Vyleesi? Addyi? How women can get help for low sexual desire
Statistics vary, but more than a third of women report having low or limited libido and 10% have a condition known as hypoactive sexual desire disorder (HSDD). Many — but not all — are looking for help to increase their sex drive.
The U.S. Food and Drug Administration recently approved Vyleesi (bremelanotide), an injectable medication for premenopausal women with low libido. Addyi (flibanserin), approved in 2015, is a once-a-day pill designed to increase sexual desire.
Dr. Stacy Tessler Lindau, who runs the University of Chicago Medicine’s Program in Integrative Sexual Medicine and WomanLab.org, discusses what this latest pharmaceutical option means for women.
When should women talk to their doctor about low sex drive?
A woman who is distressed about low sex drive should raise the concern with a doctor. Some women do have lower sex drive than they used to or have lower sex drive than their partner, but they see no problem. In fact, if you are satisfied with the level of your sex drive or are not bothered by it, then you don’t need a doctor’s help.
What are some of the treatment options available?
Treatment options depend on the cause. New onset of low libido can be a symptom of an underlying physical or mental health problem. A drop in libido can be related to a life stage or event like pregnancy, postpartum or grief. A woman might find that her libido is heavily influenced by her partner’s interest in sex, so an evaluation should include the partner’s health and sexual function.
Other possible causes can include: treatments that interfere with sex hormone metabolism, like anti-hormone therapies used for breast cancer; medication for mood disorders such as depression and anxiety; alcohol; chronic poor-quality sleep; and painful sex, often due in part to vaginal dryness. Many women with a low libido concern benefit from a combined body, mind and relationship approach.
Why is it important to have pharmaceuticals available for women with HSDD?
Most libido problems can be addressed without medication and, even with newly approved treatments, there is typically no quick fix. My bias as a physician is to use medication as a last resort — it’s costly, can have side effects and rarely addresses the root cause of the problem. And I’m also a believer that the more safe and effective options we have to help alleviate human suffering, the better. Treatments for male sexual function problems have extended sexually active life for millions of men and their partners. Of course, we should expect the same for women and their partners.
How are Addyi and Vyleesi taken, and what are the side effects?
Addyi must be taken daily for effect. More worrisome side effects may include sleepiness and fainting, as well as negative interactions with alcohol and other prescription medications. Vyleesi is self-administered as an injection in the thigh or abdomen about 45 minutes before a sexual encounter. Nausea is a common side effect, which seems counter-productive. If you ask a nauseated woman if she is interested in having sex in the next 45 minutes, there is a high likelihood she will say no.
Both Addyi and Vyleesi have been incorrectly called “the female Viagra.” Why is that terminology so wrong?
Viagra and other popular erectile dysfunction drugs help men with what amounts to a plumbing problem that limits their ability to get and maintain an erection. Addyi and Vyleesi are designed to increase sex drive. The effect is modest at best — these are not magic wands for libido. In both women and men, sexual function includes libido or interest in sex, sexual arousal (including erection) and orgasm. Communication and relationship problems often affect libido and can be effectively addressed with a certified sex therapist.