Northwest Institute for Healthy Sexuality
Flibanserin (Addyi) Position Statement

The FDA made a landmark decision on August 18, 2015 when it approved flibanserin (Addyi), the first medication in history to treat hypoactive sexual desire disorder in reproductive aged women.

What is Flibanserin

  • Flibanserin is a non-hormonal drug taken daily for the treatment of hypoactive sexual desire disorder (HSDD) in women. It has been studied in pre and post-menopausal women, but currently has approval for pre-menopausal women (women who have not yet gone through menopause).
  • Flibanserin is believed to work on key neurotransmitters, or chemicals, in the brain that affect sexual desire.
  • Flibanserin has been evaluated for its ability to increase the frequency of satisfying sexual events, increase the intensity of sexual desire and decrease the associated distress women feel from its loss.
  • Flibanserin does not cause hypersexuality or excessive sexual behaviors. In clinical trials, flibanserin has outperformed placebo with statistical significance in improving sexual experiences, and women treated with flibanserin perceived their improvement to be clinically meaningful.
  • The most common side effects include sleepiness, dizziness and nausea.

About Hypoactive Sexual Desire Disorder (HSDD)

  • HSDD is the medical term for decreased interest in sex, or low libido. HSDD is the most commonly reported form of female sexual dysfunction. HSDD is defined as a persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty, and which is not better accounted for by a medical, substance-related, psychiatric (e.g., depression) or other sexual condition.
  • The cause of HSDD is believed to involve a multitude of social, psychological and biological factors and may be attributed to a complex interplay of these factors including relationship problems, medication side effects, hormone disorders, and mood issues.

What is the Controversy about Flibanserin?

  •  There are organizations that both promote as well as discourage the use of flibanserin. Some argue the concept that a single pill can restore female libido oversimplifies the problem of female sexual dysfunction.
  • Another key issue of concern is that women taking flibanserin in clinical studies reported only 1.7 more satisfying sexual experiences per month than women taking placebo. Proponents argue that even though this is a modest response, it is statistically significant, and considering that there are no other medications FDA approved for low desire in women it is a legitimate option for women to consider.
  • Many advocate that HSDD is not a disease, and labeling it with a medical diagnosis does a disservice to women who in fact need to be educated that variation in sexual interest can be normal.
  • There is strong research consensus that psycho-social and interpersonal factors are the large contributions to having reduced sexual desire, including anxiety about sexual attractiveness, body image, and aging; confusion or shame about sexual orientation or fantasies; fatigue, stress, depression; experiences of sexual trauma and violence; relationship problems and length of relationship. There is concern that the medicalization of sexuality can be misleading.

What does the Northwest Institute for Healthy Sexuality Promote?

  • The Institute is devoted to empowering healthy women’s sexuality, and is committed to embracing all legitimate developments in the multi-disciplinary field of female sexual function.
  • As such, we advocate a collaborative approach for assessment, diagnosis and treatment of women who are suffering from sexual health problems. We validate the devastation to physical and psychological health and quality of life that sexual dysfunction can cause, we state, unequivocally, that female sexual disorders are real conditions and not a fabrication, nor a result, of disease mongering.
  • Female sexual disorders are valid conditions that warrant assessment, diagnosis and appropriate therapeutic interventions. The etiology of female sexual problems is often complex. It may include sexual medicine issues related to biologic etiologies including neurologic, hormonal, vascular and anatomic components as well as psychological issues relating to socio-cultural, emotional, cognitive and relationship concerns.
  • We recognize the cause of female sexual dysfunction to be multi-factorial. Therefore we also believe treatment for sexual concerns often requires a multitude of therapeutic options to achieve optimal sexual functioning. We believe flibanserin is one of many different treatment options that should be considered on an individual basis.
  • We believe a thorough medical and psychosocial evaluation is the only appropriate means to evaluate sexual dysfunction complaints in women, and flibanserin may or may not be an appropriate treatment depending on the individual presentation.
  • Flibanserin will always be prescribed in conjunction with other non-drug techniques at the Institute to improve sex education, relationship quality, address any other medical contributions to sexual complaints, and explore the other, often-complicated contributions that exist when decreased libido presents in a woman.
  • The Institute believes women should be thoroughly informed on the benefits, side effects, and consequences of taking flibanserin, compared and contrasted to other treatment options available for their sexual symptoms, and deserve to make an informed choice as to whether this medication is appropriate for them if they meet medical criteria for its use.
  • Although not all treatments will work equally for everyone, we believe women deserve to have a variety of safe and effective treatment options from all disciplines that offer expertise in sexuality including the psychological as well as medical.

When Will Flibanserin be Available?

  • Flibanserin was approved on August 18, 2015 by the FDA. It is expected to be commercially available by October 17, 2015.