Several medications can increase libido, but the right option depends on what’s causing low desire in the first place. Some drugs are FDA-approved specifically for low sexual desire in women, others work by correcting hormonal deficiencies in men, and a few are prescribed off-label to counteract libido-killing side effects of other medications. Here’s what’s currently available and how each one works.
FDA-Approved Options for Women
Two medications have FDA approval specifically for treating low sexual desire in premenopausal women diagnosed with hypoactive sexual desire disorder (HSDD). They work through different mechanisms and are taken very differently.
Flibanserin (Addyi)
Flibanserin is a daily pill taken at bedtime at a dose of 100 mg. It acts on serotonin and dopamine receptors in the brain, shifting the balance of brain chemicals involved in desire. The exact mechanism isn’t fully understood, but it activates one type of serotonin receptor while blocking another, and it also has some activity on dopamine pathways.
The biggest practical limitation is that you cannot drink any alcohol while taking flibanserin. This isn’t a soft warning. The FDA placed a boxed warning on the label because combining it with alcohol can cause dangerously low blood pressure and fainting. The drug is only available through a restricted prescribing program, and people with liver problems or those taking certain medications that affect the same liver enzymes are also unable to use it. These restrictions have made it less widely prescribed than many expected when it was approved.
Bremelanotide (Vyleesi)
Bremelanotide takes a completely different approach. Instead of a daily pill, it’s a self-administered injection given in the abdomen or thigh at least 45 minutes before anticipated sexual activity. The dose is 1.75 mg, delivered through a prefilled autoinjector pen. You can’t use more than one dose in 24 hours, and no more than 8 doses per month is recommended.
It works by activating melanocortin receptors in the brain, particularly MC4R, which are found in areas of the central nervous system involved in sexual response. One notable side effect: because it also activates MC1R receptors on skin cells, it can cause darkening of the gums and skin in some users. Nausea is the most common side effect.
Testosterone Therapy for Men
For men with clinically low testosterone (generally defined as levels below 300 ng/dL), testosterone replacement therapy reliably improves sexual desire. The relationship is fairly straightforward: libido improves in proportion to the increase in testosterone levels, and men who start with the lowest levels and achieve the highest levels during treatment tend to report the greatest improvement.
A large placebo-controlled trial of 470 men aged 65 and older with testosterone levels below 275 ng/dL found a meaningful improvement in sexual desire, with an effect size of 0.44. A meta-analysis covering over 1,200 men across 14 trials confirmed the benefit. One important nuance: once testosterone levels reach the normal range, additional testosterone doesn’t further boost desire. This is a correction for deficiency, not an amplifier for people with normal hormone levels. Researchers also found no single threshold below which every man’s libido was universally affected, meaning some men with borderline-low levels have normal desire while others are significantly impacted.
Testosterone is available as gels, patches, injections, and pellets. The choice depends on preference, insurance coverage, and how stable the blood levels need to be.
Bupropion for Desire Problems
Bupropion is an antidepressant that works primarily on dopamine and norepinephrine rather than serotonin. This makes it unusual among antidepressants because most serotonin-based antidepressants (SSRIs) suppress sexual desire as a side effect, while bupropion tends to do the opposite.
A systematic review and meta-analysis found that bupropion was nearly three times more effective than placebo at improving sexual desire in women with HSDD. Seven of eleven clinical trials showed statistically significant improvement. Interestingly, the data suggested that lower doses (around 150 mg) produced better results for desire than higher doses (300 mg), which runs counter to the assumption that more is better. Dosages in the studies ranged from 75 mg to 450 mg, with 150 mg of the sustained-release formulation showing the strongest effect.
Bupropion isn’t FDA-approved for low libido, so prescriptions for this purpose are off-label. It’s commonly used in two scenarios: as a standalone option for people with both depression and low desire, or as an add-on medication for people whose current antidepressant is suppressing their libido.
Reversing Antidepressant-Related Libido Loss
Sexual side effects from SSRIs are extremely common and one of the top reasons people stop taking their antidepressant. If switching to bupropion isn’t an option, adding buspirone is another strategy with clinical support.
Buspirone is an anti-anxiety medication that partially activates the same serotonin receptor subtype (5-HT1A) that plays a role in sexual function and has moderate activity on dopamine receptors. In clinical use, it’s been added to SSRIs at doses ranging from 15 to 60 mg daily, with some patients maintaining improvement at doses as low as 15 mg per day. The improvement likely comes from a combination of its serotonin receptor activity and effects on dopamine signaling, though the exact mechanism is still debated.
This approach allows people to stay on the antidepressant that’s working for their mood while addressing the sexual side effects separately.
Why Erection Drugs Don’t Increase Desire
Medications like sildenafil (Viagra) and tadalafil (Cialis) are sometimes confused with libido-boosting drugs, but they don’t increase sexual desire at all. They work by enhancing blood flow to the penis after sexual stimulation has already occurred. Without arousal and the brain’s signal to produce nitric oxide, these drugs have nothing to amplify. In fact, in men with low testosterone, these medications often work poorly precisely because the desire signal that triggers the whole chain of events is weak or absent. They solve a plumbing problem, not a motivation problem.
Dopamine Agonists and Unintended Effects
Dopamine agonists prescribed for Parkinson’s disease and restless legs syndrome have a well-documented, unintended side effect: they can dramatically increase sexual desire, sometimes to compulsive levels. A retrospective review found that 13.2% of Parkinson’s patients developed compulsive behaviors, including hypersexuality, after starting therapeutic doses of these medications. The effect is dose-dependent: increasing the dose can trigger it, and reducing the dose typically resolves it.
These drugs are not prescribed for low libido. The hypersexuality they cause is classified as a side effect, not a therapeutic benefit, because it’s often compulsive and distressing rather than a healthy increase in desire. But their mechanism highlights how central dopamine is to the experience of wanting, which is part of why bupropion (which also boosts dopamine) has a positive effect on libido.
Matching the Medication to the Cause
The most important factor in choosing a medication is identifying why desire is low. A man with testosterone below 300 ng/dL needs hormone replacement, not an antidepressant switch. A woman whose libido vanished after starting an SSRI needs either a medication swap or an adjunct like buspirone or bupropion. A premenopausal woman with no identifiable hormonal or medication cause may be a candidate for flibanserin or bremelanotide.
Low desire also commonly stems from relationship issues, stress, sleep deprivation, or other medical conditions, none of which respond well to medication alone. When the cause is clearly biological or pharmaceutical, though, the options above have solid evidence behind them.