Viagra - Libido - Sex Drive

In the study by Laan and colleagues,⁰²⁰¹ the effect of a single oral dose of sildenafil citrate on vaginal vasocongestion and subjective sexual arousal in healthy premenopausal women. Twelve women without sexual dysfunction were randomly assigned to receive either a single oral 50 mg dose of sildenafil or matching placebo in a first session and the alternate medication in a second session. Significant increases in vaginal vasocongestion (engorgement) were found with Viagra treatment compared with placebo. There were no differences between treatments on subjective sexual arousal experience. Analyses by suspected treatment received found that significantly stronger sexual arousal and vaginal wetness were reported for the treatment that was believed to be sildenafil vs. the treatment that was believed to be placebo. The suspected treatment sequence was incorrect for half of the women. Sildenafil was well tolerated, with no evidence of significant adverse events.

• Sildenafil was found to be effective in enhancing vaginal engorgement during erotic stimulus conditions in healthy women without sexual dysfunction but was not associated with an effect on subjective sexual arousal.
  

Researchers in Italy⁰³⁰³ set out to determine the changes, if any, on female sexual pathways using sildenafil (primary outcome), and to verify the safety of this drug (second outcome). Sixty-eight healthy volunteer women aged 19-38 years, asymptomatic for sexual disorders, were enrolled. The study consisted of 4 weeks sildenafil, 2 weeks washout, and 4 weeks placebo, by two possible sequences: sildenafil 50 mg, washout, placebo; or placebo, washout, sildenafil 50 mg. Fifty women completed the study at the first follow-up, and 38 women reached the second follow-up. Six women withdrew because of adverse events. Sildenafil improved arousal, orgasm, and enjoyment with respect to placebo. Significant differences were noted during sildenafil usage with respect to the baseline for arousal, orgasm, and sexual enjoyment. The adverse events were transient and mild or moderate.

• It was concluded that sildenafil acts on different sexual pathways in healthy women, improving their sexual experience.

In California, a study was undertaken to evaluate the efficacy and safety of sildenafil citrate in spontaneously or surgically postmenopausal women with female sexual arousal disorder (FSAD). There were significant improvements inincreased genital sensation during intercourse or stimulation and increased satisfaction with intercourse and/or foreplay. For women with FSAD without concomitant hypoactive sexual desire disorder(HSDO) sildenafil was associated with significantly greater improvement in sensation and satisfaction compared with placebo. No significant improvements were shown for women with concomitant HSDD.

• The conclusion was that Sildenafil was effective and well tolerated in postmenopausal women with FSAD without concomitant HSDD or contributory emotional, relationship or historical abuse issues.

Pfizer once had great hopes for its clinical program testing Viagra in women. In one early clinical trial, researchers gave six women Viagra and six others a placebo, sat them in front of erotic videos and used a pelvic probe to measure any change in genital blood flow. The sex organs of women given Viagra were more engorged than those given placebos. The program seemed to be succeeding. But a larger trial that included a questionnaire found that although Viagra was associated with greater pelvic blood flow, the women experiencing this effect did not feel any more aroused. Pfizer researchers spent years trying to find some well-defined group of women for whom increased pelvic blood flow and desire could be linked. 

Sexual response in women, the maker of Viagra has found, are a lot more complicated than men. After eight years of work and tests involving 3,000 women, Pfizer Inc. announced⁰⁴⁰¹ that it was abandoning its effort to prove that the impotence drug Viagra improves sexual function in women. The problem, Pfizer researchers found, is that men and women have a fundamentally different relationship between arousal and desire. For men, arousal almost always leads to desire. So by improving a man's ability to have erections, Viagra measurably affects his sexual function. But arousal and desire are often disconnected in women. Although Viagra can indeed create the outward signs of arousal in many women, that seems to have little effect on a woman's willingness, or desire, to have sex. With women, things depend on a myriad of factors. Still, Viagra can be effective in some women. Women who once had normal sexual function but then suddenly lost all desire - often as a result of taking antidepressants - can be helped by Viagra. Women who have always had low libido levels are unaffected by Viagra. Much of Pfizer's research found that the real factor in determining desire and sexual function in women is hormone levels. Procter and Gamble is testing a patch with testosterone, the male hormone, as a means of improving female sexual function. Some gynecologists are already prescribing testosterone for patients who complain of low libidos. Estrogen treatments and supplements are also commonly used.

In 2008, research is again beginning to show some encouragementfor improvements for women.

In a randomized, double-blind, placebo-controlled trial, 22 women received a 50-mg dose of sildenafil (n=11) or placebo (n=11) daily for 15 days.⁰⁸⁰² The Golombok Rust Inventory of Sexual Satisfaction (GRISS) was used for subjective evaluation of the sexual-response cycle. Clitoral blood flow was measured. Blood flow was significantly more improved in the sildenafil than in the placebo group (P<0.05).

• Sildenafil may improve clitoral blood flow and increase sexual satisfaction in postmenopausal women with orgasmic dysfunction.⁰⁸⁰²
  

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