Increased monitoring of concentrations of drugs transported by P-glycoprotein that have a narrow therapeutic index such as digoxin and sirolimus is indicated. These include drugs such as proton-pump inhibitors, selective serotonin reuptake inhibitors, benzodiazepines, and antifungals. The use of flibanserin in patients who are CYP2C19 poor metabolizers results in increased flibanserin concentrations and may increase the risk of hypotension and syncope. Furthermore, CYP3A4 inducers can substantially reduce flibanserin concentrations and are not recommended with it. Libido is negatively modulated by microcircuits where prolactin and serotonin act.12,13,14 It implies relative deficiency of microcircuit dopamine and norepinephrine, or a relative excess of microcircuit serotonin can lead to disorder of sexual interest and desire. For women whose lack of libido isn’t caused by another medical issue or a relationship issue, medication may be able to help. Low libido can result from medication side effects, stress, fatigue, pain during sex, mental health or mood. The pill is designed to improve desire by boosting levels of the neurotransmitters dopamine and norepinephrine, while decreasing levels of the neurotransmitter serotonin. Get the latest industry news, event updates, and more from Managed healthcare Executive. “Over the years, we’ve pushed for the science to speak louder than the stigma—and today’s approval shows how far we’ve come. Your doctor will most likely want to know when your dip in libido started and whether it was sudden or gradual, Streicher adds. If you experience low or no sex drive and want to get it back, start by talking to your primary care physician or gynecologist. One hurdle to treatment, however, is cost. The FDA has expanded their approval of Sprout Pharmaceuticals’ Addyi (flibanserin), the first and only FDA-approved treatment for postmenopausal women ages 65 and younger with hypoactive sexual desire disorder (HSDD), also known as low libido, according to a news release published today. On December 15, 2025, the FDA approved an expanded indication for flibanserin 100 mg (Addyi) for hypoactive sexual desire disorder (HSDD) in postmenopausal women younger than 65 years, Sprout Pharmaceuticals announced in a news release.1 Let's talk honestly about Addyi (flibanserin), the first FDA-approved medication for treating low sexual desire in women. Because hormonal fluctuations can significantly impact sexual desire, understanding your unique hormone patterns is valuable. Addyi addresses dopamine, norepinephrine, and serotonin levels to help restore the balance needed for sexual desire. HSDD is diagnosed when you experience a persistent or recurrent absence of sexual desire that causes you personal distress or creates difficulties in your relationship. It is 90% absorbed and has mean half-life of ~ 11 h. Data for the article were collected by reviewing articles on PubMed, the drug (Addyi) website, and related websites on the internet. A novel multifunctional serotonin agonist and antagonist, flibanserin, has been shown to be efficacious in treating HSDD but with a rather tenacious side effect profile. Sexual functioning is an integral part of human life. We review this drug in its entirety, controversies surrounding its approval, dosage, pharmacokinetics, indications, adverse effects, and contraindications. Not only does FSD negatively affect health-related quality of life but also general well-being.8,9 Rachel Nania is an award-winning health editor and writer at AARP.org, who covers a range of topics including diseases and treatments. Flibanserin was previously approved by the FDA in 2015 to treat HSDD in certain premenopausal women.2 Health Canada has also approved expanded use of the non-hormonal medication in women who have gone through menopause. Addyi is not intended for women who experience low libido due to preexisting medical or psychiatric conditions, relationship conflict outside of symptoms or to mitigate the side effects of another medication, such as antidepressants, which can impact sex drive. "I was in the room a decade ago when Addyi became the historic first for women's sexual health, and I have been waiting for this moment ever since," Rachel Rubin, M.D., urologist and sexual medicine specialist, said in the news release. “This milestone reflects a decade of persistent work with the FDA to fundamentally change how women’s sexual health is understood and prioritized,” Cindy Eckert, founder and CEO of Sprout Pharmaceuticals, said in the news release. Is This Just "Female Viagra"? This stigma keeps women from seeking help and doctors from asking the right questions. This affects more women than you might think. Women's health is finally getting the attention it deserves. This isn't just about medication. Sexual functioning is an integral part of human life and has been shown in research to be important to both men and women In the Study of Women's Health across the Nation, more than 75% of women reported sex to be moderately to extremely important. Female sexual dysfunction (FSD) adversely affects quality of life and general well-being. Still, the expanded approval has been welcomed by many women’s health experts. And while there is no FDA-approved testosterone therapy for women with libido issues, some doctors prescribe it off-label. Priority review is granted to drugs that “would be significant improvements in the safety or effectiveness of the treatment, diagnosis, or prevention of serious conditions when compared to standard applications,” according to the FDA.3 This approval follows the FDA’s priority review designation for flibanserin in July 2025. Current treatments include testosterone; however, it is not currently approved by the FDA, and it carries potential side effects such as extra body hair, acne and voice changes. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Whether Addyi is right for you depends on your individual situation, but knowing the facts empowers you to have an informed conversation with your healthcare provider. But for many women, it has made a meaningful difference in reclaiming an important part of their lives. But this is a legitimate medical issue, and you deserve to have your concerns addressed. Every person is different, and it is essential that we discuss our sexual preferences so that our partners are informed and we can optimize our sexual experiences. Our culture also discourages us from talking to our partners about our sexual preferences because doing so is somehow considered to be less romantic and spontaneous. What did you learn, for example, about how the clitoris, perineum, G-spot, the U-spot, or the A-spot contribute to sexual pleasure? Both Zanotti and Streicher say a sex therapist can also help with libido issues. I think for so long, people just didn’t want to think about it; they thought that after menopause, sex isn’t important to a woman. Biological changes, such as menopause, can also affect a woman’s sex drive. Food and Drug Administration (FDA) in 2015 for premenopausal women, can now be prescribed to women up to age 65. Addyi works on key neurotransmitters that affect sexual response. In my work with men, I often explore the idea that perhaps their partners are not interested in sex because they aren’t enjoying themselves. And yet it is ridiculous to think that sex is something we should just automatically know about without conversation. In addition, our society does a poor job of educating us about sex. These factors strongly influence the ways we think about and experience sex, and evidence suggest that our experiences can greatly impact our brains. Addyi has serious interaction with alcohol and is thus only available through health care professionals and pharmacies specifically certified in risk evaluation and mitigation strategy. Many women, and even some healthcare providers, don't know HSDD is a recognized medical condition with treatment options. Across three trials, about 10 percent more Addyi-treated patients reported meaningful improvements in satisfying sexual events, sexual desire, or distress. According to the FDA website, a study of over 2,400 premenopausal women showed Addyi increased the number of satisfying sexual events by 0.5 to 1 additional event per month. For people with insurance, Addyi will cost $40 annually through the drugmaker's copay program, per a company representative. “The lack of effective treatments has indeed been a barrier to patient care,” Santoro says. People should skip taking Addyi any night they have three or more drinks, and refrain from drinking anything at night after they take the drug. “However, if it’s really all libido based and it doesn’t seem to be genitourinary symptoms, Addyi might be a good option.” “Thoughts of sex initiate the anticipation of a reward, and this in turn increases positive thoughts of sex,” Dr. Santoro says. URO-1 prostate biopsy devices adopted across Novant Health System as clinical study continues A moderate or strong CYP3A4 inhibitor may be initiated 2 days after the last dose of flibanserin. Concomitant CYP3A4 inhibitors may increase flibanserin exposure and are contraindicated. Steady state of flibanserin is achieved only after 3 days of dosing and so it is incorrect to call it “female Viagra” because Viagra is used as needed. Taking the drug with food increases its absorption. With mild hepatic impairment, half-life increases to 26 h. For context, 20-plus treatments have been approved to resolve a host of male sexual issues. Addyi is a legitimate treatment option for women with HSDD, backed by clinical trials and FDA approval. Many women feel uncomfortable bringing up sexual concerns, and many doctors don't routinely ask about them. While hormonal changes particularly during menopause, after childbirth, or due to certain medical conditions can contribute to low desire, HSDD is often more complex. Addyi is a non-hormonal medication, prescribed by over 25,000 U.S. healthcare professionals and growing. At the end of the day, Manson says the FDA’s move to extend the approval of Addyi to include women up to age 65 is a huge win. The Menopause Society has a free online provider search tool to help women find a healthcare provider near them who has training in this area. “But if you don’t get taken seriously, then you should definitely seek a second opinion and find a physician who’s experienced with treating postmenopausal women.” This, along with the lack of a straightforward lab test or physical exam to prove women have low libido, can make doctors reluctant to treat the condition. When Viagra was approved in 1998 for men's erectile dysfunction, it took just six months. Yet many women suffer in silence, unsure whether their experience is normal or if help is available. If you've noticed your interest in sex has significantly declined and it's bothering you, you're not alone. We provide counseling for adults, teens, and children, and couples and help with anxiety, OCD, depression, relationship issues, postpartum issues, divorce, life transitions and stress. Trusted advice and articles that are relevant to your journey to reclaim your life. Not knowing that can lead them into a passive and disempowered role, causing them to feel that sex is obligatory and also placing a lot of performance pressure on the man. Treating low libido Other biology can also play a role; for example, if you have a health issue that hinders circulation or causes pain, you may be uninterested in sex, and medications like antidepressants can also dial down libido. But of course, brain chemistry isn’t the only contributor to sexual desire, Dr. Rahman notes. Though Addyi is often referred to as the female Viagra for its sexual-health benefits, it works differently than the ED drug. Viagra, for one, was approved for erectile dysfunction (ED) in 1998 in under six months; by contrast, Addyi took six years to gain its original approval for premenopausal women and then another decade to arrive at this week’s extension, despite ample data demonstrating safety and efficacy in women ages 18 to 80. Many women feel uncomfortable bringing up sexual concerns, and many doctors don't routinely ask about them.Addyi works completely differently, it's a daily medication that affects neurotransmitters in your brain, specifically targeting the neural pathways involved in sexual desire.A novel multifunctional serotonin agonist and antagonist, flibanserin, has been shown to be efficacious in treating HSDD but with a rather tenacious side effect profile.Yet many women suffer in silence, unsure whether their experience is normal or if help is available.The injectable medication bremelanotide (Vyleesi) is another FDA-approved treatment for premenopausal women with low libido.It is 90% absorbed and has mean half-life of ~ 11 h.The expansion “marks not only a historic milestone but a broader cultural shift of acceptance and recognition that women’s sexual health does not end at menopause,” Cindy Eckert, CEO and founder of Sprout Pharmaceuticals, the maker of Addyi, tells SELF. Addyi is the first FDA-approved treatment for low libido in women ages 65 and younger. The Addyi expansion offers a solution for women in this phase of life who may be especially subject to HSDD, where there previously was no FDA-approved treatment. On the one hand, the above elements that influence libido often take a turn for the worse with age—you’re all the more likely to be on medications or dealing with health issues post-menopause. With the approval today, flibanserin becomes the first and only treatment of its kind for women younger than 65 years, Sprout Pharmaceuticals noted. With this approval, flibanserin becomes the first and only treatment of its kind for women younger than 65 years. It is the most common form of sexual dysfunction in postmenopausal women, impacting approximately 40% - 55% of women during this time, caused by falling levels of estrogen, progesterone and testosterone. It was originally approved in 2015 for the treatment of HSDD in premenopausal women. On the other hand, the menopause transition itself can cause libido to plummet due to both the shift in hormones, particularly the drop in testosterone, and the symptoms this change can spark. Addyi can also interact with a variety of other medications, Dr. Cobb points out, so it’s important to tell your doctor all the drugs you’re currently taking if you’re considering it. So Addyi may be more effective for HSDD in some women versus others, depending on the factors that are feeding into low desire in the first place. (And as she points out, these changes in the brain can equally benefit pre- and postmenopausal women.) In most sex education programs, we are taught some anatomy but are not taught about how it impacts our sexual pleasure. Meanwhile, women are also given the message that “good girls” don’t have sex and thatwomen who enjoy sex are whores. We may also have fears that cause us to anticipate negative outcomes, such as a fears acquiring a sexually transmitted disease, becoming pregnant, or experiencing pain. From a psychological perspective, the messages we received about sex, as well as our exposure or lack of exposure to physical and verbal affection from our parents, will greatly affect our relationships and sexuality. Last summer, the US Food and Drug Administration approved a non-hormonal therapy named Addyi (aka flibanserin, the “little pink pill,” or the “female Viagra”) for treatment of low sexual libido in premenopausal women. The Food and Drug Administration recently approved flibanserin, for treatment of female hypoactive sexual desire disorder (HSDD), regarded as the most common FSD, amid great controversy. While nearly 40% of women will experience low sexual desire at some point in their lives, women beyond their reproductive years still do not have a single FDA approved medical treatment option. This marks a potential pivotal advancement in women's sexual health, addressing a long-standing unmet need for millions of women experiencing hypoactive sexual desire disorder (HSDD). Food and Drug Administration (FDA) has granted Priority Review for its supplemental application to expand the indication of Addyi® (flibanserin 100mg), the first and only FDA-approved pill for low sexual desire in women, to also include women who have gone through menopause. From a cultural perspective, we know that our society greatly sexualizes women, placing them under immense pressure to have unrealistic expectations about their bodies and sexuality. Flibanserin is a controversial drug approved for a controversial disorder amid huge controversy. Its symptoms were established as a criterion for female sexual interest/arousal disorder. For a diagnosis of HSDD, the desire problem must not be better accounted for by another psychiatric disorder such as depression, substance abuse, or medical condition. Around 43% of women report sexual problems with 22.2% reporting sexually related personal distress. Having this option on the table is a “critical acknowledgement that pleasure is important for women in midlife,” Dr. Rahman says, “for both their quality of life and overall health.” And because it’s a different piece than the ones addressed by hormone therapy for menopause, women in this life stage could experience unique benefits from Addyi, even if they’re on HT too. The FDA approval of Addyi opens the door for insurance coverage of HSDD treatment in women up to age 65. CONTROVERSIES PLAGUING FLIBANSERIN And it’s very important to women.” “It’s finally showing that this is important for women who are postmenopausal. Streicher says the therapy is particularly effective in older women. Zanotti says research is ongoing for women over 65. That delay reflects how women’s sexual desire, particularly post-menopause, has historically been deprioritized or outright disregarded, Sameena Rahman, MD, a Chicago-based board-certified gynecologist and menopause specialist, tells SELF.In December 2024, the FDA expanded Addyi's approval to include postmenopausal women under age 65.Call your doctor for medical advice about side effects.Women with HSDD have low sexual desire that is troubling to them.“I do worry for women who drink alcohol while they’re taking this medication,” Manson says.It is the most common form of sexual dysfunction in postmenopausal women, impacting approximately 40% - 55% of women during this time, caused by falling levels of estrogen, progesterone and testosterone.INDICATIONWhat is ADDYI (add-ee) (flibanserin) Tablets?Across three trials, about 10 percent more Addyi-treated patients reported meaningful improvements in satisfying sexual events, sexual desire, or distress. Trending on Urology Times That said, some women do benefit from hormone therapy, particularly testosterone therapy in postmenopausal women. If you regularly enjoy evening cocktails or wine with dinner, you'll need to adjust your habits or consider whether this medication fits your life. If your low desire stems from untreated depression, a medication you're taking, or serious relationship problems, those underlying issues need to be addressed first. For many women, loss of desire creates feelings of disconnection, inadequacy, and frustration. The company remains committed to advancing science, expanding access, and advocating for the care women deserve. "This is about expanding access, expanding awareness, and expanding agency for women who have been overlooked for far too long," Eckert added. “It gives these women a way to treat a problem that is very common and severely undertreated.” For people with insurance, Addyi will cost $40 annually through the drugmaker's copay program, per a company representative.This isn't just about medication."I was in the room a decade ago when Addyi became the historic first for women's sexual health, and I have been waiting for this moment ever since," Rachel Rubin, M.D., urologist and sexual medicine specialist, said in the news release.About Addyi ® (flibanserin)Addyi is the first and only FDA-approved pill to treat low libido (HSDD) in certain premenopausal women."Menopause does not mark the end of a woman's sexuality but for too long, medicine has treated it that way," Mary Claire Haver, M.D., OB-GYN and leading menopause expert, said in the news release.What did you learn, for example, about how the clitoris, perineum, G-spot, the U-spot, or the A-spot contribute to sexual pleasure?In clinical trials involving over 2,000 women, approximately 46-60% reported meaningful improvement.Its symptoms were established as a criterion for female sexual interest/arousal disorder. Hypoactive sexual desire disorder is characterized as a persistent lack of sexual interest. It also validates HSDD in midlife women as a condition worthy of a medical solution—which is how we’ve long addressed sexual dysfunction in men. Low sexual desire that causes you distress is not something you need to just accept or feel ashamed about. Some women notice changes earlier, while others need more time. That means it works for a little more than half of the women who try it, but not everyone. In clinical trials involving over 2,000 women, approximately 46-60% reported meaningful improvement. It's not a hormone, and it's not something you take right before sex. Perimenopause Hormone Kit Flibanserin is a nonhormonal medication that acts on key neurotransmitters, or chemical messengers in the body, that affect sexual response. Its approval was expanded 10 years later to include postmenopausal women under the age of 65. Low libido is prevalent, health experts say; it affects between 40 to 70 percent of women. Hormonal changes can also cause vaginal dryness and emotional shifts and fatigue, all of which can impact desire. Dr. Cobb sees Addyi’s expansion as “helping one piece of the libido puzzle” for a key demo. And vaginal estrogen could be used to help with the vaginal thinning and dryness that makes sex painful. In some scenarios, ob-gyns may have prescribed hormone therapy (HT), particularly if symptoms like hot flashes or insomnia seemed to be the primary thing hampering sex drive. Libido can “fall off a cliff” at menopause, even in perimenopause (the lead-up to menopause), because of a variety of factors, Dr. Rahman says. “We hope this news reinforces that women deserve science-backed solutions for diagnosable medical issues that have been tested in their bodies, not gimmicky marketing plays,” Eckert says. “Women in midlife have been told that loss of libido is a normal part of aging, something they just have to deal with, or they should plan a date night or try a little harder to push through it,” she says. Discover how imbalanced gut microbes lead to estrogen dominance, PCOS symptoms, weight gain, and mood swings and what you can do to support healthy estrogen balance naturally. Always consult a healthcare provider before making any health decisions. Up until now, women who’d surpassed menopause and were dealing with frustratingly low libido—a.k.a. It's a medical condition with treatment options available. Your doctor should take a complete medical history, ask about your symptoms, rule out other causes, and discuss whether you're a good candidate for Addyi or other treatments. Many experts recommend a combined approach medication along with therapy or lifestyle modifications for the best results. The expansion “marks not only a historic milestone but a broader cultural shift of acceptance and recognition that women’s sexual health does not end at menopause,” Cindy Eckert, CEO and founder of Sprout Pharmaceuticals, the maker of Addyi, tells SELF. Hypoactive sexual desire disorder (HSDD)—had no dedicated treatment option available to them. The brain's neurotransmitter balance plays a significant role in sexual desire, which is why a non-hormonal medication like Addyi can be effective. This is significant because many women experience changes in desire during and after menopause, and now there's an approved treatment option for this broader population. Addyi works completely differently, it's a daily medication that affects neurotransmitters in your brain, specifically targeting the neural pathways involved in sexual desire. Our discomfort with educating ourselves and talking about sex greatly contributes to our difficulties with sexual enjoyment.Women younger than 65 who have gone through menopause have no more risk from mixing Addyi with alcohol than premenopausal women, Manson says.That means it works for a little more than half of the women who try it, but not everyone.Previously, it was only approved for premenopausal women.For starters, there’s the shrinking labia and dry vagina (a.k.a. genitourinary syndrome of menopause) that can make sex downright painful.Libido is negatively modulated by microcircuits where prolactin and serotonin act.12,13,14 It implies relative deficiency of microcircuit dopamine and norepinephrine, or a relative excess of microcircuit serotonin can lead to disorder of sexual interest and desire. Links to NCBI Databases Beyond this, many physicians lack training in managing sexual health for women who have gone through menopause, Manson says.In clinical trials, women did not typically gain weight on Addyi.Addyi is the first and only FDA-approved, hormone-free pill clinically proven to treat low sexual desire in women“We hope this news reinforces that women deserve science-backed solutions for diagnosable medical issues that have been tested in their bodies, not gimmicky marketing plays,” Eckert says.Knowledge is power, and having concrete data about your body's hormone levels can lead to more targeted, effective treatment.We may also have fears that cause us to anticipate negative outcomes, such as a fears acquiring a sexually transmitted disease, becoming pregnant, or experiencing pain.You are encouraged to report negative side effects of prescription drugs to the FDA.At the end of the day, Manson says the FDA’s move to extend the approval of Addyi to include women up to age 65 is a huge win. Health officials have expanded access to a libido-boosting pill for women, approving its use beyond menopause. It is the most common form of sexual dysfunction in women, impacting an estimated 40% of women according to the Mayo Clinic. About Sprout PharmaceuticalsSprout Pharmaceuticals is leading a revolution in women's health, pioneering innovative treatments that address long-overlooked needs. After reviewing its robust safety and efficacy profile, Health Canada also approved Addyi with expanded use in women that have gone through menopause. The FDA's Priority Review designation is reserved for drugs that offer significant improvements in treatment for serious unmet medical needs. Like any medication that acts on the brain, Addyi also has some side effects. And then there are all the psychological and social components—for instance, being depressed or anxious, having a poor relationship with your partner, or even taking on the bulk of the household labor could slash your libido. “It might be that if right now, eight out of 10 times, you decline your partner when they ask you to have sex, with Addyi, perhaps you’re declining them only three out of 10 times,” Dr. Rahman explains. The new approval springs from the Priority Review designation that the FDA granted in July to Sprout Pharmaceuticals for their application to broaden Addyi’s indicated age range. Approximately one in ten women experiences hypoactive sexual desire disorder (HSDD), making it one of the most common female sexual concerns. Low sexual desire affects millions of women, but conversations about treatment remain frustratingly rare. A coalition of women's groups, even the score, had actively campaigned for the drug's approval, emphasizing that several approved drugs for male sexual dysfunction exist but not so for women. Hypoactive sexual desire disorder (HSDD) has been regarded to be the most common female sexual dysfunction (FSD) and affects nearly 1 in 10 women.4,5 It is a persistent or recurrent absence of deficiency of sexual desire or receptivity to sexual activity that causes marked distress or interpersonal difficulty. Newsletter It is the first FDA-approved drug for treatment of premenopausal women with acquired, generalized HSDD. “It’s taken a long time for us to get research into women’s health concerns, especially women’s sexual health,” Zanotti says. “When you see anybody for sexual health concerns, you really have to go through their complete medical history,” Zanotti says. ADDYI is not for use for the treatment of HSDD in women who have gone through menopause, in men or in children.ADDYI is not for use to improve sexual performance. The injectable medication bremelanotide (Vyleesi) is another FDA-approved treatment for premenopausal women with low libido. With the launch of Addyi, the first and only FDA-approved pill to treat low sexual desire (HSDD), Sprout helped shift the conversation around women's sexual wellness. Addyi is the first and only FDA-approved, hormone-free pill clinically proven to treat low sexual desire in women About Addyi ® (flibanserin)Addyi is the first and only FDA-approved pill to treat low libido (HSDD) in certain premenopausal women. With enhanced focus and tighter timelines granted by the Agency, this designation underscores the urgency and importance of closing the gap in women's sexual healthcare. "Sexual desire is ageless. Access to care should be too. Priority Review brings us closer to expanding access and empowering more women with a science-backed, FDA approved solution for their sexual wellness." Women who have concerns about libido or sexual health should start by raising the issue with their primary care provider, Manson says. Some doctors may have been reluctant to discuss low libido with postmenopausal women in part because up until now, they haven’t had any FDA-approved treatments to offer them, Santoro says. “Now that there is a safe, effective, FDA-approved treatment, doctors are more likely to talk about women’s sexual health and recognize that pleasure and quality of life are important,” Pinkerton says. "This FDA approval is a long-overdue recognition that postmenopausal women deserve evidence-based treatment options for low sexual desire.” If approved, the updated Addyi label will mark a major shift toward inclusive, life-stage-spanning innovation in sexual health, recognizing that women deserve options no matter their age. From a cultural perspective, we know that our society greatly sexualizes women, placing them under immense pressure to have unrealistic expectations about their bodies and sexuality.Trusted advice and articles that are relevant to your journey to reclaim your life.This may lead to sadness or anxiety, which could cause relationship complications, especially if the sexual activity used to be much more frequent.The U.S. Food and Drug Administration (FDA) has approved the first daily pill for low sexual desire in women who have gone through menopause.Addyi addresses dopamine, norepinephrine, and serotonin levels to help restore the balance needed for sexual desire.Most of these effects begin within the first two weeks of starting the medication and often improve over time.This stigma keeps women from seeking help and doctors from asking the right questions.The FDA approval of Addyi opens the door for insurance coverage of HSDD treatment in women up to age 65. Sexual desire affects quality of life. See a sex therapist and address the root of the problem so that you can feel liberated and enjoy sexual pleasure. Our discomfort with educating ourselves and talking about sex greatly contributes to our difficulties with sexual enjoyment. It therefore thought to impact our interest in, expectations about, and openness to sex. Addyi affects the brain neurotransmitters serotonin, norepinephrine, and dopamine, which regulate feelings of well-being, our interest in reward-seeking behaviors such as sex, and regulation of our our thinking. Until further data are available, a cautious use of the drug is warranted. Patients should not drive or engage in other activities requiring full alertness until at least 6 h after taking flibanserin. Women younger than 65 who have gone through menopause have no more risk from mixing Addyi with alcohol than premenopausal women, Manson says. “We cannot remove ourselves from a society that tends to view menopausal women as sexually unattractive and inappropriate sex partners.” "Menopause does not mark the end of a woman's sexuality but for too long, medicine has treated it that way," Mary Claire Haver, M.D., OB-GYN and leading menopause expert, said in the news release. The original approval of Addyi was made using data from three 24-week randomized, double-blind, placebo-controlled trials in premenopausal women with acquired, generalized HSDD. “The message the FDA and the healthcare system have of prioritizing sexual health in postmenopausal women I think is a game changer,” Manson says. Beyond this, many physicians lack training in managing sexual health for women who have gone through menopause, Manson says. “If the reasons women don’t desire sex have to do with specific menopause symptoms, then it’s possible that hormones to treat these symptoms might improve libido without the need for a drug like Addyi,” Dr. Manson says. It’s no wonder surveys suggest roughly half of postmenopausal women experience low sexual desire. That delay reflects how women’s sexual desire, particularly post-menopause, has historically been deprioritized or outright disregarded, Sameena Rahman, MD, a Chicago-based board-certified gynecologist and menopause specialist, tells SELF. Women with HSDD have low sexual desire that is troubling to them. About Hypoactive Sexual Desire Disorder (HSDD)Hypoactive Sexual Desire Disorder (HSDD), also known as frustrating low libido, is a persistent lack of sexual interest or desire. Addyi may be a good option for many women who experience challenges with libido that can’t be explained by other menopause symptoms that could contribute to reduced interest in sex, Manson says. “It’s estimated that 40 percent of women have low libido, and there wasn’t a clear reason that treatment should be restricted to premenopausal women,” Manson says. “There may well be social and psychological reasons that women have less sexual motivation with menopause,” Santoro says. The messages we’ve received from our culture, our families, and our experiences all play a role in women’t sexuality. In summary, we idealize romance but we don’t encourage women to embrace sexual pleasure. And with women, I explore whether they know that they are responsible for our own sexual pleasure. If you answered yes to these questions, it's worth having a conversation with your healthcare provider. Knowledge is power, and having concrete data about your body's hormone levels can lead to more targeted, effective treatment. Your doctor can help determine whether hormonal factors are contributing to your low desire and whether hormone therapy might be appropriate for you. Backed by the largest clinical trials in women's sexual health, Addyi originally received FDA approval for premenopausal women. “For the first time, there is an FDA-approved treatment for women under 65 who have low sexual desire that causes distress,” Dr. Pinkerton says. The U.S. Food and Drug Administration (FDA) has approved the first daily pill for low sexual desire in women who have gone through menopause. But that changed on December 15, 2025, when the FDA expanded its approval for the prescription drug Addyi (flibanserin), which was approved in 2015 to treat HSDD in premenopausal women, to also encompass postmenopausal women under age 65. Previously, it was only approved for premenopausal women. In December 2024, the FDA expanded Addyi's approval to include postmenopausal women under age 65. An estimated 6 million premenopausal women in the U.S. alone have HSDD, and that number increases significantly when you include postmenopausal women. It's about recognizing that women's sexual wellbeing matters. When Addyi was submitted for approval to treat women's low desire, it took six years and required clinical trials three times larger than those for Viagra. This may lead to sadness or anxiety, which could cause relationship complications, especially if the sexual activity used to be much more frequent. It also means women in midlife who prefer to avoid hormones or have a contraindication to HT can still take advantage of Addyi, Dr. Cobb adds. And even other menopause symptoms—like hot flashes, insomnia, and mood swings—can make having sex utterly unappealing. For starters, there’s the shrinking labia and dry vagina (a.k.a. genitourinary syndrome of menopause) that can make sex downright painful. In clinical trials, women did not typically gain weight on Addyi. Some women also report anxiety, constipation, or abdominal discomfort, though these are less common. Most of these effects begin within the first two weeks of starting the medication and often improve over time. That depends on your lifestyle. If you haven't seen any benefit after several months, it may not be the right treatment for you. “While there may be a higher risk for older postmenopausal women in their seventies or eighties, that shouldn’t be the case for women under 65,” Manson says. “I do worry for women who drink alcohol while they’re taking this medication,” Manson says. While the improvements were modest, the results were similar to outcomes in trials that focused only on younger women who hadn’t yet gone through menopause, says Manson. Using these hormones to treat other menopause symptoms like hot flashes or vaginal dryness doesn’t boost libido, Santoro adds. INDICATIONWhat is ADDYI (add-ee) (flibanserin) Tablets? You are encouraged to report negative side effects of prescription drugs to the FDA. Call your doctor for medical advice about side effects. Get emergency medical help or ask someone to get emergency medical help for you if the symptoms do not go away or if you feel like you could faint (lose consciousness). Before taking Addyi, you should consult with your doctor about all your medications, including prescription and over-the-counter medicines, vitamins, and herbal supplements. On the Female Sexual Distress Scale, which measures distress about one’s sex life and relationship as well as feelings of anxiety, inadequacy, stress, and embarrassment, scores also increased by 0.3 to 0.4. While it may serve as the lamp in the light in the long search for female sexual problems, it has still a long way to go. Neither is it indicated to enhance sexual performance. Currently, it is not indicated in postmenopausal women or in men. Levels of the hormones estrogen and progesterone decline during the transition to menopause and afterward, but there’s no clear hormonal reason why sex drive would drop during menopause, Santoro says. These changes happen naturally in response to thoughts of sex in people without low libido. Addyi is a nonhormonal pill that works by targeting chemicals known as neurotransmitters, which send messages via pathways in the brain that trigger sexual responses. Sprout Pharmaceuticals receives FDA approval of Addyi (flibanserin 100 mg). “There needs to be some detective work,” adds Streicher, author of a forthcoming book from AARP on menopause. The wide variety of contributing factors makes treating low libido difficult. Health conditions such as diabetes, high blood pressure and heart disease, which become more common with age, can also affect libido. And it’s “very different” for women than for men, she adds. Hypoactive sexual desire disorder isn't just about occasionally not being in the mood, that's completely normal. For decades, women's sexual health has been dismissed, minimized, or simply not talked about. Thus, our culture discourages sex-positivity, resulting of feelings of guilt and shame about sexuality and causing women to disown their right to genuine sexual desire and pleasure.