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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. Giuliano F, Hultling C, El Masry WS, Smith MD, Osterloh IH, Orr M et al.

  • Female patients should be cautious with sildenafil due to lack of approval.
  • Erectile dysfunction medications can interact with other drugs, affecting women as well.
  • Some studies suggest sildenafil may help women with arousal issues but are inconclusive.
  • Sildenafil may improve clitoral blood flow, enhancing sensitivity.
  • Libido enhancement from sildenafil varies based on individual health factors.
  • Self-medicating women with sildenafil without supervision can be risky.

Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal cord injury.

The bottom line

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).

Mohamed Alhefnawy1*, Abdulla Esawy2, Mohamed Abdelazeem1, Mohamed Elnamoury3, Ahmed Eissa4, Ahmed Zoair4, Ahmed Ghaith4, Ayman Hagras4 and Khaled Almekaty4

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 sildenafil citrate tablets 50mg 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.

Effects on sexual dysfunction

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. Maytom MC, Derry FA, Dinsmore WW, Glass CA, Smith MD, Orr M et al.

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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 . Quality of life in patients with spinal cord injury receiving Viagra (sildenafil citrate) for the treatment of erectile dysfunction.

Is Viagra an Option for Female Sexual Dysfunction?

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. 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.

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If you ever need emergency medical treatment for a heart problem, the healthcare providers who treat you will need to know when you last took sildenafil. Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine. If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule. If you are taking sildenafil for PAH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.

Authors and Affiliations

Do not take a double dose to make up for a missed one. Tell your doctor if any of these symptoms are severe or do not go away: numbness, burning, or tingling in the arms, hands, feet, or legs pain in muscles, back, arms, or legs changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green) If you experience any of the following symptoms, call your doctor immediately: sudden severe loss of vision (see below for more information) erection that is painful or lasts longer than 4 hours rash; itching; hives; difficulty breathing or swallowing; swelling of the eyes, face, throat, tongue, or lips Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately.

How should sildenafil for women be used?

Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil. Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The use of the sexual function questionnaire as a screening tool for women with sexual dysfunction.

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

Development of a questionnaire on sexual quality of life in women.

Country Legal Status Prescription Required Notes
USA Approved for certain uses Yes Off-label for women often not approved
UK Prescription-only Yes Approved for male ED; off-label use in women
Canada Restricted use Yes Prescription required; variable by province
Australia Prescription-only Yes Limited clinical guidelines for women

Phosphodiesterase type 5 inhibitors and female sexual response: faulty protocols or paradigms?

  • 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.

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

What other information should I know?

Visit the FDA's Safe Disposal of Medicines website for more information. In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Related medical questions

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies. This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

Addyi (filbanserin)

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. 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.

How Does Viagra Affect Women?

It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Liqrev, Revatio) for PAH, do not stop taking your medication until you talk to your doctor. Call your doctor if you have any unusual problems while you are taking this medication.

Osphenia (Ospemifene)

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( or by phone (1-800-332-1088). Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the tablets at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension at room temperature or in a refrigerator, but do not freeze it. Dispose of any unused suspension after 60 days.

Drug information

Keep all medication out of sight and reach of children as many containers are not child-resistant. Place the medication in a safe location – one that is up and away and out of their sight and reach. Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Talk to your pharmacist about take-back programs in your community.