Can Women Take Viagra (Sildenafil) for Low Libido?
Medically reviewed by Lindsay Cook, PharmD
The Food and Drug Administration (FDA) has not approved Viagra (sildenafil) for use in women.
However, your healthcare provider may prescribe it for off-label use in female sexual arousal disorder (FSAD)–a type of sexual dysfunction characterized by low sex drive (libido) in females.
There is currently limited evidence that Viagra benefits FASD, especially since many factors can cause a low sex drive. Other more effective options may be available, depending on the cause of your low libido.
Viagra (sildenafil) is a prescription medication approved for treating erectile dysfunction (ED) in adult males.
This article covers whether Viagra can be used for sexual dysfunction in females, potential side effects, and other pharmacological and non-pharmacological ways to boost libido (sex drive).
Getty Images / Angelo D'Amico
A Note on Gender and Sex Terminology
Verywell Health acknowledges that sex and gender are related concepts, but they are not the same.
Sex refers to biology: chromosomal makeup, hormones, and anatomy. People are most often assigned male or female at birth based on their external anatomy; some people do not fit into that sex binary and are intersex.
Gender describes a person's internal sense of self as a woman, man, nonbinary person, or another gender, and the associated social and cultural ideas about roles, behaviors, expressions, and characteristics.
Research studies sometimes don't use the terminology in this way. Terms that describe gender (“woman,” “man”) may be used when terms for sex (“female,” “male”) are more appropriate. To reflect our sources accurately, this article uses terms like "female," "male," "woman," and "man" as the sources use them.
What Is Viagra and How Does It Work?
Viagra is a phosphodiesterase-5 (PDE-5) inhibitor used to treat erectile dysfunction (ED) in males.
PDE-5 degrades cyclic guanosine monophosphate (cGMP), a nucleotide in the body that acts as a messenger between cells. Following sexual stimulation, PDE-5 inhibitors cause a local release of nitric oxide, which increases cGMP and relaxes the muscles around blood vessels. This dilation increases blood flow to the penis, making it easier to get and sustain an erection.
Sildenafil, the active ingredient in Viagra, is also marketed as Revatio, which treats pulmonary arterial hypertension and improves exercise capacity.
Does Viagra Work for Women?
Viagra is not FDA-approved for use in females, but a healthcare provider may prescribe it off-label. There’s limited evidence that Viagra is beneficial for females with sexual dysfunction.
In two separate studies, approximately 780 females experiencing a variety of sexual dysfunctions were randomized to receive sildenafil or a matching placebo. After 12 weeks, sildenafil, though well-tolerated, was not perceived as improving the sexual response in either group.
A review article indicated that evidence from randomized controlled trials shows that sildenafil citrate is moderately effective in treating FSAD. Still, more clinical trials are needed to support these findings.
Further research is needed to fully understand if women can expect any benefit from Viagra and who would most likely respond.
Sexual dysfunction in females can be complex, and there are often several contributing factors. Female sexual dysfunction can be due to an inability to reach orgasm, painful intercourse, or lower sexual desire (libido).
Viagra has been shown not to affect libido in men, and its mechanism as a vasodilator (medication that widens the blood vessels) does not seem to lend itself to treating desire disorders. Therefore, Viagra might not be the best option for improving low libido in females.
What Happens When a Woman Takes Viagra?
In males, following sexual stimulation, Viagra dilates blood vessels. It increases blood flow to the penis to result in an erection.
Preclinical studies have shown that phosphodiesterase type‑5 is present in vaginal, clitoral, and labial smooth muscle. This suggests that PDE5 is involved in female sexual function, particularly genital arousal. In females, sildenafil may also increase blood flow to the genitals. That may help increase sensitivity, arousal, and orgasmic function.
However, PDE5 is expressed in far smaller quantities in the clitoris than in the male corpus cavernosum, the part of the penis essential for an erection.
Even though some studies have shown success, Viagra might never be as effective in women with FSAD as in men with ED due to this concentration.
What Are the Side Effects of Viagra in Women?
For females who do take Viagra, common side effects may overlap with those reported when the medication is taken for ED.
Side effects may include:
Flushing (red skin)
Stuffy nose
Stop using Viagra and seek medical care if you suddenly lose vision in one or both eyes. This could be a sign of a severe eye condition. You should also stop Viagra if a sudden decrease or loss of hearing occurs.
What Other Treatments Are Available for Low Libido?
Healthcare providers may prescribe other treatments to help improve sexual dysfunction disorders in females. The treatment may depend on what type of sexual dysfunction you're experiencing and what's causing it.
Addyi (Flibanserin)
Addyi (flibanserin) is a pink tablet approved to treat hypoactive sexual desire disorder (HSDD) in premenopausal females (those who have not yet reached menopause) only. It is meant to be taken daily at your bedtime.
HSDD is caused by an imbalance of neurotransmitter activity in the brain that affects sexual desire.
This can result from either a deficiency of excitatory signals that regulate sexual response, an excess of signals that inhibit sexual response, or a combination of both.
The exact way that Addyi works to treat HSDD is unknown, but it does affect serotonin in the brain. It is stopped after eight weeks if there's no improvement. Additionally, it is not recommended for low libido caused by other health conditions or medications.
Addyi also has a boxed warning (the FDA's strictest safety warning) about the risk of severely low blood pressure and passing out.
To lower this risk, avoid alcohol use for at least two hours before your Addyi dose and until the next day after the dose. It is also important to avoid taking it with moderate or strong CYP3A4 inhibitors or if you have liver problems.
Vyleesi (Bremalontide)
Vyleesi (bremelanotide) is an FDA-approved injection for premenopausal females with HSDD.
It's unclear how exactly Vyleesi works to improve HSDD. However, it is known to activate melanocortin receptors present in the skin and central nervous system. Melanocortins are a group of small protein hormones thought to play a role in sexual response.
You can take this medication 45 minutes before engaging in sexual activity, as needed. You should not exceed one dose per day or eight doses per month. Stop using it if there is no improvement after eight weeks.
You should not take Vyleesi if you are allergic to it, have uncontrolled hypertension (high blood pressure), have known heart disease disease, or are pregnant.
Osphenia (Ospemifene)
Osphenia (ospemifene) is approved to help with painful intercourse and vaginal dryness due to menopause, which can cause a low sex drive. It comes as a tablet meant to be taken once per day.
Osphenia is an estrogen agonist/antagonist that binds to estrogen receptors to activate certain pathways (like vaginal tissue) and block others.
You shouldn't take Osphenia if you have unusual vaginal bleeding, a history of certain cancers, blood clots, a history of stroke or heart attack, or if you are pregnant.
Complementary and Alternative Options for Low Libido
Currently, there is insufficient scientific evidence to support the use of supplements in improving female sexual dysfunction.
However, the following supplements have been researched for their potential benefits on boosting libido:
While these supplements may have some benefits, larger, more comprehensive clinical trials are necessary to confirm their effectiveness before they can be regularly recommended.
Certain lifestyle behaviors can also contribute to your sexual health and overall wellness. These include:
Eating a balanced diet
Getting adequate sleep
Managing stress, such as through self-care, mindfulness, or other techniques
Regular exercise
Limiting consumption of alcohol, tobacco, and recreational drugs
Summary
Viagra is not yet approved for treating sexual dysfunction disorders in females. Although it can be prescribed off-label, studies on how well it works in the female population have had mixed results.
Other treatments are available for females, such as Addyi and Vyleesi, depending on the type of sexual dysfunction. These medications work by affecting specific pathways in the brain involved in sexual desire.
You can also try complementary and alternative treatments, such as supplements, and lifestyle changes, to help with arousal issues. And if these problems persist, talk to a healthcare provider about potential options to increase your sex drive and factors that may be impacting it.
Frequently Asked Questions
Is Viagra safe for women?
Studies have shown that both men and women can safely use Viagra. Side effects associated with sildenafil were generally mild-to-moderate, the most common being headache, flushing, nausea, stuffy nose, and visual disturbances.
What medications are FDA-approved to help increase libido in women?
The following FDA-approved drugs can help improve sexual dysfunction and boost libido: Addyi, Vyleese, and Osphenia.
Addyi must be taken every night before bed, whereas Vyleesi can be taken as needed for sexual activity, with a daily and monthly limit. Both Addyi and Vyleesi are indicated for use in premenopausal women only.
Osphenia is approved to help with painful intercourse and vaginal dryness due to menopause. It can be taken once daily.
Are there any natural ways to boost libido?
While there is limited evidence that supplements can improve female libido, some research shows benefits for DHEA, vitamin E with ginseng, and zinc.
Additionally, eating a balanced diet, getting adequate sleep, regularly exercising, and practicing self-care can contribute to overall health, which may help improve your libido.
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