Female Viagra Is Here—Kind Of

Here's how Addyi works.

August 25, 2018
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You can’t turn on the television without seeing a Viagra commercial. You know the ones: An older man and a woman who is noticeably younger end up in the bedroom after a date, all thanks to Viagra. Or maybe you recognize the commercials for Cialis: two older adults holding hands…while sitting in separate bathtubs. Every time one of those commercials comes on, I wonder when we’ll see a commercial for female Viagra.

I’m still waiting on the commercial, but it turns out that the future is now: Female Viagra is a real thing. Well, kind of.

Surprised? Me too. I had no idea that a female libido enhancer had been on the market, let alone for almost three years. But does it work? Here’s what I found out.

What is “female Viagra”?

Viagra is the trade name of the drug sildenafil citrate, which treats erectile dysfunction by increasing blood flow to the penis so that a man can get and maintain an erection during sex.

Recently, Addyi (the brand name of the drug flibanserin), has been nicknamed “female Viagra,” because it’s the first-ever pharmaceutical treatment for women’s sexual dysfunction.

The days of marginalizing women’s sexual dysfunction are numbered.”

But as it turns out, Addyi has little in common with Viagra. While Viagra treats a physical problem by stimulating blood flow, Addyi treats women’s sexual dysfunction by actually altering your brain chemistry.

According to a clinical review of flibanserin, women’s sexual desire is affected by many things: hormonal changes, psychological factors like stress, and comorbidity of other medical conditions, to name a few. (But we already knew that…)

Originally, flibanserin was created to increase serotonin levels in patients with major depressive disorder, but during clinical trials, female patients reported increased libido as a side effect. Based on further clinical trials specifically testing the drug’s effect on women’s libido, flibanserin was approved by the FDA in 2015 under the trade name Addyi to treat women’s sexual dysfunction.

Addyi, which is created and manufactured by Sprout Pharmaceuticals, is now marketed and prescribed for pre-menopausal women who suffer from hypoactive sexual dysfunction disorder (HSDD). HSDD is classified as a chronic lack of interest in sex, and it affects as many as one in 10 women.

Sexual desire isn’t just governed by hormones or stress levels; our libido is also impacted by the neurotransmitters dopamine and norepinephrine, which increase sexual desire, and serotonin, which inhibits desire. It’s not yet fully understood, but when your brain transmits too much serotonin, your libido can drastically drop.

Addyi works as a serotonin modulator to increase the flow of dopamine and norepinephrine while reducing serotonin levels to increase libido and sexual desire in women.

Sildenafil, aka Lady Era

There’s another drug on the market that you may come across if you google “ladies Viagra,” “female Viagra,” or a similar search term, and this one actually is female Viagra.

It’s called Lady Era, and it’s the trade name of the women’s version of sildenafil. Sildenafil treats women’s sexual dysfunction in a way that’s similar to what Viagra does for men: It increases blood flow to the genital area. In men, this results in an erection, and in women, sildenafil may help increase lubrication and sensation during sex.

Before you buy Lady Era, though, you should know that it’s not FDA approved. Addyi is the only drug currently approved by the FDA to treat female sexual dysfunction.

Does Addyi work?

“In the face of scientific evidence, the days of marginalizing women’s sexual dysfunction are numbered,” Cindy Eckert, CEO of Sprout Pharmaceuticals and founder of The Pink Ceiling, tells HealthyWay. “Addyi will be a key factor to leveling the playing field by cutting through that unscientific societal narrative to a data-driven discussion.”

But exactly what does the science say?

According to preliminary drug trials (which were annoyingly named after flowers, because you know, we’re women) that were conducted in 2012, Addyi increased the number of satisfying sexual events (SSE) participants had and decreased their distress caused by sexual dysfunction.

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But when you break down those numbers, the little pink pill may not be the cure-all for women’s sexual dysfunction it claims to be. A more recent 2016 study found that while, technically, women do report more SSEs per month while taking Addyi, the number of SSEs participants experienced only increased by an average of 1.5 times per month—while also increasing associated side effects like dizziness, nausea, and fatigue.

Side Effects of Flibanserin

Since flibanserin was initially created as a drug for major depressive disorder, it’s not surprising that women taking flibanserin for sexual dysfunction experience many of the side effects associated with selective serotonin reuptake inhibitors (SSRIs). Those include dizziness, nausea, somnolence (excessive sleepiness), fatigue, and dry mouth.

But women taking flibanserin can also experience more serious side effects, most notably hypotension and syncope, especially if flibanserin is combined with alcohol or some antifungal medications. In fact, Addyi comes with a black label that warns women to avoid all contact with alcohol while taking the drug. For a drug that is supposed to be taken every day, that’s a pretty tough pill to swallow (excuse the pun).

Because Addyi has only been FDA approved for three years, perhaps the biggest risk of taking flibanserin daily is that the long-term side effects on your brain and body aren’t yet known. But research is promising that Addyi, while incompatible with alcohol, may be safe to take in combination with other serotonin modulators.

Why Addyi Is Important (Despite Efficacy Rates)

HSDD is now grouped under Female Sexual Interest/Arousal Disorder (FSIAD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) that mental health professionals use to help diagnose patients. And that’s a big deal for a couple of reasons.

Ultimately, Addyi is giving women the same access to medication that men have had for decades to treat their sexual dysfunctions.”

Even though HSDD and subsequently FSIAD were introduced in the DSM three decades ago, little progress has been made toward actually treating the condition. That’s why a drug like Addyi is so important, says Eckert.

“Addyi is a groundbreaking first. For the millions of premenopausal women who have distressing low sexual desire, finally there is an FDA-approved treatment option,” says Eckert. “Addyi has opened the doors to a conversation on what’s happening for women in the bedroom biologically that, until now, has been loaded with myth and misconception. Ultimately, Addyi is giving women the same access to medication that men have had for decades to treat their sexual dysfunctions.”

And despite concerns over efficacy, Eckert says that the number of satisfying sexual events women have while taking Addyi is an average, and that the number of satisfying sexual events many women who responded positively to Addyi was much higher. “Many responders had four to six more [satisfying sexual] events,” Eckert asserts. “Regardless of that nuance, and this I want to say empathically, it’s HER CALL. For a woman who is struggling with the life impact of HSDD, just one more event can be profoundly meaningful. Women all over the country have shared their stories with me, and it’s their inspiration that fuels me to keep fighting for Addyi to be accessible to any woman who needs it.”

Eckert is right; the pink pill may not be right for every woman struggling with sexual dysfunction. But Addyi has not only started a conversation about women’s sexual health that should have begun decades ago, but it has also given women a choice when it comes to their own sexual desire (or lack thereof). And that is something every woman can get behind.

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ABOUT THE AUTHOR
Katie Martin
Katie Martin
Contributing Writer