Of all the changes your body endures during menopause, nothing can prepare you for the inevitable drop in your libido. Your mental health can influence your desire to have sex, but the primary cause is hormonal: Declining estrogen levels disrupt the blood flow needed for arousal and lubrication (1).
When that happens, your desire for sex can fizzle out. Hormone replacement therapy (HRT, also called menopause hormone therapy, or MHT), is the best way to boost estrogen, but it doesn’t have to work alone. Oral or topical L-arginine, an amino acid supplement, can help.
“L-arginine can help counteract the reduced blood flow from hormone changes in perimenopause and menopause,” says OB-GYN Sherry Ross, M.D. “This allows sexual enjoyment and orgasms to happen more easily.”
About the Experts
Sherry Ross, M.D., is a board-certified OB-GYN and author of Lady Parts.
Ashley Winter, M.D., is a board-certified urologist specializing in sexual medicine.
What Does L-Arginine Do?
L-arginine is an amino acid that your body converts into nitric oxide, which tells your blood vessels to expand and relax (2). By improving blood flow, l-arginine can increase the frequency and sensation of orgasms in the genitals.
You can find L-arginine in foods like meat, nuts, dairy, and seeds. But if you’re looking for a more immediate solution, an oral or topical supplement containing l-arginine can help increase blood flow, libido, and lubrication.
More lubrication
The first thing you may notice after taking l-arginine is an increase in lubrication (3). When you’re aroused, blood passes into the lining of your vaginal walls (1). With more blood flow comes more lubrication, which is key for comfortable and enjoyable sex, Ross says.
Easier orgasms
The improved blood flow L-arginine delivers increased sensitivity, making it easier to respond to sexual stimulation, says Ross.
Here’s why: When blood rushes to your vulva and vagina, the vaginal walls and clitoris swell and become more sensitive (1). The more sensations you feel, the easier it is for your vagina to contract and relax during climax—the two ingredients for a big O.
Better mood
L-arginine’s benefits for better menopause sex aren’t just physical, says Ross. L-arginine turns into nitric oxide, which is thought to improve mood and reduce anxiety.
This boost to your mental health may also benefit you in the bedroom. A 2024 randomized, controlled trial in BMC Psychiatry found that two grams of oral l-arginine daily improved mood in women with major depressive disorder (3).
Estrogen is important in keeping blood vessels elastic, allowing more blood to flow freely (4). The normal decline in estrogen due to menopause can narrow blood vessels, making it harder for blood to reach tissues (4).
A lack of blood flow can lead to genitourinary syndrome of menopause (GSM) or vaginal atrophy. GSM can cause vaginal dryness, decreased arousal, painful sex, and itching.
Nine percent of women who have gone through menopause deal with hypoactive sexual desire disorder, or clinically low libido (5). A 2021 review found that l-arginine may increase libido and lubrication in women with HSDD (6)
However, if you have severe vaginal atrophy, l-arginine alone may not be enough to treat GSM or boost your libido, urologist Ashley Winter, M.D., says. This is because l-arginine targets blood vessels, which may have atrophied. “And dilating atrophied blood vessels won’t get you as far,” she says.
Combining l-arginine with other treatments like vaginal estrogen cream may be needed. “For many women, vaginal estrogen is foundational for maintaining optimal sexual function and arousal during menopause,” Winter says.
Once you address vaginal atrophy, L-arginine will work that much better, she added. Still, if you can’t, or don’t want to take hormones, L-arginine may modestly improve your sexual function during menopause.
How Long Does It Take for L-arginine to Work Sexually?
While most of the current research about l-arginine focuses on men, a few smaller studies also suggest a benefit for women. A study published in BMC Psychiatry observed women who took l-arginine experienced improved lubrication at four and eight weeks, with increased orgasm frequency noted almost immediately and continuing throughout the study. (3).
A 2022 case study monitoring a single female patient reported improved blood flow to the vulva within 15 minutes, but most research suggests it can take up to three months to see results (7).
Topical vs. Oral L-Arginine
There are two ways to take l-arginine; as a pill or topical cream. The biggest difference between the two is timing.
The pill form of l-arginine can take 24 hours or more to kick in, Ross says. That means oral supplements should be taken daily. The average daily dose of oral l-arginine is six grams (g), but you can take up to 30 g (8).
Topical l-arginine, also known as Scream Cream, can be applied directly to the clitoris and vulva 15 to 30 minutes before sex to boost blood flow. Creams containing l-arginine may also include other blood flow-boosting ingredients like sildenafil and pentoxifylline to amplify its effect (9). The cream should be applied in a thin layer and gently massaged until absorbed.
Potential side effects
Side effects of l-arginine can vary. Topical l-arginine has few side effects. Oral l-arginine supplements may cause side effects, including (8):
Abdominal pain
Low blood pressure
Diarrhea
Nausea
Bloating
Headache
Liver and kidney dysfunction
Additionally, if you have genital herpes, avoid l-arginine, as it may increase your risk of a flare-up (10). If you’re on other prescription medications, make sure to talk to your doctor before taking L-arginine; when combined with the supplement, some drugs may lower your blood pressure to dangerous levels.
The Bottom Line
L-arginine is an oral or topical supplement that converts to nitric oxide, which increases blood flow to the vulva and vagina, heightening arousal, increasing lubrication, strengthening orgasms, and improving mood. Supplements containing l-arginine come in two forms: a topical cream or a pill. If you have vaginal atrophy, use l-arginine alongside vaginal estrogen for better results. Side effects from l-arginine are usually mild.
Rebekah Harding is Hone Health's staff writer. She is a certified personal trainer and nutrition coach through the National Academy of Sports Medicine (NASM) and an experienced health and lifestyle writer.
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