Addyi (Flibanserin): How Well Does It Work?
SaveAddyi (flibanserin) is a daily bedtime pill for premenopausal women with distressing low desire. The benefit is modest, about one-half to one extra satisfying sexual event per month over placebo, with a large placebo response. Side effects include dizziness, sleepiness, and low blood pressure, especially with alcohol.
Last updated: July 2026
What is Addyi and how does it work?
Addyi, the brand name for flibanserin, is a medication that acts on brain chemistry rather than blood flow. The U.S. Food and Drug Administration approved it in 2015 for premenopausal women with acquired, generalized hypoactive sexual desire disorder — distressing low desire, present for at least 6 months, that was not always there and is not tied to a single situation 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. It nudges serotonin, dopamine, and norepinephrine signaling, and it is taken every day at bedtime rather than before sex. Unlike erectile-dysfunction drugs for men, it does not work on demand and can take up to 8 weeks to show any effect 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. According to ACOG, it is only appropriate before menopause 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions..
How well does Addyi actually work?
Addyi's effect is real but small, and honest numbers matter. Distressing low desire affects roughly 1 in 10 premenopausal women, so the potential audience is large even though the average benefit is small 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. In the approval trials, women taking flibanserin reported roughly one-half to one additional satisfying sexual event per month compared with placebo, along with modest gains in desire scores and reduced distress 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. Much of the improvement, though, also occurred in women taking placebo, which shrinks the true drug effect 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. According to the American College of Obstetricians and Gynecologists, the benefit is modest and should be weighed against daily dosing and side effects 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. For postmenopausal women, a global consensus points to testosterone as the better-studied option after menopause 2Ref 2Davis SR, et al. (International consensus, endorsed by The Endocrine Society and International Menopause Society) (2019).Global Consensus Position Statement on the Use of Testosterone Therapy for Women.Global consensus that after menopause testosterone is the better-studied option, since flibanserin trials enrolled only premenopausal women..
What are the side effects and the alcohol warning?
Addyi's most common side effects are dizziness, sleepiness, nausea, and fatigue, and it can lower blood pressure. Because of the risk of dangerously low blood pressure and fainting, it has long carried warnings about combining it with alcohol, according to ACOG 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. Taking it at bedtime is meant to reduce daytime drowsiness and the chance of fainting. Certain other medications that affect the same liver enzymes can raise flibanserin levels and the risk of these effects, so a full medication review is part of starting it 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. Women who drink regularly or take interacting drugs are often not good candidates.
Who is Addyi right for, and who should skip it?
Addyi fits a specific person: a premenopausal woman with generalized, acquired low desire that distresses her, who drinks little and is willing to take a daily pill. When low desire instead traces to a relationship issue, depression, a medication side effect, or vaginal dryness and pain, treating that cause usually helps more 3Ref 3The North American Menopause Society (Menopause Society) (2020).The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society.Genitourinary syndrome of menopause (vaginal dryness and pain with sex) as a common, treatable contributor to low desire that should be addressed on its own.. For desire linked to menopausal changes, hormone therapy itself offers only small benefits, so it is not a cure-all either 4Ref 4Nastri CO, Lara LA, Ferriani RA, et al. (2013).Hormone therapy for sexual function in perimenopausal and postmenopausal women.Systematic review showing hormone therapy yields only small benefits for sexual function, so it is not a cure-all for desire tied to menopause.. It was not studied in postmenopausal women, and it is not for women whose low desire has a clear situational trigger 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. Many women do better by first addressing stress and exhaustion behind low desire or reviewing whether low desire is worth a medical visit.
When low desire is worth a prescription conversation
Deciding whether Addyi fits is a conversation for a clinician who treats sexual health. According to ACOG, a good evaluation first rules out reversible causes — medications, mood, relationship strain, and physical pain — before reaching for any drug 1Ref 1American College of Obstetricians and Gynecologists (2019).Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213.ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.. A clinician can explain the modest expected benefit, the alcohol and drug interactions, and how long to try it before deciding it is not working. Bringing up desire can feel awkward, but talking with a clinician about sexual health is routine and confidential. Because sexual well-being is part of overall health, not a performance target 5Ref 5World Health Organization (2022).WHO guideline on self-care interventions for health and well-being, 2022 revision.Framing of sexual health as part of overall well-being and self-care rather than a performance target., the goal is what feels right to you. Gale can help you prepare for that conversation.
Common questions
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How would you explain this to someone you love?
Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.
When to pause and check with a clinician
- —Feeling faint, very dizzy, or lightheaded after a dose — especially if you have had alcohol — is a reason to seek clinician review right away.
- —Low desire accompanied by persistent sadness or loss of interest in everything is a reason to seek clinician review; if thoughts of self-harm arise, call or text 988.
- —No benefit after about eight weeks of daily use is a reason to revisit the plan with your clinician rather than continue indefinitely.
- —Starting a new medication that interacts with flibanserin is a reason to check with your prescriber before combining them.
This article is general health education, not medical advice or a prescription. Whether Addyi is appropriate is a decision to make with a gynecologist or primary care clinician who can review your history and medications.
References
- 1.American College of Obstetricians and Gynecologists (2019). Female Sexual Dysfunction: ACOG Practice Bulletin, Number 213. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000003324 ✓ACOG Practice Bulletin describing flibanserin (Addyi): FDA approval in 2015 for acquired, generalized HSDD in premenopausal women; a modest effect of roughly one-half to one additional satisfying sexual event per month over placebo with a large placebo response; the requirement of distress for at least 6 months; prevalence of about 1 in 10 women; side effects and the alcohol and drug-interaction cautions.
- 2.Davis SR, et al. (International consensus, endorsed by The Endocrine Society and International Menopause Society) (2019). Global Consensus Position Statement on the Use of Testosterone Therapy for Women. Journal of Clinical Endocrinology & Metabolism. doi:10.1210/jc.2019-01603 ✓Global consensus that after menopause testosterone is the better-studied option, since flibanserin trials enrolled only premenopausal women.
- 3.The North American Menopause Society (Menopause Society) (2020). The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause. doi:10.1097/GME.0000000000001609 ✓Genitourinary syndrome of menopause (vaginal dryness and pain with sex) as a common, treatable contributor to low desire that should be addressed on its own.
- 4.Nastri CO, Lara LA, Ferriani RA, et al. (2013). Hormone therapy for sexual function in perimenopausal and postmenopausal women. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD009672.pub2 ✓Systematic review showing hormone therapy yields only small benefits for sexual function, so it is not a cure-all for desire tied to menopause.
- 5.World Health Organization (2022). WHO guideline on self-care interventions for health and well-being, 2022 revision. World Health Organization (WHO). link ✓Framing of sexual health as part of overall well-being and self-care rather than a performance target.
5 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy