Tadalafil for Women: What Happens If a Woman Takes Cialis

The development of phosphodiesterase type 5 inhibitors like Sildenafil, Tadalafil, Vardenafil, and Avanafil established a pharmacological standard in the treatment of erectile dysfunction (ED) in men. However, no such evidence-based pharmacological option was discovered for Female Sexual Dysfunction (FSD). 

According to The Diagnostic and Statistical Manual of Mental Disorders (DSM), FSD is defined as any sexual problem arising out of disorders of libido, orgasm, or sexual discomfort/ pain that causes distress to the individual or her relationship. A diagnosis requires symptoms to occur during at least 75% of sexual encounters over six months.

One of the most common types of FSD is Hypoactive Sexual Desire Disorder (HSDD). HSDD is characterized by absent sexual thoughts or significantly reduced interest in sexual activity. Diagnosis involves taking the Decreased Sexual Desire Screener (DSDS) test. 

Standard management of FSD involves a combination of cognitive behavioural therapy, use of vaginal dilators, pelvic floor exercises, relaxation techniques, and lubricants. In severe cases, surgical interventions such as vaginal reconstruction may be considered. However, a reliable drug therapy comparable to tadalafil or sildenafil for ED in men has not been established in current FSD management. 

Can Women Take Tadalafil (Cialis)?

Yes, women can take tadalafil for the treatment of  Pulmonary Arterial Hypertension (PAH) and urinary/bladder issues like lower urinary tract symptoms (LUTS) and overactive bladder (OAB). However, the positive effect of Cialis on women facing FSD is questionable. 

A 2015 evidence-based review published in the journal “Core Evidence” shows 40 mg tadalafil daily to be an effective treatment option for PAH (along with other treatment methods). A research article published in the International Urogynecology Journal in 2024 proved that a single dose of 40 mg tadalafil reduces urethral opening pressure. Therefore, it may help treat voiding dysfunction in women. Voiding dysfunction is an umbrella term for poor coordination between the bladder and urethra.  

Is Cialis (Tadalafil) FDA-Approved for Women?

Tadalafil is an FDA-approved drug to treat PAH in both men and women. If Cialis is used with finasteride to initiate BPH treatment, such use is recommended for up to 26 weeks. However, it is not approved by the FDA for treating sexual dysfunction in women.

Cialis Off-Label Use in Women

Cialis (tadalafil) is not approved by the U.S. Food and Drug Administration (FDA) for treating Female Sexual Dysfunction (FSD). Doctors sometimes prescribe it off-label to help women with certain sexual health problems. These uses include treating arousal disorder, reversing drug-induced dysfunction, and easing bladder-related issues.

One off-label use is for genital arousal disorder in premenopausal women with type 1 diabetes. A 2012 clinical trial in The Journal of Sexual Medicine reported that a daily dose of 5 mg tadalafil improved genital arousal in this group. The effect comes from better blood flow and muscle relaxation.

Another off-label use is for antidepressant-induced sexual dysfunction in women. A 2006 case report in the Journal of Sex and Marital Therapy showed that an on-demand dose of 20 mg tadalafil helped reverse this problem. Tadalafil works by countering the negative sexual effects caused by antidepressant drugs.

Cialis is also studied for Female Sexual Dysfunction linked to overactive bladder (OAB). A 2017 study in Urology found that a daily dose of 5 mg tadalafil was effective and well-tolerated. The drug relaxed the bladder detrusor muscle. This reduced the involuntary contractions that trigger urgency and bladder discomfort.

These studies show that Cialis may help women with specific conditions. It may improve arousal in women with diabetes, reverse sexual dysfunction from antidepressants, and reduce bladder-related problems. More research is still needed, but current evidence supports these off-label uses.

Does Cialis Work for Women?

Cialis has not demonstrated consistent or predictable efficacy in the treatment of FSD and is therefore not considered a reliable therapy. There are very few research studies that show potential benefits for specific female sexual dysfunction issues (e.g., in women with type 1 diabetes and in women facing medicine-induced FSD). Also, these studies were conducted on a very small scale, which makes it difficult to determine how safe Cialis is for women. 

The reason for Cialis not working in women as it does in men is largely due to physiological differences between them. Erectile dysfunction in men is largely caused by a decreased blood flow to the penis. Cialis treats this physiological issue in men to give them a firm erection. However, arousal in women works differently. It is not solely dependent on the physiology of the genitals; hormonal and psychological factors also have a huge impact. While Cialis can have some impact on the minor physiological part of arousal, it remains unable to address the hormonal and psychological problems. This makes Cialis clinically unproven as a treatment for FSD. 

How Long Does Cialis Take to Work for Women?

Cialis (tadalafil) usually starts working within 30 to 60 minutes after intake. The exact time can vary based on individual physiology. Some women may feel the effect sooner, while others may take longer to respond.

The effect of Cialis can last up to 36 hours. This does not mean constant arousal, but it shows the window of improved blood flow and potential sexual response. The duration may also vary depending on metabolism, age, and overall health.

What Does Cialis Do for Women’s Libido and Arousal?

Cialis (tadalafil) may improve arousal in premenopausal women with type 1 diabetes. A 2012 clinical trial published in The Journal of Sexual Medicine tested a daily 5 mg dose in a small group of women and found positive effects on genital arousal.

Cialis may also help with other aspects of female sexual function. It can improve sexual arousal, reduce pain during intercourse, and increase overall sexual satisfaction. More large-scale research is required to confirm these findings.

Cialis works through vasodilation, which means it relaxes blood vessels and increases blood flow. In men, this effect helps achieve stronger erections. In women, the same increase in pelvic blood flow may improve arousal, enhance natural lubrication, and possibly support stronger orgasms.

How Much Tadalafil Can Women Take?

40 mg tadalafil is the maximum safe daily dose established via the 2012 study published in the “Journal of the American College of Cardiology”. The study was to determine tadalafil’s efficacy in the treatment of PAH.

What Are the Side Effects of Tadalafil for Women?

The potential side effects of tadalafil are similar for both men and women. Depending on the quantity of tadalafil taken, the symptoms may vary from mild to moderate to severe. The side effects of tadalafil in women are similar to those in men. The intensity may range from mild to severe depending on the dose.

Common side effects:

• Headache
• Nausea
• Dizziness
• Flushing
• Nasal congestion
• Indigestion
• Muscle aches

Rare side effects:

• Sudden vision changes or loss
• Sudden hearing loss

Women-specific side effects:

• Heightened sensitivity of the clitoris
• Vaginal discomfort from tingling or pounding sensations

Is Tadalafil (Cialis) Safe for Women?

Tadalafil is an FDA-approved drug for women if taken for the treatment of PAH. However, it is not safe for use as a treatment option for FSD because the FDA doesn’t approve it. 

What are the FDA-Approved Alternatives for Women?

The three FDA-approved treatment options for women that can treat HSDD are-

1. Flibanserin (Addyi): It is an oral pill that should be taken at night before going to bed. It is an antidepressant for premenopausal women that increases libido by affecting serotonin and dopamine. However, it might take up to 8 weeks to show effects and may cause a drop in blood pressure.
2. Bremelanotide (Vyleesi): It is a self-administered injection that should be injected into the thigh/abdomen about 45 minutes prior to having sex. Also designed for premenopausal women, bremelanotide is a melanocortin receptor agonist that activates neural pathways responsible for libido. It should not be used more than once a day or 8 times a month. 
3. Hormone Therapies: Specifically developed for menopausal women, they address specific symptoms of menopause. Vaginal estrogen might help with vaginal dryness. Ospemifene (Osphena) and Prasterone (Intrarosa) may treat painful intercourse caused by vaginal/vulvular atrophy.

Can Women Take Sildenafil?

Yes, women with antidepressant-induced sexual dysfunction can use treatment. Evidence shows sildenafil for women may help in such cases. A case report in the Journal of Sex and Marital Therapy (2006) described benefits from a 20 mg on-demand dose. This evidence shows that, although originally developed for men, sildenafil can have therapeutic applications for certain female patients.

How Does Tadalafil Compare With Sildenafil?

Tadalafil lasts much longer than a sildenafil tablet. Sildenafil works for about four to six hours and shows effects within 30 to 60 minutes. Tadalafil stays active for up to 36 hours and has a longer half-life than sildenafil or vardenafil. Both drugs treat erectile dysfunction with similar effectiveness.

How Long Does Tadalafil Last?

The mean half-life of tadalafil in adults is about 17.5 hours. This means the drug stays active in the body for a long period. The effects of tadalafil last up to 36 hours. During this time, increased blood flow can support sexual response if stimulation occurs. It usually takes about 4 days for tadalafil to fully leave the system. The exact duration may vary depending on age, metabolism, and overall health.

Is Tadalafil for Men or Women?

Tadalafil mainly treats erectile dysfunction in men. A tadalafil tablet improves blood flow by blocking the PDE5 enzyme. Women may receive tadalafil for pulmonary hypertension, but not for sexual problems. The drug does not affect contraception. Doctors sometimes prescribe it off-label for women, though evidence is limited.