Female Sexual Health Pharmacotherapy — Flibanserin, PT-141, and Hormonal Options

Female sexual dysfunction pharmacotherapy in 2026 spans flibanserin (Addyi), PT-141 (Vyleesi), and hormonal options including transdermal testosterone (off-label in women) and DHEA. The evidence base is smaller than men's pharmacotherapy but is growing. NexLife's women's sexual health protocol includes compounded PT-141.

Flibanserin (Addyi)

5-HT1A agonist / 5-HT2A antagonist FDA-approved for premenopausal HSDD. Daily oral 100 mg at bedtime. Modest efficacy; boxed warning for hypotension and syncope with alcohol or CYP3A4 inhibitors.

Bremelanotide (Vyleesi / PT-141)

MC4R agonist, on-demand subcutaneous 1.75 mg before sexual activity. FDA-approved 2019 for premenopausal HSDD. The most widely-used 'on-demand' option. See full PT-141 guide.

Off-label hormonal options

• Transdermal testosterone — off-label in women; some evidence for postmenopausal HSDD at female-physiologic doses (typically 1–4 mg/day)
• DHEA — particularly for women with adrenal insufficiency or postmenopausal symptoms
• Estradiol replacement — for women with dyspareunia secondary to genitourinary syndrome of menopause; local intravaginal preferred

NexLife women's sexual health program

NexLife's women's sexual health program at $99/mo includes compounded PT-141 under physician oversight. Medical Director: Adam Kennah, M.D..

Sources

• Flibanserin prescribing information — DailyMed
• Vyleesi prescribing information — DailyMed
• ISSWSH Process of Care for HSDD — Sex Med Rev 2019