The Truth About Addyi: Why There’s No Pill That Fixes Sexual Desire

So what is Addyi?

Addyi actually began its life as an antidepressant developed by Boehringer Ingelheim. It failed as an antidepressant, but researchers noticed that in some women, it appeared to increase sexual desire as a side effect.

Boehringer attempted to get it approved as a medication for women’s sexual desire, but it failed in clinical trials because it did not show meaningful effectiveness. Boehringer eventually sold the drug to a small pharmaceutical company called Sprout Pharmaceuticals.

Sprout tried again. Once more, the drug failed to meet efficacy benchmarks in clinical trials.

At that point, Sprout launched a public relations campaign called “Even the Score,” arguing that the FDA was engaging in sexism by approving medications like Viagra for men while rejecting medications intended to increase sexual desire in women. This sparked a very public and very political debate around sexual health, equity, and drug approval standards.

After additional back and forth, and after Sprout submitted further safety data, the FDA ultimately approved Addyi, despite both efficacy and safety concerns.

Addyi’s safety concerns

Addyi alters brain chemistry. Remember, it started as an antidepressant. It must be taken every single day, not as needed. One of its major side effects is sedation and low blood pressure, which is why it must be taken at night.

It also carries a black box warning, the strongest warning the FDA can issue. Women taking Addyi are advised not to consume alcohol at all. This is not a “use it when you want” medication. It is a daily, long term commitment with real lifestyle consequences.

Because of those risks, Addyi is distributed under a REMS program. That means both the prescribing physician and the dispensing pharmacist must be specially certified.

So how effective was Addyi? What did the clinical trials actually show?

Women taking Addyi reported an average increase of about 2.5 satisfying sexual experiences per month. Women taking a placebo reported about 1.5.

In other words, on average, Addyi resulted in one additional satisfying sexual experience per month. Some women reported more improvement, others reported none.

And that is the entire point of this conversation.

We live in a healthcare environment where pharmaceutical companies focus almost exclusively on upside, and telehealth companies are often loud, exaggerated, braggadocious, and frankly misleading about what medications can realistically do.

There is no medication that reliably and universally increases sexual desire and satisfaction.

At Shameless Care, we do offer options that help many women, including Shamelessly Aroused, a topical sildenafil cream, Shameless Chemistry, which combines oxytocin and tadalafil, and nasal oxytocin. Many women absolutely rave about these products.

And some women try them and feel nothing at all.

That is the reality of sexual medicine.

Desire is complex. It is biological, psychological, relational, contextual, and emotional. No pill, cream, spray, or compound can override all of that.

Our job at Shameless Care is not to promise miracles. It’s to be honest, to explain the science, to offer options responsibly, and to be the adult in the room when the rest of the industry would rather sell fantasy.

And we’re going to keep doing exactly that.