What you can take depends almost entirely on why your libido dropped in the first place. A person with clinically low testosterone, a woman on an antidepressant that blunts desire, and someone whose sex drive faded under chronic stress are dealing with three different problems, and the most effective intervention for each is different. There are FDA-approved prescription drugs, hormone therapies with solid trial data, herbal supplements with promising but limited evidence, and lifestyle changes that address root causes rather than symptoms. The honest picture is that no single pill reliably supercharges libido in everyone, and for women in particular, a striking share of the benefit seen in clinical trials turns out to be placebo effect.
Testosterone Therapy for Men
If you’re a man with genuinely low testosterone levels, testosterone replacement therapy is the most evidence-backed option for restoring desire. Reviews consistently show a strong link between serum testosterone and libido in men, and bringing low levels back to normal range reliably improves sexual desire.1Androgens: Clinical Research and Therapeutics. Testosterone and Sexual Desire: A Review of the Evidence A meta-analysis of trials found that testosterone replacement improved sexual desire and other symptoms of low testosterone compared to placebo, though it did not improve erectile function on its own.2PubMed. Effect of Testosterone Replacement Therapy on Sexual Function and Hypogonadal Symptoms in Men with Hypogonadism
The critical detail is that testosterone therapy shows consistent benefit only in men whose levels are actually low at baseline. Once testosterone reaches a normal range, adding more does not keep boosting desire. Earlier studies that failed to show a libido benefit from testosterone often included men who already had normal levels, which muddied the results.3PubMed Central. Testosterone Therapy Improves Erectile Function and Libido in Hypogonadal Men – Section: Testosterone Therapy and Libido If your testosterone is in range and your libido is still low, the cause is almost certainly something else, and supplementing testosterone is unlikely to help.
One quirk worth knowing: in healthy men with normal testosterone, studies have repeatedly failed to find a significant correlation between testosterone levels and sexual desire. The relationship matters when levels are deficient, but above a certain threshold, more hormone does not equal more drive.4PubMed. Testosterone and sexual desire in healthy women and men
Testosterone for Women
The picture for women is more complicated but still promising in certain situations. In postmenopausal women who have had their ovaries removed and experience distressing loss of desire, transdermal testosterone patches have shown meaningful results. In one well-known trial published in the New England Journal of Medicine, women using a 300-microgram daily testosterone patch reported about three times the increase in satisfying sexual episodes compared to placebo over six months. Both doses tested also significantly improved desire and reduced distress, though the higher dose came with more unwanted hair growth.5PubMed. Testosterone for Low Libido in Postmenopausal Women Not Taking Estrogen A separate trial in surgically menopausal women found a similar pattern, with the 300-microgram patch producing a significantly greater increase in desire than placebo.6Archives of Internal Medicine. Safety and Efficacy of a Testosterone Patch for the Treatment of Hypoactive Sexual Desire Disorder in Surgically Menopausal Women
No testosterone product is currently FDA-approved for women’s sexual dysfunction, though off-label prescribing happens. A review of the safety data for postmenopausal women concluded that transdermal testosterone appears effective and safe for this population.7PubMed. Efficacy and safety of testosterone in the management of hypoactive sexual desire disorder in postmenopausal women For premenopausal women, the relationship between testosterone and desire is messier. Research has found that testosterone was positively linked to solitary desire in women but was actually negatively correlated with partnered desire once stress was accounted for.4PubMed. Testosterone and sexual desire in healthy women and men
FDA-Approved Drugs for Low Desire in Women
Two prescription drugs have been approved in the United States specifically for hypoactive sexual desire disorder in premenopausal women: flibanserin and bremelanotide. They work through completely different mechanisms.
Flibanserin (brand name Addyi) is a daily pill that acts on serotonin and dopamine pathways in the brain. The thinking is that low desire in some women results from an imbalance where the brain’s inhibitory signals overpower its excitatory signals. Flibanserin aims to nudge that balance toward excitation.8CNS Drugs. The Female Sexual Response: Current Models, Neurobiological Underpinnings and Agents Currently Approved or Under Investigation for the Treatment of Hypoactive Sexual Desire Disorder It requires daily use, cannot be mixed with alcohol, and its effects are modest. It remains the only approved drug of its kind outside the injection category.
Bremelanotide (brand name Vyleesi) takes a different approach. It is a self-administered subcutaneous injection given at least 45 minutes before anticipated sexual activity. It activates melanocortin receptors in the brain, which triggers increased dopamine release in areas of the hypothalamus involved in sexual motivation.9PubMed. The neurobiology of bremelanotide for the treatment of hypoactive sexual desire disorder in premenopausal women In two large phase 3 trials, women on bremelanotide had significant increases in desire and significant reductions in distress compared with placebo. The most common side effects were nausea, flushing, and headache, each affecting more than one in ten users.10PubMed Central. Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials Long-term data over a year showed the improvements in desire were sustained.11PubMed Central. Long-Term Safety and Efficacy of Bremelanotide for Hypoactive Sexual Desire Disorder
A point of perspective that rarely gets enough attention: a meta-analysis of female sexual dysfunction trials found that roughly two-thirds of the improvement seen in the treatment groups was also seen in women who received a placebo. The actual drug-specific benefit above placebo was relatively small.12PubMed. Female Sexual Dysfunction and the Placebo Effect: A Meta-analysis That does not mean the drugs are useless, but it does mean that the act of paying attention to your sex life, enrolling in a trial, and expecting improvement accounts for a large share of what people experience. It also suggests that non-drug approaches might capture much of the same benefit for some people.
Herbal Supplements With Actual Trial Data
The supplement aisle is full of products claiming to boost libido, and most of them have no credible evidence behind them. A handful, though, have been tested in randomized controlled trials. The results are generally encouraging in direction but limited in scale, meaning the trials are small and need replication before anyone should treat the findings as settled.
Maca Root
Maca (Lepidium meyenii) is a Peruvian root that has shown the most consistent signal for desire specifically. In one placebo-controlled trial of healthy men, an improvement in sexual desire appeared after eight weeks of supplementation and was independent of changes in testosterone, estrogen, depression, or anxiety scores.13PubMed. Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men A separate trial tested maca in people taking SSRI antidepressants who developed sexual side effects. At the higher dose of 3 grams per day, subjects experienced significant improvement in sexual function scores, including libido, but the lower dose did not produce the same effect.14PubMed Central. A double-blind, randomized, pilot dose-finding study of maca root (L. meyenii) for the management of SSRI-induced sexual dysfunction The mechanism by which maca works remains unclear since it does not appear to change hormone levels.
Ashwagandha
Ashwagandha (Withania somnifera) often gets pitched as a testosterone booster, and there is some basis for that claim. A crossover study in aging, overweight men found that ashwagandha supplementation raised testosterone by about 15% and the testosterone precursor DHEA-S by about 18% compared to placebo.15PubMed Central. A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males Another trial of adult males reported significant improvements in sexual function scores alongside increased testosterone.16PubMed Central. Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: A randomized controlled trial However, in a stress-relief trial that included both sexes, the testosterone increase in men on ashwagandha was not statistically significant when compared head-to-head with placebo using the standard between-group analysis, even though the within-group change looked meaningful.17PubMed Central. An investigation into the stress-relieving and pharmacological actions of an ashwagandha Withania somnifera extract Ashwagandha’s stress-reducing properties may indirectly help libido through lowering cortisol, but the direct libido evidence is still thin compared to what gets claimed about it online.
Tribulus Terrestris
Tribulus is widely marketed to men as a testosterone and sexual-performance booster. A systematic review found that most studies showed no significant changes in testosterone from tribulus supplementation, especially in men who had normal levels to begin with. Only two studies showed a rise in testosterone, both in men who were already hypogonadal, and even then the increases were modest.18PubMed Central. Effects of Tribulus (Tribulus terrestris L.) Supplementation on Erectile Dysfunction and Testosterone Levels in Men—A Systematic Review of Clinical Trials That said, one well-designed trial did find significant improvements in desire, orgasm, and overall sexual satisfaction with tribulus compared to placebo, suggesting it may affect sexual function through pathways unrelated to testosterone.19PubMed. Evaluation of the efficacy and safety of Tribulus terrestris in male sexual dysfunction In women, a placebo-controlled trial also found significant improvements in desire, arousal, and satisfaction after four weeks of tribulus use.20PubMed Central. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo – controlled study
Fenugreek
Fenugreek seed extracts (sold under trade names like Testofen and Furosap) have shown effects on both testosterone and subjective libido markers. A pilot study in men doing resistance training found that fenugreek glycoside supplementation produced a significantly greater increase in free testosterone than placebo over eight weeks.21PubMed Central. Beneficial effects of fenugreek glycoside supplementation in male subjects during resistance training: A randomized controlled pilot study A separate trial of a fenugreek seed extract also showed improved free testosterone and reported improved libido and cardiovascular markers.22PubMed Central. Efficacy of Furosap, a novel Trigonella foenum-graecum seed extract, in Enhancing Testosterone Level and Improving Sperm Profile in Male Volunteers A standardized fenugreek extract also demonstrated a significant positive effect on arousal and orgasm domains of sexual function.23PubMed. Physiological aspects of male libido enhanced by standardized Trigonella foenum-graecum extract and mineral formulation These trials are small, so the numbers should be taken as preliminary rather than definitive.
Korean Red Ginseng
Korean red ginseng has been studied in menopausal women, where a placebo-controlled crossover trial found it significantly improved scores in the sexual arousal domain.24PubMed. Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study In premenopausal women, however, a similar trial found that while desire and arousal scores improved with ginseng, the improvements were not statistically different from placebo, suggesting the benefit was largely a placebo response.25PubMed Central. The Effect of Korean Red Ginseng on Sexual Function in Premenopausal Women: Placebo-Controlled, Double-Blind, Crossover Clinical Trial That split suggests ginseng may be more useful for arousal issues tied to menopausal changes than for desire problems in younger women.
The Safety Problem With Sexual Enhancement Supplements
Before spending money on any supplement marketed for libido or “male enhancement,” you should know that this category has a serious contamination problem. An FDA analysis spanning nearly a decade found that sexual enhancement supplements were the single largest category of adulterated dietary supplements on the market. Nearly half of the tainted sexual-enhancement products contained sildenafil (the active ingredient in Viagra) or similar pharmaceutical compounds that were not listed on the label.26JAMA Network Open. Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With US Food and Drug Administration Warnings That means a product can appear to “work” simply because it secretly contains a prescription drug, with all the risks that entails for people who may have contraindications. If a supplement seems too effective to be herbal, it may not be.
When a Medication Is Killing Your Libido
One of the most common causes of sudden libido loss is a medication side effect, particularly SSRIs and other serotonergic antidepressants. If that describes your situation, the answer is not always to add something on top but sometimes to address the drug itself. Switching to an antidepressant with a different mechanism is one strategy clinicians use. Adding bupropion, which acts on norepinephrine and dopamine rather than serotonin, has shown promise. In an open-label study, adding bupropion sustained-release improved sexual side effects in the majority of participants, with all major categories of sexual dysfunction showing benefit.27PubMed. Bupropion-sustained release as a treatment for SSRI-induced sexual side effects Maca root, as mentioned earlier, also showed potential in people dealing with SSRI-related sexual problems specifically.
Hormonal contraceptives are another frequent but underrecognized culprit. Oral contraceptives raise levels of sex hormone-binding globulin, a protein that binds to testosterone and makes it less available to tissues. Research has found that women who use oral contraceptives have SHBG levels roughly four times higher than women who have never used them, and that these levels remain elevated even after stopping the pill.28PubMed Central. Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction If you noticed your desire dropped after starting hormonal birth control, that connection is physiologically real and worth discussing with your prescriber.
Exercise, Sleep, and Stress
The least glamorous answer to “what can I take” is sometimes “nothing, but change what you do.” Exercise has well-documented effects on sexual function in women: acute exercise increases sympathetic nervous system activity and arousal, while regular exercise improves cardiovascular health, mood, and body image, all of which feed into sexual well-being.29PubMed. The Effects of Exercise on Sexual Function in Women For men, the pathways are similar, with the added benefit that exercise helps maintain healthy testosterone levels and vascular function, both of which matter for arousal and desire.
Sleep is another overlooked factor. Obstructive sleep apnea in middle-aged men is frequently associated with decreased testosterone secretion, layered on top of the effects of aging and weight gain.30PubMed Central. Obstructive Sleep Apnea and Testosterone Deficiency Treating the sleep disorder alone does not always restore testosterone levels, but combining sleep treatment with testosterone therapy may improve both hormonal status and sexual function. Poor sleep quality more generally, even without a diagnosable disorder, raises cortisol, lowers testosterone, and saps the energy that desire requires.
Micronutrient deficiencies can quietly undermine libido as well. Zinc deficiency in men has long been known to impair testicular function, and in moderate-to-severe cases it leads to measurable hypogonadism.31PubMed. Clinical, endocrinological and biochemical effects of zinc deficiency Vitamin D deficiency has been associated with lower total testosterone levels, though that link becomes less clear after adjusting for body weight, suggesting the relationship may be partly explained by obesity rather than vitamin D alone.32PubMed Central. Association Between Vitamin D Deficiency and Testosterone Levels in Adult Males: A Systematic Review Correcting a genuine deficiency in either nutrient is cheap and straightforward and may remove a brake on your hormonal health, even if it is not the sole cause of low desire.
The Role of Cannabis
Cannabis is increasingly discussed as a libido aid, and the data suggest a complicated dose-dependent relationship. At lower doses, cannabis appears to be linked to heightened sexual desire and enjoyment, while higher doses tend to decrease both desire and performance.33PubMed Central. Update on cannabis in human sexuality Research looking specifically at women has found a similar pattern: low doses generally facilitate or have no effect on desire and receptivity, whereas high doses inhibit them.34PubMed. Effects of Cannabinoids on Female Sexual Function The problem is that “low dose” and “high dose” are poorly defined in most studies, individual tolerance varies enormously, and the research is observational rather than from controlled trials. Cannabis is not something a clinician would prescribe for low libido, but if you already use it recreationally, the evidence would suggest keeping the dose low if sexual function matters to you.
Mindfulness and Psychological Approaches
Given how large the placebo response is in sexual dysfunction trials, it makes sense that psychological interventions aimed at attention, arousal awareness, and reducing distress would have real effects. Mindfulness-based therapy has been the most studied approach. A randomized controlled pilot study of midlife and older women with low libido found that a group-based mindfulness program significantly reduced sexual distress compared to an education-only group.35PubMed Central. A virtual, group-based mindfulness intervention for midlife and older women with low libido lowers sexual distress in a randomized controlled pilot study Sexual distress, the anguish and frustration of not wanting sex, is technically a separate outcome from desire itself, but for many people the two are so intertwined that reducing distress actually frees up desire that was being suppressed by anxiety and self-judgment.
This is an area where the evidence is still early-stage, with mostly small trials, but the direction is consistent: therapies that help people get out of their heads and back into physical sensation tend to improve sexual function. Cognitive-behavioral therapy and couples counseling work on related fronts, particularly when relationship dynamics or body-image concerns are the actual driver of low desire. No pill, hormone, or supplement can fix a problem that lives in the space between you and a partner, and for many people with persistent low libido, a conversation with a therapist may ultimately be more effective than anything you can swallow or inject.