Lifestyle

What Happens If a Woman Takes Viagra?

August 1, 2022

Medically reviewed by

David Culpepper, MD

One of the most popular medications worldwide is Viagra®. This “little blue pill” has been around for almost 25 years and it's common vernacular in mainstream culture.

While it’s clearly one of the most effective treatments for erectile dysfunction, what happens if a woman takes Viagra?

What Is Viagra?

Viagra (sildenafil) is prescription medication originally developed by the pharmaceutical company Pfizer to treat the symptoms of erectile dysfunction. The active ingredient in Viagra is sildenafil.

Originally conceived as a potential treatment for hypertension (high blood pressure) and angina (severe chest pain), sildenafil produced unexpected results in men who tried it during early testing. Researchers pivoted and began testing sildenafil for its ability to create erections.

After years of clinical trials and research, the Food and Drug Administration (FDA) approved Viagra as the world’s first oral medication for erectile dysfunction. Viagra hit the market in 1998 and became one of the most popular drugs worldwide.

When Viagra lost market exclusivity and patent protection in 2017, several other pharmaceutical companies began to manufacture generic versions of Viagra using sildenafil. Pfizer also launched their own "authorized generic" sildenafil.

Prices fell, and today you can get Viagra generics for as little as $2/pill.

How Does Viagra Work?

Sildenafil is the active ingredient in Viagra and is in a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors. Sildenafil, along with other PDE5 medications like tadalafil and vardenafil, work by dilating the arteries and relaxing the smooth muscles in the penis, letting the penis stay relaxed longer.

By performing these tasks, the amount of blood flowing into the penis increases and the amount of blood that flows out decreases, resulting in engorgement and an erection.

It’s important to note that taking a PDE5 inhibitor will not automatically result in an erection!

When a man encounters physical or mental sexual stimulation, the brain releases chemical messengers that expand the blood vessels located in the pelvic region. The most important of these chemicals is called nitric oxide. PDE5 inhibitors more or less piggyback on the effects of nitric oxide and enhance its effects. Without some stimulation, Viagra generally can't do its work.

Nitric oxide triggers an increase in another substance in the body called cyclic guanosine monophosphate (cGMP). CGMP is directly responsible for increased blood flow to the penis.

Here's the thing: sildenafil inhibits the phosphodiesterase type 5 enzyme (PDE5), another substance in the body that degrades and eliminates cGMP. It is in some ways the body's naturally brake or restriction mechanism on cGMP.

By inhibiting PDE5, sildenafil and drugs like it "remove the brakes" from the erection process, improving blood flow to the penis.

Nitric oxide affects cGMP, which is negated by PDE5. Sildenafil inhibits this PDE5 effect.

Why Would a Woman Need Viagra?

Obviously, women cannot experience erectile dysfunction, but that doesn’t mean that they can’t experience issues related to sexual health and function.

For women, the term is female sexual dysfunction (FSD) or female sexual arousal disorder (FSAD), and it's a common issue. While there has been much less research into female sexual dysfunction compared to erectile dysfunction, a review of 95 studies into female sexual dysfunction found that just under 41 percent of premenopausal women experienced some form of FSD. Other estimates have the number as high as 63 percent of women.

Unlike erectile dysfunction, which is largely measured by strength and duration of an erection, female sexual dysfunction can have a much wider variety of symptoms and is different for every woman.

One study of 400 women experiencing female sexual dysfunction focused on the exact issues that they faced:

181 women (45.3%) experienced a lack of sexual desire
150 women (37.5%) experienced a lack of arousal
165 women (41.2%) experienced a lack of lubrication
168 women (42%) experienced an inability to achieve orgasm
178 women (44.5%) experienced a lack of sexual satisfaction
170 women (42.5%) experienced an excessive amount of pain

What Would Happen If a Woman Were To Take Viagra?

Viagra helps men to maintain erections by improving blood flow into the penis.

For women, nitric oxide and cGMP have a similar effect as they do in men. By regulating blood flow, both are involved in sexual function and women's orgasms. For a woman to experience an orgasm, there is a certain amount of vaginal and labial pressure required. These pressure levels are controlled by elevated blood flowing into the clitoris.

There's reason to believe that women can benefit, then, from Viagra and medications like it.

What does the science say?

Can Viagra Treat Women?

Research into the effects of Viagra for sexual purposes in women suggest possible improvements to sexual function, but not definitive benefits. So far, the jury is out on Viagra/sildenafil for women.

A 2009 review of medical studies involving women and sildenafil suggests that some women with FSAD may benefit from sildenafil, though identifying who will benefit will require more testing. These authors conclude: "a modest improvement in arousal with sildenafil citrate treatment, compared with placebo (albeit with caveats in the Basson and Brotto study). Further studies to identify which patients with FSAD would be most likely to respond to sildenafil citrate could be beneficial."

The same study points out that cGMP is much lower in women's genitals than in men. This could be one explanation for the different patient outcomes.

During one study performed over the course of 12 weeks, 202 postmenopausal women experiencing female sexual dysfunction were given Viagra. Some women were given Viagra doses that ranged between 25, 50, and 100 milligrams while others were given a placebo. The women that were given Viagra experienced an overall increase in their genital sensations and an increase in sexual satisfaction with intercourse and/or foreplay.

Meanwhile, more recent studies have not been entirely supportive.

A 2011 medical study found that in women with sexual arousal disorder and spinal cord injuries, sildenafil treatment did not improve function over a placebo.

A 2012 study found similar, that sildenafil did not augment the genital response in women with sexual arousal disorders.

Another volunteer study found that postmenopausal women with genital female sexual arousal disorder and orgasmic impairment do not benefit from sildenafil.

Happy women smiling

Are There Side Effects If a Woman Takes Viagra?

Clinical trials and research into the side effects of Viagra were, naturally, performed almost exclusively on men.

But the small studies done on sildenafil in women suggest the side effects of Viagra in women are similar to those in men. Some of the common side effects associated with Viagra include:

Flushing in the body or face
Indigestion, abdominal cramps, and diarrhea
Headache or migraine
Nasal congestion or runny nose
Heart palpitations and shortness of breath
Nausea and vomiting
Visual changes such as blurry vision or blueish tint

In addition to these possible side effects, Viagra can have a negative interaction with other medications, especially those used to treat high blood pressure. Mixing Viagra with nitrates is especially dangerous and can lead to a significant drop in blood pressure.

What Women Can Use Instead of Viagra

For women experiencing female sexual dysfunction, treatments are few compared to men experiencing erectile dysfunction. Part of the reason is that the sexual process for a female is much more complicated than for men.

The treatments for women's sexual disorders include:

Flibanserin

The drug Addyi (flibanserin) hit the market in 2015 and was largely advertised as a “female Viagra.” However, it's failed to meet expectations and has been rather underwhelming. Despite not reaching the popularity or effectiveness of Viagra, flibanserin is probably still a better option than using a PDE5 inhibitor like Viagra for women.

Flibanserin primarily focuses on three important chemicals in the brain: dopamine, norepinephrine, and serotonin. For women, the brain is believed to play a much more important role in the female sexual response.

Flibanserin works by raising dopamine and norepinephrine, while lowering serotonin. This is intended to increase sexual excitement and desire. Typically the recommended dosage is 100 milligrams taken before bed every night.

Hormone Replacement Therapy

Another potential treatment for women is to restore estrogen levels to a healthy range through hormone replacement therapy. These medications are available as topical creams, oral medications, skin patches, sprays, vaginal tablets, and vaginal rings.

This treatment is typically reserved for postmenopausal women as a way to replace estrogen levels that have fallen after menopause. However, it can sometimes be used “off label” for female sexual dysfunction.

The Takeaway

While it may improve blood flow to the genitalia, Viagra doesn’t appear to be a particularly effective treatment for female sexual dysfunction. More research may help elucidate a subgroup of women with FSAD who can benefit from treatment with Viagra, but when it comes to what would happen if a woman takes Viagra, don't expect fireworks.

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