Flibanserin: 25 Common Questions Answered

    Dr. Leah Millheiser, MD Headshot
    Medically reviewed by Leah Millheiser, MD Written by Our Editorial Team Last updated 10/01/2019

    Launched in 2015, flibanserin (marketed as Addyi®) has attracted a lot of attention. Designed specifically for women with hypoactive sexual desire disorder (HSDD), flibanserin can restore your sex drive and help you enjoy a healthy, fulfilling sex life.

    Like many other prescription medications, flibanserin isn’t something you’ll want to rush into without doing your research first. Below, we’ve answered 25 of the most common questions about flibanserin to help you make a more informed decision about whether it’s right for you. 

    What is Flibanserin?

    Flibanserin is a prescription medication used to treat hypoactive sexual desire disorder, a sexual dysfunction where you have a persistently low interest in sex and it causes you distress.

    Sold under the brand name Addyi®, flibanserin works by targeting neurotransmitters in your brain responsible for sexual arousal and desire. 

    Specifically, flibanserin works by causing your body to increase its production of dopamine and norepinephrine. These two neurotransmitters are responsible for stimulating your sex drive and increasing your level of interest in sexual activity. 

    By increasing production of these neurotransmitters, flibanserin can help restore your sex drive if you have HSDD. Our Flibanserin 101 guide goes into more detail on how flibanserin works, as well as its potential benefits, side effects and interactions. 

    What is Hypoactive Sexual Desire Disorder (HSDD)?

    Hypoactive sexual desire disorder (HSDD) is a type of sexual dysfunction where you have a persistently low level of interest in sexual activity, which in turn makes you feel distressed or negatively affects your interpersonal relationships.

    As many as 10 percent of women are affected by HSDD to some level, making it one of the most common female sexual disorders. 

    While it’s normal to have some days or weeks where you simply aren’t in the mood for sexual activity, if you have HSDD, you may completely lose interest in sex for an extended period of time (six months or longer).

    Our HSDD 101 guide, found at the bottom of this article, goes into more detail on how HSDD can develop, how it can affect you and what you can do to treat it. 

    Is Flibanserin a Type of “Female Viagra®?”

    Flibanserin is often referred to in the media as a form of “female Viagra®.” While flibanserin can help to improve sexual performance for women just like Viagra® does for men, its mechanism of action is very different from those of male erectile dysfunction drugs. 

    ED medications such as Viagra® and Cialis® work by increasing blood flow to the penis, making it easier for men to achieve an erection. These drugs have no effect on the neurotransmitters that are responsible for sexual desire. 

    Instead of targeting the genitals directly, flibanserin works by increasing your brain’s production of the neurotransmitters responsible for sexual desire. This causes an increase in sexual desire that allows you to enjoy a healthy sex life.

    In short, flibanserin should not be called female Viagra®.

    Is Flibanserin Effective?

    Studies show that flibanserin is effective as a treatment for HSDD. Women with HSDD who use flibanserin tend to have a higher level of sexual desire, with a greater number of “desire days” every month.

    In three separate 24-week, randomized, double-blind, placebo-controlled studies that compared Addyi® to placebo, women who took 100mg of Addyi® experienced, on average 10 to 15 percent more sexually satisfying events (SSEs) per month, and a 12 to 13 percent increase in sexual desire according to the standards set forth in the Female Sexual Function Index (FSFI)

    Is Flibanserin FDA Approved?

    Flibanserin was approved by the FDA in August 2015, making it the first drug of its kind to gain approval. Currently, flibanserin is approved as a treatment for premenopausal women with hypoactive sexual desire disorder.

    Is Flibanserin Over-the-Counter?

    Flibanserin is a prescription medicine. While over-the-counter sexual health medications and supplements do exist, you’ll need a doctor’s prescription to buy flibanserin. 

    How Safe is Flibanserin?

    Overall, flibanserin is generally a safe and effective medication. As part of the FDA approval process, the medication went through extensive clinical trials and tests. However, like other drugs, flibanserin can and does have a risk of side effects and other potential risks.

    The most common side effects of flibanserin include fatigue, dizziness, drowsiness, nausea, insomnia and dry mouth.

    When you use flibanserin and alcohol at the same time, you can experience a rapid, significant decrease in blood pressure and/or fainting. This can occur even if you only drink a small amount of alcohol — even one glass of wine, beer or a single cocktail can trigger this effect.

    Because of this, you will need to completely stop drinking alcohol if you use flibanserin to treat HSDD. And because mixing them can result in severe hypotension and syncope, you must also cease using any kind of CYP3A4 inhibitors while taking flibanserin. 

    Why is it Unsafe to Take Flibanserin With Alcohol?

    On its own, flibanserin can cause a drop in your blood pressure. With alcohol, flibanserin can cause a significant decrease in blood pressure that can make you feel light-headed and dizzy and cause you to faint. 

    Even small amounts of alcohol can have this effect if you use flibanserin, meaning you will need to abstain from all alcohol — even a nightly glass of wine — while using this medication. 

    Does Flibanserin Have Other Side Effects?

    There is a risk of side effects while taking flibanserin, just like with all drugs. The most common side effects of flibanserin are fatigue, nausea, dizziness, drowsiness, insomnia and dry mouth.

    Since  fatigue and drowsiness are common side effects of flibanserin, it’s recommended that women who use flibanserin not drive or operate heavy machinery for at least six hours after they take their recommended dose. 

    Flibanserin can become more concentrated in your body if you also use certain medications, such as fluconazole or ketoconazole (two drugs commonly used to treat fungal infections). Because of this, you’ll need to let your doctor know if you use other medications before using flibanserin as a treatment for HSDD to make sure it’s safe to take. 

    Does Flibanserin Interact With Other Drugs? 

    Taking flibanserin at the same time as certain other drugs or supplements can cause a range of interactions, including an increased risk of side effects than if you were only taking flibanserin or an increased or decreased exposure of the other drug or supplement. This is why it’s so important to tell your doctor what other medications and supplements you are taking before you begin flibanserin.

    Can Anyone Use Flibanserin?

    Flibanserin is FDA-approved for the treatment of HSDD in premenopausal women. 

    While there are several studies that show flibanserin may be helpful in treating postmenopausal women, it has not been approved by the FDA for use in women who’ve already experienced menopause. 

    However, it’s important to remember that flibanserin may not be used to treat sexual dysfunction in men. 

    Does Flibanserin Affect Your Hormones?

    Flibanserin is not a hormonal medication, meaning it is not meant to increase your sex drive by affecting your levels of sex hormones such as estrogen, progesterone or testosterone. Instead, flibanserin works by targeting the neurotransmitters responsible for sexual desire.

    Does Flibanserin Cause Weight Gain or Fluid Retention? 

    Flibanserin is not linked to weight gain, either due to fat or fluid retention. A 2017 study actually shows that flibanserin is linked to mild weight loss, with women given flibanserin experiencing a small reduction in body mass index (BMI) after 24 weeks of treatment. 

    Despite this, flibanserin is not designed as a diet medication and should not be used for weight loss. 

    Is it Safe to Use Flibanserin With Birth Control?

    Clinical trials evaluating the safety and effectiveness of flibanserin as an HSDD treatment included  women who use hormonal contraceptives such as the birth control pill. Of the women participating in these studies who reported use of hormonal contraceptives, a higher percentage experienced side effects like dizziness, drowsiness and fatigue compared to those who weren’t taking hormonal contraceptives. In these studies, women using flibanserin and a hormonal contraceptive at the same time had:

    • A higher rate of dizziness (13.4 percent vs. 9.9 percent in those not on hormonal contraceptives).
    • A higher rate of somnolence (drowsiness) (12.3 percent vs. 10.6 percent in those not on hormonal contraceptives).
    • A higher rate of fatigue (11.4 percent vs. 7.5 percent in those not on hormonal contraceptives).

    Because of the potential interaction of flibanserin with contraceptives, it’s important to let your doctor know if you use hormonal birth control before you start using it.

    Can Flibanserin Treat Low Sexual Desire From Antidepressants?

    Approximately one in nine Americans take at least one antidepressant medication, according to national survey data from the Centers for Disease Control and Prevention (CDC).

    Some types of antidepressants, called SSRI medications, can significantly reduce your level of interest in sexual activity. Many women who use SSRIs report difficulties becoming and remaining aroused, as well as difficulty reaching orgasm. 

    Currently, scientific data on flibanserin’s effectiveness as a treatment for SSRI-induced low sex drive is limited. If you’ve noticed a low sex drive after starting an antidepressant, it’s best to talk to your doctor about safe, effective treatment options. 

    Does Flibanserin Treat Low Sex Drive From Stress?

    Lifestyle factors like stress, lack of sleep and relationship dissatisfaction can all contribute to a lower-than-normal sex drive. This type of low sex drive is usually situational, meaning when you are less stressed, get some sleep or become more satisfied with the relationship that is causing you angst, your sex drive is likely to return. 

    In these cases, you are better off treating the underlying cause of your temporary loss of sex drive, rather than taking filbanserin. However, if your low sex drive persists and is causing you distress, you may have HSDD and filbanserin may be able to help you. 

    If you’re experiencing a low sex drive from lifestyle-related stress factors, flibanserin may not be effective. 

    Is Flibanserin Effective for Men? 

    Addyi® is FDA-approved to treat HSDD in pre-menopausal women. It hasn’t been studied as a medication to treat sexual dysfunction-related conditions in men. Men should not use flibanserin to improve sexual performance or treat a low sex drive. 

    Does Flibanserin Work for All Women?

    Although flibanserin has been shown to be effective as a treatment for HSDD, not all women experience an improvement in their sex drive after starting the treatment.

    In approving flibanserin for the treatment of HSDD in premenopausal women, the FDA reviewed clinical studies which involved more than 11,000 people. In three of these studies, between approximately 40 percent to 60 percent of participants reported that finasteride at least minimally improved their level of sexual interest and number of satisfying sexual events experienced (compared to between approximately 30 percent to 50 percent of those taking placebo). 

    In general, some women appear to respond better to flibanserin than others. 

    According to the prescribing information for Addyi®, the name brand for flibanserin, women who don’t see any improvement or increase in their sexual desire by week eight of treatment should stop taking flibanserin.

    Is Flibanserin Effective for Postmenopausal Women? 

    Although flibanserin is only FDA-approved for use in premenopausal women, studies of flibanserin in postmenopausal women indicate it may also be effective as a treatment for HSDD postmenopausal women. A study from 2017 found that flibanserin “was generally well tolerated” and “could be efficacious” in postmenopausal women with HSDD. More studies are needed in postmenopausal women to support finasteride’s effectiveness in that treatment group. 

    Can I Take Flibanserin Only When Needed?

    Unlike Viagra®, Cialis® and other sexual performance medications for men, flibanserin needs to be taken nightly in order to be effective. Flibanserin has not been shown to produce any benefits when taken on a once-off, episodic basis. 

    Can Flibanserin Make You Too Interested in Sex?

    Flibanserin is designed to improve your sexual desire if you’re affected by HSDD. Flibanserin is not designed to and should not cause you to become hypersexual or desire to have sex all the time. 

    How Long Can You Use Flibanserin?

    Flibanserin has been used for periods of up to 18 months in large-scale clinical trials. This is the longest amount of time that the medication has been used in a study environment — if used for a longer period of time, it might continue to provide positive results.

    Currently, there are no scientific studies of flibanserin covering a time period of longer than 18 months. 

    Is Flibanserin the Only Treatment for HSDD? 

    There are numerous factors that contribute to low sex drive, ranging from your hormone levels to your satisfaction with your relationship, lifestyle or mental and physical health.

    Whether your low sex drive is associated with HSDD and you don’t want to try flibanserin — or you have tried it, and found it didn’t work — or it’s just temporary and you’re looking for a quick fix, there are a variety of treatments that can be used to improve sex drive in women. If you have a low level of interest in sex as a result of a hormonal deficiency, your doctor might recommend a hormone-based treatment.

    If your low interest in sex is caused by antidepressants, your doctor might recommend an alternative medication that’s less likely to affect your sex drive. Many women experience an increase in sexual interest after switching from an SSRI to a medication such as bupropion. 

    Changing your habits and lifestyle can also contribute to a stronger sex drive. Regular aerobic exercise, stress reduction and quitting cigarettes and alcohol are all linked to improvements in sexual desire and performance for men and women. 

    Finally, non-pharmaceutical treatments such as counseling and sex therapy can improve your sexual self-confidence and help restore your sex drive. 

    What if Flibanserin Doesn’t Work For You?

    If you don’t respond to flibanserin, your doctor might prescribe an alternative treatment. It’s important to remember that your interest in sex is multifactorial, and that while flibanserin is effective for treating some aspects of a low sex drive, it might not be the best option for you.

    How Much Does Flibanserin Cost? 

    We offer access to Addyi® (flibanserin) for $99 per month after an online consultation with a physician who will determine if the prescription is appropriate for you.

    Learn More About Flibanserin and HSDD

    Worried you might have HSDD? Our HSDD 101 guide goes into more detail on the symptoms of HSDD, as well major causes and the most effective treatment options. 

    Interested in learning more about flibanserin? Our complete guide to flibanserin covers Addyi® (flibanserin) in more detail, from what this medication is used for, to side effects, interactions and more. 

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.