What to know about 'Viagra' for females
Low sex drive, also known as hypoactive sexual desire, affects about 10% of females.
Some females take Viagra, off-label, to treat low sexual desire. Meanwhile, the Food and Drug Administration (FDA) has approved two drugs, flibanserin (Addyi) and bremelanotide (Vyleesi), to address this issue.
Drugs that treat low sex drive have different effects in females and males.
This article describes the FDA-approved medications, including how these drugs work and possible side effects. It also explores alternative treatments.
What types are there?
The FDA has approved two drugs to address low sexual desire in women:
There are drugs available to treat low sex drive in women.
A person injects this medication, which researchers developed to increase sexual desire in females who are premenopausal.
Just as a male takes Viagra before having sex, a female injects Vyleesi in the stomach or thigh at least 45 minutes before sex.
The effects can last for up to 24 hours. People should not use the drug more than eight times per month.
Like Vyleesi, Addyi treats low sexual desire in premenopausal females, but Addyi comes in pill form. The person takes this drug daily, even if they do not intend to have sex that day.
It can take up to 8 weeks to see increases in sexual desire, though some people experience the effects much sooner.
Drugs not approved by the FDA
Some females address low sexual desire using drugs that the FDA has not approved for this purpose. In certain circumstances, these medications may help. They include:
Some females use Viagra, on an off-label basis, to treat low sexual desire. This was especially common before Addyi and Vyleesi became available.
In males, Viagra increases blood flow to the penis, allowing them to get and sustain erections. Females also experience increased blood flow to the genitals during arousal, so in theory, Viagra could have a similar effect.
Few studies have tested this theory. One small 2008 study did find that Viagra might help address low libido in females when the issue results from taking certain antidepressants: selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors.
A number of other medications may boost low sexual desire by targeting the cause. For example, when low libido results from trauma or anxiety, anti-anxiety medications may help.
The FDA has only approved Vyleesi and Addyi to treat low sexual desire in premenopausal females. In people who are going through or who have gone through menopause, estrogen replacement therapy may help increase low libido.
How do they work?
Addyi may be effective when low sex drive is linked with serotonin levels in the brain.
Researchers do not know how Addyi works, but findings indicate that it changes the brain's serotonin system. When a low sex drive is linked with serotonin levels in the brain, Addyi may be particularly effective.
Also, Addyi indirectly effects dopamine, a neurotransmitter related to pleasure and motivation.
Researchers are likewise unsure how Vyleesi works in the body. They know that it effects melanocortin receptors, but the link with increased sexual desire remains unclear.
The FDA reports two placebo-controlled trials that have shown statistically significant increases in sexual desire and arousal among females who used Vyleesi.
However, the researchers found that Vyleesi did not increase the number of sexually satisfying experiences. This suggests that increasing levels of desire alone will not change a person's sense of the quality of sex.
Who could benefit?
Vyleesi and Addyi treat premenopausal hypoactive sexual desire disorder, which is the medical term for low libido in females who have not gone through menopause.
There is no "normal" number of sexual thoughts or experiences. Also, there is no cutoff point at which sexual desire becomes clinically low. What defines low libido is that a person is distressed by what they consider a lack of interest in sex.
This means that the people who may benefit from "Viagra for women" are females who feel that their sex drives are low and who want to have more sex.
This may include people who:
- take medications that affect sexual desire
- experience sexual boredom
- suddenly feel less interested in sex
The most common side effects of Addyi include:
- sleep issues — especially sleepiness, which can be serious, and difficulty falling asleep
- dry mouth
- low blood pressure, which may cause fainting when the person stands
The most common side effects of Vyleesi are:
- flushing and hot flashes
- skin irritation or a rash at the injection site
- a cough
- nasal congestion
- darkening of the skin, resulting in dark spots called hyperpigmentation
- high blood pressure
- a decreased heart rate
- As with any drugs, it is also possible to have an allergic reaction to these medications.
Couples can try speaking to a sex therapist about any necessary reconciliation of sexual desires.
Sexual desire is complex, and the cause of low libido may not be something that medication can address. Trauma, unsatisfying sex, or boredom can each reduce desire.
Some research suggests that long term, monogamous relationships may lead to a reduction in desire among females. A 2017 study that included male and female participants found that — among females only — being in a relationship for longer than 1 year correlated with a decrease in sexual desire.
The same study pointed to a number of other factors that can reduce libido, including:
- feeling pressure to conform to social norms of sex, including religious mandates
- ever having had a sexually transmitted infection, or STI
- not feeling emotionally connected with a partner during sex
- having a partner with a history of sexual difficulties
- having trouble talking about sex
- not sharing sexual interests with a partner
When low sexual desire results from any — or a combination — of these factors, medication may not be effective.
Some alternatives to medication, depending on the cause of low libido and a person's preference, could include:
- sex therapy with a partner to support discussion and any necessary reconciliation of sexual desires
- individual therapy to address any trauma or negative feelings about sex
- open communication with a partner about sexual desires
- changing the structure of a relationship, such as by trying polyamory
- reducing any boredom by exploring new sexual fantasies, toys, and techniques, for example
Heterosexual norms may also be problematic for some females. While a sexual partner may believe that sex is the same thing as intercourse, other types of sex may enhance a female's pleasure.
Research consistently shows that most females need or prefer clitoral stimulation to have an orgasm. Prioritizing this form of stimulation, such as with oral sex or manual stimulation during intercourse, can make sex more pleasurable for some females, and this may increase their libido.
Low sexual desire is a complex issue. There are many possible causes — including hormonal shifts, relationship challenges, and issues with brain chemistry — and one person may experience a combination of these factors.
A person may benefit from discussing any sexual concerns with a knowledgeable and compassionate healthcare provider.
Low sexual desire is treatable, though medication cannot treat all causes. If taking medication does not increase libido, a person should explore other options and any underlying issues with a healthcare provider.