Should Viagra Be Available for Women?

You've probably heard of Viagra for erectile dysfunction in men, but have you heard of a medication designed to treat female sexual dysfunction (FSD)? Maybe not. Despite an estimated $1.7 billion market for FDS products in 2005, no medication was FDA-approved for its treatment until 2015.

Prior to the FDA approval of female-specific sexual dysfunction medication, Viagra was (and continues to be) tested on women. While the mechanism of action appears to be similar for men and women, conflicting research has prevented Viagra from being widely prescribed to women.

How Does Viagra Work?

Viagra is a phosphodiesterase type 5 (PDE5) inhibitor which enhances the production of guanosine monophosphate. Guanosine monophosphate relaxes smooth muscle cells and vasodilates and increases blood flow to the genitals. In men, Viagra's effect is an erection.

However, PDE5 is also expressed in smooth muscle of the vagina, clitoris, and labia, resulting in vaginal engorgement and clitoris erection. It's believed that in women with an organic cause of FSD, blood flow to the genitals is diminished. On a related note, research shows that in some women with atherosclerosis, blood flow to the genitals is diminished.

Research on Viagra in Women

Experimental use of female use of Viagra is dependent on the type of FSD a women is experiencing. For example, a prominent yet controversial 2003 study published in The Journal of Urology—one of the first to suggest Viagra may benefit women—suggested Viagra may improve sexual function in women with arousal problems, but not women with desire issues. Researchers Berman et al found a 12-week regimen of 50 milligrams of sildenafil (Viagra) significantly improved arousal sensation, lubrication, and orgasm in women with FSAD (female sexual arousal disorder). However, in women with other types of FSDs, such as hypoactive sexual desire disorder (HSDD) or dyspareunia, Viagra offered no significant improvement.

While Viagra may help resolve some physical issues related to arousal, studies do not support its use for the more complex aspects of FSAD.

With the notable exception of the Berman study, other studies have shown Viagra to be ineffective in the treatment of arousal and desire issues. For example, one randomized-control trial showed that Viagra caused no significant changes in physical response during sexual activity in both premenopausal and postmenopausal women. Another study showed that because of a lower concentration of PDE5 in the vagina and clitoris as compared with the penis, the effect of Viagra is markedly reduced in women.

Conflicting data on Viagra's efficacy in women makes it a last-defense option for female sexual dysfunction. Even then, such usage is not FDA-approved.

FDA-Approved Options

Until some years ago, there were no approved drugs to treat FSD. In 2015, Addyi (flibanserin) was approved for the treatment of female HSDD. In June 2019, Vyleesi was approved to treat acquired, generalized hypoactive sexual desire disorder (HSDD).

Addyi is a non-hormonal drug in the form of a pink tablet while Vyleesi is an injectable drug. They are both used to treat pre-menopausal women with low sexual desire. More specifically, they are intended for women who had previously not experienced any issues with sexual desire.

Neither of these drugs should be compared to Viagra, whose mechanism of action is completely different. Viagra works by increasing blood flow to the genitals using by dilating blood vessels. Addyi and Vyleesi, on the other hand, work on neurotransmitters and melanocortin receptors, respectively. The exact mechanism of action for these two drugs is relatively unknown.

A Word From Verywell

You may want to consider Viagra only as a last-line treatment after a thorough and multifactorial review of your female sexual interest/arousal disorder by your OB/GYN or primary care doctor.

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  2. K Park, I Goldstein, C Andry, MB Siroky, RJ Krane, KM Azadzoi. Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency. International Journal of Impotence Research. 1997;9:27-37. doi:10.1038/sj.ijir.3900258


  3. Basson R, McInnes R, Smith MD, Hodgson G, Koppiker N. Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with female sexual arousal disorder. J Womens Health Gend Based Med. 2002;11(4):367–377


  4. National Institutes of Health. Flibanserin. Drug Information Portal, U.S. National Library of Medicine.

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