For decades, postmenopausal women who raised concerns about low sexual desire were met with shrugs, platitudes or the familiar refrain that it was simply “normal” to lose interest with age. This week, that narrative officially changed.
The FDA has granted approval for Addyi (flibanserin) for postmenopausal women—marking the first time in history that there is a clinically proven, FDA-approved treatment for hypoactive sexual desire disorder (HSDD) in this population. For Cindy Eckert, founder and CEO of Sprout Pharmaceuticals and the subject of the recent documentary The Pink Pill: Sex, Drugs & Who Has Control, the milestone is about far more than a medication. It’s about validation, agency and dismantling a long-standing belief that women’s desire is optional.
In this candid conversation, Eckert explains what this approval means for women sitting in exam rooms today, why desire is a brain-based health issue—not a moral failing or hormonal inevitability—and how this moment could serve as a blueprint for fixing other blind spots in women’s health care.
Flow Space: The FDA had already removed some of the strictest guardrails around Addyi and has FINALLY—just this week—granted approval to Addyi for the treatment of postmenopausal women. Congratulations!! What practical difference will it make for a 58-year-old sitting in her doctor’s office saying, “I love my partner, but my desire is gone”?
Cindy Eckert: For the first time in history, her doctor can look her in the eye and say we have a clinically proven, FDA-approved treatment for that.
That may sound simple, but it’s transformative. For decades, women in perimenopause and menopause have walked into exam rooms and walked out with a pat on the shoulder, a prescription to relax or an “it’s just normal” in the absence of real medical solutions.
Now, there’s a clear treatment path. The FDA has validated that there’s a biological basis to what women struggling with sexual desire are experiencing and approved a medication that met their safety and efficacy requirements to treat it.
This approval gives that woman the power to ask questions, to be taken seriously and to decide what she wants to do next. It turns an isolating moment often dismissed into a medical conversation rooted in respect.
Now that Addyi is approved for postmenopausal women, what does “doing right by women” look like in this next chapter—whether that’s access, insurance coverage, medical education or something entirely new?
It means access that’s real, not theoretical. It means insurance coverage that reflects the importance of women’s sexual health in the same way insurance has covered men’s sexual health treatments for decades. It means educating healthcare providers so women don’t have to be the most informed person in the room just to be heard.
But it also means something deeper: changing the reflexes of the system. Listening when women describe their bodies. Trusting them. Not allowing the media to infantilize women when reporting on women’s health by skewing the risk data. It means acting faster when science speaks louder than stigma. This approval set that new bar.
You’ve called this fight “never really about a pill” but about dismantling the idea that women’s pleasure is optional. With this new FDA approval, what cultural shift do you hope this unlocks for midlife and postmenopausal women who’ve long been told low desire is something they should simply accept?
Men are taught by society from a young age that pleasure is theirs to receive. Women are taught that pleasure is theirs to deliver. The progress we’ve made proves that narrative is obsolete. Everyone, men and women alike, have a right to desire. They deserve the healthiest and happiest life for themselves—both in and out of the bedroom.
So for any woman reading this who has been told—directly or indirectly—that wanting her desire back was unrealistic, selfish or simply not worth addressing, this approval says otherwise. It says desire is part of your health. And it’s not “normal” to be told to just let it go because your body ages or changes.
Culturally, I hope this gives women permission to want what they want—without apology, without explanation and without being told to “just accept it.” Midlife shouldn’t mean shrinking. It should mean agency.
In The Pink Pill: Sex, Drugs & Who Has Control, the film widens the lens beyond Addyi to show the broader inequities in women’s health care. With this approval now in place, what part of that systemic story feels most urgent to you— and where do you hope the conversation goes next?
I open the film saying “I took on the government for women’s sexual pleasure and won, here’s why I did it”… because it is important to lay bare all the hidden break points that hamper women’s health progress even when the science is clear. If our awareness and intolerance of those obstacles become heightened, we will shorten the distance between evidence and taking action.
So where I hope the conversation goes next is accountability. Regulators, doctors, insurers and media have a crucial responsibility to consider their role in women’s health progress or lack thereof. The optimist in me says that if we’ve been able to correct a decades-long blind spot in women’s sexual health with this approval, we can do the same in pain, cardiovascular disease, autoimmune conditions, menopause care—you name it. This moment should be a blueprint, or should I say pinkprint.
The film includes painful moments where women’s low desire is dismissed as a “made-up problem.” How do you hope this FDA decision challenges that narrative, especially for postmenopausal women who have spent years feeling unheard or minimized in the exam room?
This decision says, very plainly: that era is over. Science has spoken.
For all of the women who’ve been medically gaslit when they asked for help with their low desire because they wanted something better for themselves, this is validation. You were right when you felt something was wrong. It’s not all in your head. And you are entitled to the choice to address it.
The highest scientific authority in the country has stamped their approval on the importance of this condition and having reviewed scientific evidence, they acted on that data by giving you and your doctor a treatment option. Now it’s your choice if you would like to take it.
I hope it helps women speak up for themselves without reservation in the exam room. And I hope it reminds clinicians that listening is not a courtesy. It’s a responsibility.
You’ve spoken candidly about how HSDD is a brain-based condition—“brain, not blood flow.” How do you explain this science to postmenopausal women who assume desire loss is strictly hormonal or inevitable with age?
I would love for them to google the brain scan studies that lit the fire in me to pursue a medical treatment for HSDD, a condition so common the Mayo Clinic estimates it affects 40% of women.
Turns out all the “it’s normal with age” narrative completely ignores the scientific understanding of desire. Study after study has shown that women struggling with their libido have less activation in the reward center of their brain. The neurotransmitters that drive our sexual response can become imbalanced for a variety of reasons, and we can treat that imbalance with a nonhormonal pill. It’s not that you have to take Addyi to the exclusion of hormones, it just serves a different purpose. Addyi is the only medication of its kind and the only FDA approved treatment for HSDD in women under 65 years.
link
