Sildenafil for women patients with antidepressant-induced sexual dysfunction

Using lubricants or vaginal moisturizers, particularly after menopause, can help can make sex more pleasurable. Prioritize exercise, manage stress and sleep — they can all affect your sex drive more than you might think. Talk with a therapist, especially one who specializes in sexual health or trauma, if your low sex drive is related to things like mental health concerns, past sexual trauma or negative body image. Have an open conversation with your healthcare provider. They can help you identify the cause and explore personalized solutions. Viagra might sound like a quick fix, but it rarely is.

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And mixing Viagra and alcohol is a big no-no because it can worsen the side effects, Dr. Zanotti warns. While Viagra might work on the physical side of things, other FDA-approved treatments can help women with other issues, like sexual desire. “Viagra might help some women with the physical mechanics of sex, but it’s not going to help with other things that keep you from being ‘in the mood,’” Dr. Zanotti points out. Because the research hasn’t proven that it’s beneficial for women, most healthcare providers consider it a last resort — not a first-line treatment. While it may improve physical arousal for some, Viagra doesn’t directly impact desire. If you’re struggling with low libido, you’re not alone, and real help is available.

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Vyleesi® (bremelanotide): A self-injection that you use before sex. It’s approved only for premenopausal women whose low libido isn’t caused by another health condition. Wellbutrin® (bupropion): An antidepressant that may help improve libido, especially if your low sex drive is related to depression or SSRI use. Hormone replacement therapy (HRT): This may help improve vaginal dryness and restore sexual comfort (thus, boosting libido) for women going through menopause. Testosterone therapy: This can be prescribed to treat low libido in women entering menopause and in the years that follow. Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more. The steroid medication may raise your blood pressure and cause heart palpitations Lower your risk by sticking to the right dose and avoiding long-term use without medical guidance Authorized take-back programs, services and drop-off locations are the best, safest way to get rid of expired medicine These illegal supplements have negative impacts for vital organs and may cause psychosis, heart attacks and more Popular among teens, these inhalants give you a quick high, with serious harmful effects ‘Black box warnings’ on medications outline potential risks and important instructions These similar versions of brand-name drugs are safe, effective and often less expensive Though these painkillers work in different ways, they can both help reduce a fever and pain These tiny saltwater larvae can get trapped under your swimsuit and trigger an itchy reaction called seabather’s eruption Searching nature for edible items requires training and knowledge to avoid poisonous plants Yes, but you can protect yourself with hats, scarves or even hair sunblock Aging WellAllergiesCancer Care & PreventionChronic PainCold, Flu & Respiratory IllnessesDiabetes & EndocrinologyDigestiveEar, Nose & ThroatEye CareInfectious DiseaseLungOral HealthParentingPregnancy & ChildbirthRecipesRheumatology & ImmunologySenior HealthSex & RelationshipsSleepUrinary & Kidney HealthWeight Loss Rendered: Mon May 25 2026 22:05:31 GMT+0000 (Coordinated Universal Time) Treatment-emergent sexual dysfunction is a frequent adverse effect occurring with medication use and is a major influence for premature discontinuation of antidepressant treatment, which leads to treatment failure and costly disease management outcomes. Sexual dysfunction is recognized as being associated with selective and nonselective serotonin reuptake inhibitor (SRI) antidepressants, which are the most frequently prescribed medications for outpatients aged 18 to 65 years and represent 90% of the 180 million antidepressant prescriptions filled in the United States.1 Antidepressant treatment–associated sexual dysfunction is estimated to occur in 30% to 70% of men and women treated for major depression with first- or second-generation agents,2 a principal reason for a 3-fold increased risk of nonadherence that approaches 70% in the first months of treatment and leads to increased relapse, recurrence, disability, and resource utilization by affected patients.3 However, the literature in this field is less developed for women with more highly variable prevalence rates and less conclusive data compared with men. In women, sexual dysfunction is associated with decreased sexual interest, genital sensitivity, and vaginal lubrication; delayed or absent orgasm; dyspareunia; reduced sexual activity; and overall dissatisfaction or loss of pleasure in sexual relations.

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Sometimes, sexual dysfunction isn’t about biology — it’s about everything else going on in your life that puts sex on the back burner. “Sexual health in women is about more than just blood flow,” Dr. Zanotti says. “It’s about your mental health, your relationship, how comfortable you feel in your body and so much more.” Here are a few strategies that may help: If sex is painful, pelvic floor physical therapy may help. As you get older, vaginal tissue becomes drier and less elastic. Among the numerous strategies proposed for managing sexual dysfunction associated with SRI treatment, selective phosphodiesterase type 5 inhibitors, which have been limited to studies involving men, have demonstrated the best evidence-based data to support broad-based and clinically meaningful treatment efficacy.4 However, to our knowledge, no randomized controlled trial (RCT) has demonstrated effectiveness for women experiencing sexual dysfunction associated with SRI treatment. Compared with men, women are prescribed antidepressants at rates of 2 to 1 and can be expected to represent a significant number of patients needing relief.5 Without evidence-based data to treat sexual function associated with SRIs in women, clinicians may lack the confidence to manage it effectively, which leaves patients exposed to excess random pharmacology.6 Although sexual dysfunction is a major influence in determining the selection or switching of antidepressants, it is frequently overlooked because clinicians fail to inquire, misattribute it as a symptom of depression that will improve with treatment, or because 80% of women do not discuss adverse sexual effects with their physician.7,8 Sexual dysfunction associated with SRIs is dose related, usually occurs early in treatment, and rarely remits spontaneously. Selective phosphodiesterase type 5 inhibitors (sildenafil, vardenafil, tadalafil), which are effective and well tolerated for treatment of erectile dysfunction in men,9 including men with depression10 and associated with SRI treatment,11 are not approved by the US Food and Drug Administration (FDA) for women with sexual dysfunction.

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For men with erectile dysfunction, that’s a game-changer. In women, Viagra may increase blood flow to the vulva and vaginal tissues, which could enhance your pleasure by heightening your sensitivity and promoting lubrication. Some women taking Viagra may find that having sex is more pleasurable. (And who can argue with that as a perk?) But that’s not true for everyone. Some women taking Viagra may experience side effects like: If you have low blood pressure or you’re taking blood pressure medication, Viagra can cause a further drop that may lead to dizziness and even fainting. However, interest in their potential use in women was encouraged by reports that nitric oxide synthase isoforms, nitric oxide, and phosphodiesterase type 5 inhibitors are present in female genital tissue, and phosphodiesterase type 5 inhibitor enhancement of nitric oxide–cyclic guanosine monophosphate in nonadrenergic-noncholinergic signaling for women seems similar to men.12 When several trials involving premenopausal and postmenopausal women treated with sildenafil failed to demonstrate significant improvements for sexual arousal disorder,13 the manufacturer abandoned pursuit of FDA approval for treating women.

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No pill is going to make sure the laundry is done, the kids are asleep, or that you’re feeling confident in yourself and your relationship. But Dr. Zanotti notes a few medications that may help increase your interest in sex: Addyi® (flibanserin): A daily pill for premenopausal women with low sexual desire. It affects brain chemicals tied to libido. Like Viagra, it can lower blood pressure and shouldn’t be taken with alcohol. Subsequent RCTs narrowed their focus on more specific hormonal factors and demonstrated efficacy with improved frequency of sexual intercourse, arousal, orgasm, and satisfaction. One trial involved premenopausal women with sexual arousal disorder but with normal sexual desire. They were randomized to receive 1 of 3 treatments: 25 mg or 50 mg of sildenafil or placebo.14 A protocol-specified trial involved premenopausal or postmenopausal women with sexual arousal disorder without concomitant hypoactive sexual desire disorder. Women with low baseline estrogen and androgen levels received therapy, so their hormone levels would be within the range of normal therapy and were randomly assigned to receive either a flexible dose of between 25 mg and 100 mg of sildenafil or placebo.15 In a third trial, postmenopausal women receiving estrogen hormone therapy and who had acquired sexual arousal disorder and impaired orgasm found that a single dose of 50 mg of sildenafil compared with placebo reduced orgasm latency and increased subjective arousal in those having the lowest vaginal pulse amplitude percentage change.16 In a fourth trial involving asymptomatic premenopausal women, a sildenafil-placebo crossover reported increased arousal and orgasm function.17 Case reports18 and open-label studies19 have also suggested efficacy for phosphodiesterase type 5 inhibitor treatment of women with sexual dysfunction associated with SRI treatment.