Marca Sipski Alexander reports no commercial interests with the study sponsor. Raymond Rosen reports no current commercial interests with the study sponsor.

At the time of this research, Dr Rosen served as a consultant and research advisor for Pfizer Inc. Claes Hultling reports no commercial interests with the study sponsor. Tara Symonds and Scott Haughie are employees of Pfizer. Susanne Steinberg was an employee of Pfizer when the study was conducted.

Sildenafil in women with sexual arousal disorder following spinal cord injury. Sexual Health in the Neurogenic Patient Current Bladder Dysfunction Reports (2020) Knowledge Gaps in Urologic Care of Female Spinal Cord Injury Patients Current Urology Reports (2019) Sexual Function after Spinal Cord Injury: Innervation, Assessment, and Treatment Current Sexual Health Reports (2016) Learn more about compounded Sildenafil creams made for women. Sildenafil and its brand medication, Viagra, has been around since 1998 for the treatment of erectile dysfunction in men.

Chemical synthesis

The use of the sexual function pfizer sildenafil 50 questionnaire as a screening tool for women with sexual dysfunction. Development of a questionnaire on sexual quality of life in women. Phosphodiesterase type 5 inhibitors and female sexual response: faulty protocols or paradigms? This study was sponsored by Pfizer Inc. Editorial support was provided by Anne Johnson, Janet E Matsuura, PhD, and Deborah M Campoli-Richards, BSPharm, RPh, of Complete Healthcare Communications, Inc., and was funded by Pfizer Inc. And, since then, it has revolutionized how doctors approach male sexual health complaints. This has lead to the question of if Sildenafil or Viagra may just have positive sexual effects in women as well. Men and Women do have different sexual anatomies, but at the core of arousal is the same function involving smooth muscle relation and increased blood flow to the genital area, which is the underlying function of PDE-5 inhibitors such as Sildenafil. These similarities have led to studies being done on women who are struggling with female sexual arousal disorder (FSAD). FSAD has to do with persistent difficulties in arousal in female patients. One placebo-controlled trial in women who were experiencing sexual dysfunction while taking an antidepressant found that adding in Sildenafil helped improve reported arousal, lubrication, and orgasm as compared to the placebo groups, but did not change any reported pain from sexual intercourse. Another placebo-controlled study looked into using Sildenafil in postmenopausal women with FSAD and found significant improvements in reported arousal, as long as they did not also have hypoactive sexual desire disorder (HSDD).One study considers PDE-5 inhibitors, such as Sildenafil, to have conflicting results when it comes to treating FSAD. Suggesting that these medications should be kept as the last option due to FSAD being composed of many different factors including medical, psychological, and sexual, and requiring a global approach to treatment. A consensus of if oral Sildenafil tablets should be a treatment option for women experiencing a lack of arousal or FSAD is still up for debate, although some doctors may prescribe Sildenafil tablets off-label for women.

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These studies suggest that Sildenafil may help with sexual issues stemming from a lack of appropriate physical arousal, but Sildenafil does not help with increases in sexual desire or libido. It should be noted that using Sildenafil tablets does still come with the risk of side effects.

Medication Type Interaction Effect Risk Level Notes
Nitrates Severe hypotension High Contraindicated
Alpha-Blockers Increased risk of hypotension Moderate Dose adjustment may be needed
CYP3A4 Inhibitors Increased sildenafil levels Moderate to high Watch for adverse effects
CYP3A4 Inducers Decreased effectiveness Moderate Alternative treatments considered

These studies have noted headaches, flushing, heartburn, nasal congestion, and visual disturbances to be more common in the Sildenafil treatment groups. Sildenafil tablets are currently only FDA approved for sexual disorder use in men with erectile dysfunction, and women should not attempt to use them unless under the guidance of their doctor who has decided to prescribe them off-label.

Risk Details Precaution
Cardiovascular complications Increased blood pressure, arrhythmias Screen for cardiovascular disease before use
Drug interactions Severe hypotension, adverse effects from combinations Complete medication history before prescribing
Allergic reactions Rashes, swelling, difficulty breathing Discontinue and seek medical attention if occurs
Psychological dependency Over-reliance on medication for arousal Counseling for emotional health
Misuse and overdose Increased adverse effects Strict adherence to prescribed dose

You may find the active ingredient, Sildenafil, in formulations other than the manufactured oral tablet from compounding pharmacies that include it in formulations meant to help improve female sexual satisfaction and blood flow called “scream creams”. In these topical creams, the medication is meant to be applied externally to help enhance smooth muscle relaxation and improve blood flow to the vaginal and clitoral regions for a period of a few hours. These compounded creams may also contain other ingredients mean to enhance the blood flow and sensitivity of the area, and they require a prescription from a doctor in order to be made up. Topical Sildenafil-containing scream creams are thought to greatly reduce the amount of medication that is delivered systemically through the entire body and may help reduce any whole-body side effects as compared to the Sildenafil tablets.

Patients and Methods

Sildenafil-treated women and placebo-treated women had an increase in their percentage of sexual activities throughout the course of the study, with no statistically significant difference between groups in the percentage of successful sexual activities at end of treatment versus baseline. There were also no statistically significant differences between sildenafil- and placebo-treated women on the aforementioned measures. The most common adverse events included headache and vasodilatation. The results of this study are similar to other reports regarding a lack of clinically meaningful benefit of sildenafil in other populations of women. This study was sponsored by Pfizer Inc.

Vyleesi (bremelanotide)

Gain free access to this article, as well as selected content from this journal and more on nature.com Targeting recovery: priorities of the spinal cord-injured population. Targeting recovery: priorities of the spinal cord-injured population. Sexual activities, response and satisfaction in women pre- and post-spinal cord injury. Sexual activities, desire, and satisfaction in males pre- and post-spinal cord injury. Arch Sex Behav 1993; 22: 217–228.

Cite this article

Sexual arousal and orgasm in women: effects of spinal cord injury. The effects of spinal cord injury on psychogenic sexual arousal in males. Sexual responsiveness in women with spinal cord injuries: differential effects of anxiety-eliciting stimulation. Arch Sex Behav 2004; 33: 295–302. Effects of level and degree of spinal cord injury on male orgasm. Compounded Sildenafil creams for women are often meant to be applied about 30 minutes before sexual activity and gently rubbed in.

Where the Magic Happens

Giuliano F, Hultling C, El Masry WS, Smith MD, Osterloh IH, Orr M et al. Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal cord injury. Maytom MC, Derry FA, Dinsmore WW, Glass CA, Smith MD, Orr M et al. A two-part pilot study of sildenafil (VIAGRA) in men with erectile dysfunction caused by spinal cord injury. Hultling C, Giuliano F, Quirk F, Peña B, Mishra A, Smith MD .

Complementary and Alternative Options for Low Libido

Quality of life in patients with spinal cord injury receiving Viagra (sildenafil citrate) for the treatment of erectile dysfunction. Sildenafil effects on sexual and cardiovascular responses in women with spinal cord injury. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR 4th edn (Text Revision). Development of a sexual function questionnaire for clinical trials of female sexual dysfunction. J Womens Health Gend Based Med 2002; 11: 277–289. These creams may then enhance your sensitivity, natural lubrication, sensation, elongation, and overall physical arousal for up to 2 hours after application. Sildenafil creams for women are currently only available from compounding pharmacies which can make them up for you according to a prescription from a doctor.

THE BIG “O” (OVERVIEW)

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only.

Increased genital blood flow

The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care. To evaluate the efficacy, safety and tolerability of oral sildenafil in women with female sexual arousal disorder as a result of SCI (paraplegia/tetraplegia).

Regional issues

The study was conducted at clinical practice sites in North America (n =23), 11 European countries (n =23), Australia (n =4) and South Africa (n =2). 129 women were randomized and treated with sildenafil or matching placebo. A 4-week baseline period was followed by 12 weeks of treatment, which could be increased from 50 to 100 mg or decreased to 25 mg once during the treatment period, depending on efficacy and tolerability. By use of an event log, sexual activity was monitored between screening and the end of treatment. The Sexual Function Questionnaire, the Sexual Quality of Life Questionnaire–Female, a global efficacy question and Sexual Distress Question were also assessed. Sildenafil creams does not currently exist as a manufactured pharmaceutical product, so you will not be able to have this made at a regular non-compounding pharmacy. Here at Strut Health, you can have a free online questionnaire-based telemedicine visit with our U.S. licensed doctors to see if a compounded sildenafil-containing cream for women may help with your sexual issues. If you are a good candidate for treatment, your prescription can be shipped to your front door from a compounding pharmacy with our free shipping.

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