From the Guidelines
Flibanserin (Addyi) is currently the most effective FDA-approved medication specifically for increasing libido in premenopausal women with hypoactive sexual desire disorder, as it results in approximately 1 additional satisfying sexual event every 2 months in premenopausal individuals 1. When considering treatment options for low libido in women, it's essential to evaluate the underlying causes, including relationship issues, stress, depression, or other medical conditions that might be addressed through different interventions.
- Flibanserin is taken as a 100mg tablet once daily at bedtime, and patients should commit to at least 8 weeks of treatment to evaluate effectiveness.
- Another option is bremelanotide (Vyleesi), administered as a 1.75mg subcutaneous injection in the abdomen or thigh 45 minutes before anticipated sexual activity, with a limit of one dose per 24 hours and 8 doses per month, which has been shown to increase sexual desire and reduce distress related to low sexual desire in premenopausal individuals with HSDD 1.
- For postmenopausal women, while flibanserin is not FDA-approved for this population, some data suggest it can be effective and safe in this setting as well 1.
- It's crucial for women using flibanserin to completely avoid alcohol due to serious interaction risks, including severe hypotension and fainting.
- Before starting any treatment, a thorough evaluation is essential to identify underlying causes of low libido and to discuss the potential benefits and risks of each medication option, including the use of off-label medications like bupropion and buspirone, which may be considered for some survivors with HSDD 1.
From the FDA Drug Label
VYLEESI is a prescription medicine used to treat hypoactive (low) sexual desire disorder (HSDD) in women who have not gone through menopause, who have not had problems with low sexual desire in the past, and who have low sexual desire no matter the type of sexual activity, the situation, or the sexual partner. ADDYI is a prescription medicine used to treat hypoactive (low) sexual desire disorder (HSDD) in women who have not gone through menopause, who have not had problems with low sexual desire in the past, and who have low sexual desire no matter the type of sexual activity, the situation, or the sexual partner.
Most Effective Medication for Libido Increase in Women:
- Bremelanotide (VYLEESI) and Flibanserin (ADDYI) are two prescription medications approved for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women.
- Both medications have been shown to be effective in increasing libido in women with HSDD, but the most effective medication for an individual patient may depend on various factors, including medical history, lifestyle, and personal preferences.
- It is essential to consult a healthcare provider to determine the best course of treatment for HSDD, as they can help patients weigh the benefits and risks of each medication and make an informed decision 2, 3.
From the Research
Medications for Libido Increase in Women
- Flibanserin and bremelanotide are the two medications approved by the Food and Drug Administration for the treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women 4, 5, 6, 7.
- Bupropion and buspirone may be considered off-label treatments for HSDD, but their efficacy and safety have not been extensively studied 4, 6.
- Testosterone, sildenafil, and herbal medications such as Herbal vX or Tribulus terrestris have shown some clinical benefit in women with sexual dysfunction disorders, but trials have significant design, dosing, or generalizability limitations 6, 8.
Efficacy and Safety of Medications
- Flibanserin has been shown to improve sexual desire and reduce distress related to lack of desire, but its efficacy is limited and it has potential adverse effects 4, 5, 6.
- Bremelanotide has demonstrated significant improvement in desire and a significant decrease in distress related to lack of desire, with common adverse effects including nausea, facial flushing, and headache 7.
- The clinical benefit of bremelanotide may only be modest, and its place in therapy is unknown 7.
Treatment Approach
- Treatment of HSDD involves a multimodal approach, including nonpharmacologic interventions such as psychotherapy and lifestyle adjustments, alongside pharmacologic options 4, 5.
- Validated tools and objective measures inform tailored premenopausal HSDD care plans and aid in striking a balance between potential risks and adverse effects while maximizing meaningful clinical benefits 4.