Condition
Low libido
7 compounds were checked against low libido. 6 earned a graded row; the rest are named below.
Last updated
Compounds with a graded row
Ordered by rung, strongest first. The rung rates the study design; the chip beside it says what the study measured. Both are needed.
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DHEA
human RCT Direct outcome Not approved for this condition
- Who was studied
- 24 women with adrenal insufficiency, double-blind randomised crossover, oral DHEA 50 mg daily for 4 months and placebo for 4 months with a 1-month washout; this is not a population selected for low sexual desire
In women with adrenal insufficiency, oral DHEA 50 mg daily increased the frequency of sexual thoughts (P=0.006), sexual interest (P=0.002) and satisfaction with the mental and physical aspects of sexuality (P=0.009 and P=0.02) compared with placebo; the women were enrolled for adrenal insufficiency, not for a diagnosis of low sexual desire, and the instrument was a sexuality questionnaire rather than the FSFI. The separate prescription vaginal insert, prasterone 6.5 mg, is FDA- and EMA-approved for moderate to severe dyspareunia due to menopausal vulvar and vaginal atrophy; dyspareunia is painful intercourse, not low desire, and that approval does not stand for a desire indication and does not transfer to oral over-the-counter DHEA, for which no regulator has approved any product or reviewed any dose. No trial of DHEA in people diagnosed with low sexual desire is on file.
Source DOI 2 primary sources read for this row
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Melanotan II
human RCT Direct outcome Not approved for this condition
- Who was studied
- 20 men with psychogenic and organic erectile dysfunction, double-blind placebo-controlled crossover, subcutaneous dosing; an earlier crossover in the same programme enrolled 10 men with erectile dysfunction of no known organic cause
Melanotan II is an unapproved non-selective alpha-MSH analogue; no regulator has approved it for low sexual desire, erectile dysfunction, or anything else, in any country. In a double-blind placebo-controlled crossover in 20 men, Melanotan II produced penile erection in 17 of 20 in the absence of sexual stimulation with a mean 41 minutes of RigiScan tip rigidity above 80%, and increased sexual desire was reported after 13 of 19 Melanotan II doses versus 4 of 21 placebo doses (P<0.01); that desire measure was an investigator-collected report, not a validated instrument such as the IIEF. Nausea and yawning were frequent, with severe nausea in 12.9% of subjects at 0.025 mg/kg, and no trial in women and no trial of a desire endpoint as a primary outcome is on file.
Source PubMed 2 primary sources read for this row
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Oxytocin
human RCT Direct outcome Not approved for this condition
- Who was studied
- 30 pre- and postmenopausal women with sexual dysfunction, randomised double-blind placebo-controlled crossover over 22 weeks, intranasal oxytocin 32 IU self-administered within 50 minutes before intercourse for 8-week periods
This is the one trial on file that measured a validated desire endpoint in women with sexual dysfunction rather than physiology in healthy volunteers, and it was negative: the Female Sexual Function Index rose 26% on oxytocin and 31% on placebo, the Sexual Interest and Desire Inventory 29% and 23%, and the Sexual Quality of Life 144% and 125%, with no statistically significant difference between oxytocin and placebo on any measure. The authors concluded that oxytocin and placebo improved sexual function comparably. Oxytocin is not approved for low sexual desire by any regulator; the remaining human oxytocin literature relevant here is single-dose physiology and brain-imaging work in healthy volunteers, which measured no desire outcome in an affected population.
Source DOI 1 primary source read for this row
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PT-141
human RCT Direct outcome Approved for this condition
- Who was studied
- premenopausal women with acquired, generalised hypoactive sexual desire disorder, n=1247 randomised across two identical 24-week Phase III trials (RECONNECT, NCT02333071 and NCT02338960), mean age 39; postmenopausal women and men were outside the enrolled population
The FDA approved bremelanotide (Vyleesi, 1.75 mg subcutaneous, initial US approval 2019) for premenopausal women with acquired, generalised hypoactive sexual desire disorder, and the label states plainly that it is not indicated for hypoactive sexual desire disorder in postmenopausal women or in men, and not to enhance sexual performance. The registrational trials measured the Female Sexual Function Index desire domain (integrated effect 0.35, P<.001) and the Female Sexual Distress Scale desire/arousal/orgasm item 13 (integrated effect -0.33, P<.001) against placebo, both validated desire endpoints. Nausea, flushing and headache each occurred in at least 10% of women given bremelanotide; no trial in postmenopausal women or in men is on file, so nothing here establishes what the compound does in those populations.
Source DOI 2 primary sources read for this row
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Testosterone
human RCT Direct outcome Off-label use
- Who was studied
- two separate populations. Women: postmenopausal women with hypoactive sexual desire disorder, pooled from blinded randomised placebo-controlled trials of at least 12 weeks (Islam 2019 meta-analysis), at roughly one tenth of the male replacement dose; premenopausal women were not the studied population. Men: 470 men aged 65 or over with low libido and average total testosterone below 275 ng/dL, randomised to testosterone gel or placebo for 1 year (the Testosterone Trials sexual function trial).
In postmenopausal women, randomised trials measured satisfying sexual events and desire, arousal and orgasm domains, and the 2019 Global Consensus Position Statement records postmenopausal hypoactive sexual desire disorder as the only indication the randomised evidence supports; no testosterone product is approved for women anywhere, so male formulations are used off-label at about a tenth of the male dose, with acne and hirsutism the reported excess adverse effects, and no randomised safety data beyond about two years. In older men with low testosterone, a separate question and a separate trial population, the Testosterone Trials sexual function trial measured the Psychosexual Daily Questionnaire and reported significantly greater sexual activity, sexual desire and erectile function than placebo over one year; that evidence is about hypogonadism in men and does not transfer to women, and the female evidence does not transfer to men. Approved male testosterone products are labelled for hypogonadism, not for low sexual desire as such.
Source DOI 3 primary sources read for this row
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hCG
human case series Direct outcome Off-label use
- Who was studied
- 20 men with hypogonadal symptoms and total testosterone above 300 ng/dL, multi-institutional retrospective review, median 8 months of hCG monotherapy, no control group
In a retrospective series of 20 men treated for low libido, fatigue or erectile dysfunction, mean total testosterone rose 49.9% from 362 to 519.8 ng/dL and 50% of patients reported symptom improvement; the symptom report was uncontrolled and used no validated desire instrument such as the IIEF, so the testosterone figure is the only quantified result and it is a surrogate marker. Reports of improved libido in men treated with hCG for hypogonadotropic hypogonadism come from similarly uncontrolled series. hCG is approved for other indications, including hypogonadotropic hypogonadism in males, and is not approved for low sexual desire by any regulator; no randomised trial with a desire endpoint is on file.
Source DOI 1 primary source read for this row
Checked, and nothing recorded
1 compound was checked against low libido and produced no gradeable row.
A compound is here because someone looked and the sources did not support a row — not because nobody looked. Under the rubric, uncertainty resolves to no row, and a row resting on a vendor page or a clinic blog is worse than no row at all.
What this page does not say
It reports what was measured, in whom, and how directly. It does not say what to take or at what dose, and a row here is a record of a study rather than a reason to use anything. Every rung links to the rubric that assigned it.