Low sex drive in females can be addressed through FDA-approved medications, hormone therapy, certain supplements, and off-label prescriptions, depending on the underlying cause. Two prescription drugs are specifically approved for low sexual desire in premenopausal women, while hormonal options target menopause-related changes. Supplements have weaker evidence but show promise in specific situations.
FDA-Approved Medications for Low Desire
Only two medications have full FDA approval specifically for low sexual desire in women, and both are limited to premenopausal women diagnosed with hypoactive sexual desire disorder (HSDD). They work differently and are taken in completely different ways.
Flibanserin (Addyi)
Flibanserin is a daily pill taken at bedtime at a dose of 100 mg. It works on brain chemistry, boosting activity at one type of serotonin receptor while blocking another, which shifts the balance of neurotransmitters involved in sexual motivation. Think of it less like a pill you take before sex and more like an antidepressant: it adjusts your baseline over weeks, and most women need at least four weeks to notice a difference. If nothing changes after eight weeks, it’s generally discontinued.
The most common side effects are dizziness, sleepiness, nausea, fatigue, insomnia, and dry mouth. The bigger practical concern is alcohol. Drinking close to the time you take flibanserin 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 standard drinks before taking your dose at bedtime, or skip the dose entirely if you’ve had three or more drinks. After taking it, you should avoid alcohol until the next day.
Bremelanotide (Vyleesi)
Bremelanotide takes a completely different approach. Instead of a daily pill, it’s a self-administered injection given under the skin of the stomach or thigh at least 45 minutes before anticipated sexual activity. It activates receptors in the brain tied to arousal and desire, so it works on demand rather than building up over time.
The limit is one injection per 24 hours and no more than eight doses per month. Nausea is the most frequently reported side effect, and it can also cause flushing and headache. Many women find the injection format inconvenient, but the on-demand nature appeals to those who don’t want to commit to a daily medication.
Hormone Therapy for Menopause-Related Changes
For women in perimenopause or menopause, falling estrogen levels cause vaginal dryness, thinning tissue, and discomfort during sex, a condition called genitourinary syndrome of menopause. When sex hurts, desire naturally drops. Treating the physical discomfort often brings desire back on its own.
Estrogen applied locally (as a vaginal cream, a slow-releasing ring, or a small suppository) restores moisture and tissue elasticity without delivering large amounts of hormone to the rest of the body. These are distinct from systemic estrogen pills or patches, which treat hot flashes and other whole-body symptoms. Local estrogen specifically targets the tissue where the problem is, and many women notice improvement within a few weeks. For some, simply removing the pain barrier is enough to restore a satisfying level of desire.
Testosterone is sometimes prescribed off-label as well, typically as a low-dose cream or gel. Women’s bodies naturally produce small amounts of testosterone, and levels decline with age. Some research supports a modest boost in desire with supplementation, but there is no FDA-approved testosterone product for women, so dosing and monitoring require close medical oversight.
Off-Label Prescription Options
Bupropion, an antidepressant that works on dopamine and norepinephrine rather than serotonin, is one of the more commonly discussed off-label options. It’s particularly relevant for women whose low desire is linked to another antidepressant, since selective serotonin reuptake inhibitors (SSRIs) are well known for suppressing libido. Bupropion either replaces the SSRI or is added alongside it. Clinical trials have tested doses starting at 150 mg daily and increasing to 300 mg, with participants rating their perception of change in desire after several weeks. It’s not approved for this purpose, but it has a long track record of use and a side effect profile most prescribers are comfortable with.
Supplements With Some Evidence
The supplement aisle is full of products marketed for female libido, but very few have meaningful clinical data behind them. Two stand out as having at least some trial evidence, though neither is as well-supported as prescription options.
Maca Root
Maca is a plant native to Peru that has been studied in small trials for sexual function. In one study of 45 women with antidepressant-related sexual dysfunction, taking 3 grams of maca root daily for 12 weeks led to higher rates of improvement compared to a placebo. The catch: this benefit was only observed in postmenopausal participants. Maca is generally well tolerated and widely available as a powder or capsule, but the evidence base is thin, and results vary between studies.
Ashwagandha
Ashwagandha, an adaptogenic herb used in traditional Ayurvedic medicine, has been studied for stress-related sexual dysfunction. A standardized root extract called KSM-66 has been used in trials at a dose of 600 mg per day (split into two 300 mg capsules). The proposed mechanism is indirect: ashwagandha lowers cortisol and reduces stress, which may remove a barrier to desire rather than directly stimulating it. If chronic stress or anxiety is a major factor in your low drive, this may be worth trying, but don’t expect pharmaceutical-level results.
Lifestyle Factors That Move the Needle
No pill or supplement works in a vacuum. Low desire in women is almost always multifactorial, meaning it’s rarely just one thing. Relationship quality, stress levels, sleep, body image, and mental health all feed into it, sometimes more powerfully than any medication can overcome. A few practical levers are worth attention.
Sleep deprivation suppresses sex hormones and tanks mood. Even modest improvements in sleep duration and quality can shift desire noticeably within a couple of weeks. Regular exercise, particularly strength training and cardiovascular work, improves blood flow, raises energy, and boosts confidence, all of which contribute to sexual motivation. Stress management matters too, whether that’s therapy, meditation, or simply reducing an unsustainable schedule.
For women on SSRIs or hormonal birth control, the medication itself may be the primary driver of low desire. Switching to a different antidepressant class or a non-hormonal contraceptive method can make a dramatic difference, sometimes more than adding a libido-specific treatment on top.
Choosing the Right Approach
The best option depends heavily on your situation. Premenopausal women with no obvious medical cause may be candidates for flibanserin or bremelanotide. Menopausal women dealing with painful sex should start with local estrogen, since it addresses the root issue directly. Women on SSRIs might benefit most from switching to or adding bupropion. And women whose low desire tracks closely with chronic stress or exhaustion may get more from lifestyle changes and adaptogens than from a prescription.
Many women combine approaches, using a supplement alongside hormone therapy, or pairing medication with couples counseling. Low desire rarely has a single fix, but most women find meaningful improvement once they identify the right combination of factors to address.