In the United States, there are currently two FDA-approved medications specifically designed to address the complexities of female sexual interest/arousal disorder (FSIAD): Vyleesi (bremelanotide) and Addyi (flibanserin). These medications are often colloquially referred to as “Viagra for females.” They play a crucial role in assisting those who struggle with diminished sexual desire and arousal.
The Food and Drug Administration (FDA) has sanctioned these two medications—flibanserin (marketed as Addyi) and bremelanotide (known as Vyleesi)—to help counteract the challenges associated with low libido in women. It's important to note that both medications are intended exclusively for use in women who have not yet gone through menopause, highlighting a specific scope of application for these therapies.
This article aims to provide comprehensive information about the FDA-approved options available for treating low libido in women. We will delve into the mechanisms of action for these medications, explore the range of possible side effects, and discuss alternative strategies that might be beneficial in this context.
The FDA has fully endorsed two medications aimed at addressing FSIAD: Vyleesi (bremelanotide) and Addyi (flibanserin).
Addyi (flibanserin)
Addyi was notably the first medication to receive approval for the treatment of FSIAD. It is specifically formulated for premenopausal individuals and comes in the form of an oral pill.
This medication is prescribed to be taken daily in the evening, ideally right before sleep, regardless of whether there are immediate sexual intentions for the day.
Patients may need to wait as long as 8 weeks to notice a significant improvement in sexual desire, although some individuals may experience its effects sooner than expected.
Vyleesi (bremelanotide)
The FDA has indicated that Vyleesi serves as a treatment option for FSIAD in premenopausal females.
To use Vyleesi, a person must self-inject the medication into their thigh or abdominal area at least 45 minutes prior to engaging in sexual activity. Its effects may last for a maximum of 24 hours. Importantly, individuals should restrict usage to no more than eight injections each month.
Comparison table
The following table presents a side-by-side comparison of Vyleesi and Addyi:
It is important to note that Viagra is not FDA approved for use in females. To grasp the rationale behind this, it is beneficial to understand the original intent of Viagra and the specific physiological processes it targets within the male body.
When a male becomes sexually stimulated, nitric oxide is typically released, which elevates levels of a critical regulatory compound within cells called cyclic guanosine monophosphate (cGMP).
This surge in cGMP leads to smooth muscle relaxation, facilitating increased blood flow to the penis and ultimately resulting in an erection.
In males, the erection subsides when an enzyme known as phosphodiesterase type 5 (PDE-5) starts to break down cGMP.
Sildenafil, the pharmacological agent in Viagra,
In certain situations, a healthcare provider
Individuals interested in exploring the possibility of using Viagra should consult with a healthcare professional, who may consider an off-label prescription if suitable.
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In contrast, Vyleesi targets specific melanocortin receptors tied to sexual function. This drug's action modulates the neural pathways that are integral to sexual response.
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Addyi is effective for approximately
After a period of three days on the medication, the levels of Addyi in the system stabilize. However, since some individuals may have difficulties metabolizing CYP2C19—an enzyme protein crucial for drug processing—this can potentially cause drug accumulation in the body, leading to unwanted side effects.
In contrast, the effectiveness of Vyleesi typically persists for about 2.7 hours, and the average duration for the drug to be fully eliminated from the body is around 6.5 hours. There is a possibility that Vyleesi may slow down the metabolism of concurrently administered medications.
Both Vyleesi and Addyi are specifically indicated for treating FSIAD in premenopausal women. To date, there has been limited research investigating the effects of these medications on individuals who are menopausal or postmenopausal.
These medications may provide relief for premenopausal individuals facing conditions such as:
- medications that impact sexual desire
- feelings of sexual boredom or disinterest
- a sudden decrease in sexual interest
Various factors can contribute to a reduced libido in females, including the following
- vaginal dryness
- difficulty achieving orgasm
- pain during sexual intercourse
- emotional factors such as stress, anxiety, and depression
- certain health conditions, including diabetes and cardiovascular disease
The FDA-approved drugs for FSIAD can lead to various side effects.
Addyi
The potential side effects associated with Addyi may include:
- feelings of drowsiness
- dry mouth
- nausea
- dizziness
- general fatigue
- insomnia
- individuals with pre-existing liver issues
- those using oral contraceptives
- individuals taking CYP3A4 inhibitors
- people who are nursing
- individuals who have consumed alcohol within the last two hours
Taking Addyi can result in severe hypotension and fainting, especially in patients who consume alcohol or possess liver dysfunction.
Vyleesi
Side effects associated with Vyleesi may include:
- nausea and vomiting
- flushing and hot flashes
- irritation or rash at the injection site
- headaches
- flu-like symptoms
- fatigue
- dizziness
- darkening of the skin, which may lead to hyperpigmentation on the gums, face, and breasts
- elevated blood pressure
- decreased heart rate
- tingling sensations
Additionally, Vyleesi may potentially hinder the effectiveness of oral medications because it can slow gastric emptying.
It is also advised that individuals taking medications containing naltrexone for managing alcohol and opioid dependence avoid using Vyleesi, as it can diminish the efficacy of such treatments.
Like many medications, both Vyleesi and Addyi carry the risk of causing allergic reactions. It is crucial for anyone experiencing symptoms of an allergic reaction or anaphylaxis to seek immediate medical assistance.
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Before considering any supplements aimed at increasing libido, it is paramount that individuals consult with a healthcare professional. Doctors can provide insights into the safety and effectiveness of such products, as well as potential medication options like Addyi and Vyleesi.
Vyleesi (bremelanotide) and Addyi (flibanserin) serve as effective treatments for female sexual interest/arousal disorder (FSIAD) in premenopausal individuals.
It is essential to remember that the FDA has not authorized the use of Viagra for females, and it is recommended to refrain from over-the-counter libido-boosting supplements.
Medication alone may not address every underlying issue leading to low sexual desire. Individuals should reach out to their healthcare providers for personalized guidance regarding optimal medications and other potential approaches to enhance their libido.