Meet the Addyi Pill—a.k.a. Pink Viagra: Why the FDA’s New 2025 Approval Is a ‘Historic First’ for Women Over 50
Not just 'female Viagra'—see how the Addyi pill rebalances the brain to bring back the spark
Viagra, the little blue pill, has been a household name for more than a generation. And now women’s sexual health is finally entering the long-overdue conversation. The FDA recently approved the use of a prescription libido drug called Addyi for post-menopausal women experiencing low sex drive. Here, everything you need to know about the prescription Addyi pill, already being dubbed “female Viagra.”
What is the Addyi pill, and who is it for?
Addyi (pronounced add-E) is the brand name of the prescription drug flibanserin. It’s being called a historic first in women’s health. But it was a long road to this moment. The drug formulation was originally being tested as an antidepressant when scientists discovered its libido benefits.
Addyi was first approved by the FDA in 2015 to treat hypoactive sexual desire disorder (HSDD), or low sex drive, in pre-menopausal women. And just this month, the FDA expanded that approval to include post-menopausal women under age 65. Alyssa Dweck, MS MD, Chief Medical Officer of Bonafide Health, says, “By definition, HSDD suggests a persistent lack of sexual desire that causes distress and is not due to other identifiable causes” such as a chronic health condition, medication use or relationship turbulence.
Woman's World Answers
Why menopausal women may benefit most from Addyi
This is big news for midlife women, since low libido is a common side effect of menopause. In fact, 50 percent of women in the US struggle with some type of sexual dysfunction in their lifetime, according to the National Institutes of Health.
Even more than that, “For many women, their libido is tied to their identity, mental health and relationship wellbeing,” says Uma Darji, MD, who practices family medicine. “Menopause brings real biological changes that include shifts in hormones, sleep disruption, mood changes and stress. Acknowledging that this is a legitimate medical concern that is worthy of research and treatment is long overdue.”
How the Addyi pill works and how it differs from Viagra
Addyi doesn’t work like traditional Viagra, which is only taken when needed in anticipation of sex. It’s a once-daily pill, taken at bedtime. (Timing is important, since drowsiness is a side effect.) And yes, it is a little pink pill, earning it the nickname “pink Viagra.”
Unlike Viagra, Addyi works on the brain chemistry related to libido and desire. It helps to increase dopamine and norepinephrine (part of our reward and alert systems), while decreasing serotonin (a known arousal inhibitor). And while Addyi works on the brain, it is not a hormonal medication the way that many menopause drugs are. This is not hormone replacement therapy (HRT).
What can the Addyi pill do?
Research shows an increase in satisfying sexual events and small but significant improvements in desire within four to eight weeks of starting treatment.
“Over the years I have had a few occasions to prescribe Addyi and did see some response,” says Janette Gray, MD, internal medicine physician and author of The Truth about Sex Hormones. “It does take a month or two to kick in. I believe it is always good to have various treatment options and to continue to broaden the study of women’s sexual health.”
Dr. Darji adds, “Although I have yet to prescribe this medication, I have heard through others in passing that it is a challenge for some women to take it daily, but they have noted some improvement in libido.”
Women’s early reviews of the Addyi pill
What are women saying about it online? One 43-year-old user, posting on Reddit, shared, “I’ve been on Addyi for several months. At first, it was just a really good sleeping pill. After consistent use—about a month—I started craving sex. During the day, night, whenever. I now have intense [orgasms] every single time. I want sex more.”
Another user shared online, “I’m on it now, haven’t noticed a difference yet. I’m on week 10, but it says you should notice something by week eight, so, can’t say it’s working.”
Addyi pill side effects to watch for
“It’s not a magic pill and may not be for everyone,” cautions Dr. Darji. There are some common side effects associated with using Addyi, including:
- Drowsiness
- Fatigue
- Dizziness
- Nausea
- Dry mouth
- Trouble sleeping
There is one safety concern to consider: Addyi does not mix well with alcohol. Combining this pill with wine or cocktails can trigger severe low blood pressure, fainting and even unconsciousness. Doctors recommend waiting at least two hours after having a single standard alcoholic drink to take Addyi. If you’re planning to drink more, skip the medication for the night. Also, people with liver problems should not take Addyi.
Is Addyi covered by insurance?
Addyi is covered by approximately 55% of major insurance plans for women with an official health diagnosis of HSDD, though coverage depends on your individual plan. When covered, patients may pay as little as $40 annually through a savings program.
If your specific plan doesn’t cover Addyi, it’s worth advocating for coverage—especially since many insurers have covered erectile dysfunction medications for men for years. Check with your insurance provider about your specific coverage options.
For women paying out-of-pocket, PHILRx—a mail-order pharmacy—delivers Addyi to your home for $149 per month, the lowest available price. They also honor a savings program that reduces costs to $40 annually if your insurance covers the medication.
Alternatively, GoodRx offers Addyi for $299 per month for cash payments, with the same $40 annual program for those with insurance coverage. Over 70,000 retail pharmacies nationwide—including chains like Walgreens—honor the GoodRx program.
Why it took so long to get ‘female Viagra’ approved
“Women’s health in general has taken a major back seat to men’s health, with most studies using male cohorts. In fact, last year, the NIH budget for women’s health was about 10 percent, with menopause only receiving less than .03 percent of the budget,” says Dr. Gray. “A good example is the fact that there are more than 30 FDA-approved testosterone medications for men and none for women.”
Another reason: Libido is simply harder to treat in women than in men. Dr. Gray explains, “Women are more complicated than men when it comes to sexual desire and arousal. Estrogen, progesterone and testosterone play a role in a woman’s desire. And levels of these hormones can vary month to month and at different phases of a woman’s life.”
Why the first women’s libido pill is so historic
“I see how often women’s sexual health concerns are minimized,” says Dr. Darji. “Unfortunately, symptoms often are brushed off as normal or treated as something women should simply live with. This is especially true during perimenopause and menopause.”
But the FDA’s recent approval of Addyi offers hope to many. “This may seem like one small step for pharma, but it is one large leap for women’s health,” says Dr. Darji. “This FDA decision reflects years of advocacy to close a gap that women have lived with for decades.”
Other ways to treat low libido
“Although having the first FDA-approved, non-hormonal treatment for hypoactive sexual desire disorder for menopausal women is historical and great to have as a treatment option, I still prefer to get to the root cause, if possible,” Dr. Gray adds. “Most often, hormonal imbalance or deficiency is the cause and is easily treated with sex hormones.”
But, as Dr. Dweck reminds us, “Testosterone, often used off-label for low desire in women, is not FDA approved in women, causing access and affordability barriers.”
The bottom line on ‘pink Viagra’
“What excites me most about this decision isn’t just Addyi itself, but what it represents,” Dr. Darji says. “It signals a broader shift toward taking women’s quality of life seriously at every stage, including after menopause. It opens the door for more research, more options and more honest conversations about sexual health without shame or dismissal.”
She adds, “Ultimately, this is about validating women’s experiences and recognizing that desire, intimacy and overall wellness don’t have an expiration date. That’s a powerful message for the future of women’s health.”
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