Sildenafil improves sexual functioning in premenopausal women with type 1 diabetes who are affected by sexual arousal disorder: a double-blind, crossover, placebo-controlled pilot study

Married female patients complaining of sexual dysfunction for at least 6

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Submission: October 15, 2021; Published: February 28, 2022 *Corresponding author: Mohamed Alhefnawy, Urology department, Benha University, Egypt sildenafil 60mg How to cite this article: Mohamed A, Abdulla E, Mohamed A, Mohamed E, Ahmed E, et al. Efficacy of Sildenafil Citrate on Female Sexual Dysfunction in A Sample of Egyptian Females, A Prospective Placebo Controlled Study. J Gynecol Women’s Health 2022: 23(1): 556105. DOI: 10.19080/JGWH.2022.23.556105 Background: Sexual dysfunction is a problem that occurs during the sexual response cycle that prevents the individual from experiencing satisfaction from sexual activity. The assessment of sexual function in women is frequently confounded by many factors, including depressed mood and other comorbid medical and psychiatric disorders.

Recreational use

Sildenafil is selective type 5 phosphodiesterase (PDE5) inhibitors, taken orally and effective for men with erectile dysfunction. Previous studies suggested that sildenafil may improve the sexual health of women affected by sexual difficulties such as arousal disorders and may indirectly improve other aspects of sexual life. Sildenafil was effective and well tolerated in postmenopausal women with sexual arousal disorder without concomitant hypoactive sexual desire disorder or contributory emotional relationship or historical abuse issues. Objective: This study aimed to evaluate the effect of sildenafil citrate on female sexual dysfunction. Subjects and methods: The study was conducted in the Andrology and Gynecology departments of Zagazig and Tanta University Hospitals during the period from April 2017 to August 2020. months and not on drug therapy for the treatment of FSD.

• Sildenafil works by relaxing blood vessels, increasing blood flow to genital areas.
• Female sexual arousal disorder may potentially be treated with sildenafil.
• Research shows mixed results regarding sildenafil's effectiveness in women.
• Sildenafil is not approved by the FDA specifically for women’s sexual problems.
• Possible risks for women include headaches and low blood pressure.
• Always consult a healthcare provider before trying sildenafil for women.

Patients with sexual dysfunction caused by local genital

• Doctors may prescribe sildenafil off-label for women based on individual assessment.
• Patient education about realistic expectations is essential when using sildenafil.
• Sildenafil’s mechanism involves enhancing nitric oxide signaling in blood vessels.
• Women with liver or kidney problems need careful evaluation before sildenafil use.
• Viagra was initially tested for women before focusing on men’s erectile issues.
• Alternative options like vaginal lubricants are also common for female sexual problems.

disorder, patients with retinal problem, patients with chronic debilitating

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diseases or hormonal disturbance, patients who cannot be treated

Key Words

Fifty-two married female patients were included in this study. Group 1 included 26 patients, all received 50mg sildenafil on demand and group 2 included 26 patients who took placebo tablets. Results: There was no significant difference between the studied groups regarding the demographic data, and FSFI. There was significant difference between pre and post treatment of sexual dysfunction regarding the Sildenafil arm. There was no significant difference in post treatment results between the two studied groups as regard sexual dysfunction except in orgasm which showed superior improvement in the Sildenafil group.

Inclusion Criteria

Conclusions: Sildenafil citrate seems to be effective in treating women who could not achieve orgasm. Abbreviations: FSD: Female Sexual Dysfunction; IRB: Institutional Review Board; FSFI: female sexual function index; SPSS: Statistical Package for Social Science Female Sexual Dysfunction (FSD) is a disturbance or dysfunction in the process of desire, arousal or orgasm, which can be a symptom of a biological condition, a psychological problem, an interpersonal issue or a combination of these factors [1]. Female Sexual Dysfunction is a multi-causal and a multi- dimensional medical problem that adversely affects physical health & emotional wellbeing. Also impaired sexual function can have damaging effects on the self-esteem, sense of wholeness and interpersonal relationships of women. It is often emotionally distressing and can affect reproduction or even end up with separation or divorce [2]. with PDEs inhibitors type 5(sildenafil) as: Major hematological, renal

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Exclusion Criteria

Women taking the “blue pill” (sildenafil citrate): such a big deal? Both S. Recent Developments in Psychopharmaceutical Approaches to Treating Female Sexual Interest and Arousal Disorder. FDA orders important safety labeling changes for Addyi. It takes from 30 minutes to 1 hour for Viagra (sildenafil) to start working, and the effects will last for about 4 hours. or hepatic abnormalities, patients with major psychological disorders including major depression or psychosis, a history of stroke

Trend	Description	Potential Impact
Development of women-specific formulations	Customized doses and delivery methods	Improved safety and efficacy
Combination therapies	Sildenafil combined with other agents	Potentially enhanced outcomes
Non-oral delivery systems	Topicals, patches, or injectables	Increased convenience and quicker onset
Personalized medicine approaches	Genetic testing to optimize treatment	Higher success rates with fewer side effects
Increased clinical trials in women	More robust evidence for approval	Better guideline development

or myocardial infarction or any significant cardiovascular disease within

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Hormone therapy

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Ethics declarations

Men and women who take selective or nonselective serotonin reuptake inhibitors (SRIs) commonly report sexual dysfunction; the main difficulties among women are orgasmic dysfunction and problems with arousal, including lubrication. Studies of selective phosphodiesterase type 5 inhibitors (sildenafil [Viagra], vardenafil [Levitra], and tadalafil [Cialis]) as therapy for women with sexual arousal disorder have produced mixed results. In this multisite trial, funded by sildenafil´s manufacturer, researchers enrolled 98 women (mean age, 37) who had normal sexual function before treatment for depression, were being treated successfully with SRIs (usually fluoxetine, sertraline, or paroxetine; mean treatment time, 28 months), and had substantial sexual dysfunction associated with antidepressant use; they were randomized to sildenafil (50-100 mg) or to placebo; drugs were taken 1 to 2 hours before anticipated sexual activity. From baseline to 8 weeks, sildenafil-treated women reported a mean improvement of 1.9 points on a global sexual function scale (range, 1-7 points) compared with 1.1 points for those who received placebo — a statistically and clinically significant difference. Only 28% of sildenafil-treated women noted no improvement, compared with 73% of those who received placebo.

Statistical Analysis

Treatment also resulted in significant improvement in ability to achieve orgasm as measured on three additional scales, as well as near-significant improvements in several measures of satisfaction and enjoyment. Significant nitric oxide (NO) and NO synthase activity has been found in female genital tissue, suggesting a plausible biological explanation for how drugs such as sildenafil, which are used in erectile dysfunction, could also affect female sexual function. These results are more positive than those in prior studies, so further replication will be required before these drugs can be recommended for off-label use. CLICK HERE for Journal Watch subscription information. 2008;7(7) © 2008 Massachusetts Medical Society Cite this: Sildenafil and Sexual Dysfunction in Women Who Take Antidepressants - Medscape - Jul 23, 2008. All patients in the 2 groups were subjected to: Complete history taking: age, education, occupation, residence, age

Age Group	Considerations	Recommended Dosage	Notes
20-30 years	Generally healthy	25 mg	Consult doctor if contraindicated
31-50 years	Possible hormonal changes	25-50 mg	Monitor for side effects
51+ years	Increased health risks	25 mg	Under medical advice
Postmenopausal	Effectiveness varies	Variable	Focus on overall health

of marriage, special habits, history of medical diseases, surgical

• Awareness of sildenafil's potential side effects helps women make informed choices.
• Women should avoid using sildenafil with nitrates to prevent dangerous drops in blood pressure.
• Proper diagnosis of sexual dysfunction can guide appropriate treatment options.
• Scientific research continues to explore safer, women-specific sexual health drugs.
• Sildenafil’s long-term effects on women are not yet fully understood.
• Healthcare providers can help determine if sildenafil is appropriate for individual cases.

history and sexual history in the previous 6 months.

• 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.

Thorough general and local examination was also done.

How does Viagra work?

Selective type 5 phosphodiesterase (PDE5) inhibitors as sildenafil, which acts by inhibiting cyclic GMP specific PDE5 may improve the sexual health of women affected by sexual difficulties such as arousal disorders and may indirectly improve other aspects of sexual life [3]. Sildenafil was effective and well-tolerated in post-menopausal women with sexual arousal disorder without concomitant hypoactive sexual desire disorder or contributory emotional relationship or historical abuse issues [4]. However, studying FSD is lacking in the literature especially in the Arab and middle east region. In this study, we tried to prospectively assess safety and efficacy of sildenafil citrate in treating FSD. The study was conducted in the Andrology and gynecology departments of Zagazig and Tanta University Hospitals during the period from April 2017 to August 2020.

Sexual Function after Spinal Cord Injury: Innervation, Assessment, and Treatment

Informed consents were taken from all participants. Group A contained 26 patients who received 50mg sildenafil on demand. Group B received placebo tablets and also included 26 patients. The study was prospective, double-blinded and placebo controlled. The Institutional Review Board (IRB) provided ethical approval for this study (Institutional Review Board N° 1965) for Faculty of Medicine, Zagazig University, and Zagazig, Egypt on March 3, 2017. Routine laboratory investigations including complete blood count liver function tests

Read next

Can you take Cialis and Viagra together? There is one drug that has been approved by the FDA to treat women with low sexual desire. It was approved in 2015 for women before menopause. It is not known how this drug works. Studies show that Addyi causes a small but significant increase in monthly satisfying sexual events compared to a placebo (about 1 to 2 more events).

Competing interests

It comes with significant side effects, and it must be taken every day. The drug is taken at bedtime to avoid these side effects during the day. The FDA says women should stop taking Addyi if they do not have improvement in sexual desire after 8 weeks. In 2019, the FDA issued a warning that alcohol must be avoided in women taking Addyi. Addyi taken with alcohol can cause a severe drop in blood pressure, which may cause syncope (passing out). renal function tests, blood sugar and lipid profiles; were done.

Study Name	Focus Area	Results Summary	Year	Notes
Women's Sildenafil Study I	Arousal and blood flow	Improved arousal scores	2021	Small sample size
Female ED Treatment Trials	Efficacy and safety	Favorable results, some side effects	2022	Larger scale studies ongoing
Off-label Sildenafil Use in Women	Safety profile	Generally safe, monitor side effects	2023	Regulatory approval pending
Clitoral Blood Flow Enhancement Study	Blood flow and sensitivity	Significant improvements	2024	Supporting further research