Can't find or afford Addyi? Learn about FDA-approved and off-label alternatives for treating HSDD, including Vyleesi, testosterone therapy, and more.
Maybe your pharmacy doesn't stock it. Maybe the cost is too high. Or maybe you tried Addyi (Flibanserin) and it wasn't the right fit for you. Whatever the reason, if you're looking for alternatives to Addyi for treating hypoactive sexual desire disorder (HSDD), you have options.
In this guide, we'll cover what Addyi is, how it works, and the most common alternatives that doctors may recommend in 2026.
Addyi is the brand name for Flibanserin, the first FDA-approved daily pill for the treatment of HSDD in women under 65. HSDD is characterized by persistently low or absent sexual desire that causes personal distress or relationship difficulties — and that isn't explained by other medical conditions, medications, or relationship issues.
Addyi was approved by the FDA in 2015 and is manufactured by Sprout Pharmaceuticals. It's taken as a 100 mg tablet once daily at bedtime. For a complete overview, see our post on what Addyi is and how it works.
Addyi is classified as a multifunctional serotonin agonist and antagonist (MSAA). It works by:
This dual action increases levels of dopamine and norepinephrine while decreasing serotonin in the brain's prefrontal cortex. The result is a gradual improvement in sexual desire over several weeks of daily use.
Addyi is not a hormone and is not the same as medications like Viagra. It works on brain chemistry, not blood flow. For more, see how Addyi works: mechanism of action explained.
There are several valid reasons to explore alternatives to Addyi:
Vyleesi is the second FDA-approved medication for HSDD in premenopausal women. It was approved in 2019 and works through a completely different mechanism than Addyi.
Vyleesi is a melanocortin receptor agonist. It activates melanocortin receptors in the brain that are involved in sexual arousal and desire. Unlike Addyi, which you take daily, Vyleesi is used as needed — you give yourself a subcutaneous injection at least 45 minutes before anticipated sexual activity.
Vyleesi may be a better fit if you prefer as-needed dosing over daily pills, if you can't avoid alcohol, or if you have concerns about the CYP3A4 drug interactions that come with Addyi. However, the injection route and high rate of nausea are drawbacks for some women.
While not FDA-approved for women, low-dose testosterone is one of the most commonly prescribed off-label treatments for HSDD, particularly in postmenopausal women.
Testosterone plays a role in sexual desire in both men and women. Women with low testosterone levels may experience reduced libido. Low-dose testosterone — typically applied as a compounded cream or gel — can help restore desire in some women.
Testosterone therapy may be worth discussing with your doctor if you're postmenopausal, if Addyi and Vyleesi haven't worked, or if blood tests show low testosterone levels. It's important to work with a provider experienced in hormonal therapy.
HSDD often has psychological components, and cognitive behavioral therapy (CBT) or sex therapy can be effective treatments — either alone or in combination with medication.
A trained therapist helps you identify and address psychological factors contributing to low desire, such as stress, body image issues, relationship dynamics, or past trauma. Sex therapy specifically focuses on sexual functioning and intimacy.
Therapy is a good option for any woman with HSDD, especially if psychological factors play a role. Many experts recommend combining therapy with medication for the best outcomes.
If your low desire is related to painful intercourse (dyspareunia) caused by vaginal dryness or atrophy, Ospemifene (Osphena) may help. It's a selective estrogen receptor modulator (SERM) FDA-approved for moderate-to-severe dyspareunia in postmenopausal women.
Addyi was a groundbreaking medication when it launched, but it's not the only option for women with HSDD. Whether you're looking for a different dosing format, fewer drug interactions, a lower price, or a non-medication approach, there are real alternatives available.
Talk to your healthcare provider about which option makes the most sense for your situation. And if you do want to try Addyi first, check out our tips for finding Addyi in stock and saving money on Addyi.
You focus on staying healthy. We'll handle the rest.
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