The Best (Instant?) Female Arousal Pills

If you’re a woman struggling with low libido or other sexual dysfunction concerns, you’re not alone. Research estimates that 10% of adult women live with Hypoactive Sexual Desire Disorder (HSDD), and other studies report that approximately 40-50% experience at least one distressing sexual symptom in their lives due to the hormone changes of menopause.1 2 These symptoms vary widely from person to person and can manifest both physically and mentally.

Since these symptoms can be highly distressing and result in lowered self-esteem or relationship difficulties, you may be looking for the quickest fix possible. But with so many options on the market — a lot of which are from shady companies making impossible promises — how do you know which ones are effective and, most importantly, safe?

In this guide to the best female arousal pills and topicals, we give you all the details of our top picks, including safety, effectiveness, cost, discounts, and much more.

If you’re in a hurry, here’s a quick summary of our findings.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions about staying healthy and living healthier lifestyles.

For this review of the best female arousal products, we examined more than 100 scientific studies and other credible sources covering female sexual function, product ingredients, safety, and effectiveness. We also thoroughly investigated the companies behind these products and purchased many of them ourselves, allowing our testers to evaluate factors such as ordering, packaging, ease of use, and the overall customer experience. As new research, products, and treatment options become available, we’ll continue updating this guide accordingly.

Additionally, like all health-related content on this website, this guide was thoroughly vetted for accuracy by one or more members of our Medical Review Board.

There’s a wide variety of female arousal pills, gels, creams, and other products on the market. With some containing less-than-safe ingredients or making claims that aren't well supported by research, it's important to know which options are both safe and effective. We evaluated each product based on its safety, effectiveness, cost, and convenience, while also considering the strength of the clinical evidence behind its ingredients and overall formulation.

In the sections ahead, we explain how each product performed in these areas and where certain options stood out. All of our recommendations met a high standard overall. When we highlight a category winner, it doesn't mean the other products performed poorly — only that it offered a distinct advantage in that particular area.

Safety

Advantage: Bonafide Ristela

Many products marketed as "instant female arousal pills" rely on proprietary blends, understudied ingredients, or exaggerated claims. Our recommendations stood apart by using transparent formulas, clinically studied ingredients, and safety profiles that are generally well understood.

Bonafide Ristela earned a slight edge in this category because of its simple, clinically studied formulation. Sold internationally as Lady Prelox, the product has been evaluated in multiple human studies, where it was generally well-tolerated while improving measures of female sexual function.78 Unlike some competing products, Ristela doesn't rely on hormones or hormone precursors, and its four active ingredients have relatively straightforward safety profiles for most healthy adults.

That doesn't mean it's appropriate for everyone. Because Ristela contains L-arginine, it may trigger herpes simplex (HSV-1 or HSV-2) flare-ups in susceptible individuals, and its nitric oxide-supporting ingredients may interact with certain blood pressure medications or nitrates.3 76 As with any supplement, it's a good idea to talk with your healthcare provider before starting treatment, especially if you have an underlying medical condition or take prescription medications.

Life Extension Sexual Health for Her was a close runner-up. Its formula combines clinically studied doses of Libifem fenugreek extract and saffron extract, both of which have demonstrated favorable safety profiles in human studies.61 73 74 75 However, these botanical ingredients have a somewhat broader range of potential medication interactions than Ristela's formula. For example, fenugreek may interact with diabetes medications and blood thinners, while saffron may not be appropriate for people taking certain antidepressants or anticoagulants.

Our prescription recommendations naturally require additional consideration. Joi + Blokes The Mood and Scream Cream contain medications that should only be used under the supervision of a licensed healthcare provider. While telemedicine makes these treatments convenient to obtain, they aren't appropriate for everyone and require a review of your medical history and current medications before use.

Effectiveness

Advantage: Joi + Blokes The Mood

Judging the effectiveness of products intended to support female sexual function can be challenging. Low desire and difficulty with arousal can have different underlying causes, and people may respond differently to the same treatment.

Joi + Blokes The Mood has the advantage here largely because it contains bremelanotide, the active ingredient in Vyleesi, an FDA-approved treatment for acquired, generalized HSDD in premenopausal women.11 52 In two phase 3 randomized, placebo-controlled trials involving 1,267 women, bremelanotide significantly improved sexual desire and reduced distress related to low desire compared with placebo.60 The Mood pairs bremelanotide with tadalafil and oxytocin, which may offer additional support for different aspects of sexual function, although the evidence behind these ingredients is less robust.

For tadalafil, the limited research in women suggests it may support genital arousal by increasing blood flow.70 One small 12-week study of premenopausal women with type 1 diabetes found that 5mg of tadalafil daily improved measures of genital arousal and increased clitoral blood flow.72 Another small case series reported improvement in antidepressant-associated sexual dysfunction with tadalafil.71 These studies are encouraging, but they're small and lack the rigorous evidence available for bremelanotide, so tadalafil alone wouldn't be enough to make The Mood our efficacy standout.

Evidence for oxytocin is weaker still. In a randomized, double-blind crossover trial involving 30 women with sexual dysfunction, intranasal oxytocin improved sexual-function scores over time, but the improvements weren't significantly different from placebo.68 That makes oxytocin an interesting addition to The Mood, but not a major reason for our recommendation.

There’s encouraging evidence behind some of our other recommendations, too. The Lady Prelox formula underlying Bonafide Ristela improved Female Sexual Function Index (FSFI) scores in a small clinical study, while a 2024 randomized trial of 3.6% topical sildenafil — like the sildenafil found in Joi + Blokes Scream Cream — found improvements in several measures of arousal and sexual function, particularly among women without concomitant orgasmic dysfunction.53 78

Cost

Advantage: Life Extension Sexual Health for Her

Comparing the cost of female arousal products isn't always straightforward. Some are designed to be taken every day to support long-term libido and sexual function, while others are intended for occasional, on-demand use. Looking only at the sticker price doesn't tell the whole story, so we also considered how many servings or applications each product provides.

Among our recommendations, Life Extension Sexual Health for Her offers the best overall value. A 30-day supply costs $34.50, or about $1.15 per day. Bonafide Ristela is the next most affordable oral option, while CERE Enchantment Gel and Joi + Blokes Scream Cream carry higher up-front prices but provide enough applications to keep their estimated per-use costs relatively reasonable.

The clear outlier is Joi + Blokes The Mood. Although its $149 monthly subscription includes access to a prescription treatment, each shipment contains only six troches, making it the most expensive product in this guide on a per-dose basis. That higher cost may be worthwhile for people seeking an on-demand prescription option, but for readers primarily concerned with affordability, Life Extension stands out as the best value.

Convenience

Advantage: Joi + Blokes The Mood

Convenience means different things depending on what you're looking for. Some people prefer a daily supplement that becomes part of their routine, while others would rather use a product only when they anticipate sexual activity. For this category, we considered factors such as ease of access, dosing, delivery options, and how easily each product fits into everyday life.

Joi + Blokes The Mood earned the advantage largely because of how easy it is to use on demand. Each dose comes as a fast-dissolving troche that's placed under the tongue 30-60 minutes before sexual activity, so there's no need for water, swallowing pills, or applying a topical. One of our testers also found the taste surprisingly pleasant, with a sweet, slightly fruity flavor and a hint of vanilla.

That said, convenience is highly personal. Daily supplements like Life Extension Sexual Health for Her and Bonafide Ristela may be easier for people who prefer a consistent routine over planning ahead for on-demand use. Likewise, topical products such as CERE Enchantment Gel and Joi + Blokes Scream Cream may appeal to those who prefer localized treatment, even if application is slightly less convenient than taking a pill or troche.

In the chart below, we compare our top picks across several key factors to help you decide which product best suits your needs. If you’re interested in learning more details, you can find our complete evaluation of these products in their dedicated sections.

Note: Best possible monthly cost reflects the lowest monthly cost available through subscription or bulk savings opportunities.

Female libido support products are generally intended to aid women or assigned female at birth (AFAB) individuals who:

• Are experiencing a dip in their libido or sex drive
• Have difficulty achieving orgasm
• Are struggling with vaginal dryness19
• May be feeling less pleasure from sex due to various reasons, such as menopause symptoms
• Are diagnosed with hypoactive sexual desire disorder (HSDD) or another form of female sexual dysfunction (FSD)

Some of the products, like over-the-counter (OTC) arousal topicals or gels, can also be used simply because you want to enhance your sexual experience. Prescription topicals, like Joi + Blokes Scream Cream, though, are typically intended for people struggling with distressing sexual symptoms. (Joi + Blokes online consultation quiz specifically asks if you’ve been experiencing a lower interest in sex than usual.)

Who should look elsewhere?

Besides having male anatomy or a safety restriction (more on that in the following section), there aren’t too many reasons why the female libido-supporting products in this guide couldn’t be used by someone interested in trying them. However, certain products may be more ideal than others depending on your unique needs.

• Individuals with HSDD may do better with one of the two available FDA-approved prescriptions — Addyi (pill) or Vyleesi (injection).
• Those looking for an “instant” fix could find that topicals, Joi + Blokes The Mood, or Vyleesi is what they need (these work within an hour).
• People seeking a more long-term solution might prefer supplements or Addyi (these options take weeks or months to work, but the potential benefits last longer).

While many of the sketchy “instant female arousal” pills on the market are not safe, the products we mention in this guide should be safe for most healthy adults. However, we’d be remiss not to mention a few safety considerations that should be kept in mind, including:

• Pregnant or nursing individuals would be safest sticking with OTC topicals only, as some ingredients in supplements and prescriptions may harm your baby.
• The herbal ingredients in various supplements may interact with certain medications or health conditions, so it’s important to get the all-clear from your doctor before taking them.
• Many of these products increase nitric oxide (NO) production, which can lower blood pressure. Those with cardiovascular concerns or who are on blood pressure medications should consult a doctor to make sure these products are safe to try.63
• Products containing L-arginine — such as Bonafide Ristela and VitaFLUX — could trigger a herpes flare-up (oral, genital, or both).3
• Some libido-support products for women may contain a synthetic form of DHEA, a hormone that acts as a precursor to androgens and estrogens.5 This ingredient has the potential to interact with a host of medications, increase the risk of certain cancers, lower “good” HDL cholesterol, trigger manic episodes, and more.6 12

At varying times and for many reasons, including the hormonal changes of menopause, women and AFAB individuals may notice that their desire for sex is much lower than it used to be.13 43 Fortunately, there are a few generally safe and effective female arousal products on the market.

These products take on a few different forms — supplements, gels or topicals, and prescription medications — each with its own way of working to rectify your concerns. But how exactly do they work?

Supplements

Female libido support supplements often tout being an “all-natural” approach to treating sexual concerns. These supplements generally contain herbal and botanical ingredients, vitamins and minerals, or organic compounds, like amino acids. Some may use synthetic forms of hormones, like DHEA and melatonin.41

The main goals for these products typically include the following potential benefits:

• Increasing blood flow to the genitals and relaxing smooth muscle tissue by influencing nitric oxide (NO) production.14
• Regulating sex hormones — estrogen and testosterone — which may improve sex drive and other related symptoms.15 16
• Balancing neurotransmitters, some of which play a major role in libido and sexual excitement.17

Prescription pills and injections

Currently, there are only two FDA-approved treatments for HSDD: Addyi, a pill, and Vyleesi, an injection. HSDD is believed to be caused by an imbalance of excitatory and inhibitory neurotransmitters in the brain. But other factors, like satisfaction in a relationship or self-esteem, may also play a role.18

Due to the believed involvement of neurotransmitters, Addyi and Vyleesi act on different signaling pathways in the brain. Addyi affects serotonin receptors and indirectly influences dopamine and norepinephrine, while Vyleesi’s active ingredient, bremelanotide, is a melanocortin receptor agonist.18 52

Another prescription option, Joi + Blokes The Mood, combines tadalafil (generic Cialis), oxytocin, and bremelanotide (the same active drug found in Vyleesi). Bremelanotide is FDA-approved as an injection for acquired, generalized HSDD in premenopausal women, but its use in The Mood’s compounded troche is not FDA-approved.52 Tadalafil is also being used off-label; while PDE5 inhibitors such as tadalafil and sildenafil have been investigated for female sexual dysfunction, results have been mixed.66 Oxytocin has been studied for female sexual dysfunction as well, though evidence supporting its effectiveness remains limited. In one small randomized trial, intranasal oxytocin did not significantly improve sexual function compared with placebo.68

Topicals

Female arousal gels or creams can also help with sexual satisfaction. While these products can’t affect things like hormone or neurotransmitter balance, some of the ingredients can increase genital blood flow and sensitivity, and others can add additional vaginal lubrication.

Like supplements, OTC female arousal topicals often rely on botanical ingredients and amino acids. But prescription topicals, like Joi + Blokes Scream Cream and Wisp’s OMG! Cream, add drugs, such as sildenafil, to the mix. Like the tadalafil in The Mood mentioned above, the sildenafil in these two prescription topicals is used off-label. However, a 2024 randomized controlled trial of 3.6% topical sildenafil found improvements in several measures of arousal and sexual function, particularly among women with female sexual interest/arousal disorder (FSIAD) who did not also have orgasmic dysfunction.53

At the time of this writing, Joi + Blokes The Mood is one of the closest things to an “instant” female arousal pill. The dissolvable prescription troche contains tadalafil, bremelanotide, and oxytocin and is intended to be taken 30-60 minutes before sexual activity. Other prescription options, such as Cake Meds Libido Lift Rx, are also designed for on-demand use.67

Otherwise, pills tend to take the longest to start working (anywhere from a couple of weeks to a month or so). The FDA-approved pill, Addyi, and OTC supplements have the potential to promote the longest-lasting benefits, however, as they build up and continue to be in your system.

If pills don’t interest you, then topicals, such as Scream Cream and Enchantment Gel, or the prescription injection, Vyleesi, could be good alternatives. These all work within an hour, but the effects last only a short time. Topicals can be effective for around 20-60 minutes, and Vyleesi content in the body peaks at around one hour before falling again.57

You may not necessarily have to choose between these two approaches. At the time of this writing, there don’t appear to be any known risks associated with using an oral pill or supplement for potential longer-term benefits while also using a female arousal topical for a more immediate boost. However, if you’re using one of the prescription medications discussed in this guide, check with your doctor before combining treatments.

Best over-the-counter pill

Bonafide focuses largely on women's health products for concerns including menopause, vaginal health, and sexual function. Its Ristela supplement is designed specifically to support physical arousal, orgasm, and overall sexual satisfaction by promoting genital blood flow.

Ristela is sold in other countries under the registered trade name Lady Prelox, and that formula has been evaluated in multiple human studies on female sexual function.40 50 78 This gives Ristela more direct clinical support than many OTC libido supplements, which often combine ingredients that have only been studied separately.

There’s one important caveat, though. Ristela isn't an on-demand treatment. Bonafide recommends taking it every day for at least two months, and clinical research suggests improvements may begin around four weeks and become more pronounced by eight weeks.50 78

So, among OTC pills, we think Ristela offers one of the strongest evidence bases for physical arousal, but readers looking for something to take shortly before sex will be better served by an on-demand prescription such as Joi + Blokes The Mood.

Ingredients and efficacy

Each two-tablet serving of Ristela contains:

• L-arginine HCl: 800mg
• L-citrulline HCl: 800mg
• Rosvita rose hips extract: 200mg
• Pycnogenol French maritime pine bark extract: 80mg

Here’s a closer look at Ristela’s ingredients and what the research says about them:

More important than the evidence for any one ingredient is the research on the complete formula. In one eight-week study involving 100 women aged 37-45 with moderate sexual dysfunction, total FSFI scores improved significantly, with benefits apparent after four weeks and increasing further by eight weeks.78 A separate placebo-controlled study of postmenopausal women reported improvements in desire, arousal, lubrication, orgasm, satisfaction, and pain.50 Another study involving peri- and postmenopausal women found improvements in sexual function and vaginal dryness.40

There are limitations to this research. The studies were relatively small, and a 2021 systematic review identified potential risk of bias in several trials evaluating L-arginine combination products.10 We'd like to see larger, independently replicated trials, but the finished-formula research still gives Ristela more directly applicable evidence than we typically see from OTC female sexual health supplements.

Safety

Ristela was generally well-tolerated in the Lady Prelox studies we've reviewed. In the 100-woman reproductive-age study, researchers reported no unwanted effects and no discontinuations related to supplementation.78 The postmenopausal study similarly reported no adverse effects, while the vaginal-dryness study found no safety or tolerability problems.40 50

Ristela is third-party tested and manufactured in an FDA-registered, GMP-compliant facility. The formula is hormone-free and contains no soy, gluten, or GMOs.

Still, Ristela isn't appropriate for everyone. Its L-arginine creates most of the meaningful safety considerations. Mayo Clinic notes that supplemental L-arginine may interact with:76

• Blood pressure medications
• Nitrates such as nitroglycerin
• Anticoagulant or antiplatelet drugs
• Diabetes medications
• PDE5 inhibitors such as sildenafil

Because several of these combinations may lower blood pressure further, people using cardiovascular medications should speak with their healthcare provider before taking Ristela. Mayo Clinic also advises against L-arginine supplementation in people who have had cold sores or genital herpes because higher arginine levels may reactivate herpes simplex virus.37

Purchasing and pricing

Ristela is available as either traditional tablets or drink mixes, and both versions are priced the same. The tablets require two pills once daily and can be taken with or without food, while the drink mix provides the same active ingredients in a single daily packet. Bonafide recommends consistent use for at least two months to give the product enough time to work.

At the time of our research, pricing for either version breaks down like this:

The three-month plan offers the best value, reducing the monthly cost from $58 to $43, or about 26% compared with buying one box at a time. You'll pay $129 up front for 90 servings, but that commitment makes sense for Ristela in particular: Bonafide recommends using it consistently for at least two months, so a three-month supply gives you enough time to evaluate whether it's working. Subscription orders also ship free.

Bonafide's return policy is less generous than we'd like for a product that may require up to eight weeks to evaluate. The company accepts unopened, unused products from first-time orders within 30 days of shipment and unopened recurring orders within 14 days. Refunds are also reduced by a $7 return-shipping fee. That means you can't realistically try Ristela for the recommended two months and return it if you don't experience a benefit.

This is one area where Life Extension Sexual Health for Her has a significant customer-experience advantage: its much longer satisfaction guarantee gives you substantially more time to determine whether the supplement works for you.

Best budget over-the-counter pill

Life Extension Sexual Health for Her combines two ingredients with randomized human research supporting aspects of female sexual function: Libifem fenugreek extract and saffron extract. Like Ristela, it’s intended for consistent daily use rather than on-demand support, with ingredient studies suggesting benefits may begin around four weeks and become more noticeable by six to eight weeks.

The two ingredients also take somewhat different approaches. Libifem has been studied for its effects on sexual desire and arousal, as well as sex hormones, while saffron research has found potential benefits across desire, arousal, lubrication, and satisfaction.73 80 That makes Sexual Health for Her a relatively simple formula, but one that addresses several aspects of female sexual function without relying on a long list of ingredients with little supporting evidence.

Ingredients and efficacy

Each capsule contains:

• Libifem fenugreek seed extract: 300mg
• Saffron extract: 15mg

Life Extension recommends one capsule twice daily, providing 600mg of Libifem and 30mg of saffron per day — the same daily amounts used in key clinical studies.

Here’s what we know about each:

The main limitation is that Life Extension's finished two-ingredient formula hasn't been clinically tested. We therefore can't assume that combining fenugreek and saffron will produce all of the benefits observed when each was studied separately. Still, both ingredients are included at the same daily doses used in human trials, giving Sexual Health for Her a stronger evidence base than many budget libido supplements.

Safety

Life Extension also does well from a quality-control standpoint. Sexual Health for Her is produced in a GMP-compliant U.S. facility, and the company tests raw materials and finished products for contaminants, potency, and active ingredient levels. Certificates of analysis are available upon request. The capsules are vegetarian, gluten-free, non-GMO, and free from all nine major food allergens.

Both of Sexual Health for Her’s ingredients appear to be generally well-tolerated at the doses used here. In the six-week saffron trial, adverse events were similar between the saffron and placebo groups, and no participant discontinued treatment because of an adverse event.80

Fenugreek deserves a little more caution. Supplemental amounts can cause gastrointestinal symptoms such as nausea and diarrhea, and the National Center for Complementary and Integrative Health (NCCIH) notes that large doses may cause a harmful drop in blood sugar.36 This could be particularly relevant for people taking medications that already lower blood glucose.

Pregnancy is another important consideration. NCCIH advises that fenugreek isn't safe during pregnancy in amounts greater than those normally found in food, while there isn't enough information to determine whether larger supplemental amounts are safe while breastfeeding. Anyone who is pregnant, breastfeeding, taking medication, or managing a health condition should talk with a healthcare professional before using this supplement.

Purchasing and pricing

Each bottle contains 60 capsules, which works out to a 30-day supply when taken as directed — one capsule in the morning and one in the evening, both with food. At $34.50 per bottle, Sexual Health for Her is the least expensive oral supplement among our top recommendations, which is why Life Extension earns our budget pick.

At the time of our research, pricing breaks down like this:

A subscription reduces the price by 13%, bringing the monthly cost to $30, or $1 per day. Life Extension's subscription program is also unusually flexible: you can choose your delivery frequency and date, pause or skip shipments, change quantities, or cancel at any time. Subscription orders also receive free standard shipping within the U.S.

The return policy adds to the value. Life Extension gives customers 365 days from purchase to return a supplement for a refund, exchange, or replacement. That's particularly useful for Sexual Health for Her because the ingredient research suggests it may take several weeks to determine whether you're benefiting.

Compared with Ristela, Life Extension costs considerably less per day and gives you far more time to decide whether it's working. The tradeoff is in the evidence: Ristela's complete formulation has been studied, whereas Life Extension relies on separate trials of its two active ingredients.

Best (and fastest) prescription pill

Joi + Blokes is a telehealth platform offering prescription treatments for men and women, including The Mood, an on-demand compounded medication for sexual function. Compounded medications are prepared by specialized pharmacies for individual patients rather than mass-produced in a single FDA-approved formulation. That allows clinicians to combine multiple active ingredients in one treatment, but it also means the finished product hasn't gone through the same FDA approval process as a commercially manufactured drug.

The Mood comes as a dissolvable troche that's taken before sexual activity, making it one of the faster and more convenient prescription options in this guide. Unlike our OTC recommendations, it requires a prescription, but the process is relatively simple and can be completed asynchronously, without a live appointment. You'll provide your health information for review by a licensed clinician, and if treatment is approved, the prescription is filled by one of Joi + Blokes' partner pharmacies and shipped directly to your door.

Ingredients and efficacy

Each troche of The Mood contains:

• Oxytocin: 20IU
• Bremelanotide (PT-141): 1mg
• Tadalafil: 5mg

The three ingredients target sexual function in different ways, but the strength of the evidence behind them — and how closely that research applies to The Mood's doses and delivery method — varies considerably.

Bremelanotide therefore does most of the scientific heavy lifting in The Mood. Tadalafil adds a plausible blood-flow component with some human evidence, while oxytocin is the least convincing of the three based on current research. Most importantly, The Mood's exact three-drug combination and sublingual delivery haven't been clinically tested, so evidence for the individual ingredients shouldn't be interpreted as evidence that the finished treatment will produce the same results.

Safety

Because The Mood combines three prescription medications, its safety profile is more complicated than those of our OTC recommendations. A licensed clinician must review your medical history before prescribing it, which helps screen for contraindications and drug interactions.

Bremelanotide can temporarily increase blood pressure and decrease heart rate. FDA labeling for Vyleesi contraindicates injectable bremelanotide in people with uncontrolled hypertension or known cardiovascular disease and advises considering cardiovascular risk before treatment.52 The most common side effects in the phase 3 trials included nausea, flushing, and headache.60

Tadalafil raises a somewhat different cardiovascular concern because it can lower blood pressure. FDA prescribing information contraindicates tadalafil with nitrates because the combination can cause excessive hypotension. Tadalafil can also amplify blood-pressure-lowering effects from alpha blockers, antihypertensive medications, and substantial alcohol intake.33

Common tadalafil side effects include headache, indigestion, flushing, nasal congestion, back pain, and muscle aches. Rare but serious reactions can include sudden vision or hearing changes.

Pregnancy is a contraindication, too. FDA labeling advises discontinuing Vyleesi if pregnancy is suspected and recommends effective contraception while using bremelanotide.52 Because The Mood uses bremelanotide through an unapproved route and combines it with other medications, anyone who is pregnant, trying to become pregnant, or breastfeeding should discuss these issues directly with the prescribing clinician.

And again, one limitation is worth emphasizing: the FDA safety information comes from approved formulations of the individual drugs, not from clinical testing of The Mood itself.

Purchasing and pricing

The Mood is available by subscription only, with six troches included per month:

The savings become substantial with longer commitments: the six-month plan costs $594 up front, which works out to an effective monthly price of $99 — about 34% less than the $149 monthly plan. But even at the lowest price, The Mood remains one of the most expensive products in this guide at roughly $16.50 per use. The monthly option costs nearly $25 per troche.

That cost is somewhat easier to justify when you consider that The Mood is an on-demand compounded prescription and the price includes clinician review and home delivery. Still, six doses per month isn't many, particularly for people who anticipate using the treatment regularly.

Joi + Blokes subscribers can easily cancel their medication from their online dashboard, and HSA/FSA payments are accepted. However, once your order ships, it isn't eligible for a refund.

Best prescription topical

Scream Cream is Joi + Blokes’ topical alternative to The Mood and may make more sense for people who want localized, on-demand support rather than a medication taken by mouth. Like The Mood, it’s a compounded prescription, meaning its ingredients are combined by a specialized pharmacy rather than sold as an FDA-approved finished drug.

To use it, apply a pea-sized amount to the clitoral and vaginal areas and gently massage it in about 30 minutes before anticipated sexual activity. Effects typically last 30 minutes to 2 hours, depending on individual response, and a 90-day supply provides about 60 applications.

The prescription process is similar to The Mood: a licensed clinician reviews your health information asynchronously, and approved medication is filled by a partner pharmacy and shipped directly to your home.

Ingredients and efficacy

Scream Cream contains:

• Sildenafil: 2%
• Theophylline: 3%
• Pentoxifylline: 2%
• L-arginine: 6%

As we’ve discussed elsewhere in this guide, both sildenafil and L-arginine can support nitric oxide-related blood flow. In Scream Cream, they’re paired with theophylline and pentoxifylline, two additional prescription drugs with vascular and smooth-muscle effects. Of these four ingredients, sildenafil has the strongest direct evidence for female sexual arousal.

Overall, we think Scream Cream is a plausible and promising prescription topical, largely because topical sildenafil has direct human evidence for female sexual arousal and the additional ingredients have mechanisms that could reasonably complement it. The main limitation is that Scream Cream’s exact four-ingredient formulation hasn’t been tested in a controlled clinical trial, so we can’t say with certainty how much benefit the combination adds beyond sildenafil alone.

Safety

There’s some reassuring safety evidence for topical sildenafil. In a separate analysis of the 2024 phase 2b trial, researchers evaluated 3.6% sildenafil cream in healthy premenopausal women over 12 weeks. Side effects occurred at similar rates with sildenafil and placebo, and all were mild or moderate. The most common treatment-related complaint was discomfort where the cream was applied.26

Researchers also looked for side effects among sexual partners across more than 2,500 sexual experiences and found no significant difference between sildenafil and placebo. However, these findings apply to the 3.6% sildenafil cream studied, not Joi + Blokes' four-drug formulation.

Sildenafil requires caution for people taking nitrates, however. Oral sildenafil is contraindicated with nitrate medications because the combination can cause a dangerous drop in blood pressure.25 We can't assume that a topical product results in the same amount of sildenafil reaching the bloodstream, but Scream Cream hasn't been studied closely enough to rule out that concern.

Scream Cream's other ingredients add some uncertainty because there isn't comparable safety research on this specific combination when applied to genital tissues. Theophylline can cause side effects such as headache, rapid heartbeat, nausea, and low blood pressure, while pentoxifylline affects blood flow and can interact with certain medications.31 32 Additionally, we don't know how much of these drugs enters the bloodstream when Scream Cream is used as directed, so it's important that the prescribing clinician reviews your medications and cardiovascular history.

Finally, Scream Cream hasn't been studied during pregnancy or breastfeeding, so we'd recommend discussing its use with the prescribing clinician in either situation.

Purchasing and pricing

Scream Cream is sold as a 90-day supply with an estimated 60 applications and is available either as a one-time purchase or by subscription.

The subscription saves 20%, lowering the price from $139 to $111 for a 90-day supply and bringing the estimated cost per application from about $2.32 to $1.85. Subscribers also receive free shipping, while one-time purchases carry a $10 shipping fee. That makes the subscription considerably more economical for anyone who expects to use Scream Cream regularly.

Even with its relatively high up-front price, Scream Cream costs far less per use than The Mood. With roughly 60 applications per supply, you're getting an on-demand compounded prescription for less than the cost of a single month of The Mood. One drawback is that prescription products are nonrefundable once shipped.

Best over-the-counter topical

CERE was founded by board-certified OB/GYN Amir Marashi, MD, with a focus on female sexual wellness. Along with products like arousal gels and sex toys, the company has been involved in research examining clitoral anatomy, blood flow, and sexual response. Enchantment Gel fits naturally into that focus, combining L-arginine and L-citrulline with chamomile in an OTC topical designed to support physical arousal.

One of its biggest advantages is simplicity. Enchantment Gel is used on demand rather than every day: apply it externally to the vulvar or clitoral area before sexual activity. There’s no need to wait several weeks to see whether it works, as you would with Ristela or Life Extension Sexual Health for Her, and unlike Scream Cream, it doesn't contain prescription medications or require a prescription.

Ingredients and efficacy

CERE highlights three main ingredients in Enchantment Gel:

• L-arginine
• L-citrulline
• Chamomile

The company doesn’t publish the concentrations of these ingredients, which limits our ability to compare its formula dose-for-dose with other products. However, that matters somewhat less here because the finished Enchantment Gel itself has been evaluated in human research.

The human study is encouraging, but it’s important not to overstate what it proves. It included only five participants, had no placebo group, and measured physiological changes rather than outcomes such as pleasure, orgasm, or sexual satisfaction. Researchers also found that the increase in blood flow observed at five minutes had returned toward baseline by seven minutes. The authors themselves called for larger, blinded studies that measure sexual-function outcomes.

Still, this is one reason Enchantment Gel earns our OTC topical recommendation. Many arousal gels rely largely on plausible mechanisms and marketing claims; here, we at least have direct evidence showing that the actual product can measurably increase clitoral blood flow, even if we still need much stronger research to know how reliably that translates into a better sexual experience.

Safety

Enchantment Gel has a relatively straightforward safety profile compared with prescription topicals because it doesn’t contain drugs such as sildenafil, pentoxifylline, or theophylline. The 2025 pilot study specifically monitored participants for pain, numbness, burning, rash, itching, and other adverse effects during the testing period, although the study was far too small and short to establish long-term safety.24

CERE also formulates Enchantment Gel without parabens, sulfates, phthalates, formaldehyde, soy, nuts, GMOs, pesticides, or heavy metals. The company specifically says the gel is safe for oral sex, which gives it a practical advantage over prescription topicals where partner exposure may be more complicated. CERE still labels the product for topical use, so “safe for oral sex” shouldn’t be interpreted as meaning it’s intended to be swallowed.

Chamomile is generally well-tolerated on the skin, but allergic reactions are possible. The National Center for Complementary and Integrative Health notes that people with allergies to ragweed, chrysanthemums, marigolds, or daisies may be more likely to react to chamomile.23

There also isn’t enough product-specific research to establish Enchantment Gel’s safety during pregnancy or breastfeeding. NCCIH similarly notes that little is known about chamomile safety during either period, so we’d recommend checking with a healthcare professional before use.

Purchasing and pricing

Enchantment Gel comes in a 30mL bottle and costs $58 as a one-time purchase. CERE doesn’t currently offer a subscription for Enchantment Gel.

• Price: $58.00
• Approx. applications: 30-45
• Approx. cost per application: $1.29-$1.93
• Shipping: $10.00

At $58, Enchantment Gel is also relatively affordable compared with many other arousal topicals. Based on our estimate of 30-45 applications per bottle, it works out to about $1.29-$1.93 per use. That's considerably less up front than the $139 you'll pay for Scream Cream, though Scream Cream provides more applications and its subscription can lower the per-use cost.

CERE's return policy is less impressive. Opened or used products aren't eligible for refunds, so you won't be able to try Enchantment Gel and return it simply because it didn't work for you. CERE does offer free discreet U.S. shipping on orders of $85 or more, but a single $58 bottle won't meet that threshold.

Honorable mention over-the-counter pill

Promescent is best known for its sexual-health products, including delay sprays, lubricants, and other intimacy products. VitaFLUX is its daily nitric oxide supplement, with versions marketed to both men and women that use the same core formula. For women, Promescent positions VitaFLUX primarily around circulation, natural lubrication, libido, and orgasm intensity.

VitaFLUX was previously our top OTC pill, and we still think it’s a solid option — particularly if Ristela feels too expensive. Its main drawback is the evidence. Several VitaFLUX ingredients have research supporting their potential roles in sexual function, but we haven't found a clinical trial evaluating this complete formula in women. Ristela, by comparison, has multiple studies on its finished formulation, which is enough to move Promescent into honorable-mention territory.

Ingredients and efficacy

Each six-capsule daily serving contains:

• L-arginine: 2,000mg
• L-citrulline: 1,000mg
• L-carnitine tartrate: 1,000mg
• Magnesium: 64mg
• Zinc: 10.5mg

Promescent currently recommends splitting those six capsules between morning and evening.

We’ve already covered the nitric oxide pathway elsewhere in this guide, and it’s the most compelling part of VitaFLUX’s formula. L-arginine and L-citrulline can support nitric oxide production, which helps blood vessels relax and increases circulation — including blood flow involved in genital arousal.77 A systematic review of L-arginine-containing treatments for female sexual dysfunction found improvements in FSFI scores or individual domains in six of seven included studies, although most evaluated combination formulas rather than L-arginine alone.10

VitaFLUX provides 2,000mg of L-arginine daily, putting it within the general range evaluated in some of that research. Its 1,000mg of L-citrulline may further support L-arginine and nitric oxide levels, though direct research on L-citrulline for female sexual function is much thinner.10

The remaining ingredients are less convincing for sexual function specifically. L-carnitine plays an established role in cellular energy production, but direct human research connecting supplementation to improved female arousal and sexual function is limited.21 22 Zinc may be more useful for women who are deficient: one clinical study in postmenopausal women with low zinc levels found that supplementation improved several measures of sexual function.27 Evidence tying magnesium supplementation directly to female arousal is considerably weaker.

That leaves VitaFLUX with a plausible, reasonably dosed formula — particularly around nitric oxide — but not the same level of evidence we have for Ristela. We wouldn't assume that combining these five ingredients produces greater benefits than the individual research suggests.

Safety

VitaFLUX should be reasonably well-tolerated by many healthy adults, but its nitric oxide-supporting ingredients also contribute to some of its most important precautions.

As discussed earlier, L-arginine can trigger herpes outbreaks in susceptible individuals and may interact with medications that affect blood pressure, including nitrates and antihypertensive drugs.3 63 L-carnitine may also interact with thyroid hormone and certain other medications.4

The zinc dose is modest at 10.5mg, well below the 40mg tolerable upper intake level for adults, but people taking other zinc-containing supplements should account for their total daily intake.29 30

We'd also recommend avoiding VitaFLUX during pregnancy or breastfeeding unless a healthcare professional specifically approves it, since this finished combination hasn't been adequately studied in either population.

Purchasing and pricing

One of VitaFLUX's biggest advantages over Ristela is cost. Each bottle contains 180 capsules, enough for 30 days at the recommended six-capsule daily dose. You can buy one bottle or save more with a three-bottle purchase, and subscribing takes another 15% off either option.

The three-bottle subscription offers the best value at $91.68 for 90 servings, or about $1.02 per day. Even without subscribing or buying in bulk, VitaFLUX's $39.95 one-time price is noticeably lower than Ristela's $58 for the same 30-day supply. For someone primarily interested in nitric oxide and blood-flow support, that price difference could make VitaFLUX an appealing alternative. The tradeoff is the finished-formula research that helped Ristela earn our primary OTC recommendation.

The biggest inconvenience is the serving size: six capsules per day, typically split into two doses. That's considerably more burdensome than Ristela's two daily tablets or Life Extension's two capsules.

Promescent provides free U.S. shipping on orders over $20, so every VitaFLUX option qualifies. Its 30-day money-back guarantee is also better than Ristela's policy, which only allows returns of unopened products and doesn't give you a meaningful opportunity to try the supplement. Life Extension remains the standout here, however, with its 365-day satisfaction guarantee. For a daily supplement that may take several weeks to evaluate, that extra time is a significant advantage.

Honorable mention prescription topical

Wisp is a sexual-health-focused telehealth platform offering prescription treatments for concerns ranging from vaginal infections to sexual function. OMG! Cream is its compounded topical for arousal, available in an Original formula with 1% sildenafil and an Extra Strength version with 3% sildenafil. Both are intended to increase blood flow to the clitoris and support arousal, sensitivity, and lubrication.

Like Scream Cream, OMG! Cream is used on demand rather than every day. Apply a pea-sized amount to the clitoral and vaginal areas about 30 minutes before anticipated sexual activity. Each bottle contains 0.51 fl oz and provides about 15 uses when used as directed.

The prescription process is fully online. You'll answer questions about your symptoms and health history for review by a licensed provider; if needed, the provider may follow up by secure chat or phone. Approved medication is then shipped free in discreet packaging.

Ingredients and effectiveness

OMG! Cream contains:

• Sildenafil: 1% in Original or 3% in Extra Strength
• Pentoxifylline
• Ergoloid mesylates
• Peppermint

As with Scream Cream, sildenafil is the ingredient with the strongest evidence for female sexual arousal.

Overall, we think OMG! Cream remains a credible prescription topical, particularly the 3% Extra Strength version. Topical sildenafil has direct human evidence, and Wisp gives readers a relatively inexpensive way to access a concentration close to what was studied clinically. The limitation is the same one we see with other compounded treatments: OMG! Cream's complete formulation hasn't been clinically tested, so the evidence for sildenafil can't automatically be extended to the finished product. Compounded drugs also aren't FDA-approved, meaning the FDA doesn't evaluate their safety, effectiveness, or quality before marketing.42

Safety

Topical sildenafil has shown a reassuring safety profile in human research. In a separate analysis of the 2024 phase 2b trial, 3.6% sildenafil cream was generally well-tolerated, with side effects occurring at similar rates in the sildenafil and placebo groups. Researchers also found no significant increase in adverse effects among sexual partners exposed during intercourse.26

That research applies to the studied sildenafil cream, however, not Wisp's full OMG! formulation. Pentoxifylline and ergoloid mesylates add additional prescription drugs with their own potential side effects and interactions, so a provider should review your medication history before prescribing OMG! Cream.

Sildenafil also requires caution in people taking nitrates, since systemic sildenafil can cause a dangerous drop in blood pressure when combined with nitrate medications.25 We can't assume a topical formulation produces the same bloodstream exposure as oral sildenafil, but the absence of published absorption data for OMG! Cream makes provider review important.

Pregnancy and breastfeeding are another area where we'd defer to the prescribing clinician because the finished compounded formula hasn't been adequately studied in either population.

Purchasing and pricing

OMG! Cream comes in two strengths, and each bottle provides approximately 15 uses. The Original formula is available in either one- or two-bottle purchases, while Extra Strength is currently sold only as a single bottle.

The two-bottle Original subscription offers the lowest cost per use at $2, while the Extra Strength formula costs $2.60-$3.00 per application. That extra cost may be worthwhile for readers specifically interested in sildenafil because the 3% concentration comes much closer to the 3.6% used in the 2024 clinical trial.

Wisp remains a reasonably affordable prescription topical overall. The Original formula starts at just $33 for 15 uses with subscription, and shipping is always free. Scream Cream costs $139 for an estimated 60 applications, or $111 with subscription. That’s a much higher up-front cost, but it works out to about $2.32 per use one time or $1.85 with subscription, making it competitive with — and on subscription, slightly cheaper per use than — Wisp’s Original formula.

Subscriptions are shipped every three months, and Wisp allows early refills or pauses but doesn't offer much flexibility in the standard delivery interval. HSA/FSA payments are accepted, and the medical review is included in the medication cost. Prescription medications are nonrefundable once dispensed, which is worth considering before committing to a larger order.

To learn more about Wisp and the platform’s telehealth visit process, check out our full Wisp review.

Honorable mention prescription pill

Hello Cake is a sexual-wellness company offering everything from lubricants and condoms to prescription sexual-health treatments. Libido Lift Rx is its on-demand prescription option for women, designed to support desire, arousal, blood flow, and sensitivity. Unlike a standard pill, it comes as a mint-flavored troche that dissolves under your tongue.

The prescription process is completely virtual. You’ll complete a medical intake that’s reviewed by a licensed provider, generally within 24 hours, and approved prescriptions are filled and shipped directly to you. Cake says Libido Lift Rx begins working in about 15-30 minutes, with effects lasting up to 36 hours on average.

That makes it a legitimate alternative to Joi + Blokes The Mood for readers who want an on-demand oral treatment. The difference is the evidence: The Mood contains bremelanotide, which has much stronger clinical support for HSDD, while Libido Lift relies mainly on tadalafil, plus more limited evidence for oxytocin and L-citrulline.

Ingredients and effectiveness

Each Libido Lift Rx troche contains:

• Tadalafil: 10mg
• Oxytocin: 200IU
• L-citrulline: 200mg

Because these ingredients have already appeared elsewhere in this guide, the most important question here is how well Cake’s doses line up with the available research.

Overall, Libido Lift Rx has a plausible on-demand formula, with tadalafil providing the strongest rationale for its effects. Its 10mg dose is within the range explored in female sexual-function research, while oxytocin and L-citrulline may offer additional support.

The main limitation is that Libido Lift Rx itself hasn’t been clinically tested. Cake confirms that the medication is compounded at a 503A pharmacy and isn’t FDA-approved as a finished product, so evidence for the individual ingredients doesn’t prove that this exact combination will produce the same results.

Safety

Because Libido Lift combines prescription tadalafil with oxytocin and L-citrulline, a clinician reviews your medical history before prescribing it.

Tadalafil presents most of the important drug-interaction concerns. It can lower blood pressure and should not be combined with nitrates or riociguat because of the risk of excessive hypotension.64 Cake also flags potential interactions involving hypertension medications and prostaglandins.

Possible side effects include headache, flushing, vision changes, gastrointestinal upset, and nausea. Cake advises stopping treatment and contacting the prescribing physician if concerning symptoms occur.

Libido Lift Rx also shouldn’t be used during pregnancy or while trying to conceive. Because the finished combination hasn’t been adequately studied in pregnancy or breastfeeding, we’d discuss either situation with the prescribing clinician before treatment.

Purchasing and pricing

Libido Lift Rx gives you considerably more control over how many doses you receive than most prescription options in this guide. You can choose 6, 12, 18, 24, or 30 doses per month, with one- or three-month supplies available. Cake also allows subscribers to adjust or cancel their prescription through their account.

At the time of our research, pricing breaks down like this:

The pricing is unusually straightforward: a one-month supply costs $10 per dose, regardless of quantity. Choosing a three-month supply lowers that to $8.50 per dose, a 15% savings.

That still makes Libido Lift Rx more expensive per use than most OTC options, but it’s considerably less expensive than Joi + Blokes The Mood, which costs roughly $16.50-$24.83 per troche depending on subscription length. For readers who want a fast-acting prescription pill but don’t want to spend nearly $25 per use, that price difference is meaningful.

All of these order sizes qualify for free shipping because Cake offers free shipping on orders of $50 or more. Prescriptions typically take 2-3 business days for pharmacy fulfillment followed by another 3-5 business days in transit.

One important limitation is availability. Libido Lift Rx currently isn’t available in:

• Alabama
• California
• South Carolina
• Guam
• Puerto Rico.

And because Libido Lift Rx is compounded specifically for each patient, all prescription sales are final. Cake doesn’t accept returns or provide refunds for unused medication.

Addyi (flibanserin) — also known as “the little pink pill” — is an FDA-approved prescription pill to treat HSDD.8 62 Addyi was originally approved for premenopausal women, but the FDA expanded its indication in December 2025 to include women under 65.

HSDD involves persistently low sexual desire that causes personal distress. Neurotransmitters in the brain are believed to play a role in sexual desire and HSDD, although other factors, like self-image or happiness in a relationship, may also contribute.18

Some HSDD symptoms include:54

• Decrease in sexual thoughts
• Lack of response to sexual stimuli
• Loss of interest in sex
• No desire to initiate sex
• Avoiding sexual situations

Importantly, low sexual desire alone doesn't necessarily mean you have HSDD. The lack of desire also needs to cause personal distress. If you don't care about having fewer sexual thoughts or desires, it generally wouldn't meet the criteria for HSDD.

Safety and use

The active ingredient in Addyi is flibanserin, which is FDA-approved to treat HSDD. You take Addyi once daily at bedtime. Alcohol consumption alters the protocol: if you have one or two drinks, you should wait at least two hours before taking Addyi, and if you have three or more drinks, you should skip your dose that night. You should also avoid alcohol after taking Addyi until the following day. Vyleesi, the other FDA-approved prescription discussed in this guide, doesn’t carry the same alcohol restriction. People with liver problems should also avoid Addyi.

You may experience some side effects on Addyi, including:

• Dizziness
• Sleep difficulties
• Nausea
• Dry mouth
• Fatigue
• Low blood pressure
• Loss of consciousness

The prescription’s website includes a comprehensive overview of drug interactions, side effects, and potential risks. We recommend bringing up any conditions or medications that might be relevant to your use of Addyi during your doctor consultation.

Overall, research points to Addyi being well-tolerated and effective at improving sexual desire in premenopausal individuals with HSDD.55 This medication does take some time to potentially work, however. Like the supplement options, Addyi can take around four weeks to a couple of months before the effects kick in. But according to the manufacturer, if you haven’t seen any improvement after taking Addyi for eight weeks, then the medication should be discontinued.

Cost and ordering

To receive a prescription, you’ll need to consult with a physician. If you’d rather not wait to see a doctor in person, you can visit the Addyi website and consult with a doctor online using the telehealth service beyondMD for $19. You’ll fill out a questionnaire about your current health status and lifestyle, and a licensed provider will review it and decide if Addyi sounds like a fit for you.

Otherwise, if you prefer to order the prescription through a face-to-face appointment, you can contact Addyi for a list of prescribers. If the doctor you see prescribes the medication, you can pick it up at a local pharmacy or have it shipped to your home for free through Addyi’s partner pharmacy, PhilRx.

The cost of the medication varies depending on insurance coverage. Some insurance plans offer Addyi for only $20 each month. If you don’t have insurance, the average cost is around $150 for a 30-day supply.

Vyleesi (bremelanotide) is an FDA-approved injectable prescription medication that can be used as needed to treat HSDD in premenopausal women. Clinical trials investigating the effectiveness of Vyleesi for the treatment of HSDD have shown promising results.56 60 Versus a placebo, researchers reported that Vyleesi “significantly increased sexual desire.”

To take Vyleesi, you use the autoinjector pen to give yourself an injection under the skin on your thighs or stomach about 45 minutes before sexual activity. The manufacturer notes that it shouldn’t be used more than once per day or more than eight times per month.

Safety and use

The active ingredient in Vyleesi is bremelanotide, an FDA-approved drug to treat HSDD. It’s important to note that this medication does bring about the possibility of side effects, including (but not limited to):7

Because Vyleesi can alter your heart rate and blood pressure, it isn’t recommended for people with hypertension or cardiovascular issues. Even if you don’t have those concerns, it’s important to speak with your primary care provider to ensure Vyleesi is safe for you.

Cost and ordering

You can obtain a Vyleesi prescription through your own healthcare provider or use the third-party telehealth service available through Vyleesi's website. If prescribed, your prescription can be sent to BlinkRx, Vyleesi's partner pharmacy, which handles payment, applicable savings offers, and free home delivery.

What you'll pay depends largely on your insurance coverage. Vyleesi currently states that most eligible patients with commercial insurance pay $0 for a four-dose box through BlinkRx. If you don't have insurance coverage for Vyleesi, a four-dose box is available for $99, or about $24.75 per dose.

Vyleesi also offers financial assistance for eligible patients. You must be at least 18, and people insured through government-funded programs such as Medicaid or TRICARE aren't eligible for the savings program.

Pills, creams, and gels aren't the only options for addressing low desire or difficulty becoming aroused. The right approach depends largely on what's contributing to the problem in the first place.

For example, vaginal moisturizers and lubricants may be more appropriate when dryness or discomfort is the primary concern. People experiencing sexual changes related to menopause may also want to discuss local vaginal estrogen or other treatments for genitourinary syndrome of menopause (GSM) with their healthcare provider.

Sex therapy or couples counseling may be helpful when stress, anxiety, relationship concerns, or other psychological factors are contributing to sexual difficulties.81 And because certain medications — particularly some antidepressants — can affect sexual function, a healthcare provider may be able to adjust your medication or recommend another approach.

Finally, sexual wellness devices, including vibrators and other forms of clitoral stimulation, can increase physical stimulation without requiring medication or supplements. These may be useful on their own or alongside other approaches discussed in this guide.