Women looking to boost sexual desire have several options, ranging from FDA-approved prescription medications to supplements and hormone therapy. What works best depends on whether low desire is a persistent pattern or something tied to a specific cause like stress, medication side effects, or a nutritional deficiency. Here’s what the evidence actually supports.
Two FDA-Approved Prescription Options
Only two medications have been approved specifically for low sexual desire in women, and both require a prescription. They work in fundamentally different ways, so understanding the distinction helps you figure out which might be relevant.
Flibanserin (Addyi)
Flibanserin is a daily pill that shifts the balance of brain chemicals involved in sexual motivation. It raises dopamine and norepinephrine while lowering serotonin, which together affect how your brain processes reward and responds to sexual cues. It’s not a pill you take before sex. You take it every night at bedtime, and it typically takes several weeks of consistent use before effects build up.
In clinical trials, women taking flibanserin reported roughly one extra satisfying sexual event per month compared to placebo. That sounds modest, and it is. But desire scores also improved significantly across multiple large studies. The BEGONIA trial, for instance, found that desire scores rose by about 50% more than placebo. The honest picture: this medication helps some women meaningfully, but it’s not transformative for everyone.
Side effects include dizziness, drowsiness, nausea, and fatigue. There’s also an important alcohol restriction. You need to wait at least two hours after having one or two drinks before taking it at bedtime, and if you’ve had three or more drinks, you skip the dose entirely. Mixing the two close together raises the risk of a dangerous drop in blood pressure or fainting. After taking it at bedtime, you should avoid alcohol until the following day.
Bremelanotide (Vyleesi)
Bremelanotide works completely differently. Instead of a daily pill, it’s a self-injection you give yourself at least 45 minutes before anticipated sexual activity. You use a prefilled pen to inject it into your abdomen or thigh. It activates pathways in the brain related to arousal, so it functions more like an “as needed” option rather than something that builds up over time.
Nausea is the most common side effect, particularly after the first few uses. Some women also experience flushing or headache. The on-demand format appeals to women who don’t want to take a daily medication, but the injection can feel like a barrier for others.
The Placebo Factor Worth Knowing About
One thing worth understanding before pursuing any treatment: the placebo effect in female sexual desire studies is enormous. An analysis of eight clinical trials found that women receiving a sugar pill improved by 3.62 points on a standard sexual function scale, while women receiving active medication improved by 5.35 points. That means roughly 68% of the improvement seen in treatment groups was also seen in the placebo group. This doesn’t mean desire medications are useless, but it does mean that expectation, attention to the problem, and the act of doing something about it all play a real role in how desire works. Context matters as much as chemistry for many women.
Testosterone Therapy
Testosterone isn’t just a male hormone. Women produce it too, and levels decline naturally with age, especially after menopause. Low testosterone is linked to reduced sexual desire, and supplementing it can help, though the prescribing landscape is complicated.
No testosterone product is FDA-approved for women in the United States (Australia is the one country where a women’s formulation exists by prescription). In practice, doctors prescribe men’s testosterone products off-label at about one-tenth the male dose, typically as a cream or gel applied to the skin. The North American Menopause Society supports this approach for postmenopausal women with low desire, provided testosterone levels are monitored to stay within the normal premenopausal range (generally under 27 to 39 ng/dL).
Transdermal application, meaning through the skin, is the recommended route because it delivers the most stable, physiologic levels. Injections and implants tend to push levels too high, and oral testosterone can negatively affect cholesterol. Compounded testosterone products, which are custom-mixed by specialty pharmacies, are not recommended by NAMS because they lack standardized safety and efficacy data. If you pursue testosterone therapy, a prescription from a provider who monitors your blood levels is important.
Supplements With Some Evidence
Several supplements are marketed for female libido, but the evidence behind them varies widely. A few have at least some clinical data worth considering.
Tribulus terrestris has the most consistent evidence among herbal options. Studies in women with sexual dysfunction used doses of roughly 250 to 280 mg per day for 90 days and found improvements in desire and overall sexual function with minimal side effects. Both a lower dose split three times daily and a single daily dose appeared effective.
Maca root is widely promoted for libido, but the clinical evidence in women is thin. One of the more rigorous attempts to study it, a trial using 3,000 mg daily in women, was terminated because it couldn’t recruit enough participants to produce meaningful data. Smaller studies have shown some positive signals, particularly for women on antidepressants, but the evidence base remains weak compared to the marketing claims.
Ashwagandha (specifically the KSM-66 extract at 600 mg daily) is currently being studied for its effects on sexual health in healthy women over an eight-week period, but completed, published results in this specific population are still limited. It has better-established evidence for reducing stress and cortisol, which can indirectly support desire, but calling it a proven libido booster for women would be premature.
Nutritional Deficiencies That Tank Desire
Before reaching for a supplement or prescription, it’s worth checking whether a basic deficiency is dragging your desire down. Iron deficiency anemia is a surprisingly common culprit. A study of reproductive-age women found that every dimension of sexual function and satisfaction was significantly lower in women with iron deficiency anemia compared to healthy women.
The connection runs through several pathways. Low iron causes fatigue and anxiety, both of which suppress desire directly. Iron deficiency is also linked to higher rates of underactive thyroid function, which further reduces libido. Perhaps most relevant, low ferritin levels are associated with changes in testosterone and sex hormone-binding protein, meaning iron deficiency can actually alter the hormonal environment that drives desire. If you’re experiencing heavy periods, fatigue, and low libido together, a simple blood test checking hemoglobin and ferritin could reveal a very treatable cause.
What Typically Works Best
For most women, low desire isn’t a single-cause problem, which is why single-solution thinking often disappoints. The women who see the biggest improvements tend to address multiple factors at once: correcting a nutritional deficiency, reducing a medication side effect (SSRIs are a common libido suppressor), managing stress or sleep, and sometimes adding a targeted treatment on top of that foundation. Prescriptions like flibanserin or bremelanotide work best when the basics are already covered, not as a substitute for addressing them.
Persistent low desire that causes real distress has a clinical name: hypoactive sexual desire disorder. The diagnostic criteria require that the low desire is ongoing, causes personal distress, and isn’t fully explained by another condition, medication, or relationship issue. If that description fits, it’s a recognized medical condition with treatment options, not something to just push through.