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Flibanserin works like a neurochemist in the brain, carefully tweaking and modulating key neurotransmitter levels to heighten sexual desire. It specifically targets serotonin and dopamine activity in the interconnected circuits that govern sex drive.
As a serotonin 1A receptor agonist, flibanserin mimics serotonin’s effects on these arousal pathways. This stimulates dopamine and norepinephrine release, energizing the pleasure and reward centers.
But flibanserin also blocks serotonin 2A receptors, decreasing inhibitory serotonin signaling. It’s like removing the chemical brakes so dopamine and norepinephrine can accelerate desire.
Through this delicate rebalancing act, flibanserin helps light up the neural circuitry of sexual motivation and arousal that can become sluggish for some women suffering from low libido. Like adjusting knobs on a soundboard, flibanserin tunes neurochemical levels in the brain so sex doesn’t feel like a dull, distant concept but an ecstatic crescendo women actively crave.
Flibanserin was developed and approved by the FDA specifically for treating low sexual desire in premenopausal women. It is used to help boost libido in women who have marked distress or interpersonal issues due to persistently low sex drive.
The drug is only indicated for acquired HSDD—a low desire that develops despite previously normal levels of sexual interest. It also should only be taken by premenopausal women, as the safety and efficacy in menopausal women haven’t been established.
In clinical trials of premenopausal women with acquired HSDD, flibanserin appeared beneficial in increasing sexual desire, decreasing distress, and boosting satisfying sexual events.
Specific benefits included heightened sexual motivation and desire, improved ability to orgasm, decreased sex-related distress, and enhanced relationship satisfaction.
Common flibanserin side effects can include dizziness, sleepiness, nausea, and fatigue. Less common side effects are insomnia, dry mouth, constipation, anxiety, and headaches.
Due to its mechanism, flibanserin can cause hypotension and fainting if taken with alcohol. Accidental injury is possible if fainting occurs. The side effects seem manageable if alcohol is avoided completely.
The recommended flibanserin dosage is 100 mg, taken once per day at bedtime. It should not be taken more than once a day.
To reduce side effects, flibanserin is started at 50 mg once daily at bedtime for 2 weeks before increasing to the 100 mg regular dosage. If certain enzyme inhibitors are taken, a starting dose of 25 mg nightly may be needed.
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