Best low libido treatments for women in 2026: the buyer’s shortlist

2. Addyi (flibanserin), best for an FDA-approved daily pill

Addyi (flibanserin) is one of two medicines the FDA has approved specifically for low desire in women. Its current label covers women under 65 with acquired, generalized hypoactive sexual desire disorder, meaning low desire that developed over time, happens in every situation and causes distress. It is a pill taken once a day at bedtime, every day, and it works gradually rather than on the day you take it.

The label carries a boxed warning for low blood pressure and fainting in certain settings. It also sets alcohol rules: wait at least two hours after one or two standard drinks before your bedtime dose, skip that night’s dose after three or more drinks, and don’t drink again until the next day.

On addyi.com, the maker says patients with insurance coverage pay as little as $20 a month (eligible patients only) and that the cash price is $149 a month through the PHILRx pharmacy, delivered free. The site also links to a third-party telehealth visit. Benefits in trials were modest: a meta-analysis found about half an extra satisfying sexual event per month over placebo (Jaspers 2016).

Addyi suits women who want an FDA-approved, steady daily treatment. It suits women less if they drink most evenings, or if they prefer something taken only before sex.

Facts from addyi.com, as of October 2026.

3. Vyleesi (bremelanotide), best for an FDA-approved as-needed option before menopause

Vyleesi is bremelanotide, the same molecule as PT-141, given as a 1.75 mg autoinjector under the skin of the thigh or abdomen at least 45 minutes before sex. Its FDA label covers premenopausal women with acquired, generalized HSDD, and says it is not indicated after menopause. The label limits use to one dose in 24 hours and says more than eight doses a month isn’t recommended, and that treatment should stop after eight weeks if it isn’t helping.

In two 24-week trials of 1,267 women, bremelanotide modestly improved desire and reduced distress compared with placebo (Kingsberg 2019). Nausea was the most common side effect, affecting about 40% of women, most often after the first dose. Bremelanotide can also cause a temporary rise in blood pressure, so the label advises against it in women with uncontrolled high blood pressure or heart disease.

On vyleesi.com, the maker says most commercially insured patients pay $0 for a 4-dose box, and that without coverage a 4-dose box is $99. Prescriptions are filled by BlinkRx, a digital pharmacy, and government-insured patients aren’t eligible for the savings program. Vyleesi suits premenopausal women who want an FDA-approved as-needed option and don’t mind giving themselves a small injection.

Facts from vyleesi.com, as of October 2026.

4. Testosterone, best for low desire after menopause

After menopause, testosterone has the strongest evidence of any treatment for low desire. The 2019 Global Consensus Position Statement, written by international medical societies, says the only evidence-based use of testosterone in women is for hypoactive sexual desire disorder in postmenopausal women (Davis 2019). A meta-analysis of 36 trials with 8,480 women found that it improved desire, arousal, orgasm and satisfying sexual events in postmenopausal women. Acne and hair growth were more common, and no serious adverse events were recorded (Islam 2019).

No testosterone product is FDA-approved for women in the US, so it is prescribed off-label, usually as a small dose of a transdermal gel or cream made for men. The consensus recommends checking blood levels before starting and during treatment, keeping them in the normal premenopausal female range, and stopping if there is no benefit after six months. It specifically says compounded “bioidentical” testosterone can’t be recommended for low desire, and pellets and injections aren’t recommended either.

Testosterone is a good fit for postmenopausal women with distressing low desire who have a clinician willing to prescribe it and monitor levels. The consensus says there isn’t enough evidence to use it for other symptoms, such as energy, mood or bone health. Our guide to testosterone and libido covers dosing ranges and side effects in more detail.

Facts from pubmed.ncbi.nlm.nih.gov, as of October 2026.

5. Sildenafil arousal cream, best for arousal and sensation rather than desire

Several online menopause services sell a compounded cream containing sildenafil, the active ingredient in Viagra, to apply before sex. The idea is to increase blood flow to the clitoris and vulva, which may help with arousal and sensation rather than interest in sex. On its sexual health page, Alloy lists its O-mazing cream at $89.97 for a 3-month supply, and a bundle with estradiol vaginal cream at $169.95 for 3 months. Winona lists a sildenafil arousal cream at $79 per order on its product page. Evernow also offers one through its membership.

These creams are compounded. Evernow’s own product page says its cream is not FDA-approved and hasn’t been evaluated by the FDA for safety or effectiveness. We couldn’t find large randomized trials of topical sildenafil for women to cite here, so the main reason to try it is that it’s a low-commitment option for arousal problems specifically.

Unlike desire medicines, a sildenafil cream does nothing for low interest in sex. Sildenafil widens blood vessels, so tell the prescriber about any heart or blood-pressure medicines you take, especially nitrates. It suits women whose desire is intact but whose body is slow to respond, and who are happy to try a compounded product first.

Facts from myalloy.com, as of October 2026.

6. Intrarosa (prasterone), best for low desire driven by painful sex after menopause

When sex becomes painful, desire often fades as a result, and treating the pain can bring it back. Intrarosa is a vaginal insert of prasterone, a form of DHEA, used once a day at bedtime. Its FDA label covers moderate to severe pain during sex caused by vulvar and vaginal atrophy due to menopause. It is FDA-approved for pain, not for low desire.

In a 12-week trial of 482 postmenopausal women with vaginal atrophy and painful sex, prasterone improved overall sexual function scores compared with placebo, including desire, arousal and lubrication (Labrie 2015). That study was run by the drug’s developer, and the gain was modest. The DHEA in Intrarosa acts locally in the vagina; oral DHEA supplements are a different product.

Low-dose vaginal estrogen is the other main option for menopausal dryness and pain, and many women try it first. Both work on the vaginal tissue rather than on interest in sex directly, so they make most sense when discomfort is part of the problem. A clinician can help you choose between them and check that nothing else, such as a skin condition or pelvic floor tension, is causing the pain. For more, see our guide to painful sex after menopause.

Facts from dailymed.nlm.nih.gov, as of October 2026.