Women dealing with low libido have several evidence-backed options, ranging from FDA-approved medications to hormonal therapies and supplements. The right choice depends on what’s driving the problem: stress, hormonal changes, medication side effects, or something harder to pin down. Here’s what actually works, what the evidence shows, and what to expect from each option.
Two FDA-Approved Medications
Only two prescription drugs are specifically approved for low sexual desire in women, and they work in very different ways.
Flibanserin (Addyi)
Flibanserin is a daily pill taken at bedtime that works on brain chemistry related to desire. It’s not a quick fix. You may need up to eight weeks of nightly use before noticing a difference, and the FDA recommends stopping if nothing has improved by that point. The most common side effects are drowsiness and dizziness, which is why bedtime dosing is required.
The biggest practical consideration with flibanserin is alcohol. You need to wait at least two hours after having one or two drinks before taking it, and if you’ve had three or more drinks that evening, you skip the dose entirely. After taking it at bedtime, you shouldn’t drink alcohol until the next day. Mixing the two raises the risk of a dangerous drop in blood pressure and fainting.
Bremelanotide (Vyleesi)
Bremelanotide takes a completely different approach. Instead of a daily pill, it’s a self-administered injection in the abdomen or thigh, used as needed at least 45 minutes before sexual activity. In clinical trials, about 58% of women using it reported meaningful improvement, compared to roughly 36% on placebo.
The trade-off is nausea, which affected 40% of women in trials. Flushing hit about 20%, and headaches around 11%. For many women, the nausea lessens over time, but it’s a significant enough side effect that it rules the drug out for some people.
Testosterone Therapy
Testosterone isn’t FDA-approved for women, but it’s one of the most widely studied and prescribed off-label treatments for low desire, particularly in postmenopausal women. It’s typically delivered through a compounded cream or gel applied to the skin, since the doses women need are a fraction of what’s available in men’s products.
The evidence supporting testosterone for postmenopausal women is strong enough that multiple international medical societies endorse it as an option. For premenopausal women, the data is thinner and the approach is less standardized. If your doctor prescribes testosterone, they’ll typically monitor your blood levels periodically to make sure they stay within the normal female range, since excess testosterone can cause acne, hair growth, or voice changes.
DHEA Supplements
DHEA is a hormone your body naturally produces that serves as a building block for both testosterone and estrogen. Levels decline steadily with age, and supplementation has shown real effects on sexual function in several forms.
For postmenopausal women, a prescription vaginal insert containing 6.5 mg of DHEA (sold as prasterone) is FDA-approved specifically for painful sex caused by vaginal dryness and tissue thinning. Clinical trials showed it significantly improved dryness, pain during sex, and overall sexual function with minimal side effects.
Oral DHEA supplements, available over the counter at doses of 25 to 75 mg daily, have also shown benefits. In one study of premenopausal women, desire scores increased by 17% and arousal scores by 12% after supplementation. Women who started with the lowest sexual function scores saw the most dramatic improvements: desire jumped 40%, arousal 46%, and orgasm scores 54%. That pattern is common in libido research. The worse things are at baseline, the more room there is for improvement.
Herbal Supplements With Some Evidence
The supplement aisle is full of products marketed for female libido, but only a few have any clinical backing. Maca root is the best studied, typically used at 1.5 to 3.5 grams daily for 6 to 16 weeks. Small trials have shown improvements in sexual desire, though the evidence isn’t as robust as it is for hormonal options. Maca is generally well tolerated and widely available.
L-arginine is another supplement that works through a different mechanism. Your body uses it to produce nitric oxide, which increases blood flow to genital tissue. The same basic process that drugs for erectile dysfunction target in men applies in women, just with less dramatic visible results. L-arginine is sometimes combined with other ingredients in women’s arousal supplements, though standardized dosing for this purpose hasn’t been well established.
When Medication Side Effects Are the Problem
Antidepressants that boost serotonin are one of the most common causes of reduced libido in women. If your low desire started around the same time as a new medication, that connection is worth exploring with your prescriber. One well-studied solution is adding a second medication that works on a different brain pathway to counteract the sexual side effects. This approach has been shown to meaningfully restore desire and arousal in women experiencing medication-related sexual dysfunction.
Switching to a different class of antidepressant is another option. Some antidepressants carry a much lower risk of sexual side effects than others. This is a conversation to have with whoever manages your prescription, since abruptly stopping or changing antidepressants requires medical guidance.
What Else Affects Desire
Low libido in women is rarely just physical. Stress, sleep deprivation, relationship dynamics, body image, and hormonal shifts from birth control, pregnancy, breastfeeding, or perimenopause all play significant roles. A medication or supplement can help, but it works best when the bigger picture is also addressed.
Estrogen levels matter too, especially around and after menopause. When estrogen drops, vaginal dryness and discomfort during sex can make the whole experience unappealing, which reads as low desire but is really a response to pain. Vaginal estrogen or moisturizers can solve that specific problem without affecting libido directly.
Exercise consistently shows up in research as a libido booster, likely through a combination of improved blood flow, better mood, reduced stress hormones, and increased body confidence. It’s not as targeted as a medication, but it has no side effects and benefits nearly everything else about your health at the same time.
Setting Realistic Expectations
None of these options produce overnight results, and none of them will recreate the effortless desire you may remember from your twenties. The FDA-approved medications, for example, show statistically significant improvements over placebo, but “statistically significant” can mean going from very low desire to moderate desire, not from zero to insatiable. Most women who benefit describe the change as a return of background awareness and openness to sex rather than a sudden surge of spontaneous desire.
The timeline varies by approach. Bremelanotide works within about 45 minutes of a single dose. Flibanserin requires weeks of daily use. Testosterone typically takes one to three months. DHEA and herbal supplements fall somewhere in between. If the first thing you try doesn’t work, that doesn’t mean nothing will. The causes of low desire are complex enough that finding the right solution often takes some trial and adjustment.