There’s no doubt about it: Viagra is one of the most famous medications out there. We’ve all heard of the “little blue pill,” seen the commercials and know what to do if your erection lasts longer than four hours. But what about Viagra for women? Is there an equivalent and if so, how does it work?
The answer is, as it often goes with health, both simple and complicated. Short answer: no, there is not a Viagra for women. Instead, several medications have earned the moniker because they treat female sexual dysfunction, despite working quite differently from the original.
Read on to learn more about the two prescriptions most frequently dubbed female Viagra, or the little pink pill, how they work and what options there are for you if you’re looking for help with low libido.
The US FDA approved Addyi, which was quickly nicknamed “female Viagra,” in 2015 – but it’s not currently licensed for use in the UK. Despite the nickname, though, Addyi is actually the first drug of its kind and not a counterpart to an existing medication. That’s because Viagra (sildenafil) treats erectile dysfunction and Addyi (flibanserin) treats low libido.
“Addyi is not a female Viagra,” writes Angela Chen for The Verge[1]. “Viagra increases blood flow and makes it physically easier for men to have sex. A female Viagra, then, would make it more physically comfortable for women to have sex.” Chen points out that this problem already has an easy solution — moreover, one that doesn’t even require a prescription. It’s called lube.
What, then, is Addyi? Originally developed as an antidepressant, Addyi targets neurotransmitters in your brain. It increases the release of dopamine and norepinephrine, which are linked to arousal, and lowers the release of serotonin, which is connected to inhibition. So although Addyi might be called “female Viagra,” it doesn’t work like male Viagra at all.
No. Viagra is only licensed for use in men and is not approved as a treatment for women.
Because Viagra increases blood flow to the genitals, there have been theories that it could increase pleasure during sex for women. However, studies analysing the impact of Viagra on female sexual dysfunction have not produced consistent, promising results.[2]
There are two prescriptions that are commonly referred to as “female Viagra”: Addyi (flibanserin) and Vyleesi (bremelanotide). Neither of these medications, however, are available in the UK. And they’re both fundamentally different from actual Viagra.
Here’s how. When a man is prescribed Viagra, he still has a normal libido — meaning, he still wants to have sex. It’s just that the actual, physical mechanics of sex need a little help. Female Viagra, in contrast, is a treatment for low libido. That means it’s intended to boost desire, rather than make sex physically possible.
“Our neurochemistry affects how we feel, and think, about sex,” says Dr. Laura Castaneda, the Clinical Lead for EveAdam Germany. “There are drugs which have been proven to activate dopamine, therefore mediating the brain’s reward and pleasure systems. But, as we know, people are more complex than that. Our sexual desire is also strongly influenced by social, emotional and environmental factors, which in the end model our thoughts and feelings, creating the basis for presence (or lack!) of desire.”
The specific type of low libido that Addyi and Vyleesi address is called Hypoactive Sexual Desire Disorder, or HSDD. In the US, both Addyi and Vyleesi are only approved to treat HSDD in pre-menopausal women.
Because Addyi was approved by the FDA first, it’s usually what people think of when they hear the term “female Viagra.” However, there is now a second treatment called Vyleesi which also treats HSDD in women.
Neither Addyi nor Vyleesi do the equivalent of what Viagra does for men — make sex physically possible. Instead, they work on neurotransmitters in the brain to help make you more aroused. Addyi comes in a pill form, and Vyleesi is an injection.
Addyi is a non-hormonal drug made by Sprout Pharmaceuticals to treat Hypoactive Sexual Desire Disorder, or HSDD, in women. It’s a pink pill designed to be taken every day.
Addyi works on the chemicals in the brain. It turns down the ones responsible for inhibition, and cranks up the ones responsible for arousal.
Addyi has a number of side effects, like dizziness, faintness, and a drop in blood pressure. The risk of side effects increases if taken alongside hormonal birth control or when drinking alcohol, so women who are prescribed Addyi are asked to abstain from alcohol and certain medications.
Vyleesi is the only FDA-approved treatment for HSDD[3] which can be taken right before sex. It’s different from Addyi in this way. It’s also safer to drink alcohol while taking Vyleesi. This makes it more convenient, but since it’s not intended to be taken daily, there are limits to how often someone can take it.
To use Vyleesi, the injection is done at least 45 minutes before sex — however, this should be no more than once every 24 hours, up to a maximum of 8 times a month.
According to the manufacturer of Vyleesi’s website, “The exact way that Vyleesi works isn’t fully known.” Like Addyi, it targets chemicals in the brain to stimulate sexual desire.
Vyleesi can also cause serious side effects, like an increase in blood pressure or decrease in heart rate. More common side effects include nausea, reactions at the injection site, headaches and vomiting.
If you’re looking for “female Viagra” home remedies, your best bet is to pinpoint the cause of low desire before trying to treat it. While there are a number of herbal products that claim to increase female sexual function, these are not licensed or authorised treatments.
According to the International Society for Sexual Medicine, there are four basic questions[4] that can tell you if you’ve got HSDD.
In short: if your sex drive is lower than it used to be and that fact makes you unhappy, you might have HSDD.
One of the criticisms of HSDD is that it’s difficult to quantify desire — especially since sex occurs not in a vacuum but in a society that has some very complicated feelings about desire, particularly women’s desire. In order to be diagnosed with HSDD, you must experience both a lower sense of desire than you had in the past and distress at this new, lower desire.
But if desire exists on a continuum, how low is too low? And how much of the distress element of an HSDD diagnosis comes from outside sources (“I wish my sex drive were higher to please a partner” or “Society makes me feel like my sex drive should be higher”) vs something internal?
The truth is, “there’s no set norm for how much interest you are supposed to have in sex,” writes Dr. Heidi Collins Fantasia in Nursing for Women’s Health[5]. Some people identify as asexual, and view their (lack of) desire as an orientation and not a condition to be cured.
Sex drive is incredibly complex, as you can tell by the media attention around “fixing” it. The best way to increase your sex drive, or stop it from being low, is by taking care of your health and wellness. Easier said than done, right?
“I agree with the view that our perception of our own bodies plays a significant role in sexual desire,” says Dr. Laura Castaneda. “This idea is supported by many studies showing that becoming more aware and mindful of the body, and viewing our bodies non-judgmentally, can be a way to really tune into arousal. So, ultimately, while a pill might help getting our neurotransmitters going, the rest is up to us!”
Like your mood, your sex drive responds to your general wellbeing. Unhealthy habits like smoking and heavy drinking can reduce your interest in sex, so try cutting back on the weekend mimosas and keep to a mostly-healthy diet with treats in moderation.
Stress and depression can also cause a lower sex drive. While stressful situations are not always under our control, do what you can to reduce stress in your life, get a good night’s sleep, enjoy the outdoors when possible and make exercise a daily habit, even if it’s just fifteen minutes of stretching or a walk outdoors. If you think you’re experiencing depression, talk to your doctor. They might have suggestions for treatment, possibly including medication.
Some medications can also change your desire for sex. Many women find that some types of birth control lower their sex drive, in which case it might be worth trying a different prescription.
It’s true — the pill you take to keep you protected against pregnancy might be making you want to have less sex. And while that’s certainly one way to keep from becoming pregnant, it’s probably not what you had in mind.
Because there are so many different types of birth control, and they each impact the hormones already in your body, the way you react to one might be completely different from how you react to another. They’ll all be equally effective at preventing pregnancy, but different pills can cause or treat acne, increase or decrease your appetite, stabilize or worsen your moods and, yes, change your sex drive.
If you’re taking hormonal birth control and think it might be negatively affecting your sex drive, it’s time to find another pill (or patch, or ring).
