Sildenafil Works for Women with Sexual Arousal Problems
Sildenafil is a standard treatment for male erectile dysfunction, but its application in female sexual dysfunction remains uncertain. These Italian authors conducted a randomized, double-blind, crossover study to explore the use of sildenafil in 51 women (aged 22-38) with documented ovarian function who reported adequate sexual desire but decreased arousal.
Subjects were recruited from a sexual dysfunction clinic; each had a lack of vaginal lubrication and a lack of clitoral and vaginal sensation or slow sexual response. The women received 4-week regimens of 25-mg sildenafil, 50-mg sildenafil, and placebo in random order, with a 1-week washout between treatments; each tablet was to be taken 1 hour before intercourse, not more than once daily. The women rated measures of sexual response by standardized questionnaire at baseline and each month thereafter.
The subjects used the study drug or placebo a mean of 2.7 to 2.8 times weekly. Compared with placebo, all of the sexual-response parameters were significantly higher with either dosage of sildenafil (P<0.001 for achievement of arousal and orgasm; P<0.05 for enjoyment, frequency of intercourse and fantasies, and satisfaction with frequency). Compared with baseline, the only improvement with placebo was an increase in frequency of orgasm (P<0.05). Response did not differ between the 2 sildenafil dosages. Six women (12 percent) using sildenafil and 2 (4 percent) using placebo discontinued treatment because of adverse effects, including vision problems, headache, or fear of potential problems; there was no clear attribution of these effects to sildenafil, however.
Comment: Sildenafil appeared to improve sexual arousal in this small, self-selected group of young women. However, these were women who reported normal sexual desire but enough dissatisfaction with their sexual response to seek treatment at a sexual dysfunction clinic. As in other placebo-controlled studies, side effects may have indicated to patients that they were using the study drug, therefore biasing the outcome. Sildenafil has not proven useful for women's sexual dysfunction in most other studies; however, women who fit the narrow definition outlined in this study and who have no contraindications (i.e., use of nitrates; history of cardiovascular disease) may be offered a trial of 25-mg sildenafil, because the 2 dosages did not differ in effect.
Published in Journal Watch Women's Health October 16, 2001
Caruso S et al. Premenopausal women affected by sexual arousal disorder treated with sildenafil: A double-blind, cross-over, placebo-controlled study. BJOG 2001 Jun 108 623-628.
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