How can phosphodiesterase inhibitors (medications such as sildenafil [Viagra], tadalafil [Cialis], and vardenafil [Levitra]) be helpful to women? I thought they were only for men.

Phosphodiesterase inhibitors are medications that have been used in women for the treatment of sexual complaints. Phosphodiesterase inhibitors have been approved for the treatment of erectile dysfunction in men. Numerous attempts have been made to show an efficacy in women, but most fail to show any significant benefit in randomized clinical trials. The proposed mechanism of action is that the medication relaxes the clitoral and vaginal smooth muscle. Some potential side effects include headache, uterine contractions, dizziness, hypotension, myocardial infarction (heart attack), stroke, and sudden death. New and exciting emerging data may support their use in women who suffer from sexual complaints as a result of hypertension, diabetes, neural and vascular disease, or selective serotonin reuptake inhibitor (SSRI) use.

Erectile dysfunction

A persistent or recurrent inability to achieve or maintain an erection sufficient enough to accomplish a desired sexual behavior such as intercourse or coitus; earlier it was described as impotence.

Recent data suggest that men who use phosphodiesterase inhibitors may actually be helping their spouses achieve sexual satisfaction. In a recent article titled “Trough the Eyes of Women: The Partners’ Perspective on Tadalafil,” which was published in the Journal of Urology in September 2006, Althof and associates attempted to evaluate patient and partner responses to the efficacy and overall satisfaction with use of tadalafil to treat erectile dysfunction. This was a double-blinded placebo controlled 12-week trial of approximately 746 couples, who either received placebo or 10 mg or 20 mg of tadalafil. Female partners of men who were taking the medication reported significantly improved overall sexual satisfaction and corroborated the man’s report of erectile improvement and penetration ability. The men were understandably happy and many reported improved erection, penetration, and overall satisfaction with the sexual experience while taking the medication. This study is one of many that examine the couple’s response and receptiveness to treatment for erectile dysfunction. It is important to recognize that sexual complaints do not exist in an individual vacuum but rather intricately involve the partner and his or her reaction to treatment.

Treating one partner without examining the other is like assembling only half of a jigsaw puzzle.

Treating one partner without examining the other is like assembling only half of a jigsaw puzzle — you may get the fuzzy concept of the picture, but the clear, detailed picture is far from apparent. The concept is that sexual complaints, assessment, treatment, and compliance with therapeutics involve the dyad, the two individuals involved in the intimate relationship. To ignore the sexual partner may limit success in a treatment for a sexual health concern.


Selections from the book: Michael L. Krychman, “100 Questions and Answers About Women’s Sexual Wellness and Vitality: A Practical Guide for the Woman Seeking Sexual Fulfillment”, 2010.

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