Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and published for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to prescription medication.
Addyi is a prescription medication for women with low sexual drive. It’s approved by the Food and Drug Administration (FDA) in the U.S. to treat Hypoactive Sexual Desire Disorder (HSDD). The generic version of this medication is called flibanserin and we’ll use these two terms interchangeably throughout this article because they refer to the same drug.
In this article we’ll review the medical research on Addyi to determine if it’s likely to be safe and effective. We’ll also review the side effects and highlight some natural alternatives.
Does Addyi Work?
Addyi has been studied in many medical trials which examined its effects on female libido. One recent medical review published in the Journal of Women’s Health analyzed the results of three individual medical trials on Addyi for premenopausal women with low sexual desire.
All three trials showed a positive effect for the Addyi group, with an average sexual desire score nearly doubling (from 1.2 to 2.1 “satisfying sexual events” over the 28 day trial period). The researchers noted that the results were consistent across demographics like race, and that the medication not only improved sexual desire but also reduced sexual distress.
Addyi has also been studied in postmenopausal women. A 2017 medical trial examined its efficacy for improving sex drive in women who had experienced menopause. The average age of women enrolled in the trial was just over 56 years.
The results from this study were less favorable than the study on premenopausal women. Sexual function was noted to be improved in the group taking Addyi on a clinical rating scale called the Female Sexual Function Index desire domain (FSFI-d) score, but there was no difference in the number of satisfying sexual events.
The most thorough meta-study we could find on Addyi reviewed results from women across different hormonal and age demographics. The researchers analyzed data from 8 individual medical trials and 5,914 patients to determine how effective the drug was for improving sexual function.
Addyi was found in the review to be effective on average, but to a relatively low degree. Treatment with the drug resulted in 0.5 additional satisfying sexual events compared to baseline per month.
We can conclude from the available research that Addyi is effective for improving sexual desire in women, but not to a particularly impressive degree. It appears slightly more effective in premenopausal women than postmenopausal women based on the studies we reviewed.
How Does Addyi Work?
Sexual function and desire comes from both mental and physical stimuli, and Addyi functions on the mental level. According to the meta-study linked in the previous section, it increases circulating levels of dopamine and reduces levels of serotonin in the brain.
These two neurotransmitters are associated with a wide range of physical functions, moods and hormonal signaling. Medical research has proven that overactivity of serotonin can cause female sexual disorders, so decreasing levels of this chemical compound is likely what makes Addyi effective. Serotonin can inhibit sexual desire and arousal.
Addyi acts as an agonist on dopamine D4 receptors, which means it binds to the receptors and activates cellular signaling. This appears to be its main mechanism of action, along with its ability to be an agonist at several other receptor sites in the brain.
Addyi Side Effects
Any medication that functions by artificially modulating cellular signaling in the brain should be expected to have side effects.
According to the previously-linked meta-study analyzing data from over 5,000 patients, Addyi was 4x more likely than placebo to cause dizziness. It was also 4x more likely to cause sleepiness, and 2.35x more likely to cause nausea. Risk of fatigue as a side effect also increased by 64% on average.
One of the biggest risks of Addyi use is its interactions with alcohol. The two taken together can cause severely low blood pressure and passing out. The FDA requires a black box warning on Addyi’s label, which is the most severe type of warning, due to the alcohol interaction risk, but revised that requirement recently as postmarket data indicated that small amounts of alcohol could be tolerated while taking Addyi.
In our opinion the side effect profile of Addyi is relatively mild. It doesn’t confer the risk of severe events like internal bleeding or suicide like many prescription medications.
Should I Take Addyi Generic?
As referenced in the intro to this article, the generic form of Addyi is called flibanserin. These two drugs have the exact same active ingredient.
Medical research has conclusively proven that generic drugs are just as effective as brand-name drugs. If the generic version is cheaper, it makes logical sense to take it.
The difference in cost between generic and branded drugs is especially significant for patients with high-deductible insurance plans or those without health insurance, so we recommend patients in those groups especially to speak with their doctor about flibanserin if they were prescribed Addyi.
There are some natural compounds for enhancing female sex drive with promising research backing which may have a lower risk of side effects than Addyi.
A dietary supplement containing amino acid l-arginine called ArginMax was shown in a medical review to be promising for female sexual enhancement. Women taking the supplement reported a frequency of intercourse that was nearly 3x higher than a placebo group. Sexual satisfaction scores averaged nearly 70% for the ArginMax group, while averaging only 37% for the placebo group.
L-arginine is a nitric oxide precursor, and nitric oxide increases arterial blood flow to the genitals, as outlined in the review. This enhances sexual desire on average.
A botanical compound called maca root was found in a clinical trial published in the CNS Neuroscience & Therapeutics journal to resolve sexual dysfunction caused by SSRI medications. 17 of the 20 trial participants were women.
The study authors documented that 3 grams (g) of maca daily enhanced sexual function and libido. More research is needed to validate this effect, but maca has been used for sexual function for hundreds of years by traditional cultures.
We recommend using gelatinized maca rather than raw maca, because raw maca can cause digestive issues. It’s an indigestible plant starch, much like potato (which you wouldn’t consume raw).