare provider or pharmacist before trying products that claim to boost libido.
Also, be aware of the bold claims of sexual enhancement products sold by retailers, distributors, or online. The FDA cautions that some of these products may contain hidden ingredients that harm your health.
Addyi
Flibanserin, approved to treat HSDD in premenopausal females
Not for use in males
Taken by mouth at 100 mg each day at bedtime
Can cause low blood pressure and fainting
Should not be taken within two hours of drinking alcohol
Should be avoided in people taking CYP3A4 inhibitors or those with liver dysfunction
Use has not been tested in pregnant people
Stop using after eight weeks if no benefit or improvement
Vyleesi
Bremelanotide, approved to treat HSDD in premenopausal females
Not for use in males
Subcutaneous injection of 1.75 mg, 45 minutes before sex
Use only once in 24 hours, and eight times per month
Can temporarily increase blood pressure and heart rate
Should not be used in people with known heart disease or untreated high blood pressure
Should not be used in pregnant people (animal studies suggest the risk of fetal harm)
Talking to Your Healthcare Provider
Addyi and Vyleesi are approved to treat FSIAD/HSDD, so it's important to ensure the diagnosis. You must be open with your healthcare provider about your sex drive and how it affects your quality of life. Your provider will want to rule out health conditions, medications, and other problems contributing to low libido.
Even with a diagnosis, there's still a lot to consider. The two drugs have different routes of administration. You will need to consider if you want to take a pill daily, or if you are comfortable injecting yourself before sexual activity. Here are some questions you might want to ask:
- Which drug do you recommend and why?
- What are the potential side effects and risks?
- Will it interact with any of my other medications or dietary supplements?
- What if I'm thinking about getting pregnant?
- What are my other options?
Female sexual function involves complex physiological, psychological, and social interactions. Underlying causes of low sexual desire include:
- Stress
- Relationship problems
- Age and menopausal status
- Medical conditions
- Medications
- Depression, anxiety
Treatment depends on the specific cause. Finding ways to manage stress and treating chronic medical conditions may help improve sexual desire.
Alternative Remedies
While research is limited, you can try some natural female enhancement/libido boosters. These include:
- Cognitive behavioral therapy (CBT), psychosexual counseling, and relationship counseling
- L-arginine and ginseng
- Exercise, yoga, and stress management
Summary
There's no female version of Viagra (a drug that treats ED). Viagra doesn't affect libido and isn't approved for use in females. Addyi and Vyleesi, often called "female Viagra," are approved to treat low libido in some females, but they don't affect sexual performance.
If your libido has been lower than usual for six months or more and is causing distress, it may be time to see a healthcare professional. With a diagnosis of FSIAD/HSDD, these "female Viagra" drugs may be an option. Your provider can explain the benefits and risks based on your situation and personal preferences.
