Does Viagra Work for Women?

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It wasn’t that long ago that men who were unable to maintain an erection were referred to as being impotent. It was bad enough to have a penis that wouldn’t cooperate, but then to have a diagnosis that labeled you as weak, incompetent and powerless was too much to expect any man to deal with. Lucky for the guys, in 1998, when Viagra™ came on the market, the impotent man disappeared and was replaced by the guy with erectile dysfunction. The man with ED was handsome, successful and sexy. And always good to go.

And since that time, women who have had difficulty having an orgasm, (the equivalent of erectile dysfunction), have been saying, “Where’s my Viagra™? The guys get to just take a pill to help their problem. Where’s our pill?” The answer, of course, is that it is nonexistent. Despite the claims of over-the-counter products promising to wake up an unresponsive clitoris, none have been shown to do much of anything beyond the benefits of rubbing it in. Very slowly. Currently, there are zero FDA-approved medications to treat women who have difficulty having an orgasm.

Viagra™ is the trade name for sildenafil and is one of a class of drugs known as a phosphodiesterase type 5 inhibitor or PDE5 Inhibitor. Sildenafil dilates blood vessels and was initially developed as a blood pressure and heart medication. During the clinical trials, it was a total bust in terms of treating hypertension and angina. But the guys taking the drug reported that they were getting amazing erections. Evidently, the blood flow to the genitals improved far more than the blood flow to the heart. So, Pfizer, the company that developed Viagra™, pivoted. And the rest is history.

Viagra and other PDE5 inhibitors are only FDA-approved to treat an uncooperative penis. Though, as a longtime doctor and researcher in obstetrics and gynecology, the question I have gotten almost daily is if it is reasonable for women to take it to help with an uncooperative clitoris. It seems like it should.

Many post-menopausal women have difficulty with orgasm because of decreased clitoral blood flow. Sildenafil increases penis blood flow. Working on the premise that a penis is just a large clitoris, one would think taking sildenafil would be a reasonable strategy. One would think. Unfortunately, the handful of scientific studies published have been inconsistent as far as female response and orgasm.

The most promising research on the use of sildenafil is in women who have difficulty having an orgasm, specifically because of taking an SSRI, or an anti-depressant. In up to 30 percent of women, the sexual side effects caused by the SSRI are temporary. But, if the inability to have an orgasm is persistent, sildenafil may help. In an eight-week trial of 100 women with delayed or no orgasm due to taking an SSRI, 72 percent of women receiving sildenafil had improvement compared to only 27 percent who received a placebo.

I want to emphasize, Viagra™ is currently only FDA-approved for men, so there is no established dosing or comprehensive safety data for women. Headache, flushing and nausea are the most reported side effects. Though, I have prescribed Viagra and Cialis for my patients with SSRI-induced difficulty with orgasm, and in most cases, it works. This is not a do-it-yourself project so please talk to your doctor before you steal your partner’s pills!

But I have good news for you. Really good news. Sildenafil cream, to be applied directly to vulvar and vaginal tissue, is in clinical trials to stimulate arousal and is expected to be FDA-approved in the next year or so, You don’t have to wait for the FDA since compounded sildenafil cream is currently available. You will still need a prescription and it is important to get it from a trusted compounding pharmacy.

I want to mention a product that is often called “Viagra for women.” Flibanserin, trade name Addyi™, is a medication that is FDA-approved for pre-menopausal women to help boost a lagging libido. Addyi™ does not increase blood flow to the clitoris and does not increase the ability to have an orgasm. It is not a female Viagra™.

So, overall, oral sildenafil seems to be most beneficial in women whose anti-depressants have sabotaged their ability to orgasm. And for women who don’t take an antidepressant but are curious to use Viagra to see if they have a faster, better or more reliable orgasm, just know there is no data. And it would be nice to have more research in this area beyond what happens in bedrooms across America. My book, Come Again? A Guide to Midlife Libido and Orgasm, is a solution-driven guide about orgasmic dysfunction due to menopause, cancer, vascular, neurologic and other medical conditions that will be released in June 2024 and is now available for pre-order.


Would you like to see a Viagra for women? Let us know in the comments below.