Two FDA-approved medications are specifically designed to increase sexual desire in women: flibanserin (sold as Addyi), a daily pill, and bremelanotide (sold as Vyleesi), an injectable used before sex. Both are prescription-only, approved for premenopausal women with persistently low sexual desire that causes personal distress. Beyond these, off-label testosterone therapy and a handful of supplements have some evidence behind them, though none are as well-studied.
Addyi: The Daily Pill
Flibanserin, brand name Addyi, is the only FDA-approved pill for low sexual desire in women. It works on brain chemistry, acting on serotonin receptors in a way that shifts the balance between signals that inhibit desire and those that promote it. The exact mechanism isn’t fully understood, but the drug also interacts with dopamine pathways. You take 100 mg at bedtime every night, and it typically takes several weeks of daily use before any effect becomes noticeable.
In clinical trials, women taking Addyi experienced roughly one additional satisfying sexual encounter per month compared to women on a placebo. That might sound modest, but the trials also showed statistically significant improvements in desire scores and reductions in distress about low libido. The effect builds gradually and isn’t something you feel on any given night.
The biggest practical limitation is alcohol. Drinking and taking Addyi close together raises the risk of dangerously low blood pressure and fainting. Current FDA labeling says to wait at least two hours after one or two drinks before taking it at bedtime, and to skip the dose entirely if you’ve had three or more drinks. After taking it, you shouldn’t drink again until the next day. This makes the medication a poor fit for anyone who drinks regularly in the evening.
Vyleesi: The As-Needed Injection
Bremelanotide, brand name Vyleesi, takes a completely different approach. Instead of a daily pill, it’s a self-administered injection you give yourself in the thigh or abdomen at least 45 minutes before anticipated sexual activity. It activates pathways in the brain involved in sexual arousal through a different mechanism than Addyi, and it generally has a milder side effect profile.
In clinical trials, women using Vyleesi reported a 25% improvement in sexual desire scores compared to 17% for placebo. The most common side effects are nausea (which can be significant for some women), flushing, headache, and reactions at the injection site. The nausea tends to decrease with repeated use.
Cost can be a barrier. Without insurance, a single dose runs up to $290. About 71% of commercial insurance plans cover it, and Medicaid coverage is even higher at 92%, but Medicare doesn’t cover it at all and fewer than 20% of marketplace (ACA) plans do. Most plans that cover it require prior authorization, meaning your provider needs to submit documentation before the prescription is approved.
Who Actually Qualifies for These Medications
Both Addyi and Vyleesi are approved only for premenopausal women diagnosed with a condition called hypoactive sexual desire disorder, now more broadly classified as female sexual interest/arousal disorder. The diagnostic bar is specific: you need to have experienced a significant drop in sexual interest for at least six months, and it has to be causing you genuine distress. A temporary dip during a stressful period doesn’t qualify.
The diagnosis also requires ruling out other explanations. If the low desire is caused by relationship problems, another medication you’re taking, depression, or a medical condition, those issues are addressed first. This matters because low libido is extremely common, and the cause often turns out to be something treatable on its own, like a medication side effect or hormonal shift, rather than something requiring a new prescription.
Off-Label Testosterone Therapy
Testosterone plays a role in sexual desire for women, not just men. There’s no FDA-approved testosterone product for women, but doctors sometimes prescribe low-dose testosterone cream off-label, particularly for women entering or past menopause. This is the only symptom of low testosterone in women where research supports treatment, according to Cleveland Clinic specialists.
The cream is typically applied to the lower abdomen or buttocks. Doctors who prescribe it emphasize staying within a narrow therapeutic range, because too much testosterone causes side effects like acne, hair growth, and voice changes. Blood levels are usually checked within four to six weeks of starting, then every six months. Most experts recommend limiting treatment to two years or less, since long-term safety data in women is limited. Injections and pellet implants are generally discouraged because they make it harder to control how much hormone your body absorbs.
Supplements With Some Evidence
No over-the-counter supplement has anywhere near the evidence base of a prescription medication, but a few have shown modest results in clinical studies. Tribulus terrestris has the strongest data: a 2021 systematic review and meta-analysis found it improved overall sexual function, desire, arousal, and orgasm scores compared to placebo. Panax ginseng showed benefits for arousal and desire in some studies, particularly in menopausal women. Maca root has mixed but occasionally positive results for desire in perimenopausal women.
The key limitation with all supplements is inconsistency. Dosing, purity, and formulation vary wildly between products, and “positive results in some studies” is a much lower bar than FDA approval. These might be worth trying if you prefer a non-prescription starting point, but set realistic expectations.
Birth Control and Libido
Before adding anything to increase desire, it’s worth checking whether something you’re already taking is suppressing it. Combined oral contraceptives (the standard pill containing both estrogen and progestin) are one of the most common culprits. The estrogen component is what typically affects sex drive, which is why the patch and vaginal ring, which also contain estrogen, can have the same effect.
Progestin-only methods, including the “mini pill,” hormonal IUDs, and certain injections, are less likely to lower libido. Some women are still sensitive to them, but in theory, progestin alone shouldn’t suppress desire. If you noticed your interest in sex dropped after starting a new contraceptive, switching formulations is one of the simplest and most effective interventions available.
Realistic Expectations
None of these options work like a light switch. Addyi adds roughly one satisfying sexual experience per month on average. Vyleesi improves desire scores by a meaningful but not dramatic margin. Testosterone cream helps some women noticeably and does little for others. The medications that exist are real, evidence-backed tools, but they work best as part of a broader picture that includes addressing stress, relationship dynamics, hormonal factors, and other medications that might be getting in the way.