Sildenafil improves sexual functioning in premenopausal women with type 1 diabetes who are affected by sexual arousal disorder: a double-blind, crossover, placebo-controlled pilot study

It increases blood flow to the penis, resulting in an erection. Studies have demonstrated that PDE5 is present in vaginal, clitoral, and labial smooth muscle. This suggests that PDE5 is involved in female sexual function, particularly genital arousal. In females, sildenafil may also increase blood flow to the genitals.

How Does Viagra Affect Women?

For years there were no FDA-approved medicines for treating problems with sexual arousal or sexual desire in women. Yet 4 in 10 women report having sexual concerns. The FDA now has approved two medicines. The FDA has approved a daily pill called flibanserin (Addyi) to treat low sexual desire in women before menopause. This medicine started as a treatment for depression.

Competing interests

Addyi may boost sex drive in women with low sexual desire. It's for women who are not happy with their low sex drive. Possible serious side effects include low blood pressure, dizziness and fainting. These side effects are more likely to happen if the medicine is mixed with alcohol. The FDA says not to drink alcohol if you take this medicine.

Recreational use

Experts suggest that you stop taking the medicine if your sex drive doesn't improve after eight weeks. The FDA also has approved a medicine given as a shot to treat low sexual desire in women before menopause. Bremelanotide (Vyleesi) is injected under the skin in the belly or thigh at least 45 minutes before having sex. It should not be used more than once a day or more than eight times a month. Side effects can include nausea, headache, vomiting and reactions at the site of the shot. That may help increase sensitivity, arousal, and orgasmic function.

Parameter	Description	Typical Values	Notes
Absorption Rate	Time to reach peak plasma levels	30-120 minutes	Varies with food intake
Half-Life	Duration of drug activity	4 hours	Metabolized mainly in liver
Bioavailability	Percentage of drug absorbed	40-50%	Affected by gastric pH
Metabolism	Enzymes involved	CYP3A4	Liver metabolism mainly
Excretion	How drug is eliminated	Feces and urine	Mainly fecal excretion

However, PDE5 is expressed in far smaller quantities in the clitoris than in males. Even though some studies have shown success, Viagra might never be as effective in female sexual arousal disorder as in males with erectile dysfunction due to the reduced quantities of PDE5. For females who do take Viagra, common side effects may overlap with those reported when the medication is taken for ED.

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Stop using Viagra and seek medical care if you suddenly lose vision in one or both eyes.

Factor	Impact	Explanation	Recommendations
Anxiety	Reduced efficacy	Anxiety can impair sexual response	Counseling or therapy suggested
Depression	Reduced libido affecting outcomes	Mental health impacts physiological response	Medical treatment advisable
Stress	Interferes with arousal	Acute stress can impair drug effectiveness	Stress management techniques
Confidence in intimacy	Enhances perceived effectiveness	Positive attitude can improve outcomes	Psychological support recommended

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This nucleotide sildenafil products over the counter acts as a messenger between cells. Following sexual stimulation, PDE-5 inhibitors cause a local release of nitric oxide, which increases cGMP and relaxes the muscles around blood vessels. This dilation increases blood flow to the penis, making it easier to get and sustain an erection. Sildenafil, the active ingredient in Viagra, is also marketed as Revatio, which treats pulmonary arterial hypertension and improves exercise capacity. In males, following sexual stimulation, Viagra dilates blood vessels. You should also stop Viagra if a sudden decrease or loss of hearing occurs.

Where can you buy ‘female Viagra’ pills?

Research studies sometimes don't use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like "female," "male," "woman," and "man" as the sources use them. Viagra (sildenafil) is a prescription medication approved for treating erectile dysfunction (ED) in adult males. PDE-5 degrades a nucleotide called cyclic guanosine monophosphate (cGMP). Healthcare providers may prescribe other treatments to help improve sexual dysfunction disorders in females.

• Sildenafil is often known by the brand name Viagra, primarily for men.
• Researchers are exploring other PDE5 inhibitors for women’s sexual health.
• Efficacy of sildenafil in women might depend on underlying health conditions.
• Women with cardiovascular issues should be particularly cautious with sildenafil.
• Some women report increased sexual satisfaction after using sildenafil.
• Medical advice is crucial before women consider sildenafil as a treatment.

The treatment may depend on what type of sexual dysfunction you're experiencing and what's causing it. Addyi (flibanserin) is a pink tablet approved to treat hypoactive sexual desire disorder (HSDD) in premenopausal females and postmenopausal females under age 65.

Adverse effects

Talk with your healthcare professional to see if this medicine might be right for you. Sexual problems may be due to trouble with arousal, a lack of desire or both. Many factors can affect sexual desire in women. Many women find that the stresses of daily life lower their desire for sex. Highs and lows in sexual desire may go along with the beginning or end of a relationship or with major life changes, such as pregnancy or menopause.

Altitude sickness

For some women, orgasm can be hard to reach. This can cause worries that lead to a loss of interest in sex. Desire often is linked to a sense of closeness between partners, as well as sexual issues from the past. Some chronic conditions, such as diabetes or multiple sclerosis, can cause changes in arousal or orgasm. If you have trouble with sexual desire or response, talk with a member of your healthcare team.

A note about sex and gender

You might want to talk to a sex therapist. Medicines, hormones, creams, lubricants, clitoral stimulation or other treatments sometimes can help. There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. Women’s health topics - straight to your inbox Get the latest information from our Mayo Clinic experts on women’s health topics, serious and complex conditions, wellness and more. HSDD is caused by an imbalance of neurotransmitter activity in the brain that affects sexual desire. The imbalance can result from either a deficiency of excitatory signals that regulate sexual response, an excess of signals that inhibit sexual response, or a combination of both. The exact way that Addyi works to treat HSDD is unknown, but it does affect serotonin in the brain. It is stopped after eight weeks if there's no improvement.

Chemical synthesis

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Interactions with other medications

You may opt out of email communications at any time by clicking on the unsubscribe link in the email. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. American Association for Marriage and Family Therapy. Overview of sexual dysfunction in women: Management. Viagra is sometimes prescribed to treat female sexual arousal disorder, but its effectiveness is still unclear.

Addyi (filbanserin)

If a woman takes Viagra, it might help increase blood flow to the genitals, which could increase sensitivity and arousal. While some studies show Viagra might work for female sexual dysfunction, more research is needed to know for sure. When a woman takes Viagra, it may increase blood flow to her genitals, potentially enhancing sensitivity and arousal, though its effectiveness is still inconclusive and it's not FDA-approved for this purpose. While generally safe, mild side effects can occur, and other more effective treatments for female sexual arousal disorder exist. Evidence is limited regarding the benefits of Viagra (sildenafil) for females with sexual dysfunction. Additionally, it is not recommended for low libido caused by other health conditions or medications.

What should I do if I forget to take a dose?

While Viagra is not FDA-approved for women, healthcare providers may prescribe it off-label. Oral sildenafil (Viagra): In 2024, a review examined the effectiveness of sildenafil for female sexual dysfunction. Six randomized controlled trials met the criteria, considered the gold standard for evaluating treatments. Four out of six studies found that oral sildenafil was effective for female sexual dysfunction. However, in two of the studies, it was not effective.

What is FSAD?

More research is needed, and whether or not sildenafil is effective at treating female sexual dysfunction remains inconclusive. Topical sildenafil (Viagra): There is minimal research on the use of topical sildenafil. One randomized controlled trial aimed to explore whether topical sildenafil could improve genital blood flow and treat female sexual arousal disorder. The study found that sildenafil cream increased sexual arousal sensation, desire, and orgasm, and reduced sexual distress. Female sexual dysfunction is complex and can have multiple causes, such as a difficulty reaching orgasm, painful intercourse, or low libido.

Hormone therapy

More research is needed to identify which women may benefit from Viagra. Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. Sex refers to biology: chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex. Gender describes a person's internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics. Addyi also has a boxed warning (the FDA's strictest safety warning) about the risk of severely low blood pressure and passing out. To lower this risk, avoid alcohol use for at least two hours before your Addyi dose and until the next day after the dose. It is also important to avoid taking it with moderate or strong CYP3A4 inhibitors (e.g., erythromycin or verapamil) or if you have liver problems. Vyleesi (bremelanotide) is an FDA-approved injection for premenopausal females with HSDD. It's unclear how exactly Vyleesi works to improve HSDD. However, it is known to activate melanocortin receptors present in the skin and central nervous system. Melanocortins are a group of small protein hormones thought to play a role in sexual response.

Brand Name	Formulation	Dosage Options	Notes
Viagra Women	Oral tablet	25 mg, 50 mg	Off-label use, not approved by FDA
Female Arousal Gel	Topical gel	N/A	Claimed to enhance blood flow
Sildenafil Citrate	Generic oral tablet	25-100 mg	Widely used off-label in women
Custom Compounded	Customized formulations	Variable	Prescribed by special clinics

You can take this medication 45 minutes before engaging in sexual activity, as needed.

• Sildenafil is a medication primarily used to treat erectile dysfunction in men.
• Women sildenafil is an off-label use aimed at improving female sexual arousal.
• Clinical trials are ongoing to assess efficacy of sildenafil for women.
• Side effects of sildenafil may include headaches, flushing, and nasal congestion.
• Women may experience increased blood flow and libido with sildenafil.
• Proper dosage and medical consultation are essential before use.

You should not exceed one dose per day or eight doses per month. Stop using it if there is no improvement after eight weeks.

• Awareness of sildenafil's potential side effects helps women make informed choices.
• Women should avoid using sildenafil with nitrates to prevent dangerous drops in blood pressure.
• Proper diagnosis of sexual dysfunction can guide appropriate treatment options.
• Scientific research continues to explore safer, women-specific sexual health drugs.
• Sildenafil’s long-term effects on women are not yet fully understood.
• Healthcare providers can help determine if sildenafil is appropriate for individual cases.

You should not take Vyleesi if you are allergic to it, have uncontrolled hypertension (high blood pressure), have known heart disease disease, or are pregnant. Osphenia (ospemifene) is approved to help with painful intercourse and vaginal dryness due to menopause, which can cause a low sex drive. It comes as a tablet that is taken once daily.

• Some women seek sildenafil for increasing genital blood flow and sensation.
• The placebo effect can influence perceived benefits in women using sildenafil.
• Women with cardiovascular risk should avoid sildenafil unless approved by a doctor.
• Topical or alternative therapies might be considered alongside or instead of sildenafil.
• Scientific consensus on sildenafil’s safety for women remains under development.
• Proper dosing and medical oversight are key to minimizing risks.

Osphenia is an estrogen agonist/antagonist that binds to estrogen receptors to activate certain pathways (like vaginal tissue) and block others.

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