Sildenafil Citrate and Endometrial Receptivity

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.

• 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.

Thus, increasing vasodilatation and potentiating the effects of nitrous oxide (NO) on the vascular smooth muscle [1-2].

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J Sex Med 7(2): 858-872. Leddy LS, Yang CC, Stuckey BG, Sudworth M, Haughie S, et al. (2012) Influence of sildenafil on genital engorgement in women with female sexual arousal disorder. Sildenafil increases serum testosterone levels by a direct action on the testes. Lo Monte G, Graziano A, Piva I, Marci R (2014) Women taking the blue pill (sildenafil citrate) such big deal.

Regional issues

(1999) Safety and efficacy of sildenafil in postmenopausal women with female sexual dysfunction. Given the success of medicines to treat trouble getting and keeping an erection, called erectile dysfunction, companies have looked for a medicine to help women with sex. Viagra even has been tried as a treatment for sexual dysfunction in women. But the U.S. Food and Drug Administration (FDA) hasn't approved this use of Viagra. 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]. 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.

Detection in biological fluids

Diagnostic and Statistical Manual of Mental Disorders. (2014) Prevalence Survey of Sexual Dysfunction among Women in the Reproductive Age. (2007) Female sexual dysfunction in Lower Egypt. El Gelany S, Moussa O (2013) Reproductive health awareness among educated young women in Egypt. Spector IP, Carey MP and Steinberg L (1996) The sexual desire inventory: Development factor, structure, and evidence of reliability.

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(2011) Sexual dysfunction and difficulties in Denemark: Prevelance and associated socio-demographic factors. Arch sex behave 40(1): 121-132. Abdallah I Y, AbdelrahmanSh (2014) female sexual dysfunction in relation to the age of marriage .thesis submitted for fulfillment of master degree in dermatology and Andrology in Banha city, Banha University, Egypt. Omidi A, Ahmedvand A, Najarzadan MR, Mehrzad F (2016) Compairing the effect of treatment with sildenafil and cognitive-behavioral therapy on treatment of sexual dysfunctioninwomen: arandomized controlled clinical trials. Chivers MI, Rosen RC (2010) Phosphodiesterase type 5 and female sexual response. In non-pregnant females, SC causes uterine artery vasodilation therefore it also be employed to treat menstrual pain and muscle spasms [7].

• Remember that sildenafil is not designed specifically for women; evidence is ongoing.
• Consult your healthcare provider for personalized advice concerning usage.
• Be aware that psychological and physical factors both influence female libido.
• The medication can help improve vaginal blood flow during arousal.
• Regular use without medical supervision is not recommended.
• Some women may experience improved sexual confidence with sildenafil.
• Manage expectations by understanding that results vary widely.
• Do not suddenly stop other medications without doctor approval.
• Educate yourself about symptoms of potential adverse reactions.
• Maintaining overall health can enhance the effectiveness of sildenafil.
• Use caution if combining sildenafil with herbal supplements.
• Ensure comprehensive sexual health assessment before commencing treatment.

SC is increasingly used in the pregnant patient for the treatment of pulmonary hypertension [8]. 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 use include: headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision.

• Sildenafil citrate can be prescribed off-label for female sexual dysfunction.
• Consult a doctor before using sildenafil citrate tablets for women.
• Side effects in women may include headache, flushing, or nasal congestion.
• Sildenafil works by increasing blood flow to enhance female arousal.
• Dosage for women varies; always follow medical advice.
• Sildenafil tablets may interact with other medications, like nitrates.
• Not approved by FDA specifically for female sexual dysfunction.
• Use with caution in women with heart conditions or high blood pressure.
• Possible benefits include improved libido and vaginal blood flow.
• Sildenafil should be taken on an empty stomach for best results.
• Long-term safety of sildenafil in women is not well established.
• Store sildenafil citrate tablets in a cool, dry place out of children’s reach.

Some complained of blurriness and loss of peripheral vision.

• Sildenafil citrate is a phosphodiesterase type 5 inhibitor.
• It may help women with sexual arousal disorder by increasing blood flow.
• Discuss mental health factors affecting libido with a healthcare specialist.
• Be aware of possible nasal congestion after taking sildenafil.
• Avoid using expired medication, as effectiveness may diminish.
• The effectiveness varies among women; results are individual.
• Use sildenafil responsibly to minimize potential adverse effects.
• Women should inform providers of all medications taken regularly.
• Sildenafil is not a cure for sexual dysfunction, only a symptomatic aid.
• Adequate sexual education can improve understanding and expectations.
• Proper dosage and timing are important for safety and efficacy.
• Sex therapy or counseling may complement medication use effectively.

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].

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.

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You may opt out of email communications at any time by clicking on the unsubscribe link in the email. 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. 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.

MeSH terms

Click to view a preview and subscribe below. 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. Zoma WD, Baker RS, Friedman A, Clark KE (2004) Sildenafil citrate (Viagra) increases uterine blood flow and potentiates estrogen-induced vasodilation. 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”.

More about sildenafil

For some women, orgasm can be hard to reach. 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.

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You might want to talk to a sex therapist. Medicines, hormones, creams, lubricants, clitoral stimulation or other treatments oral sildenafil sometimes can help. There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. Women’s health topics - straight to your inbox Get the latest information from our Mayo Clinic experts on women’s health topics, serious and complex conditions, wellness and more. (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. 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.

Methods and Objectives

Experts suggest that you stop taking the medicine if your sex drive doesn't improve after eight weeks. The FDA also has approved a medicine given as a shot to treat low sexual desire in women before menopause. Bremelanotide (Vyleesi) is injected under the skin in the belly or thigh at least 45 minutes before having sex. It should not be used more than once a day or more than eight times a month. Side effects can include nausea, headache, vomiting and reactions at the site of the shot.

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Talk with your healthcare professional to see if this medicine might be right for you. Sexual problems may be due to trouble with arousal, a lack of desire or both. Many factors can affect sexual desire in women. Many women find that the stresses of daily life lower their desire for sex. Highs and lows in sexual desire may go along with the beginning or end of a relationship or with major life changes, such as pregnancy or menopause. 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.

Route of administration

For years there were no FDA-approved medicines for treating problems with sexual arousal or sexual desire in women. Yet 4 in 10 women report having sexual concerns. The FDA now has approved two medicines. The FDA has approved a daily pill called flibanserin (Addyi) to treat low sexual desire in women before menopause. This medicine started as a treatment for depression.

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Addyi may boost sex drive in women with low sexual desire. It's for women who are not happy with their low sex drive. Possible serious side effects include low blood pressure, dizziness and fainting. These side effects are more likely to happen if the medicine is mixed with alcohol. The FDA says not to drink alcohol if you take this medicine. 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.