Research on how the drug affects female arousal is sparse. But doctors have been prescribing creams and pills anyway.
Could the drug used to treat erectile dysfunction help women who have difficulties with arousal?
It’s a question that sexual medicine researchers have puzzled over since at least the late 1990s, when the Food and Drug Administration approved sildenafil, known as Viagra, for men.
Doctors prescribe sildenafil off-label to some female patients, either in the form of low doses of the pill or as a topical cream made by compounding pharmacies. Telehealth companies, like Alloy and Wisp, sell the creams on their platforms. Daré, a pharmaceutical company, is in the process of seeking approval from the F.D.A. for its topical sildenafil cream, which it plans to market specifically to women. Yet the research, including a study from Daré out today, suggests that if the drug is at all effective at increasing arousal in women, it’s only likely to do so for a small subset.
So should women experiencing sexual difficulties consider trying sildenafil? Here’s what experts advised.
Female Sexual Arousal Disorder and the Promise of Viagra
Research over the years, including the new study funded by Daré, has suggested that sildenafil might help women who have female sexual arousal disorder. This is the inability to attain or maintain sexual excitement, often including a lack of lubrication or genital swelling, to the extent that a person experiences distress as a result.
F.S.A.D. is technically separate from having low sexual desire, though in many cases, the two conditions overlap. It is sometimes a side effect of selective serotonin reuptake inhibitor antidepressants, and can also occur alongside other conditions that disrupt blood flow or nerve function, including diabetes and spinal cord injuries.
Difficulty with physical arousal in women is akin to erectile dysfunction in that it can come down to blood flow, said Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University, who has prescribed sildenafil for her female patients for almost a decade. Increased blood flow, particularly to the clitoris, heightens nerve sensitivity and triggers lubrication. Sildenafil dilates blood vessels, which makes it easier for blood to flow through them.