Sildenafil Use in Women with Antidepressant-Induced Sexual Dysfunction

Sildenafil improved arousal (P<0.001), orgasm (P<0.05), and enjoyment (P<0.001) with respect to placebo. Significant differences were noted during sildenafil usage with respect to the baseline for arousal (P<0.01), orgasm (P<0.001), and sexual enjoyment (P<0.001). The adverse events were transient and mild or moderate.

Conclusions: Our study suggests that sildenafil acts on the different sexual pathways in healthy women, improving their sexual experience. This study could help to understand the physiologic and pathophysiologic aspects of female sexuality.

Mechanism of action

To connect with a member of our team, please email development@FACTSaboutFertility.org. Interested in becoming an individual or organizational member? You can learn more and register here. To discuss with a member of our team, please email membership@FACTSaboutFertility.org. Objectives: To determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), and to verify the safety of this drug (second outcome).

Exclusion Criteria

Study design: Following previous research on symptomatic women, we wanted to study the effects of sildenafil on asymptomatic women. We would like to make it clear from the outset that this study is part of an ongoing line of research and this drug, and others of its type, should be used under strict medical supervision only on symptomatic patients. A randomized double-blind cross-over, placebo-controlled study was conducted at the Family Planning Centre of the Group for Sexological Research, Department of Microbiological and Gynecological Science, School of Medicine, University of Catania, Italy. Sixty-eight healthy volunteer women aged 19-38 years, asymptomatic for sexual disorders, were enrolled. The study consisted of 4 weeks sildenafil, 2 weeks washout, and 4 weeks placebo, by two possible sequences: sildenafil 50 mg, washout, placebo; or placebo, washout, sildenafil 50 mg. In comparison with current psychosexual therapies, which are long-term, compliance would be improved with use of this drug.

Additional studies are required to define the use of sildenafil in a clinical setting.

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In women, this medication has been found to improve uterine blood flow, leading to an estrogen-induced proliferation of the endometrium. In the 2020 study summarized below, Li et al review the efficacy of sildenafil citrate to treat women with infertility and a thin endometrium. Randomized controlled trials that studied sildenafil citrate versus controls were searched from PubMed, EMBASE, and the Cochrane Controlled Trials Register Database. For the meta-analysis, the inclusion criteria included: (1) women with infertility undergoing in vitro fertilization-embryo transfer, intracytoplasmic sperm injection, frozen-thawed embryo transfer, or induction of ovulation and (2) patients with thin endometrium or poor endometrial response. For the intervention, sildenafil citrate was compared with either no treatment or placebo.

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The study assessed endometrial thickness and pattern via ultrasound, and the uterine radial artery resistance index (RI) was measured as well. Clinical pregnancy rate was determined by ultrasonographic documentation of at least one fetus with a heartbeat at 6-7 weeks of gestation. Biochemical pregnancy was identified by a serum hCG level above 10 mIU/mL. Nine studies with a total of 1,452 patients were used in this meta-analysis. Endometrial thickness was assessed in eight trials with a total of 1,382 participants.

Missed Dose

The heterogeneity or variation between studies was substantial; therefore, one study was excluded, and the variation significantly diminished. With the final seven pooled analyses, the endometrial thickness in the sildenafil citrate treatment group was significantly higher than in the control group. Changes in the radial artery resistance index (RI) following sildenafil citrate were examined in three studies with a total of 962 participants included. The RI was found to be significantly lower in the sildenafil citrate treatment group than in the control group. “The endometrial thickness in the sildenafil citrate treatment group was significantly higher than in the control group.” The clinical pregnancy rate was examined in four studies with a total of 1,110 participants, and the biochemical pregnancy rate was examined in five studies with 400 participants. Viagra is sometimes prescribed to treat female sexual arousal disorder, but its effectiveness is still unclear.

• Sildenafil citrate tablets are typically taken 30-60 minutes before intimacy.
• Monitoring by a healthcare professional is recommended for women.
• Use sildenafil cautiously if you have a history of stroke or heart attack.
• Combining sildenafil with other ED medications is dangerous.
• Pregnancy and breastfeeding considerations should be discussed with a doctor.
• Sildenafil does not induce arousal but enhances physiological responses.
• Not suitable for women with or at risk of abnormal heart rhythms.
• Potential for psychological as well as physical benefits exists.
• Ensure trusted pharmacy sources when purchasing sildenafil for women.
• Sildenafil is available in various dosages, such as 25 mg, 50 mg, 100 mg.
• Discontinue use if adverse effects like chest pain occur.
• A comprehensive sexual health evaluation can determine if sildenafil is appropriate.

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.

• Female-specific studies on sildenafil show mixed results.
• Sildenafil is sometimes used off-label for female libido enhancement.
• Always check for allergies before taking sildenafil citrate tablets.
• Sildenafil may cause vision disturbances in some women.
• Proper hydration can reduce side effects when using sildenafil.
• Combining sildenafil with alcohol can increase risks.
• Be aware of potential interactions with hormonal contraceptives.
• Do not share sildenafil tablets to prevent misuse or overdose.
• Women should report any adverse reactions to their healthcare provider.
• Sildenafil may help with certain conditions like Female Sexual Arousal Disorder.
• Cost of sildenafil for women varies, and insurance may not cover it.
• Follow prescribed instructions precisely to avoid overdose.

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.

Before taking this medicine

Director’s Note: Beyond endometrial thickness, many factors may influence a couple’s ability to conceive. When women chart with a fertility awareness-based method, signs or symptoms observed may indicate potential underlying causes of infertility. For example, a chart displaying very short or light periods may reflect the development of a thin uterine lining, which can be confirmed by ultrasound. This research study suggests that physicians may be able to use sildenafil citrate to facilitate the development of the endometrial lining and potentially restore the reproductive system to its normal function. “Effect of Sildenafil Citrate on Treatment of Infertility in Women with a Thin Endometrium: A Systematic Review and Meta-Analysis.” Journal of International Medical Research, vol.

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11, 2020, p. 030006052096958., [2] Infertility (2023a) Centers for Disease Control and Prevention. [3] “Art Success Rates.” Centers for Disease Control and Prevention, Centers for Disease Controland Prevention, 14 June 2022, [4] Heger A, Sator M, Pietrowski D. Endometrial Receptivity and its Predictive Value for IVF/ICSI-Outcome. 2012;72(8):710-715.

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doi:10.1055/s-0032-1315059 Myrta Isabel Olivera-Dubón Myrta Isabel Olivera-Dubón, MD, is a graduate of Universidad Central del Caribe School of Medicine in Bayamón, PR, and will be starting family medicine residency at Glen Cove Hospital in Long Island, NY. She earned a Bachelor of Arts in Psychology and Spanish Literature from George Washington University. Dr. Olivera-Dubón completed the FACTS elective in the women sildenafil fall of 2022 and hopes to integrate fertility awareness-based methods (FABMs) as a tool to educate and empower patients to make choices that are right for them and their families. You can support the ongoing work of FACTS here. While Viagra is not FDA-approved for women, healthcare providers may prescribe it off-label.

Detection in biological fluids

Efficacy of sildenafil was assessed by the Personal Experiences Questionnaire (PEQ) based on the 5-point Likert scale. The questionnaire quantified subjective sexual aspects at baseline, during washout, after treatments, and at the follow-ups. Statistical analysis was done with the Wilcoxon's rank-sum test and Student's t-test. Results: 50/68 women completed the study at the first follow-up, and 38 women reached the second follow-up. Six women withdrew because of adverse events. 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.

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Both the clinical pregnancy rate and the biochemical pregnancy rate were found to be significantly higher in the sildenafil citrate treatment group than in the control group with no significant heterogeneity. The endometrial pattern was assessed in four studies with a total of 1,130 participants demonstrating a significant proportion of isoechoic endometrium with poorly defined outer walls and central echogenic line in the sildenafil citrate treatment group compared to the control group. Given the moderate heterogeneity found, one study was excluded, resulting in significantly diminished heterogeneity. This research found that women with infertility and a thin endometrium benefit from sildenafil citrate. Optimal endometrial receptivity is important for a successful pregnancy.

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Thus, this finding suggests a potential therapeutic intervention for women with thin endometrium that is easy to use and inexpensive. [1] Improved uterine blood flow, especially to the basal endometrium, results in estrogen-induced proliferation of the endometrium. Yet, successful implantation also depends on the ability of the blastocyst to penetrate the endometrium and create a source of blood supply. [1] Sildenafil increases the expression of p53 and vascular endothelial growth factor, resulting in improved angiogenesis. [1] Li et al concluded that sildenafil citrate improves endometrial thickness, receptivity, and the clinical pregnancy rate.

Comparison table

“Li et al concluded that sildenafil citrate improves endometrial thickness, receptivity, and the clinical pregnancy rate.” Compared to the existing literature, this research by Li et al seems more reliable, as it included more studies and followed strict inclusion criteria. Yet, the meta-analysis has some limitations as well, including the fact that some of the studies analyzed differed in timing, dosage, and route of administration of sildenafil citrate. Some studies combined sildenafil citrate with ovulation-stimulating drugs, which could have resulted in bias. Also, some studies lacked follow-up results of miscarriage and live birth rates. Finally, since many studies combined the use of sildenafil with estrogen, more randomized controlled trials are needed that assess the effect of sildenafil citrate on a thin endometrium to further clarify its therapeutic effect.