Female libido

Female desire and arousal — the scored clinical construct captured by the Female Sexual Function Index (FSFI): desire, arousal, lubrication, orgasm and satisfaction.

Mood increases it.

Cyranowski 2004, Arch Gen Psychiatry (PMID 15003432) — prospective 1-year assessment of 68 women treated for recurrent major depression: controlling for partner availability and SSRI status, depressive symptoms were associated with decrements in sexual desire, sexual cognition/fantasy and arousal, while SSRI treatment tracked orgasmic difficulty only — separating the mood effect from the medication effect. Reinforced by Worsley 2017 (PMID 28499520), a community-based sample of midlife women in which moderate-to-severe depressive symptoms carried an adjusted OR of 2.69 (95% CI 1.99-3.64) for hypoactive sexual desire dysfunction. PMID 15003432. PMID 15003432

Blood flow (nitric oxide) increases it.

Musicki 2009, J Sex Med (PMID 19138376) — review of endothelial nitric oxide synthase regulation in female genital tract structures: the NO/cyclic-GMP pathway has a primary role in regulating clitoral and vaginal blood flow and smooth-muscle relaxation during sexual arousal, and estrogen's effect on genital blood flow is attributed largely to its regulation of eNOS. PMID 19138376

Appetite receptor signaling increases it.

Melanocortin agonism raises female sexual desire — proven at drug GRADE, in a diagnosed population. Kingsberg SA et al., “Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials”, Obstet Gynecol 2019 (PMID 31599840; NCT02333071 and NCT02338960). Reconnect = two identical phase 3, double-blind, placebo-controlled multicenter trials of bremelanotide subcutaneous as needed, 24 weeks, randomized 1:1. Integrated N=1202: mean change vs placebo FSFI-desire +0.35 and FSDS-DAO item 13 -0.33 (P<.0001 both). Responder rates 58.3% / 58.2% vs 36.1% / 35.4% placebo. Scope — read this before any claim rests on this edge: (1) bremelanotide is a prescription injectable drug, not a botanical — the edge shows the pathway is real, not that any supplement reproduces it; (2) the population is premenopausal women with diagnosed, acquired, generalized HSDD, not healthy women; (3) the effect sizes are small (+0.35 on FSFI-D); (4) adverse events nausea, flushing and headache each exceeded 10% in both studies; (5) funding: Palatin Technologies and AMAG Pharmaceuticals — the manufacturers. PMID 31599840

Oxidative stress reduces it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Calms body-wide inflammation reduces it.

key contributors to age-related ED include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Testosterone increases it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Estrogen balance increases it.

Estrogen contributes to the control of genital blood flow during the sexual response, and vascular effects of estrogen ARE mostly attributed to its regulation of endothelial nitric oxide production. So the hormonal arm runs through the vascular one rather than beside it. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Insulin sensitivity increases it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Cellular aging reduces it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Reduces scarring reduces it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Heart calcium handling increases it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Alertness chemical increases it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Memory chemical increases it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

Social bonding hormone increases it.

Named across five reviews of erectile and female arousal physiology. Key contributors include reduced nitric oxide bioavailability due to endothelial oxidative stress and inflammation, diminished cavernosal smooth muscle content leading to impaired veno-occlusion, and increased arterial stiffness compounded by metabolic disorders. doi 10.21037/tau-2025-419 · PMID 19138376 · PMC11988752

It increases Mood.

This is what the symptom costs rather than what it causes physiologically. It is shown at reduced weight because no separate effect size has been reported for this arm. The asymmetry is deliberate and stated. the Mood (Positive Affect) → Female Desire & Arousal link is drawn on the depression effects list at RR-grade evidence; this is the return arm on weaker evidence and the asymmetry is deliberate. This link rests on the reviews of this outcome as a whole, and no effect size specific to it has been reported.

It reduces Calm under stress.

This is what the symptom costs rather than what it causes physiologically. It is shown at reduced weight because no separate effect size has been reported for this arm. The asymmetry is deliberate and stated. Same bidirectionality caveat as sexual.

It increases Orgasm.

The Rosa damascene oil group showed increased sexual desire, orgasms, and satisfaction over time, with decreased pain compared to the placebo group. PMC4045980

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