For many women facing low libido and lack of desire for intimacy or sex, the options of “female Viagra” have been life changing and reaffirming. Many things can affect hormone levels which incite the rise and fall, the ebb and flow of libido through the years. Some of these things are menopause, pregnancy, stress, relationships, and medical treatments for cancer and long-term illness like chemotherapy, radiation, and heavy medications. For nearly 15% of women, low sex drive causes distress, relationship disconnect, and undue worry. This condition is often called hypoactive sexual desire disorder, or HSDD.
Aside from supplements that have limited and unproven effects, the FDA has approved two prescription drugs that can help to treat HSDD. While they are often referred to as “female Viagra,” they are indeed very different and do not work at all the same inside of the body as the male Viagra that most are aware of. For males, Viagra fixes the problem of erectile dysfunction by helping their bodies work physically when they want to have sex. Male Viagra helps by relaxing the muscles in the penis and flooding the tissues with blood flow so an erection can be possible.
For women, a low libido is a much more complicated problem. There are many factors that play into female libido and sexual desire. Hormones, relationship stability, mental stability, physical state, stress, and other life’s stressors all play a role, which is why these medications are so helpful for so many.
The two medications approved by the FDA are:
- Bremelanotide (or Vyleesi) is a shot that is self-given in the belly or thigh approximately 45 minutes before you plan to have sexual intercourse or intimate acts. It is recommended that one shot be taken in any 24-hour period, and only eight shots can be taken per month.
- Flibanserin (or Addyi) is a pink pill that is taken orally every evening.
Both medications work by increasing the activity of neurotransmitters, or chemical messengers, in the brain that are linked to arousal. Addyi is taken daily, regardless of if you are sexually active every day or not. Vyleesi is taken only when needed. Both of these drug’s work to help your mind ease back in to the feelings of arousal.
Many times, doctors will suggest taking sexual education courses from a reputable sexual wellness expert along with counseling with medications. Covering all aspects of causes and reasons for low libido can only help to strengthen the patient’s overall outcome. Plus, there are often other side effects that coincide with low libido for women like severe vaginal dryness, vaginal pain, and atrophy.
Obtaining the Medications
You will need a doctor’s prescription and diagnosis with HSDD to receive either of the medications. At your appointment, they may ask you questions like these:
• Have you been satisfied with your level of sexual desire before?
• Has your sex drive gotten lower?
• Does your lack of libido bother you?
• Would you like it to increase?
• Are there other things (medication, pregnancy, surgery, or stress) that could be affecting your sex drive?
After determining if you do have HSDD, and ruling out other causes for your low libido, they will most often fill you in on these prescription options. Being distressed about this issue can be the most important factor in getting the prescription. Many doctors will also remind you that these medications will not make sex better and will not work if the underlying cause on your low libido is a rocky relationship or dislike of your partner.
Most insurance companies will cover HSDD medications with proper documentation and diagnosis. The out-of-pocket costs for Addyi average around $100 for thirty pills, or one month’s supply.
Side Effects & Risks of these Medications
Both prescriptions have different risks and concerns, and the one you decide on with your doctor will depend on your health, and what works best with your lifestyle. Many women do not relish the thought of giving themselves injections, and some simply cannot. Others will have zero interest in taking or remembering to take a pill every day.
In most research studies, the focus has been pre-menopausal women in the trials, so the FDA has approved these drugs for pre-menopausal women only. Those women who are pregnant or breastfeeding should also avoid these medications. Other women who should not take these drugs are:
- Those with HIV, hepatitis C, or high blood pressure that is uncontrolled,
- Those who have cardiovascular disease,
- Those who have liver disease.
These medications also have listed drug interactions with common medications like Diflucan, and certain antibiotics. If you are taking other medications, be sure to discuss all possible interactions with your doctor, medical care team, or pharmacist.
Women who are taking either of the HSDD medications should not drink alcohol from two hours before they take the drug through the following morning, as they have been noted to lower blood pressure to dangerous levels.
Commonly reported side effects from these medications are, but not limited to:
- Dry mouth
- Tiredness and fatigue
- Fainting
- Dizziness
- Flushing of the skin
- Headache or migraine
- Nausea
The shot can also cause darkening of the skin across the body and the gums.
When will my Libido Return?
Measuring the effects of taking the drugs can be complex, and different in each patient. Your doctor will survey you on how active your sexual activities have been and note any changes. For some, the increase of one sexual event per month is considered a win. For others, that might not be enough progress. Progress of each patient is often up to them, their desires, and their overall want to reclaim their intimacy.
There is no “normal” amount of sex or desire. So, any change that a woman notes in her libido or desire is recorded, and doctors will take and follow the lead and need of their patients. Many doctors suggest taking the medication for at least eight weeks, and if at the end of that trial there is no notable change, they will often suggest trying the alternative, or other methods to help to restore libido and intimacy.
The end all of these “female Viagra” medications is that they are not perfect, but indeed a step in the right direction to help women to reclaim their intimacy. Research will continue, improvements will be made, but the end all will remain with the patient in working to take back their needs, desires and wants in life after turmoil.
Citations:
Centers for Disease Control and Prevention
National Institutes of Health and Human Services
Pfizer