The function of sildenafil on female sexual pathways: a double-blind, cross-over, placebo-controlled study

Sher G, Fisch JD (2002) Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. (2001) “Monitoring of fetuses with intrauterine growth restriction: a longitudinal study,” Ultrasound Obstet Gynecol 18 (6): 564-570.

Jerzak M, Kniotek M, Mrozek J, Baranowski W (2008) Sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage. El Far M, El Motwally Ael G, Hashem IA, Bakry N (2009) Biochemical role of intravaginal sildenafil citrate as a novel antiabortive agent in unexplained recurrent spontaneous miscarriage: first clinical study of four case reports from Egypt.

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Webb DJ, Freestone S, Allen MJ, Muirhead, GJ (1999) “Sildenafil citrate and blood-pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist”. (2007) A systematic review of experimental and clinical studies of sildenafil citrate for intrauterine growth restriction and pre-term labour. Roh CR, Budhraja V, Kim HS, Nelson DM, Sadovsky Y (2005) “Microarraybased identification of differentially expressed genes in hypoxic term human trophoblasts and in placental villi of pregnancies with growth restricted fetuses,” Placenta 26(4): 319-328. (2004) Hypothesis: selective phosphodiesterase-5 inhibition improves outcome in preeclampsia. Warnes CA (2004) Pregnancy and pulmonary hypertension. (2009) A randomised, double-blinded, placebo-controlled study of the phosphodiesterase type 5 inhibitor sildenafil for the treatment of preeclampsia. Kaplan SA, Reis RB, Kohn IJ (1999) Safety and efficacy of sildenafil in postmenopausal women with sexual dysfunction. Basson R, McInnes R, Smith MD (2000) Efficacy and safety of sildenafil in estrogenized women with sexual dysfunction associated with female sexual arousal disorder. Rosen R, Riley A, Wagner G (1999) The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Mark E SmithBio chemistryUniversity of Texas Medical Branch, USA Lawrence A PresleyDepartment of Criminal JusticeLiberty University, USA Thomas W MillerDepartment of PsychiatryUniversity of Kentucky, USA Gjumrakch AlievDepartment of MedicineGally International Biomedical Research & Consulting LLC, USA Christopher BryantDepartment of Urbanisation and AgriculturalMontreal university, USA Robert William FrareOral & Maxillofacial PathologyNew York University, USA Rudolph Modesto NavariGastroenterology and HepatologyUniversity of Alabama, UK Andrew HagueDepartment of MedicineUniversities of Bradford, UK George Gregory ButtigiegMaltese College of Obstetrics and Gynaecology, Europe Emilio Bucio-CarrilloRadiation ChemistryNational University of Mexico, USA Casey J GrenierAnalytical ChemistryWentworth Institute of Technology, USA Hany AtalahMinimally Invasive SurgeryMercer University school of Medicine, USA Abu-Hussein MuhamadPediatric DentistryUniversity of Athens , Greece The annual scholar awards from Lupine Publishers honor a selected number Read More..

Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. [4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] It is unclear if it is effective for treating sexual dysfunction in females.

What is sildenafil?

You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. American Association for Marriage and Family Therapy. Overview of sexual dysfunction in women: Management. Email Us: info@lupinepublishers.com Call Us: +1 (914) 407-6109 57 West 57th Street, 3rd floor, New York - NY 10019, USA Department of Obstetrics & Gynecology, Tanta University, Egypt Received: October 03, 2018; Published: October 09, 2018 Corresponding author: Mohamed Nabih EL-Gharib, Professor of Obstetrics & Gynecology, Faculty of Medicine, Tanta University, Egypt Sildenafil citrate (SC) is a medicinal drug used to treat male erectile dysfunction and pulmonary hypertension. Sildenafil is a selective and potent competitive inhibitor of the cyclic guanosine monophosphate (cGMP) -specific phosphodiesterase-type 5 (PDE-5) enzymes, which, by preventing the breakdown of cGMP, potentiate the action of NO in tissues that contain PDE-5.

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Thus, increasing vasodilatation and potentiating the effects of nitrous oxide (NO) on the vascular smooth muscle [1-2]. SC increases uterine blood flow and potentiates estrogen-induced vasodilatation [3]. Sildenafil citrate is metabolized is in the liver by cytochrome P450, the metabolites are: N-desmethylsildenafil (about 50% potency for PDE5). The biological half-life is from 3 to 4 hours, it is excreted in feces and in urine [4]. Sildenafil is developing as a potential applicant for the treatment of intrauterine growth retardation and for premature labor [5].

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Sildenafil has also been proposed as a potential therapeutic strategy to maintain placental function in pre-eclampsia [6]. Should sildenafil citrate possess vasodilatory effects in the feto-placental circulation, this would significantly enhance its therapeutic use in treating placental insufficiency. SC has recently been demonstrated not to alter the contractile response to vasoconstrictors or to endothelial dependent vasodilators. In non-pregnant females, SC causes uterine artery vasodilation therefore it also be employed to treat menstrual pain and muscle spasms [7]. SC is increasingly used in the pregnant patient for the treatment of pulmonary hypertension [8]. [8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically within twenty minutes and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin.

[8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure.

Pharmacology of Sildenafil

Its safety and efficacy combined with its lack of teratogenic or feto-toxic effects mean that its use for the treatment of pulmonary hypertension in pregnancy is likely to increase [9]. The most common adverse effects of sildenafil citrate tablets 150 mg sildenafil citrate use include: headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. Some complained of blurriness and loss of peripheral vision. In July 2005, the FDA found that sildenafil could lead to vision impairment in rare cases [and several studies have linked sildenafil use with non-arteritic anterior ischemic optic neuropathy [10]. The FDA announced that all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss [11].

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Vaginal sildenafil might be an interesting therapeutic option before conception in women with histories of reproductive failure [12]. In addition, intravaginal sildenafil citrate tablets used as suppositories might be a new, interesting, safe antiabortive option in the treatment of threatened miscarriage in patients with a history of unexplained recurrent spontaneous abortion. The dose intravaginal sildenafil citrate is 25 tablets given 3- 4 times daily [13]. Wareing M, Myers JE, O Hara M, Baker PN (2005) Sildenafil citrate (Viagra) enhances vasodilatation in fetal growth restriction. Zoma WD, Baker RS, Friedman A, Clark KE (2004) Sildenafil citrate (Viagra) increases uterine blood flow and potentiates estrogen-induced vasodilation. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal.

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This can cause worries that lead to a loss of interest in sex. Desire often is linked to a sense of closeness between partners, as well as sexual issues from the past. Some chronic conditions, such as diabetes or multiple sclerosis, can cause changes in arousal or orgasm. If you have trouble with sexual desire or response, talk with a member of your healthcare team. You might want to talk to a sex therapist.

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

Learn more about Mayo Clinic’s use of data. We use the data you provide to deliver you the content you requested. To provide you with the most relevant and helpful information, we may combine your email and website data with other information we have about you. If you are a Mayo Clinic patient, we will only use your protected health information as outlined in our Notice of Privacy Practices. You may opt out of email communications at any time by clicking on the unsubscribe link in the email. [8] It also results in dilation of the blood vessels in the lungs.

• Sildenafil citrate tablets are typically taken 30-60 minutes before intimacy.
• Monitoring by a healthcare professional is recommended for women.
• Use sildenafil cautiously if you have a history of stroke or heart attack.
• Combining sildenafil with other ED medications is dangerous.
• Pregnancy and breastfeeding considerations should be discussed with a doctor.
• Sildenafil does not induce arousal but enhances physiological responses.
• Not suitable for women with or at risk of abnormal heart rhythms.
• Potential for psychological as well as physical benefits exists.
• Ensure trusted pharmacy sources when purchasing sildenafil for women.
• Sildenafil is available in various dosages, such as 25 mg, 50 mg, 100 mg.
• Discontinue use if adverse effects like chest pain occur.
• A comprehensive sexual health evaluation can determine if sildenafil is appropriate.

Pfizer originally discovered the medication in 1989 while looking for a treatment for angina. [11] It was approved for medical use in the United States and in the European Union in 1998.

• Sildenafil may improve blood flow to the clitoris, aiding arousal.
• Use caution with grapefruit or grapefruit juice, which can affect drug levels.
• Document any pre-existing medical conditions before starting sildenafil.
• Sildenafil may cause dizziness; avoid activities requiring alertness.
• Women with liver or kidney impairment should consult a physician first.
• The drug is not a hormone; it works on blood vessels.
• Patients should report any sustained erections or discomfort.
• Combining sildenafil with certain antidepressants may alter effectiveness.
• Keep track of any changes in sexual satisfaction or function.
• Sildenafil should be used as part of a comprehensive treatment plan.
• Avoid using sildenafil with recreational drugs that affect the cardiovascular system.
• Always follow up with your healthcare provider for ongoing assessment.

[5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication.

• Female-specific studies on sildenafil show mixed results.
• Sildenafil is sometimes used off-label for female libido enhancement.
• Always check for allergies before taking sildenafil citrate tablets.
• Sildenafil may cause vision disturbances in some women.
• Proper hydration can reduce side effects when using sildenafil.
• Combining sildenafil with alcohol can increase risks.
• Be aware of potential interactions with hormonal contraceptives.
• Do not share sildenafil tablets to prevent misuse or overdose.
• Women should report any adverse reactions to their healthcare provider.
• Sildenafil may help with certain conditions like Female Sexual Arousal Disorder.
• Cost of sildenafil for women varies, and insurance may not cover it.
• Follow prescribed instructions precisely to avoid overdose.

[15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse).