Flibanserin for Low Desire After Menopause: What the Expanded Approval Means

Losing interest in sex is common in midlife, and for some women it causes distress. In December 2025, the FDA expanded the approval of flibanserin, a daily prescription pill first approved in 2015 for premenopausal women, to include postmenopausal women under 65.¹ Here is what the label says about who it’s for and how to take it safely.

Who it’s approved for

Flibanserin is approved for women under 65 with low sexual desire that:²

• Developed after a time of normal desire (acquired) and happens in every situation (generalized)
• Causes marked distress or difficulty in the relationship
• Isn’t explained by another medical or mental health condition, relationship problems, or the effects of a medicine

It isn’t approved to enhance sexual performance.²

That means a clinician should first look for other causes, such as pain with sex, vaginal dryness, depression, sleep problems or medicines like some antidepressants. Our guide to vaginal dryness covers one common cause.

How it’s taken

The dose is 100 mg once a day at bedtime. Taking it during waking hours raises the risk of low blood pressure, fainting, injury and drowsiness.² The label says to stop after 8 weeks if there’s no improvement.²

The boxed warning

The label carries a boxed warning about low blood pressure and fainting:²

• Alcohol: wait at least two hours after one or two standard drinks before taking your bedtime dose. Skip the dose that night if you’ve had three or more drinks.
• Certain medicines: flibanserin can’t be taken with moderate or strong CYP3A4 inhibitors, which include the antifungal fluconazole, the antibiotics erythromycin and ciprofloxacin, some heart medicines, and grapefruit juice.
• Liver problems: it isn’t for people with liver impairment.

The fluconazole interaction matters if you’re treated for yeast infections. In one study, 3 of 15 people who took flibanserin with fluconazole had low blood pressure or fainting.² Make sure every prescriber and your pharmacist know you take it.

Side effects

The most common side effects in trials included dizziness, sleepiness, nausea, tiredness, trouble sleeping, urinary tract infections, anxiety and dry mouth.²

Questions to ask

1. Could something else be lowering my desire, like pain, dryness, mood, sleep or a medicine?
2. Does flibanserin interact with anything I take, including antifungals, antibiotics and supplements?
3. How much do I drink, and can I follow the alcohol rules?
4. How will we know if it’s working by 8 weeks?
5. What will my insurance cover?

Try: “My interest in sex has dropped since menopause and it’s affecting my relationship. Can we look at possible causes first, and would flibanserin be safe with my other medicines?”

Down There, Decoded includes a Down-There Log and a See script for appointments. Use them to note symptoms, medicines and questions so your visit covers what matters to you. Explore the intimate-health playbook.