(025) Analysis of Off-Label Medication Prescriptions and Google Search Trends for Postmenopausal Female Hypoactive Sexual Desire Disorder

Abstract Introduction Hypoactive sexual desire disorder (HSDD) can affect adult women of all ages, causing distress and decreased quality of life. This can be exacerbated by genitourinary symptoms of menopause, with an estimated 32% of peri- and postmenopausal women affected by HSDD. Objective In the United States two drugs have been approved to treat HSDD in premenopausal women: bremelanotide (Vyleesi®), which was approved in 2019, and flibanserin (Addyi®), approved in 2015, but no medications have been approved for postmenopausal women. Herein we sought to compare national off-label prescribing trends for these two medications, and Google trends for various search terms to elucidate patients’ interest and online search behaviors regarding this condition. Methods We contacted the pharmaceutical companies for Vyleesi® (Cosette Pharmaceuticals, Bridgewater, NJ) and Addyi® (Sprout Pharmaceuticals, Raleigh, NC) and obtained current deidentified prescriber data. Google trends from January 2019 to October 2025 were queried to analyze which search terms were most utilized. Results Vyleesi and Addyi are both commonly prescribed off label for postmenopausal women, with 23% of Vyleesi and 26% of Addyi prescriptions written for patients over the age of 50. Obstetricians and gynecologists are the most common prescribers for both at ~40%; urologists made up 2-4% of prescribers. Google search trends are illustrated in Fig. 1. “Increase Libido Menopause” was almost always the most common search term. “Low Libido Menopause” was also frequently searched. “Hypoactive Sexual Desire Disorder Menopause” was rarely searched, with only two timepoints in 2020 and 2025. “Sex Therapy Menopause” and “Medication Low Libido Menopause” were also not often searched. Conclusions Medications for premenopausal HSDD are commonly prescribed for peri- and postmenopausal patients with this condition. Google search trends demonstrate that patients are interested in improving their menopausal sexual symptoms but may not know the specific condition or treatments, or may be obtaining information via other sources. HSDD is prevalent in menopausal women and additional research should assess patient education and treatment programs. Disclosure No.