How Addyi Works in the Female Brain

The chief complaint among women is not lack of arousal, but lost desire, according to Dr.

• Pink pills are sometimes used to address sexual dysfunction in women.
• They are marketed as natural or holistic remedies, depending on ingredients.
• Medical approval varies; some are unregulated, over-the-counter supplements.
• Users should check for FDA approval or medical supervision before use.

Irwin Goldstein, an influential sexual health researcher and paid proponent of both Viagra and Addyi, who also appears in the film.

• Pink pills are part of a broader trend towards female-centered wellness.
• They can potentially enhance intimacy, confidence, and overall satisfaction.
• Unregulated products pose risks of contamination or inappropriate ingredients.
• Always verify product credentials and manufacturer reputation before purchase.

“Most people don’t walk in saying, ‘I don’t swell sufficiently,’” he told me.

Critics say that the way it has been defined in the psychological literature—as a lack of sexual fantasies and spontaneous interest in sex—doesn’t reflect how most women experience their sexuality. Judging women by this male-centric standard, said Brotto, risks pathologizing huge swaths of women who fall within a normal range of sexuality, selling them a drug, and calling it feminism.

• The pink pill aims to boost women's libido and sexual satisfaction.
• It often contains ingredients like aphrodisiacs or hormonal components.
• Some pink pills are marketed as supplements; others are pharmaceutical drugs.
• Effectiveness varies; consult a healthcare provider before use.

By forcing Addyi into a Viagra-shaped box, both the FDA and the drug’s makers have only increased confusion over the role of desire and arousal in female sexuality.

Addyi’s website spotlights women who don’t feel physical desire and whose bodies don’t respond during sex—in other words, women with arousal problems, which Addyi doesn’t address.

Warnings & Precautions

Just as Prozac promises to lift that gray cloud and give you back the pleasure you once took in life, Addyi promises to give you back your appetite for sex. “Desire starts in the brain,” the drug’s website reads. The problem is the media’s insistence on comparing Addyi to another, more well-known pastel-colored pill. “It’s known as Viagra for women,” a newscaster’s voice announces, barely a minute into The Pink Pill: Sex, Drugs & Who Has Control, a documentary that premiered at DOC NYC earlier this month and charts Addyi’s fraught, tortuous journey to FDA approval. Now, women have the pink pill, Addyi, the first FDA-approved treatment for low female sexual desire.

Less common

As the film shows, the legacy of Viagra has plagued Addyi from the start. Although Addyi doesn’t work on the genitals, it was reviewed by the FDA’s reproductive and urological drugs division, which also approved Viagra. The FDA required Addyi to show in clinical trials that it increased the number of “satisfying sexual events” a woman had per month, mirroring the requirement that Viagra boost a man’s number of “successful sexual events.” (Successful, in this case, meant that penis was rigid enough to penetrate vagina.) But what made a sexual event satisfying for a woman—she had an orgasm? She ate a cookie afterward?—was never fully defined. “That was asinine,” said Dr. Sprout’s previous marketing campaign, “Even the Score,” argued that there were 26 drugs for male sexual dysfunction, but none for women, ignoring the fact that Addyi tackles a very different problem than Viagra.

Perhaps the one thing Viagra and Addyi have in common is that both reify unrealistic, normative standards for what sexual behavior should look like. Viagra gave us the narrative that male sexuality is mechanical, a simple on-off switch—that what matters for men is not their desire, but their erections.

Why did it take so long to earn FDA approval for Addyi in the first place?

But nothing proved as obvious or easy to measure. Part of the problem was, the split between arousal and desire isn’t quite as neatly defined as the cake analogy would suggest. Arousal is usually thought of as what’s happening in your body in the moment, explains Lori A. Brotto, a psychologist at the University of British Columbia and expert in female sexual problems. But researchers still disagree on how to measure it, and whether it can also include “feelings of mental excitement,” leaving “little agreement about the most intrinsic features of this construct,” three psychologists wrote in 2013. Meanwhile, the way people talk about Addyi narrows the conversation around female sexual problems, says Brotto.

• Some pink pills combine herbal extracts like ginseng or maca for effects.
• They are popular in wellness circles for enhancing intimacy and confidence.
• Research on pink pills' long-term safety is limited; caution is advised.
• Available through online stores, pharmacies, or clinics in some regions.

If drugs like Addyi are the only tools doctors have to offer, she worries, they’ll reach for them before determining what other factors might be leading to a patient's lack of lust. “If all you have is a hammer, right?” she said.

Boxed Warnings with Addyi

But for women, they’re all in your head. If you had a problem with your sex life in the 1950s, you were likely one of two things: impotent or frigid. Both sounded more like a character flaw than a medical diagnosis. (“Frigidity” goes back to Freud, who first invented the “vaginal orgasm” and then deemed anyone who didn’t achieve it “frigid.”) But you could say the playing field was even. Both male and female sexual problems were “all in your head”—that is, under the purview of psychology.

Missed Dose

The two branched off in 1992, when the National Institutes of Health replaced the wince-worthy “impotence” with the more respectable “erectile dysfunction,” defined as an inability or difficulty maintaining an erection over a period of six months or more. Suddenly, a hard penis was lovegra woman the proxy for healthy male sexuality. While “frigidity” eventually fell out of favor, there was no equivalent effort to replace it. So in 1998, when Viagra’s blockbuster success set off a gold rush for a similar drug for women, researchers ran into a problem: they had no female version of erectile dysfunction to target. They tried valiantly to isolate one, using electrodes and infrared cameras to measure arousal factors like vaginal engorgement, blood flow, lubrication, and clitoral erection. The gendered narratives behind these pills obscure the fact that desire and arousal, mind and body, are involved in every sexual experience.

What does finally receiving FDA approval for Addyi in post-menopausal women mean for women’s health?

(Clayton, who appears in the film, has consulted for numerous pharmaceutical companies. I was also listed as a consultant on the film, as was my book Vagina Obscura, but I had no part in the narrative.) In biological terms, Viagra is an arousal drug; Addyi is a desire drug. Desire is the match; arousal is the flame. Think of it like this: When you crave a birthday cake—imagining the funfetti frosting melting on your tongue—that’s desire. When your mouth waters and your stomach gurgles in response, that’s arousal.

How should I store Addyi?

Aisling Chin-Yee, the Canadian filmmaker behind the documentary, is aware of the distinction. “It is super cringey to call it the female Viagra for so many reasons,” she told me. (More reasons: Addyi has to be taken every night, not just when one might want to get busy, can’t be combined with alcohol, and might make you faint.) Starting the film with the comparison, she says, gives viewers a launching-off point to consider the double standards at play in the fight to get Addyi into doctors’ offices and women’s medicine cabinets. But while the film does explain Addyi’s mechanism of action, framing a female desire drug as the equivalent of a male arousal drug echoes ancient assumptions about the nature of male and female sexuality. The implication is that for men, sexual problems are all in your penis. They also obscure the fact that the real female Viagra is, well, Viagra.

The research behind the “pink pill”

If you have problems with Vaginal improvement, vaginal healing remodeling, improving collagen and function can be done with FDA cleared treatments, including CO2 treatments, such as The MonaLisa Touch therapy, Erbium treatments, and RF treatments such as ThermiVa. Thes treatments can treat sexual pain, increase vaginal tightness, help treat rectoceles and cystoceles, and vulvovaginal disorders such as atrophy. MonaLisa Touch can treat sexual dysfunction it can be used as an isolated therapy or in conjunction with current management strategies for these conditions. Emsella Pelvic Floor strengthening treatment has beneficial effects on urogynecologic symptoms as well, including incontinence, overactive bladder, pelvic floor laxity, and burning. These therapies are a well tolerated, almost painless, procedure with few side effects.

Keys to patient success

Indications are also for patients with the urogenital syndrome of menopause or from anti-estrogen therapies. There are also many uses for autologous platelet rich plasma on sexual function, including peri and intraclitoral and g-spot injection treatments which have been shown to enhance sexual function. And now using PGDF for these injections is additionally helpful. Come in to Women’s Health Practice for a consultation. Addyi, otherwise known as the pink pill, might boost your tanked libido, provided it isn’t caused by a medical condition or a less-than-stellar partner. In people with vulvas, Viagra works in exactly the same way, pumping blood to the genitals and leading to clitoral and labial swelling.

Why the FDA rejected Addyi twice

Anita Clayton, a psychiatrist and expert in female sexual problems at the University of Virginia, who worked as a paid consultant for Addyi. “Women will not know what you're talking about. They will not be able to rate this.” While Addyi failed its first two FDA trials, the third showed a modest increase of about one “event” per month, which was deemed significant enough to lead to its approval in 2015. This, for some, was gender parity: “I took on libido booster for woman the government for women’s sexual pleasure,” Cindy Eckert, the founder of Sprout Pharmaceuticals, which developed Addyi, says in the film. The answer says a lot about how medicine has struggled to imagine male and female sexuality—and how gendered assumptions continue to shape the medical interventions we have today.

Other Medical Problems

Viagra solves a plumbing problem, pumping blood to the penis until it swells, like blowing up a balloon. Addyi, by contrast, works on the brain, adjusting levels of neurotransmitters, like dopamine and serotonin. While the drug was initially explored as an alternative antidepressant, it instead showed a promising secondary effect in women: it seemed to boost low desire, defined as a troubling lack of spontaneous thoughts and fantasies about sex. In other words, Viagra gets the juices flowing; Addyi, ostensibly, generates the fantasies. “In no way is there really a similarity, except that they both treat a type of sexual dysfunction,” said Clayton. Researchers are currently investigating the use of topical sildenafil (the generic form of Viagra) gel to increase sensation, arousal, and orgasm in women.

And while Addyi has mainly been tested in heterosexual, pre-menopausal, partnered women, there is no reason it can’t be used in queer women, post-menopausal women, gender-diverse folks, and yes, men (who, it turns out, also have brains).