In the United States, two drugs have been approved to treat female sexual interest/arousal disorder (FSIAD): Vyleesi (bremelanotide) and Addyi (flibanserin). These medications are often touted as “Viagra for females,” though their mechanisms and approved uses differ significantly from those of Viagra, which is primarily designed for male erectile dysfunction.
Both Vyleesi and Addyi have received approval from the Food and Drug Administration (FDA) specifically to address low sexual desire or arousal in premenopausal females. It's important to note that these drugs are not intended for postmenopausal individuals or those who have experienced menopause.
This comprehensive article outlines the FDA-approved medications available for treating low libido in females, including their mechanisms of action, potential side effects, and additional treatment options that may also be beneficial.
To effectively address FSIAD, the FDA has approved two specific medications: Vyleesi (bremelanotide) and Addyi (flibanserin), both of which have unique profiles and methods of administration tailored to meet the individual needs of premenopausal females.
Addyi (flibanserin)
Recognized as the first medication approved for the treatment of FSIAD, Addyi is particularly intended for use in premenopausal individuals. This medication is available in pill form and is typically taken on a daily basis before bedtime, regardless of whether sexual activity is anticipated that day.
Users may start to notice an increase in sexual desire within approximately 8 weeks, although some individuals report experiencing positive effects much sooner than this timeframe, marking a potential shift in their sexual health and wellbeing.
Vyleesi (bremelanotide)
Vyleesi is specifically indicated for the treatment of FSIAD among premenopausal females as well. Unlike Addyi, Vyleesi is administered via injection, requiring an individual to inject the medication into their thigh or abdominal region at least 45 minutes prior to engaging in sexual activity. The therapeutic effects of Vyleesi can persist for up to 24 hours, yet it is crucial not to exceed eight uses of this medication within a single month.
Comparison table
The following table provides a side-by-side comparison of Vyleesi and Addyi, highlighting their distinct characteristics and usage guidelines.
While Viagra is a well-known treatment option for male erectile dysfunction, it is not FDA approved for use in females. To understand this distinction, it is essential to recognize that Viagra was formulated specifically to target physiological responses in the male body, particularly in relation to the erection process.
In males, sexual stimulation triggers the release of nitric oxide, leading to the elevation of cyclic guanosine monophosphate (cGMP), a compound that facilitates smooth muscle relaxation and enhances blood flow to the penis, resulting in an erection.
The process is reversed when an enzyme known as phosphodiesterase type 5 (PDE-5) breaks down cGMP, leading to the eventual loss of an erection.
Viagra, which contains sildenafil as its active ingredient,
In some situations, healthcare professionals may choose to prescribe sildenafil off-label for treating FSIAD in females. A recent 2024 study discovered that topical applications of sildenafil cream can yield positive outcomes for females diagnosed with FSIAD.
Women interested in exploring Viagra as a treatment option should consult with a healthcare provider, who can assess their individual situation and discuss potential off-label prescriptions.
Conversely, Vyleesi acts on melanocortin receptors that are integral to sexual function, modulating the cerebral pathways related to sexual response and enhancing overall arousal.
The
Addyi has a duration of action that extends for approximately
Following three days of consistent use, the levels of Addyi stabilize, although some individuals do not adequately metabolize CYP2C19, an essential enzyme, which may cause drug accumulation and subsequent side effects.
On the other hand, Vyleesi has a shorter average duration of action, lasting approximately 2.7 hours, with an average clearance time of 6.5 hours from the body. It is important to note that Vyleesi may slow the metabolism of other medications, affecting how they are processed.
Currently, Vyleesi and Addyi are approved only for the treatment of FSIAD in premenopausal individuals. Rigorous research has yet to analyze the effects of these medications in women who are transitioning into or have already undergone menopause.
The clinical benefits of these medications may extend to premenopausal individuals facing particular challenges such as:
- Taking other medications that impact libido
- Experiencing sexual boredom
- Suddenly losing interest in sexual activity
Various factors associated with a decreased sexual drive among females can include:
- Vaginal dryness
- Challenges in achieving orgasm
- Pain during sexual intercourse
- Psychological factors such as stress, anxiety, or depression
- Underlying health conditions like diabetes or cardiovascular disease
The FDA-approved medications for treating FSIAD can present the following potential side effects.
Addyi
The side effects commonly reported with Addyi may include:
- Drowsiness
- Dry mouth
- Nausea
- Dizziness
- Fatigue
- Insomnia
- Increased risk for those with liver issues
- Potential interactions for those on oral contraceptives
- Concerns for those taking CYP3A4 inhibitors
- Considerations for nursing mothers
- Risks for individuals who consumed alcohol in the preceding two hours
Mixing Addyi with alcohol or having underlying liver conditions can lead to severe hypotension and fainting, underscoring the importance of caution when combining substances.
Vyleesi
Side effects associated with Vyleesi may include:
- Nausea and vomiting
- Facial flushing and hot flashes
- Irritation or rash at the injection site
- Headaches
- Flu-like symptoms
- Fatigue
- Dizziness
- Skin darkening, which can result in hyperpigmentation on various body areas such as gums, face, and breast tissue
- High blood pressure impacts
- Changes in heart rate
- tingling sensations
It should be noted that Vyleesi has the potential to reduce the efficacy of oral medications due to slower gastric emptying. Caution is also advised for individuals taking naltrexone, as Vyleesi may diminish the effectiveness of these medications used for treating addiction.
As with other pharmaceuticals, both Vyleesi and Addyi carry a risk of causing allergic reactions. It's critical to seek immediate medical attention if any signs of an allergic reaction or anaphylaxis manifest.
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Before considering any supplements to enhance libido, it is essential for individuals to consult with a healthcare professional. Doctors can provide tailored advice regarding the appropriateness of these supplements and may recommend effective medications like Addyi or Vyleesi when applicable.
In summary, Vyleesi (bremelanotide) and Addyi (flibanserin) offer valuable treatment options for addressing female sexual interest/arousal disorder (FSIAD) specifically designed for premenopausal individuals.
It's critical to recognize that the FDA has not approved Viagra for use in females, and there are significant cautions against using over-the-counter libido-boosting supplements. Medication alone may not address all the underlying causes of low sexual desire. Individuals seeking to improve their libido should reach out to a healthcare provider for guidance on appropriate treatments and practices.