Does Female Viagra Exist? Expert Explains

Around 4 in 10 women are estimated to struggle with some kind of a problem related to their sexual health. Yet, while actual Viagra for men has been approved for the treatment of erectile dysfunction for almost 30 years, drugs targeted to manage the most common type of female sexual dysfunction — hypoactive sexual desire disorder (HSDD), or low libido — became available on the market only relatively recently.

Despite being very common, HSDD is highly underdiagnosed and undertreated. In this article, we review the treatment options for low sexual desire, as well as answer the question: is there a female counterpart to Viagra?

What is female Viagra?

There is no such thing as 'female Viagra,' nor is taking literal Viagra approved for the treatment of any type of female sexual dysfunction. If you hear someone talking about female Viagra, there’s a great chance they might be talking about medications designed to treat hypoactive sexual desire disorder.

Hypoactive sexual desire disorder

HSDD is a condition characterized by significantly lowered interest in sexual activity, reduced erotic thoughts, and other associated symptoms that are experienced for a prolonged time and cause significant distress. The prevalence of HSDD in North American women is estimated to range from 9–26%.

Viagra vs. treatment for HSDD

Viagra, as we know, is a medication used to treat erectile dysfunction in people with penises. It contains sildenafil, which temporarily increases blood flow to the penis, leading to a firmer or longer-lasting erection when sexually excited.

Female Viagra, on the other hand, is nothing like that. The FDA has approved two medications for the treatment of low sexual desire in women of reproductive age: Addyi and Vyleesi.

Types of female Viagra

Managing HSDD in people assigned as female at birth (AFAB) is not as easy as treating erectile dysfunction. While counseling is typically needed, healthcare providers who help women manage HSDD may prescribe medications.

Prescription medications

As mentioned briefly above, the FDA has approved two drugs for the treatment of HSDD in women before menopause. Both aim to boost the activity of chemical messengers in the brain involved in the mechanism of sexual arousal. They won’t make sex feel more enjoyable or pleasant, but they may boost libido.

Addyi are pills taken by mouth daily, whether the user intends to have sex that day or not. These pills contain flibanserin. Improvement in sexual desire is expected in 4 to 8 weeks of use.

Vyleesi, on the other hand, is an on-demand injectable. It’s injected under the skin of the belly or thigh 45 minutes before intercourse. It contains bremelanotide. However, it cannot be used more than eight times per month or more than once a day.

Some healthcare providers may also prescribe an antidepressant, Wellbutrin (bupropion), and testosterone, for the treatment of low libido, however, these medications are used off-label, which means they have been originally intended for other purposes.

Over-the-counter options

Non-prescription alternatives to these drugs are available, however, they are supplements, which means that they haven’t been evaluated by the FDA for their efficacy and safety. This means we can only rely on scientific research on supplement formulations or individual ingredients.

ArginMax and Zestra are two non-prescription options commonly used by women for sexual enhancement.

ArginMax is a supplement that contains l-arginine, ginkgo, ginseng, damiana, and a combination of vitamins and minerals, and a small study conducted in the past has suggested it may increase sexual desire in women.

Zestra, on the other hand, is a topical product applied to the vulva before sex. A few small trials have demonstrated its positive effects on sexual desire in women, however, some experienced burning after application, which might be a huge turn-off by itself.

Other over-the-counter options include 'arousal pills' that contain herbs like maca root and ashwagandha. However, the evidence of their effectiveness is inconclusive. It’s important to consult your healthcare professional before starting any supplement, especially if you have any chronic disease and are using medications on a daily basis.

Herbs that go into over-the-counter sexual enhancement pills may interact with the drugs you’re taking, which can put you at a higher risk of side effects or alter the effectiveness of medications you’re taking.

The Golden Pill

If you’ve ever typed 'self-treatment options for low libido' to Google, you probably have stumbled upon a few scandalous-sounding articles about something called 'The Golden Pill' being the female Viagra.

Let’s clear the air here: as already mentioned, there’s no such thing as female Viagra. However, FDA-approved treatment options for hypoactive sexual desire disorder in women of reproductive age — Addyi and Vyleesi — are often called the female Viagra, though they have little to do with actual Viagra administered to people with penises.

The Golden Pill, on the other hand, is a herbal supplement made by Elle Sera. It claims to balance hormones and includes five herbs intended to act as libido enhancers. A one-time 90-day supply costs around a whopping $230.

The botanicals combined in the supplement are suggested to be potentially beneficial in managing low libido in women. However, as it’s a dietary supplement, the effectiveness and safety of The Golden Pill have not been evaluated by the FDA.

Female Viagra benefits

Both of the FDA-approved medications for HSDD, Addyi and Vyleesi, are meant to be used when low sexual desire continues, no matter the type of sexual activity, partner, or situation, and when low desire hasn’t been a problem in the past.

This means they are not equal to the original Viagra taken by people with penises, as Viagra only solves the 'mechanical' issue. As HSDD is much more complex, it only works in certain cases: it won’t spark the desire in women whose low libido is a consequence of relationship problems or other medical conditions, so these issues must be addressed separately.

Addyi

Addyi is a daily pill taken at bedtime. Each tablet contains 100 mg of flibanserin. It enhances sexual desire by targeting certain neurotransmitters that act as messengers in the nervous system.

Limited evidence shows it may also positively affect women's sexual health by boosting satisfaction with sex as well as reducing distress related to low libido.

Vyleesi

Each self-injectable pen of Vyleesi contains 1.75 mg of bremelanotide, which is intended to be used 45 minutes prior to sex. Self-injection should be done in the belly or thigh area.

It works by helping modulate the brain pathways involved in sexual response. Studies show that bremelanotide may aid in female sexual wellness by improving desire, arousal, and orgasms, as well as lowering intimacy-related distress in women before menopause.

Potential side effects

As with any medications, Addyi and Vyleesi can cause side effects ranging from mild and temporary to serious and life-threatening. Using them as instructed by your doctor and reading the label carefully before using the medication may help you lower your risk of adverse effects.

Addyi, or flibanserin, may cause lightheadedness, sleepiness, nausea, increased fatigue, inability to fall asleep, and mouth dryness. Less frequent side effects include anxiety, belly pain, and constipation, among others.

Using Addyi with certain medications poses a risk of fainting and low blood pressure, so it’s important to let your provider know all the medications you’re using.

Common side effects of Vyleesi include:

• Nausea
• Flushing
• Skin reactions in the injection site
• Headache

Rarely, using Vyleesi may increase blood pressure, cause vomiting, hyperpigmentation (skin darkening) in the injection site, and restless leg syndrome.

If you suspect that you might be experiencing a side effect from these medications, consult your healthcare provider. Perhaps it’s not the right fit for you. In case of extreme dizziness, dangerously low blood pressure, allergy, or any other concern that seems worrying, see a doctor immediately.

Precautions and considerations

These medications are not suitable for women after menopause, people with penises, and children. They shouldn’t be used by pregnant and breastfeeding people as well. When consulting a healthcare provider for the treatment of HSDD, let them know if you’re planning to try for a baby soon.

Make sure to give your doctor your medical history in detail, as Addyi might not be suitable if you have liver problems, and Vyleesi shouldn’t be prescribed to people with heart problems or badly controlled high blood pressure, among other contraindications. Be honest so your healthcare provider can tell you whether it’s safe for you to use these medications.

Mention if you’re using any drugs or supplements, as they might interact with the drugs prescribed for HSDD. Even using birth control pills or drinking alcohol or grapefruit juice may put you at a higher risk of side effects.

Herbal supplements vs. female Viagra

The main difference between herbal supplements and female libido medications is that supplements may be used without a prescription, and drugs often referred to as female Viagra are prescribed to women with a diagnosed hypoactive sexual desire disorder. It’s a clinical diagnosis that requires women with vaginas to fit certain criteria.

Another crucial difference is that Addyi and Vyleesi are both FDA-approved medications, which means they are proven to be effective and safe when used as indicated. Supplements, on the other hand, may not deliver any noticeable results. Of course, drugs are not guaranteed to have a feasible effect on each and every person as well, however, they have been tested more thoroughly.

If you choose to try a supplement for managing low sexual desire, make sure to do your research beforehand and consult your healthcare provider. Even though most supplements contain natural herbs, it does not mean they cannot cause any harm, especially if you’re using medications on a daily basis.

Why is calling Addyi and Vyleesi female Viagra wrong?

One thing we’ve learned today is that female Viagra doesn’t exist. Actual Viagra is meant to solve a 'mechanical' problem in people with penises by helping them to get and maintain an erection. Though people with vulvas also experience erections when blood flows in their clitoris and enlarges it during sexual arousal, neither Vyleesi nor Addyi targets this mechanism.

Instead, these medications aim to increase libido, or sex drive, which is an extremely delicate matter. It cannot be fixed with a snap of fingers, and it can't be equated to erectile dysfunction, and its treatment as addressing women’s libido is way more complex.

If you’re struggling with low libido and start noticing it’s causing you distress, see your healthcare provider. They’ll help you find out the reason behind this issue and decide what treatment options suit you the best.