I’m pleased to share with you some exciting news about a treatment for low sexual desire that has an unintended consequence you may actually appreciate–weight loss. Some patients reported that after using flibanserin for as short as 8 weeks, that they began noticing that their clothes were looser and the number on the scale was surprisingly lower. Sounds too good to be true, I know, but let’s take a look at what flibanserin is and how it affects the brain.  Flibanserin is a serotonin 1A receptor agonist and a serotonin 2A receptor antagonist, which influences biological and neurological processes. While its primary effect is to increase sexual desire, it also has an impact on anxiety, appetite, memory, mood, and sleep. Researchers found that this treatment reaches the part of the brain that experiences sexual desire, but it may also impact satiety, that feeling of fullness at the end of a meal. Unlike some weight loss medications, there appears to be no weight regain with flibanserin (at least for about 18 months of study). More research will help us learn more about these effects, both sexual desire and weight, over the long term, but this is considered clinically meaningful in my book.

Flibanserin was first approved by the Federal Drug Administration (FDA) in August 2015 for low libido in women and was immediately dubbed the “female Viagra” although that is a misnomer.  Viagra treats a blood-flow issue to the penis, a physical issue, not desire which is an issue of the mind. For most women, sexual desire starts “north,” in the brain.

The Science Behind Improving Sexual Desire
Flibanserin was originally created as an antidepressant and although it didn’t work very well for depression, patients noted a pleasant side effect, an increase in sexual desire. It went back to the lab for further research, leading us to this moment in a new sexual revolution for premenopausal women. Considering that many women experience sexual dysfunction at some point, it is worth going for an evaluation with your doctor, ruling out extenuating circumstances (i.e., relationship problems), and see if this loss of desire is an actual diagnosable disorder, hypoactive sexual desire disorder or HSDD. If it is there is a solution.

Optimal Timing and Dose
The effectiveness of the 100 mg bedtime dose of flibanserin was evaluated in three pivotal 24-week trials of 2,400 premenopausal women with hypoactive sexual desire disorder (HSDD), otherwise known as “not ever in the mood for sex…ever!” The average age of women in the trials was 36 years, and these women had experienced diminished sex drive for about five years. While many have said that this medication only works in a small percentage of patients, and only has a little benefit at that, our experience is that those who respond do so in 8 weeks, and really recognize the difference. However, flibanserin has not been shown to enhance sexual performance in normal women, but it’s a starting point for women who have not been able to put a name to their low sexual desire condition, or have not found an effective treatment.  Additional treatments such as vaginal estrogen and or testosterone may be used for physical issues such as vaginal dryness or pain with intercourse.

Flibanserin is not without some side effects such as dizziness and in a few cases, lower blood pressure. But taken as directed, specifically, at bedtime, and without alcohol, you may be in for a satisfying sexual experience and some weight loss, which you will be thankful for all year long.