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.
Flibanserin is a prescription drug used to improve libido in women. It’s approved by the Food and Drug Administration (FDA) in the U.S. to treat Hypoactive Sexual Desire Disorder (HSDD) in women, which is sometimes caused by hormonal changes during menopause.
The branded version of the drug is called Addyi. We’ll use these two terms interchangeably throughout this article because they refer to the same active pharmaceutical ingredient.
In this article we’ll review medical studies on flibanserin to determine if the medication is safe and effective for increasing sex drive in women. We’ll review side effects of the drug, compare the generic and branded versions, and share some natural compounds which may improve sex drive in women without needing a prescription.
Does Flibanserin Work?
Flibanserin has been studied extensively for its libido-enhancing effects, which one would expect given that it’s approved by the FDA (a process which requires significant research backing).
A medical study published in 2019 examined the data from three individual clincal trials on flibanserin for pre-menopausal women with low sexual desire.
All three clinical trials documented enhanced sex drive for those taking flibanserin. The average sexual desire score increased the number of “satisfying sexual events” from 1.2 to 2.1 over the 28 day trial period. The study authors noted that the results were consistent across demographics like race and ethnicity, and that flibanserin not only improved sexual desire but also reduced sexual distress.
The medication has also been studied in post-menopausal women. A medical trial published in The Journal of Sexual Medicine analyzed its efficacy for enhancing sexual desire in women past menopause. The average age of the trial participants was around 56 years old.
The data from this trial was less favorable than from the study on pre-menopausal women. Sexual function was slightly improved, as measured by a clinical metric called the Female Sexual Function Index desire domain (FSFI-d) score, but there was no difference in the number or frequency of satisfying sexual events.
The most thorough medical review we could find on flibanserin included data from women across different hormonal and age demographics. The study authors pulled data from 8 individual medical trials and 5,914 total patients to determine how effective flibanserin was on average for improving sexual desire.
The medication was found in this review to be effective, but not to an impressive degree in our opinion. Flibanserin increased the average number of satisfying sexual events by 0.5 per month.
Flibanserin is effective at improving female libido to a statistically significant degree based on medical research. That said, the clinical results aren’t that impressive in our opinion. The drug appears to be somewhat more effective in pre-menopausal women than in post-menopausal women based on the studies we reviewed.
How Does Flibanserin Work?
Libido is a complex and multifactorial aspect of human biology. It’s affected by both mental and physical factors, and the mechanism of action of flibanserin appears to be mostly mental. The drug increases levels of dopamine and reduces levels of serotonin in the brain, according to one of the medical reviews linked in the previous section.
These two neurotransmitters affect both mood and hormonal signaling. Medical studies have proven that increased levels of serotonin can reduce sexual desire in women, so decreasing its level is likely what makes flibanserin effective. Serotonin can reduce sexual desire and arousal.
Flibanserin also acts as an agonist to dopamine receptors, which means that it attaches to the receptors and enhances cellular signaling. High levels of circulating dopamine are associated with increased sexual desire and increased reward-seeking behavior.
Flibanserin Side Effects
Flibanserin does cause side effects in some patients, which should be expected given that it modulates levels of neurotransmitters.
The large medical review involving 5,000 flibanserin patients that we referenced previously also documented side effects of the drug. Those using flibanserin were four times more likely than those taking a placebo pill to experience dizziness. Users of the medication were also four times more likely to experience drowsiness, and 2.35 times more likely to suffer from nausea. The risk of fatigue also increased by 64% in the flibanserin group.
One of the biggest risk vectors of flibanserin involves the drug’s unfavorable interactions with alcohol. When flibanserin and alcohol are used concurrently, patients can experience severely low blood pressure and fainting. The FDA initially required a black box warning on the drug’s label due to the alcohol interaction risk, but recently revised that requirement because user data suggested that small amounts of alcohol could be tolerated while taking the drug.
The side effect profile of flibanserin is relatively mild compared to other prescription medications, but we would recommend that patients who consume moderate or high amounts of alcohol speak with their doctor about this potential interaction.
If the patient doesn’t believe they’ll be able to significantly reduce their alcohol intake, their doctor may suggest a libido-enhancing medication that doesn’t have negative interactions with alcohol.
Flibanserin Vs. Addyi
As we referenced earlier in the article, flibanserin is the generic form of the drug and Addyi is the branded form. Both of these medications contain the same active ingredient, and patients are often curious about which one to take.
Medical studies have conclusively proven that generic medications are just as effective as branded medications. This makes sense logically, given that they contain the same active ingredient.
We would recommend that patients interested in this drug speak with their doctor about flibanserin rather than Addyi, because generic drugs are often cheaper. This is an even more important consideration for patients without health insurance, who may be paying more on average per drug refill.
Flibanserin User Reviews
Flibanserin has been reviewed over 50 times on Drugs.com, which is a website that allows patients to write personal reviews of their experience with prescription medications.
We cannot verify the accuracy or authenticity of any of these reviews, but we find this site to be a useful resource because it’s one of the few user-generated-content sites for prescription drugs.
Flibanserin has an average rating of 3.3/10 at the time of writing this article, which is the worst average rating of any drug we’ve reviewed on Illuminate Health to this point. A full 50% of users have rated the drug 1/10.
The top positive review comes from a user named “Lisa” who claims the drug successfully increased her sexual desire:
“My sweet husband has been so patient with me for years now - I dreaded his advances- I can’t tell you how wonderful it is to want/desire intimacy again. It’s absolutely the best thing ever!”
The top negative review is written by a user named “Ellie” who claims the drug caused them to experience uncomfortable side effects:
“From day one I felt different. I was drowsy all day for the two months I was on it. On top of that, the dizziness and headaches were nearly unbearable. Driving was terrifying because half the time I couldn’t see very well. But of course I would do anything for my husband. Finally I visited my doctor and explained it to her. My RESTING heart rate was at 140 bpm.”
Natural Libido Enhancers
There exist some natural compounds which may be able to enhance female libido based on medical research. These compounds are available over-the-counter (OTC) which means they don't require a prescription and can be purchased online.
A dietary supplement containing the amino acid l-arginine was found in a medical review to enhance female sexual function. Women taking the supplement reported a frequency of intercourse nearly 3x higher than those taking placebo pills. Sexual satisfaction scores averaged around 70% for the l-arginine group, and only averaged 37% for the placebo group.
L-arginine is a nitric oxide precursor, and nitric oxide increases arterial blood flow to the genitals. This is why this amino acid may increase sexual desire.
An herbal compound called maca was found in a clinical trial published in 2008 to resolve sexual dysfunction caused by Selective Serotonin Reuptake Inhibitor (SSRI) medications. 17 of the 20 trial participants were women. SSRI drugs often cause sexual side effects in both sexes.
The study authors documented that 3 grams (g) of maca daily improved sexual desire and sexual function. More clinical research is needed to validate this effect, but maca has been used to enhance sexual function for hundreds of years by traditional cultures. It’s native to the Andes mountains in South America.
We would recommend 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). Many supplements use raw maca because it’s cheaper, but gelatinized maca is available for purchase as a food product in many health food stores. One brand we’ve noted selling organic gelatinized maca is Navitas Naturals.