What Addyi probably won’t do is make you spontaneously crave sex. “It might be that if right now, eight out of 10 times, you decline your partner when they ask you to have sex, with Addyi, perhaps you’re declining them only three out of 10 times,” Dr. Rahman explains. And where Viagra can have an immediate effect, it takes time for Addyi to reach its maximum benefit, Christie Cobb, MD, a board-certified ob-gyn in Little Rock, Arkansas, tells SELF. With continued use, it can essentially make it easier for you to get aroused.
But of course, brain chemistry isn’t the only contributor to sexual desire, Dr. Rahman notes. Other biology can also play a role; for example, if you have a health issue that hinders circulation or causes pain, you may be uninterested in sex, and medications like antidepressants can also dial down libido. And then there are all the psychological and social components—for instance, being depressed or anxious, having a poor relationship with your partner, or even taking on the bulk of the household labor could slash your libido. So Addyi may be more effective for HSDD in some women versus others, depending on the factors that are feeding into low desire in the first place.
Like any medication that acts on the brain, Addyi also has some side effects. It can make you sleepy (which is why it’s recommended to take it at night) and may also lead to dizziness, nausea, and headaches. (For context, these are comparable side effects to many antidepressants.) You’re also at greater risk of low blood pressure and fainting if you mix Addyi and alcohol—but it’s worth noting, the original boxed warning, which called for total abstinence, was changed in 2019 to suggest simply waiting two hours after having one or two drinks to take your daily dose, or skipping it if you’ve had three or more. Addyi can also interact with a variety of other medications, Dr. Cobb points out, so it’s important to tell your doctor all the drugs you’re currently taking if you’re considering it.
Why is the approval of Addyi for women past menopause especially important?
Libido can “fall off a cliff” at menopause, even in perimenopause (the lead-up to menopause), because of a variety of factors, Dr. Rahman says. On the one hand, the above elements that influence libido often take a turn for the worse with age—you’re all the more likely to be on medications or dealing with health issues post-menopause. On the other hand, the menopause transition itself can cause libido to plummet due to both the shift in hormones, particularly the drop in testosterone, and the symptoms this change can spark.
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