Several options can help women increase sex drive, ranging from FDA-approved medications to hormonal treatments, off-label prescriptions, and supplements with clinical evidence behind them. What works best depends on whether the issue is situational or ongoing, whether you’re pre- or postmenopausal, and whether another medication might be contributing to the problem. Here’s what the evidence actually supports.
FDA-Approved Medications
Two prescription medications are currently FDA-approved specifically for low sexual desire in premenopausal women. Both target the brain rather than the genitals, working on the neurochemistry behind wanting sex in the first place.
Flibanserin (Addyi)
Flibanserin is a daily pill taken at bedtime. It works by adjusting the balance of brain chemicals involved in desire, boosting the activity of some while dialing back others. You won’t notice a difference overnight. Most women need 4 to 8 weeks before seeing improvement. In clinical trials, women taking it reported roughly 1 to 2 additional satisfying sexual experiences per month compared to those on placebo, which is a modest but real difference for women who had very few to begin with.
The biggest practical concern is alcohol. Taking flibanserin within two hours of drinking raises the risk of a dangerous drop in blood pressure and fainting. Current FDA guidance says to wait at least two hours after one or two drinks before taking it at bedtime. If you’ve had three or more drinks, skip that night’s dose entirely. You also shouldn’t drink alcohol again until the next day after taking it.
Bremelanotide (Vyleesi)
Bremelanotide takes a completely different approach. Instead of a daily pill, it’s a self-injection you give under the skin about 45 minutes before anticipated sexual activity. It activates pathways in the brain that influence sexual arousal and desire. The limit is one dose per day and no more than eight doses per month. Nausea is the most common side effect, and some women experience temporary flushing of the face and chest. For women who don’t want to take a daily medication or who can’t manage the alcohol restrictions of flibanserin, this on-demand option can be a better fit.
Testosterone Therapy
Testosterone isn’t just a male hormone. Women produce it too, and levels decline with age, particularly after menopause. International clinical guidelines now recommend transdermal testosterone (applied to the skin as a cream, gel, patch, or spray) for women with persistently low desire, especially postmenopausal women. The typical starting dose is about one-tenth of what’s prescribed for men.
Because no testosterone product is currently FDA-approved specifically for women, doctors prescribe male formulations at adjusted doses or use compounded preparations. The starting dose is generally 5 mg per day of a 1% testosterone cream, which can be increased to 10 mg per day if needed. Blood levels should be checked 3 to 6 weeks after starting to make sure levels stay within the normal premenopausal range. Once stable, monitoring every 4 to 6 months is recommended. Your doctor will also watch for signs of excess testosterone like acne, increased facial hair, or thinning scalp hair, all of which typically resolve with a dose reduction. A baseline check of liver function and cholesterol is standard before starting.
Bupropion for Antidepressant-Related Low Desire
If your low sex drive started after beginning an antidepressant (particularly an SSRI), bupropion is one of the most studied off-label solutions. Unlike SSRIs, bupropion works on dopamine pathways in the brain, which play a role in motivation and reward, including sexual desire. A meta-analysis found that bupropion was nearly three times more effective than placebo at improving sexual desire in women, and about 14 times more favorable for improving overall sexual function. Interestingly, the lower dose (150 mg) appeared to work better than the higher dose (300 mg) for desire specifically.
All four studies examining women with SSRI-induced sexual dysfunction found significant improvement in desire when bupropion was added. Some doctors prescribe it as an add-on to the existing antidepressant, while others switch to bupropion entirely. This is a conversation worth having with your prescriber if your antidepressant is clearly the culprit.
Supplements With Clinical Evidence
The supplement market for female libido is enormous and mostly unregulated, but two botanicals have at least some controlled trial data behind them.
Maca Root
Maca is a Peruvian root vegetable that has been studied at doses of 1.5 to 3.0 grams per day. A pilot study in women with antidepressant-induced sexual dysfunction found that the higher dose (3 g/day) was associated with improvements in sexual function scores. The evidence is still limited to small studies, so expectations should be proportional, but maca has a favorable safety profile and is widely available.
Ashwagandha
A pilot study using 300 mg of ashwagandha root extract twice daily for eight weeks found statistically significant improvements in arousal, lubrication, and satisfaction compared to placebo. The treatment group also more than doubled their number of successful sexual encounters (a 126% increase versus 61% in the placebo group). This is a single small study, so the results are promising rather than definitive, but the effect size was notable.
Iron Deficiency and Sex Drive
One frequently overlooked factor is iron status. Research has found that women with iron deficiency anemia score significantly lower across every dimension of sexual function and satisfaction compared to women with normal iron levels. The connection appears to work through several pathways: low iron is linked to higher rates of underactive thyroid function, which itself dampens desire. Iron deficiency also increases depression and anxiety, both of which suppress libido. There’s even a direct hormonal connection: low ferritin levels are associated with changes in testosterone and sex hormone-binding protein levels.
The encouraging part is that treating the anemia can reverse these effects. Studies have shown that as iron levels improve, depression scores drop and sexual function recovers. If you have heavy periods, follow a restrictive diet, or experience fatigue alongside low desire, getting your ferritin levels checked is a simple and worthwhile step.
What Counts as a Clinical Problem
Not every dip in desire needs medical treatment. Stress, sleep deprivation, relationship tension, and hormonal shifts around your cycle, postpartum, or perimenopause all temporarily affect libido. A clinical diagnosis of low desire (formally called Female Sexual Interest/Arousal Disorder) requires at least three of six specific criteria to be present for six months or longer: reduced interest in sex, fewer sexual thoughts or fantasies, rarely initiating sex or responding to a partner’s initiation, reduced pleasure during sex, reduced responsiveness to erotic cues, and diminished physical sensation during sex. The key qualifier is that these changes need to cause you genuine distress, not just concern your partner or fall short of some external standard.
If the issue is clearly tied to a life circumstance (a new baby, a stressful job, a relationship problem), addressing that root cause is more likely to help than any pill. But when low desire persists beyond the obvious explanations and genuinely bothers you, the options above represent the current best evidence for doing something about it.