Addyi, the “Little Pink Pill,” Offers Hope to Women Suffering from Low Sexual Desire

Published August 16th, 2021 by Maegan Wagner, BSN RN
Fact Checked by
Bridget Reed
Medically Reviewed:
Camille Freking

Introducing Addyi | Side Effects | How do I know it is work | Cost | Sexual Health Marketplace

Low libido and sexual arousal is a serious issue that plagues millions of women. Unfortunately, it is a topic that isn’t discussed nearly enough and is still being researched. Sexual desire is a personal and complex area affected by our moods, brain chemistry, relationships, age, and health. Women have additional concerns as their hormones change drastically surrounding pregnancy and menopause. Women (and men) also experience a loss to their libido in relation to stress, careers, parenting, and schedules. Almost everyone can admit to one time or another in their lives when their interest in sex was minimal to nonexistent. This isn’t abnormal and once the factor causing this change is removed (stress at work, a rocky relationship) your libido bounces back.

But what if your loss of sexual desire lasted months or even years? What if there was no identifying cause? What if you are a healthy woman, happy in her intimate relationship, but have no response to any sexual stimuli? This would be undeniably distressing and unfortunately, it is the reality for millions of women every day. So what if there was a solution? An easy, once-daily pill. Let’s get to know Addyi and the facts behind the “little pink pill.”

Addyi and Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) describes a woman who is satisfied with her intimate relationship but is without any sexual desire. They have no sex drive and don’t respond to sexual stimulation. Women who have tried to find a solution for their low libido with therapy and lifestyle changes without success may find Addyi to be the answer to their problems. 

Addyi (flibanserin) is a hormone-free oral medication used to treat acquired, generalized hypoactive sexual desire disorder. Acquired HSDD means there have been no previous issues with sexual desire and generalized HSDD refers to a lack of sexual desire regardless of the sexual situation, stimulation, or partner. Addyi is not used to treat low sexual desire caused by medication, mental health issues, drug use, or problems with their relationship. This drug is specifically for women who have not gone through menopause and is not approved for post-menopausal women. 

Addyi is Not “Female Viagra”

Addyi was FDA-approved in 2015 to treat low sexual desire in women. It is the first FDA-approved medication to increase sexual arousal in premenopausal women. It’s nicknamed the “female Viagra” and does come in the form of a pink pill, mimicking the well-known “little blue pill.” 

While Addyi does have the same goal as Viagra, to increase sexual stimulation, their mechanisms differ. Viagra increases blood flow to the penis to treat erectile dysfunction and is taken just before engaging in sex. Addyi is taken daily at bedtime. Addyi is thought to correct an imbalance of the neurotransmitters dopamine and norepinephrine while decreasing serotonin. In other words, Addyi increases the chemicals in the brain responsible for sexual excitement and decreases the chemical that can lower it. 

Side Effects and Black Box Warning

It is imperative that women do not drink alcohol within two hours of taking Addyi. If you have consumed three alcoholic drinks in the evening, your bedtime dose of Addyi should be skipped. Once Addyi has been taken, alcohol should not be consumed until the following day. Consuming alcohol with Addyi can cause severely low blood pressure and fainting. These symptoms can also occur with certain medications or herbal supplements, specifically CYP3A4 inhibitors which include some antibiotics, medications used to treat HIV, and grapefruit juice. Always consult with your provider or pharmacist before starting a new medication or supplement.

Other common side effects include:

  • Sleepiness/somnolence
  • Difficulty falling or staying asleep
  • Dizziness
  • Nausea
  • Dry mouth
  • Tiredness

Since Addyi commonly causes fatigue and drowsiness, it is dosed to be taken at bedtime to prevent symptoms from interfering with daily life and potentially causing an accident or injury such as with driving or other activities that require full alertness.

Side effects of central nervous depression (somnolence, sedation), hypotension, and fainting can occur with Addyi even without the concurrent use of alcohol or contraindicated medications. These symptoms can be heightened if Addyi is taken during waking hours or if a higher than recommended dosage is taken.

In clinical trials, 13% of participants stopped taking Addyi due to adverse reactions. The most common adverse reactions were dizziness, somnolence, and nausea.

How Do I Know if Addyi is Working?

Addyi may begin working within 4 weeks but patients should wait up to 8 weeks for full effects. Women state noticing the following when Addyi is working:

  • Wanting to have sex again
  • Having sexual fantasies
  • Being receptive to their partner’s sexual initiation

Clinical trial results show improvement of sexual desire, with long-term benefits and risks still largely unknown. On average, women experienced one additional sexual event per month with Addyi. Participants reported improvements in satisfying sexual events, increased sexual desire, and reduced distress related to low sexual desire. Potentially disruptive and dangerous side effects must be considered, with some women concluding that the small benefit does not outweigh the risk. The manufacturer recommends that if no improvement is observed at 8 weeks that the medication should be discontinued.

The women who are likely to benefit the most from Addyi are those who have had little success with other treatments, are willing to accept the risks with continued use, and more or less can abstain from alcohol use. 

Another Addyi Drawback - Cost

While some commercial insurance plans cover Addyi with a small copay, those uninsured or underinsured may gasp at Addyi’s price tag - $500 per month.

Women interested in seeing if Addyi is right for them can do so directly through the manufacturer’s website by paying $19 for a telemedicine consultation with a provider in their state. If approved, Addyi can be shipped free to their door.

While Addyi may or may not be the solution sexually depressed women were waiting for, it is a step in the right direction. Women are deserving of fulfilling, active sex lives and the hope is that research continues to investigate this common problem so many women suffer with. At the very least, Addyi has brought awareness to hypoactive sexual desire disorder and led the way for future advancements in female sexual health.

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References

https://www.healthline.com/health/female-enhancement-pills

https://www.health.harvard.edu/womens-health/addyi-is-not-a-female-viagra-but-it-can-open-an-important-discussion

https://addyihcp.com/clinical-trials/

https://addyi.com/

https://mk0speedyaddyip6a9xx.kinstacdn.com/wp-content/uploads/2021/03/Full-Prescribing-Information.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358680/

https://www.drugs.com/slideshow/addyi-explained-1202

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