Condition
Female Sexual Dysfunction
Female sexual dysfunction means ongoing trouble with desire, arousal, orgasm, or pain during sex, often driven by hormonal shifts, stress, antidepressants, or medical conditions. Tribulus has moderate evidence behind it, with small trials finding libido went up, and early bremelanotide studies found better subjective arousal. Most of this work was small, though, and one DHEA study found no clear difference in libido.
Sources: PMID 29995725; PMID 33835907
- Supplements studied
- 7
- Medicines and peptides
- 1
- Graded outcomes
- 8
- Trials
- 13
- People studied
- 697
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Depression Symptoms Moderate Improvement | Improves (the measure goes down) | Moderate effect | 18 studies | 96 people | ||
Studies that measured depression symptoms
| ||||||
| Sexual Function | Improves (the measure goes up) | 2 studies | 34 people | |||
Maca
- Anxiety Symptoms: improves
- Follicle-Stimulating Hormone: improves
- Sexual Function: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anxiety Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 16 people | |||
| Follicle-Stimulating Hormone | Improves (the measure goes up) | 3 studies | 16 people | |||
Studies that measured follicle-stimulating hormone
| ||||||
| Sexual Function | Improves (the measure goes up) | 2 studies | 61 people | |||
| Estrogen | Changes; see studies | 1 study | 16 people | |||
| Depression Symptoms | Improves (the measure goes down) | 16 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 16 people | ||||
| Menopausal Symptoms | Improves (the measure goes down) | 16 people | ||||
| Sex Hormone Binding Globulin | Improves (the measure goes up) | 16 people | ||||
Nicotine
- Blood Pressure
- Libido: improves
- Heart Rate: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Blood Pressure No effect | NoneNo effect | 2 studies | 25 people | |||
| Libido | Improves (the measure goes up) | 1 study | 25 people | |||
| Heart Rate | Improves (the measure goes down) | 25 people | ||||
Velvet Antler
- Follicle-Stimulating Hormone
- Testosterone: improves
- Free Testosterone: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Follicle-Stimulating Hormone No effect | NoneNo effect | 1 study | 24 people | |||
Studies that measured follicle-stimulating hormone | ||||||
| Testosterone | Improves (the measure goes up) | 1 study | 24 people | |||
Studies that measured testosterone | ||||||
| Free Testosterone | Improves (the measure goes up) | 24 people | ||||
| Libido | Improves (the measure goes up) | 48 people | ||||
| Luteinizing Hormone | Improves (the measure goes up) | 24 people | ||||
| Prolactin | Improves (the measure goes up) | 24 people | ||||
| Sexual Function | Improves (the measure goes up) | 24 people | ||||
DHEA
- Libido
- Testosterone: improves
- Serum DHEA: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Libido No effect | NoneNo effect | 1 study | 79 people | |||
Studies that measured libido | ||||||
| Testosterone | Improves (the measure goes up) | 3 studies | 79 people | |||
Studies that measured testosterone
| ||||||
| Serum DHEA | Improves (the measure goes up) | 2 studies | 79 people | |||
Ginkgo Biloba
- Depression Symptoms
- Libido: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Depression Symptoms No effect | NoneNo effect | 24 people | ||||
| Libido | Improves (the measure goes up) | 4 studies | 92 people | |||
Prescription medicines and peptides studied, for context
PT-141 (Bremelanotide)
- Subjective Sexual Arousal: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Subjective Sexual Arousal Early studies showed bremelanotide positively affected subjective sexual arousal in women with female sexual arousal disorder. | Improves (the measure goes up) | Moderate effect | 37 studies |
Key findings
- LibidoImproves (the measure goes up)
- Depression SymptomsImproves (the measure goes down)
- Anxiety SymptomsImproves (the measure goes down)
The Female Sexual Dysfunction Support protocol
2 primary supplements · 8 supporting supplements
- Tribulus Terrestris250–750 mg daily (standardized to 40–45% saponins)
- Maca (Lepidium meyenii)1.5–3 g daily
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Studies cited
100 studies from PubMed
- Female Sexual Desire, Arousal, and Orgasmic Dysfunctions: A Systematic Review and Meta-Analysis of Treatment Options.
- 2024 SOGC, 2024 NCCN, 2022 ESO-ESMO, and 2018 ASCO: a comparison of female cancer survivorship guidelines for the management of sexual health concerns.
- Practical considerations and emerging approaches for the management of vasomotor and sexual symptoms in breast cancer patients on endocrine therapies.
- Intravenous peptides and amino acids for erectile dysfunction: a narrative review of current applications and future directions.
- A Comprehensive Review of Novel FDA-Approved Psychiatric Medications (2018-2022).
- Prespecified and Integrated Subgroup Analyses from the RECONNECT Phase 3 Studies of Bremelanotide
- An evaluation of bremelanotide injection for the treatment of hypoactive sexual desire disorder
- Safety Profile of Bremelanotide Across the Clinical Development Program.
- Management of Hypertension with Female Sexual Dysfunction.
- Effect of bremelanotide on body weight of obese women: Data from two phase 1 randomized controlled trials.
- The neurobiology of bremelanotide for the treatment of hypoactive sexual desire disorder in premenopausal women
- Bremelanotide
- Failure of a Meta-analysis: A Commentary on Glen Spielmans's "Re-Analyzing Phase III Bremelanotide Trials for 'Hypoactive Sexual Desire Disorder in Women'".
- Effect of Ginkgo biloba Extract on Cognitive Function: A Systematic Review
- Efficacy and Safety of Ginkgo biloba in Mild Cognitive Impairment: A Meta-Analysis
- Bremelanotide: New Drug Approved for Treating Hypoactive Sexual Desire Disorder
- Ginkgo biloba Extract (EGb 761): Pharmacological Activities and Clinical Outcomes
- Ginkgo biloba L. Historical Background and Current Applications in Medicine
- Ginkgo biloba and Brain Health: A Comprehensive Review
- Safety Profile of Ginkgo biloba Extract: Evidence from Clinical Trials
- Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials
- Long-Term Safety and Efficacy of Bremelanotide for Hypoactive Sexual Desire Disorder
- Bremelanotide: First Approval
- Long-Term Safety and Efficacy of Bremelanotide for Hypoactive Sexual Desire Disorder.
- Responder Analyses from a Phase 2b Dose-Ranging Study of Bremelanotide.
- Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials.
- Pharmacokinetics and Bioavailability of Ginkgo biloba Extract
- Neuroprotective Effects of Ginkgo biloba Extract: A Review
- Efficacy of Ginkgo biloba on Peripheral Arterial Disease: Meta-Analysis
- Ginkgo biloba Extract for Age-Related Macular Degeneration: A Meta-Analysis
- Female Sexual Dysfunction and the Placebo Effect: A Meta-analysis.
- Ginkgo biloba Extract for Cognitive Decline and Dementia: A Cochrane Review Summary
- Ginkgo biloba for Tinnitus: A Systematic Review and Meta-Analysis
- Ginkgo biloba Special Extract EGb 761 in Dementia: A Review
- Phase I Randomized Placebo-controlled, Double-blind Study of the Safety and Tolerability of Bremelanotide Coadministered With Ethanol in Healthy Male and Female Participants.
- Usefulness of ambulatory blood pressure monitoring to assess the melanocortin receptor agonist bremelanotide.
- Efficacy of Ginkgo biloba in Treating Acute Ischemic Stroke: A Meta-Analysis
- RETRACTED: Evaluation of the safety and efficacy of bremelanotide, a melanocortin receptor agonist, in female subjects with arousal disorder: a double-blind placebo-controlled, fixed dose, randomized study.
- Gateways to clinical trials.
- Gateways to clinical trials.
- Melanocortins in the treatment of male and female sexual dysfunction
- Bremelanotide: an overview of preclinical CNS effects on female sexual function
- Gateways to clinical trials.
- An effect on the subjective sexual response in premenopausal women with sexual arousal disorder by bremelanotide (PT-141), a melanocortin receptor agonist
- Gateways to clinical trials.
- Gateways to clinical trials.
- Gateways to clinical trials.
- Gateways to clinical trials.
- Double-blind, placebo-controlled evaluation of the safety, pharmacokinetic properties and pharmacodynamic effects of intranasal PT-141, a melanocortin receptor agonist, in healthy males and patients with mild-to-moderate erectile dysfunction
- Evaluation of the safety, pharmacokinetics and pharmacodynamic effects of subcutaneously administered PT-141, a melanocortin receptor agonist, in healthy male subjects and in patients with an inadequate response to Viagra.
- Gateways to clinical trials.
- Gateways to clinical trials.
- Gateways to clinical trials.
- Reduction of rise in blood pressure and cortisol release during stress by Ginkgo biloba extract (EGb 761) in healthy volunteers
- Effects of dehydroepiandrosterone and atamestane supplementation on frailty in elderly men
- Dehydroepiandrosterone combined with exercise improves muscle strength and physical function in frail older women
- Effect of 1-year oral administration of dehydroepiandrosterone to 60- to 80-year-old individuals on muscle function and cross-sectional area: a double-blind placebo-controlled trial
- Dehydroepiandrosterone replacement in healthy men with age-related decline of DHEA-S: effects on fat distribution, insulin sensitivity and lipid metabolism
- Effects of dehydroepiandrosterone vs androstenedione supplementation in men
- Oral dehydroepiandrosterone replacement in older adults: effects on central adiposity, glucose metabolism and blood lipids
- Effect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trial
- Short-term dehydroepiandrosterone treatment increases platelet cGMP production in elderly male subjects
- Dehydroepiandrosterone supplementation improves endothelial function and insulin sensitivity in men
- Supplementation with DHEA: effect on muscle size, strength, quality of life, and lipids
- Lack of dehydroepiandrosterone effect on a combined endurance and resistance exercise program in postmenopausal women
- Impact of DHEA supplementation on testosterone and estradiol levels in postmenopausal women: a meta-analysis of randomized controlled trials assessing dose and duration effects.
- Effect of oral DHEA on serum testosterone and adaptations to resistance training in young men
- Effects of short-term dehydroepiandrosterone supplementation on body composition in young athletes
- Effect of acute DHEA administration on free testosterone in middle-aged and young men following high-intensity interval training
- Dehydroepiandrosterone supplementation and bone turnover in middle-aged to elderly men
- Dehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on bone
- A systematic review and meta-analysis of randomized placebo-controlled trials of DHEA supplementation of bone mineral density in healthy adults.
- Effects of dehydroepiandrosterone supplementation on cognitive function and activities of daily living in older women with mild to moderate cognitive impairment
- Effects of dehydroepiandrosterone supplementation on cognitive function and quality of life: the DHEA and Well-Ness (DAWN) Trial
- Dhea supplementation and cognition in postmenopausal women
- Effects of dehydroepiandrosterone (DHEA) supplementation on hormonal, metabolic and behavioral status in patients with hypoadrenalism
- Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency
- A randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgia
- Dehydroepiandrosterone (DHEA) effects on HIV replication and host immunity: a randomized placebo-controlled study
- Effects of dehydroepiandrosterone supplementation during stressful military training: a randomized, controlled, double-blind field study
- Addition of dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study
- A dose-response and meta-analysis of dehydroepiandrosterone (DHEA) supplementation on testosterone levels: perinatal prediction of randomized clinical trials.
- Effect of Ginkgo biloba (EGb 761) on treadmill walking time among adults with peripheral artery disease: a randomized clinical trial
- Study of the antiischemic action of EGb 761 in the treatment of peripheral arterial occlusive disease by TcPo2 determination
- 6-Month double-blind randomised clinical trial of Ginkgo biloba extract versus placebo in two parallel groups in patients suffering from peripheral arterial insufficiency
- Reduction of atherosclerotic nanoplaque formation and size by Ginkgo biloba (EGb 761) in cardiovascular high-risk patients
- Does Ginkgo biloba reduce the risk of cardiovascular events
- A new ginkgo fresh plant extract increases microcirculation and radical scavenging activity in elderly patients
- Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial
- Polysomnographic effects of adjuvant ginkgo biloba therapy in patients with major depression medicated with trimipramine
- Ginkgo biloba for antidepressant-induced sexual dysfunction
- A placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophrenia
- The effect of extract of ginkgo biloba addition to olanzapine on therapeutic effect and antioxidant enzyme levels in patients with schizophrenia
- A double-blind, placebo-controlled trial of extract of Ginkgo biloba added to haloperidol in treatment-resistant patients with schizophrenia
- Brain-derived neurotrophic factor levels and its Val66Met gene polymorphism predict tardive dyskinesia treatment response to Ginkgo biloba
- Phase II study of Ginkgo biloba in irradiated brain tumor patients: effect on cognitive function, quality of life, and mood
- Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugs
- Short- and long-term effects of Ginkgo biloba extract on sexual dysfunction in women
- An examination of the efficacy of Ginkgo biloba extract EGb761 on the neuropsychologic functioning of cognitively intact older adults
- Acute cognitive effects of standardised Ginkgo biloba extract complexed with phosphatidylserine