What Happens if a Woman Takes Sildenafil (Viagra)?

When a woman takes sildenafil (Viagra), the drug increases blood flow to the genital area, potentially enhancing arousal, sensitivity, and lubrication. Some studies suggest it may help women with Female Sexual Arousal Disorder (FSAD), but results are mixed and benefits vary. Research shows that while sildenafil increases clitoral and vaginal blood flow, its effectiveness in improving overall sexual function and satisfaction among women is mixed. Some clinical trials, particularly those involving women with female sexual arousal disorder or sexual dysfunction related to selective serotonin reuptake inhibitors (SSRIs), report modest improvements in genital engorgement and arousal.

A study in Medscape General Medicine (2004) investigated the effects of sildenafil citrate on uterine and clitoral arterial blood flow in postmenopausal women using color Doppler sonography. The results indicated that sildenafil increased blood flow in both the uterine and clitoral arteries. This suggests it may improve genital circulation. This study provides objective evidence supporting sildenafil’s physiological effect on the female genital area. However, large randomized controlled trials have produced inconsistent results regarding improvements in sexual desire, lubrication, and orgasm frequency.

When a woman takes sildenafil, she may experience increased blood flow and genital engorgement that could help with arousal and lubrication, potentially easing symptoms of FSAD. Yet, the drug is not a universal solution for female sexual dysfunction, especially when issues of libido and psychological factors are involved. Clinicians sometimes use sildenafil as one of several treatment options for women. Research is exploring better ways to use it, including topical forms that target local effects and reduce whole-body side effects.

Explore the detailed article below to understand how sildenafil works in women, covering its mechanism of action, safety profile, and alternative treatments for FSAD.

Can Women Take Sildenafil (Viagra)?

Yes, women can take sildenafil, but it is not broadly FDA-approved for female sexual dysfunction, and the clinical evidence is mixed. Some trials show benefit in specific subgroups, while many randomized trials and systematic reviews find little or inconsistent overall benefit.

As per a meta-analysis in the International Journal of Gynaecology and Obstetrics (2015), phosphodiesterase type 5 inhibitors generally improved female sexual function compared to placebo, based on data from 14 randomized controlled trials. However, the effectiveness varied across studies due to different measurement tools and endpoints. Common adverse events, like headache, flushing, and visual changes, were significantly more frequent with PDE5 inhibitor use; however, overall safety remained relatively acceptable.

Another study in the Journal of Urology (2003) showed that sildenafil significantly improved several Female Intervention Efficacy Index (FIEI) scores compared to placebo, particularly in postmenopausal women with FSAD but without concomitant hypoactive sexual desire disorder (HSDD). Women with FSAD and concurrent HSDD showed no improvement, and most side effects, like headache, flushing, rhinitis, nausea, and visual changes, were mild to moderate. The authors concluded that sildenafil was effective and well-tolerated in carefully selected postmenopausal women receiving adequate hormone replacement.

Is Viagra FDA-Approved for Women?

No, Viagra (sildenafil) is not approved by the FDA for use in women. The drug’s approval by the U.S. Food and Drug Administration is limited to the treatment of erectile dysfunction in men. While research has explored its potential benefits for female sexual arousal disorder (FSAD), findings have been mixed and inconsistent.

Several clinical trials have tested sildenafil in women, particularly postmenopausal women with FSAD, but results show limited or no benefit for those with low sexual desire (HSDD). Any improvements were mostly seen in women without desire-related issues and who had adequate hormone levels.

Because of insufficient and inconclusive evidence, the FDA has not granted approval for sildenafil in women. However, healthcare providers may still prescribe it off-label in select cases after evaluating potential risks and benefits.

To better understand its potential, let’s explore how sildenafil works in a woman’s body.

How Does Sildenafil Work in a Woman’s Body?

Sildenafil works by inhibiting the enzyme PDE5, which normally breaks down cyclic guanosine monophosphate (cGMP). By blocking PDE5, sildenafil increases cGMP levels, leading to relaxation of smooth muscle and dilation of blood vessels in genital tissues. This process enhances blood flow to key areas involved in female sexual response, including the clitoris, labia, and vaginal walls, which are rich in vascular tissue sensitive to these changes.

Increased blood flow causes engorgement of the clitoris and labia, which heightens genital sensitivity and contributes to sexual arousal. Additionally, the enhanced circulation promotes vaginal lubrication, improving comfort and reducing dryness during sexual activity. Together, these physical changes create the physiological conditions necessary for sexual excitement and responsiveness.

While sildenafil supports the physical aspects of sexual response, such as lubrication and genital sensitivity, the experience of orgasm is complex and influenced by psychological, relational, and hormonal factors. Sildenafil may help some women achieve orgasm more easily by improving blood flow and sensitivity, but it is not a direct “orgasm enhancer,” and its effects vary widely between individuals depending on many other factors.

Does Viagra Increase Blood Flow to Female Genitals?

Yes, sildenafil (Viagra) increases blood flow to female genital tissues (clitoris, vaginal mucosa, and in some studies, uterine/endometrial circulation). But increased blood flow does not reliably translate into clinically meaningful improvement for all women with sexual complaints. A study in the International Journal of Impotence Research (2000) showed that sildenafil significantly increased genital blood flow and tissue oxygenation during stimulation, while reducing vaginal pressure and enhancing lubrication. The results imply that sildenafil activates the NO-cGMP pathway, which plays a key role in female genital arousal, potentially improving the natural arousal process.

Another study in Medscape General Medicine (2004) demonstrated that a single 50 mg dose of sildenafil in healthy postmenopausal women reduced blood flow resistance in the uterus and increased blood flow velocity in the clitoral artery. However, overall changes were not significant.

Because of that mixed clinical picture, sildenafil is not FDA-approved for general treatment of female sexual dysfunction; topical formulations are under active study and show promise in certain types of female sexual arousal disorder, but are not a universal solution. Side effects and systemic vasodilatory effects (headache, flushing, nasal congestion, occasional hypotension) also occur in women as in men, so use should be guided by a clinician.

Can Viagra Improve Lubrication in Women?

Yes, sildenafil (Viagra) increases vaginal engorgement and self-reported lubrication, but the effect is inconsistent and does not reliably improve lubrication for all women.

As per a study in Journal of Women’s Health & Gender-Based Medicine (2002), a single 50 mg oral dose of sildenafil significantly increased vaginal blood engorgement in healthy premenopausal women compared to placebo. However, subjective feelings of sexual arousal did not differ between sildenafil and placebo. Interestingly, women who thought they had taken sildenafil, whether or not they did, reported greater arousal and increased vaginal wetness.

So, sildenafil may improve lubrication for some women. Still, it is not a universally effective treatment for female vaginal dryness or low lubrication, and it is not FDA-approved as a routine therapy for female sexual dysfunction. Use should be discussed with a clinician who can weigh the likely benefit against side effects and consider alternative or complementary approaches (local estrogen, moisturizers/lubricants, addressing medications like SSRIs, or behavioral/psychosexual therapy).

Does Viagra Affect Female Arousal and Sensitivity?

Yes, sildenafil (Viagra) increases genital arousal sensations and leads to heightened sensitivity, but the clinical effect on subjective arousal and sensitivity is inconsistent across studies and populations.

Sildenafil is a PDE-5 inhibitor that raises cyclic GMP in vascular smooth muscle, producing vasodilation of genital vessels. As per a study in the European Journal of Obstetrics & Gynecology and Reproductive Biology (2003), in a randomized, double-blind, placebo-controlled crossover trial involving 68 healthy, sexually functional women aged 19-38, a 50 mg dose of sildenafil improved subjective measures of sexual arousal, orgasm, and enjoyment compared to placebo. These improvements were robust versus both baseline and placebo, and adverse effects were generally mild or moderate.

These findings suggest that sildenafil positively influences sexual response in healthy women by enhancing both physical and subjective aspects of arousal. The improvements were not limited to physiological changes but also extended to overall sexual satisfaction. This highlights its potential role in managing certain types of female sexual dysfunction.

Does Viagra Help a Woman Climax?

No, not for all women. Sildenafil (Viagra) works by inhibiting the enzyme phosphodiesterase-5 (PDE5), which increases cyclic GMP levels and promotes vasodilation in genital blood vessels. This enhances physical factors that may support orgasm, like improved genital blood flow, engorgement, and heightened sensitivity. These benefits are thought to arise from sildenafil’s ability to counteract reduced genital responsiveness or impaired vascular function.

However, research evidence from randomized controlled trials and systematic reviews remains mixed when looking at broader female populations. Studies show no significant improvement in orgasmic function for women. This suggests that while sildenafil is helpful for some, particularly when orgasm challenges have a physiological basis, it is not a universal or guaranteed solution. Psychological, hormonal, and relationship factors often play a major role in orgasmic ability, meaning a comprehensive, individualized approach, which may include therapy, lifestyle changes, or alternative medical interventions, is usually more effective than relying on sildenafil alone.

Having examined Viagra’s role in helping a woman reach climax, next we’ll discuss how quickly it starts working in women.

How Long Does Viagra Take to Work in Women?

According to the FDA label for men, sildenafil reaches peak levels in the blood within 30 to 120 minutes, averaging about 60 minutes. Viagra is not approved by the FDA for women, but it is considered that the absorption pattern is similar in both sexes. Peak levels usually occur around one hour after taking the dose, which is when effects like increased genital blood flow and swelling may begin. FDA-approved options for women are flibanserin (Addyi) and bremelanotide (Vyleesi). Both are worth considering for female sexual arousal disorder (FSAD).

Clinical studies in women, including those with FSAD or antidepressant-associated sexual dysfunction, have reported improvements in genital blood flow and subjective arousal occurring within this timeframe after taking sildenafil. However, the actual onset of noticeable sexual effects may vary depending on individual factors such as hormonal status, psychological context, and presence of sexual stimulation, which remains necessary for sildenafil to exert its effects.

It is important to note that while sildenafil acts relatively quickly, some women may require repeated or regular dosing before observing improvements in sexual function, especially in cases of complex or multifactorial sexual dysfunction. Additionally, unlike in men, sildenafil is not FDA-approved for female sexual dysfunction, and its use in women remains off-label and should be guided by a healthcare professional.

How Effective Is Topical Sildenafil Cream for Women?

Topical sildenafil cream (3.6%) shows promising efficacy for women with female sexual arousal disorder (FSAD), improving arousal sensation and related outcomes in clinical trials.

A 12-week, randomized, double-blind, placebo-controlled trial in Obstetrics & Gynecology (2024) evaluated topical sildenafil cream 3.6% in healthy premenopausal women with female sexual arousal disorder (FSAD). The treatment group reported a higher proportion of satisfying sexual events and showed promising trends toward improvements in arousal, desire, and orgasm, although the primary endpoints did not reach statistical significance.

Exploratory analyses revealed that women with FSAD, particularly those without coexisting orgasmic dysfunction, experienced greater increases in arousal sensation, sexual desire, and orgasm, along with reduced sexual distress, compared to placebo. These preliminary results suggest that topical sildenafil cream may offer a potential on-demand option for improving sexual function in certain subgroups of women with FSAD.

A study in The Journal of Sexual Medicine (2024) assessed the safety of a 3.6% topical sildenafil cream in premenopausal women with FSAD over 12 weeks. The incidence of treatment-emergent adverse events was similar between the sildenafil and placebo groups, with most side effects being mild or moderate, primarily involving application-site discomfort. Additionally, the sexual partners of the women using the cream reported comparable rates of mild adverse events, indicating that the treatment was well tolerated by both users and their partners.

Now, let’s take a closer look at the side effects women may experience when using Viagra.

What Side Effects Do Women Experience With Viagra?

Women who take sildenafil (Viagra) may experience side effects similar to those seen in men, as the drug’s mechanism of action is the same regardless of sex. Commonly reported reactions include nausea, flushing, headaches, and nasal congestion, which are usually mild to moderate and often resolve as the body adjusts. Some women also report visual changes, such as a bluish tinge, blurred vision, or increased light sensitivity, which occur due to the drug’s mild effect on the PDE6 enzyme in the retina.

Although most side effects are short-lived, some women may experience heightened sensitivity to sildenafil’s vasodilatory effects. Flushing and headaches result from widened blood vessels, and nausea may stem from similar vascular changes in the gastrointestinal tract. Vision disturbances are usually short-lived but unsettling, and rare cases of more serious eye problems have been documented, particularly in those with underlying ocular conditions.

Women with pre-existing health issues face higher risks. Those with heart disease, uncontrolled high or low blood pressure, or who take certain medications (like nitrates, strong CYP3A4 inhibitors, or alpha-blockers) have a greater chance of serious complications like severe hypotension, fainting, or cardiac events. For this reason, sildenafil should only be taken under medical supervision, with a thorough review of cardiovascular status and potential drug interactions before starting therapy.

For a quick overview, here’s a list of the potential side effects women may experience when taking Viagra.

Common Side-effects:

• Nausea
• Flushing
• Headache
• Nasal congestion
• Visual changes (bluish tinge, blurred vision, light sensitivity)

Rare, Serious Side-effects:

• Severe hypotension
• Fainting
• Cardiac events (especially in those with heart disease)
• Serious eye problems (in those with existing eye conditions)

Along with potential side effects, it’s important to consider the safety of Viagra for women who are pregnant or breastfeeding.

Is Viagra Safe for Women Who Are Pregnant or Breastfeeding?

No, sildenafil (Viagra) is not approved for use in pregnant women for sexual enhancement, and its safety in this context is not established. Some clinical trials have explored sildenafil in pregnancy for conditions like fetal growth restriction or preeclampsia, but results have been mixed, and certain studies were halted early due to possible risks to the fetus. Because of these uncertainties and potential harm, it should only be used in pregnancy under strict medical supervision for specific, evidence-based indications.

Limited research indicates that sildenafil and its metabolites pass into breast milk in very small amounts, but there is insufficient data on their effects on nursing infants. Without robust safety data, most guidelines advise against routine use during breastfeeding unless prescribed for a clear medical reason. The decision should involve a careful risk-benefit assessment with a healthcare provider.

For pregnant or breastfeeding women, sildenafil use should be avoided for sexual function purposes due to unknown safety profiles and potential risks. If a medical condition requires treatment where sildenafil might be considered, it must be done in a hospital or specialist setting with close monitoring. Self-medication is strongly discouraged.

Can Viagra Interact With Other Medications in Women?

Yes, sildenafil (Viagra) has clinically important drug interactions that apply to women as well as men. Some combinations are contraindicated, others require dose adjustment or extra caution because they markedly change sildenafil levels or produce dangerous blood-pressure drops. Clinicians should always review a woman’s full medication list (prescription, OTC, herbal, and recreational) before prescribing sildenafil.

Here’s a list of medications that are contraindicated with sildenafil:

• Nitrates (eg. nitroglycerin, isosorbide) – They cause severe, life-threatening drops in blood pressure.
• Strong CYP3A4 inhibitors (eg. ritonavir, ketoconazole, itraconazole, certain antibiotics) – They sharply increase sildenafil levels, raising side effect risk.
• Alpha-blockers or multiple antihypertensives – They may lead to symptomatic low blood pressure. It is advisable to start at a low dose and monitor closely.
• Soluble guanylate cyclase stimulators (eg. riociguat) – They are contraindicated due to additive blood-pressure-lowering effects.

With medication interactions in mind, it’s also worth exploring other treatment choices available to women.

What Are FDA-Approved Treatments for Female Sexual Disorders?

For women seeking help with sexual dysfunction, there are female-specific prescription medications that work differently from sildenafil and target other pathways involved in sexual desire and arousal. Two FDA-approved treatments include flibanserin (Addyi) and bremelanotide (Vyleesi), both prescribed for premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD).

• Addyi (flibanserin): It is an oral medication taken daily at bedtime. It acts on serotonin, dopamine, and norepinephrine receptors in the brain to restore sexual desire. Unlike sildenafil, which improves genital blood flow, Addyi targets central neurotransmitter balance. Common side effects include dizziness, sleepiness, nausea, and low blood pressure, especially if taken with alcohol or certain medications.

• Vyleesi (bremelanotide): It is an on-demand, self-injected treatment taken before anticipated sexual activity. It works by activating melanocortin receptors in the brain that play a role in regulating sexual desire. Possible side effects include nausea, flushing, headaches, and reactions at the injection site. 

While neither drug is a direct replacement for sildenafil, they are specifically designed for female sexual dysfunction and may be more effective for women whose primary concern is low desire rather than blood-flow related arousal issues.

Can Women Take Men’s Viagra?

No, Viagra is not approved for women. Its effect on female sexual dysfunction is not proven. Sildenafil citrate tablets increase blood flow to the genital area. This may help some women, but the results in studies are mixed. Female sexual dysfunction often involves hormones, mood, or relationship issues. Increasing blood flow alone may not solve the problem. Some doctors prescribe Viagra off-label for women, but this should only be done with medical supervision. Side effects can include headache, flushing, or vision changes.

Can Women Take Tadalafil?

Yes, women can take tadalafil tablets for certain approved conditions like pulmonary arterial hypertension, but it is not licensed for female sexual dysfunction. Research indicates some women may experience improved arousal, orgasm, and satisfaction, especially in cases related to diabetes or antidepressant use. However, its use for sexual dysfunction remains off-label and should be carefully managed by a doctor. While tadalafil is widely prescribed for men with erectile dysfunction due to its long duration of action, its effects on women are less studied. Potential side effects include headaches, nasal congestion, and back pain, making professional guidance essential before use.

How Does Tadalafil Compare With Sildenafil?

When comparing Sildenafil Vs Tadalafil, both medications effectively treat erectile dysfunction by increasing blood flow to the penis, but they differ in duration, onset, and patient preference. Sildenafil usually lasts around 4–6 hours, while tadalafil can remain effective for up to 36 hours, offering more spontaneity. Clinical studies suggest similar success rates, though tadalafil is preferred by many patients for convenience. Side effects of these drugs overlap, including headaches, flushing, and indigestion, but tadalafil has slightly more muscle aches and fewer flushing reports. Choice often depends on lifestyle, sexual frequency, and tolerance, making a doctor consultation important for selecting the most suitable option.

What Are The Best Pill To Treat Sexual Dysfunction?

The best pills for ED are prescription PDE5 inhibitors, which include sildenafil, tadalafil, vardenafil, and avanafil. These medications work by relaxing smooth muscle in penile blood vessels, allowing more blood to enter and produce a firm erection during sexual stimulation. Sildenafil offers reliable short-term effects, tadalafil provides longer duration, vardenafil has a similar mechanism to sildenafil, and avanafil may act faster with fewer side effects. The ideal choice depends on how quickly you want results, how long you need the effects to last, and your side effect tolerance. A healthcare provider can help determine the safest and most effective option.