The Female Version of Viagra: Flibanserin (Addyi)

Often referred to as the "female Viagra", Flibanserin, marketed under the brand name Addyi, is the first medication designed to boost sexual desire in women. However, unlike Viagra, which is used by men to treat erectile dysfunction by improving blood flow to the penis, Flibanserin works by altering brain chemistry and neurotransmitters.

How Flibanserin Works: A Shift in Brain Chemistry

Flibanserin's mechanism of action involves neurotransmitters, the body's chemical messengers that transmit signals between nerve cells in the brain. It specifically targets two neurotransmitters that play key roles in sexual desire: dopamine and norepinephrine, which are known to heighten sexual arousal, and serotonin, which can inhibit it. By decreasing the serotonin levels and increasing the levels of dopamine and norepinephrine, Flibanserin helps to restore a balance that can enhance a woman's sexual desire.

Administering Flibanserin: Patience for Desired Results

Flibanserin is a daily tablet that is taken at bedtime. It's important to note that it is not an instant fix. Women typically start to experience increased sexual desire and fewer related distress symptoms after about three weeks of daily use. As with any medication, it is crucial to follow the prescribed guidelines for use to ensure safety and effectiveness.

Off-label Use of Viagra (Sildenafil) in Women

While the idea of a "female Viagra" has been popularized, it's important to clarify that the male-targeted erectile dysfunction medication, Viagra (sildenafil), has been used off-label in women. However, the efficacy of Viagra for women is still under debate, and the FDA has not approved it for this use.

Flibanserin versus Viagra: A Matter of Mechanism and Administration

When comparing Flibanserin and Viagra, the most noticeable differences lie in their mechanisms of action and administration. While Viagra acts to improve blood flow and is taken on an as-needed basis, Flibanserin works on brain chemistry and is taken daily.

Another drug for female sexual interest/arousal disorder (FSIAD) that is different from Flibanserin is Bremelanotide (Vyleesi). This self-administered injectable drug works by activating melanocortin receptors in the brain, which are involved in many functions, including skin and hair color, feeding behavior, and sexual functions.

Flibanserin's Approval History and Treatment Target

Flibanserin, designed to treat FSIAD in premenopausal women, was first approved by the Food and Drug Administration (FDA) in 2015. The FDA approval came after a contentious debate about the drug's benefits and risks, but ultimately it was acknowledged that there was a need for a medication to address low sexual desire in women.

Comparison with Another FDA-approved Medication: Bremelanotide (Vyleesi)

Another FDA-approved medication for FSIAD is Bremelanotide (Vyleesi). Unlike Flibanserin, which is taken daily, Vyleesi is used as needed. Women inject it under the skin of the abdomen or thigh at least 45 minutes before anticipated sexual activity. Despite different administration methods, both drugs aim to increase sexual desire in women who are distressed by their low desire.

FDA's Stance on Viagra for Women and Off-label Drug Use

As of my knowledge cutoff in September 2021, the FDA has not approved Viagra (sildenafil) for use in women. It is crucial for healthcare providers and patients to be aware that off-label drug use, while common, is performed at the discretion and judgment of the provider.

To answer some common questions, Flibanserin (Addyi), the female version of Viagra, is not available over the counter.

A healthcare provider must prescribe it.

Addyi works by altering certain neurotransmitters in the brain to enhance sexual desire. Some users have reported side effects like low blood pressure, fainting, nausea, dizziness, and sleepiness. As for its efficacy, studies suggest that Addyi may increase the number of sexually satisfying events by about one per month compared to a placebo.