Answering Frequently Asked Questions About Addyi, A Non-Hormonal Treatment For Low Libido

Decreased libido is a common symptom of the menopause transition, and the most common women’s sexual health complaint we hear from patients.

In more science-y terms, it’s known as female sexual interest/arousal disorder (or FSIAD for short), which was previously referred to as hypoactive sexual desire disorder. And in less science-y terms, low sex drive.

Whatever you call it, it tends to manifest as little to no interest in any type of sexual activity, including self-pleasure or masturbation.

More and more healthcare providers are prescribing topical testosterone for menopausal women which, while not yet approved by the Food and Drug Administration (FDA), may, for some, enhance sexual mood, arousal or responsiveness to sexual stimulus, and orgasms. However, because testosterone isn’t FDA-approved for women and the studies are more limited, it can be difficult to access.

But hormonal treatments aren’t the only option for low sexual desire. Enter, Addyi. Below, we’re common questions about this increasingly popular treatment option.

What is Addyi?

Addyi, which goes by the generic name Flibanserin, is a daily pill used to treat low libido (not to be confused with sexual performance).

As of this month, Addyi is now FDA-approved for postmenopausal women, in addition to premenopausal women. We’re hoping that this will also improve insurance coverage.

How does Addyi work?

Addyi has been shown in clinical trials to modestly increase sexual desire and the number of sexually satisfying events (i.e. sexual intercourse, oral sex, masturbation, or genital stimulation by a partner), as well as reduced stress associated with a low sexual desire. Some users also note experiencing weight loss and improved sleep.

It works by interacting with serotonin receptors in our central nervous system, which has downstream effects on dopamine (which helps boost desire) and norepinephrine (which plays a role in sexual arousal).

How long does it take for Addyi to work?

Data shows that it can take up to four weeks to begin experiencing results from Addyi.

Not seeing improvements after eight to twelve weeks? Definitely talk to your healthcare provider about whether it makes sense to continue, or if a treatment modification may be needed. If you DO decide to stop, there is no weaning period or withdrawal.

How do I know if Addyi is right for me?

As Elektra Clinician Kara Govoni, CNM, MSCP, CSC likes to say: “libido and sexual desire have a biopsychosocial basis, meaning we have to treat all parts of the puzzle at the same time.” It’s not usually just a biological thing. Talking to a certified sexuality counselor or therapist may be helpful to rule out any environmental elements that could be standing in your libido’s way.

If you find you are still struggling with low sexual desire or sexual dysfunction despite addressing libido from all angles, and if this is something that’s new or rare for you, it’s worth talking to your healthcare provider about Addyi.

“Libido and sexual desire have a biopsychosocial basis, meaning we have to treat all parts of the puzzle at the same time.” – Kara Govoni, CNM, MSCP, CSC

Who shouldn’t take Addyi?

You cannot take Addyi if you have liver problems. Also, it is not known whether it’s safe to take Addyi while pregnant or breastfeeding, so definitely talk with your provider about that.

Is Addyi safe?

Side effects

When taken correctly, Addyi has been found to be safe with some minor but common side effects, including dizziness, sleep disruptions (trouble sleeping, sleepiness, tiredness, drowsiness) nausea, and dry mouth.

It’s important to avoid drinking alcohol within 1-2 hours of taking Addyi to avoid side effects like dizziness and low blood pressure.

Drug interactions

First off, before you start taking Addyi (or any medication), it’s important to tell your clinician about ALL the medications you’re taking (prescription drugs and over-the-counter meds included), as well as any supplements or vitamins.

While you’re on Addyi, be sure to avoid:

• Certain antibiotics (ciprofloxacin, telithromycin, erythromycin, clarithromycin)
• Nefazodone (an antidepressant)
• Certain antifungal medications (fluconazole, itraconazole, ketoconazole, posaconazole)
• Certain medications used to treat high blood pressure, chest pain, or other heart problems (diltiazem, verapamil, conivaptan)
• Certain Hepatitis-C medications (boceprevir, telaprevir)

It’s also recommended to avoid grapefruit juice, herbal supplements (like St. John’s Wort), and over-the-counter medications (like cimetidine) while on Addyi.

For a full list of potential drug interactions, refer to Addyi’s medication guide.

The bottom line

While Addyi can help, it’s not a magic pill. So it’s important to take a holistic approach to improving libido symptoms, including lifestyle changes, supplements and over-the-counter products, psychosocial counseling, and smart communication with your partner. Here’s some info to get you started.

• 24 Sexual Wellness Products To Help Light That Libido
• How To Talk To Your Partner About Libido
• Low Libido: The Unspoken Menopause Symptom (let’s fix that)
• Setting The Record Straight On Orgasms During & After Menopause
• Sex Should *Never* Hurt. So How Come It Sometimes Does During Menopause?
• Spontaneous vs Responsive Desire: What’s the Connection?
• Is Vaginal Estrogen Safe? What The Science Says.

Interested in discussing treatment options for low libido?

Turn to Elektra. Our board-certified, menopause trained clinicians can prescribe FDA-approved treatments for hypoactive sexual desire disorder, Addyi included.

We can also prescribe other hormonal and non-hormonal options like Vylessi (which, unlike Addyi, is only used when needed and great for those who don’t want to worry about a missed dose).

Learn more and book a visit >>