Viagra (sildenafil) is one of the most commonly prescribed medications to treat erectile dysfunction in men. Although it is not FDA-approved for treating sexual dysfunction in women, some studies have been done to see if it can have an effect. Sildenafil is the active ingredient in Viagra, which increases blood flow to the penis in men. If given to women, will it have similar effects in improving blood flow to the genitals?
PDE5 Inhibitors
The discovery of PDE5 inhibitors as a sexual dysfunction treatment occurred accidentally, as erections were found to be a side effect of the medication when it was used to treat hypertension. Soon after its release, nearly a million prescriptions were written and filled for sildenafil – the first PDE5 inhibitor available with an indication for treating erectile dysfunction. Now, multiple PDE5 inhibitors are available, including tadalafil and vardenafil.
PDE5 inhibitors like sildenafil have been shown to be relatively safe in both men and women. Their effectiveness in treating sexual dysfunction has been proven in men, but their effectiveness for women is still being debated and researched.
Female sexual arousal disorder (FSAD)
Female sexual arousal disorder (FSAD) is a common disorder, with nearly 1/4 of women reporting some sexual arousal issues to their doctor. Evidence from clinical trials has shown that sildenafil is moderately effective at treating FSAD. Studies that were performed in vitro showed that sildenafil was able to promote smooth muscle relaxation in clitoral tissue. PDE5 has also been found to be present in clitoral, labial, and vaginal smooth muscle.
While the clinical research so far shows that sildenafil is only moderately effective for treating FSAD, it may be more effective in women with particular conditions. For example, it may be used for women with FSAD secondary to multiple sclerosis, diabetes, or antidepressant use.
Other Treatments for FSAD
There are actually a few different treatments that are available to treat FSAD besides PDE5 inhibitors like sildenafil. These include Addyi (Flibanserin), Vyleesi (Bremalontide), and Osphenia (Ospemifene).
Flibanserin: This medication affects neurotransmitters to help improve libido. It does not work in the same way as a PDE5 inhibitor, which improves blood flow. Instead, it improves hypoactive sexual desire disorder (HSDD), related to an imbalance of neurotransmitter activity.
Bremalontide: Used as an injection, bremalontide’s mechanism of action is not yet fully understood. It is taken as needed prior to sexual activity to treat HSDD.
Ospemifene: To prevent vaginal dryness and painful intercourse, ospemifene can be given as an oral tablet.
Can Women Take Viagra?
The research shows that Viagra (sildenafil) may be effective for some women with sexual arousal disorders. While this indication is considered off-label, some healthcare providers may consider it worthwhile to prescribe it for women, given that it has relatively few adverse effects. In addition to oral forms of the drug, topical sildenafil creams are also available.
Articles
Sildenafil citrate for female sexual arousal disorder: a future possibility? – Nature Reviews: Urology