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Women's Health 10 min read

Sildenafil for Women: What It Is and How It Works

Is sildenafil FDA-approved for women? Everything you need to know about this medication and female sexual health

MD

Dr. Medical Team

Reviewed by licensed healthcare professionals

Sildenafil, best known by the brand name Viagra, is widely recognized as a treatment for erectile dysfunction in men. But what about women? Can sildenafil help with female sexual dysfunction? This comprehensive guide answers all your questions about sildenafil use in women, FDA approval status, and how it compares to medications specifically designed for female sexual health.

Female sexual dysfunction (FSD) affects approximately 40% of women at some point in their lives, making it a significant health concern that deserves attention and proper medical solutions.

In This Article

1 Is Sildenafil FDA-Approved for Women?

Important

No, sildenafil is NOT FDA-approved for treating female sexual dysfunction. The FDA has never approved Viagra or generic sildenafil for use in women for sexual health purposes.

While some healthcare providers may prescribe sildenafil "off-label" for women, the clinical evidence supporting its effectiveness for female sexual dysfunction is limited and inconsistent. Several studies have been conducted over the years:

  • Clinical Trial Results

    Large-scale trials conducted by Pfizer in the early 2000s failed to show significant improvement in sexual function for women taking sildenafil compared to placebo.

  • Different Mechanisms

    Female sexual dysfunction is often more complex than male ED, involving psychological, hormonal, and relationship factors that sildenafil doesn't address.

  • Limited Blood Flow Impact

    While sildenafil can increase blood flow to female genital tissues, this doesn't necessarily translate to improved sexual desire or satisfaction.

However, sildenafil IS FDA-approved for women (and men) to treat pulmonary arterial hypertension (PAH) under the brand name Revatio. This is a completely different use case from sexual dysfunction treatment.

2 Sildenafil vs. Female Viagra: What's the Difference?

The term "Female Viagra" is commonly used to describe medications approved for female sexual dysfunction, but these drugs work very differently from sildenafil. Here's a comprehensive comparison:

Feature Sildenafil (Viagra) Flibanserin (Addyi) Bremelanotide (Vyleesi)
Approved For Men with ED Premenopausal women with HSDD Premenopausal women with HSDD
How It Works Increases blood flow (PDE5 inhibitor) Affects brain chemistry (serotonin/dopamine) Activates melanocortin receptors in brain
Dosing As needed (30-60 min before) Daily pill at bedtime Self-injection as needed
Alcohol Moderate use OK Must avoid completely Use caution
Target Issue Physical (erection) Low desire (psychological) Low desire (psychological)

Key Takeaway

"Female Viagra" medications like Addyi and Vyleesi work on brain chemistry to increase sexual desire, while sildenafil only increases blood flow. This fundamental difference explains why sildenafil isn't effective for most women's sexual health concerns.

What is HSDD?

Hypoactive Sexual Desire Disorder (HSDD) is characterized by persistently low sexual desire that causes distress. It's the condition that FDA-approved female sexual dysfunction medications are designed to treat. HSDD is diagnosed when low desire isn't caused by a medical condition, medication side effect, relationship issues, or other psychiatric conditions.

3 Sildenafil for Pulmonary Hypertension

While sildenafil isn't approved for female sexual dysfunction, it IS FDA-approved for treating pulmonary arterial hypertension (PAH) in both men and women. This is actually one of the most important legitimate uses of sildenafil for women.

What is Pulmonary Arterial Hypertension?

Pulmonary arterial hypertension (PAH) is a serious condition where the blood pressure in the arteries leading from the heart to the lungs becomes abnormally high. This makes the heart work harder and can lead to:

  • Shortness of breath
  • Fatigue and weakness
  • Chest pain or pressure
  • Dizziness or fainting
  • Swelling in legs and ankles
  • Heart palpitations

Revatio (Sildenafil for PAH)

Sildenafil is sold under the brand name Revatio for PAH treatment. The typical dose is 20mg three times daily, much lower than the ED dose.

How It Helps

Sildenafil relaxes the blood vessels in the lungs, reducing blood pressure and improving exercise capacity and quality of life for PAH patients.

Did You Know?

PAH affects women more often than men—approximately 80% of PAH patients are female. This makes sildenafil (Revatio) particularly important for women's cardiovascular health, even though it's not useful for sexual dysfunction.

4 What Does Sildenafil Do?

To understand why sildenafil works differently in men and women, it's helpful to know exactly how this medication functions in the body.

Mechanism of Action

  1. 1

    PDE5 Inhibition

    Sildenafil blocks an enzyme called phosphodiesterase type 5 (PDE5). This enzyme normally breaks down a chemical called cGMP that relaxes blood vessels.

  2. 2

    Increased cGMP Levels

    With PDE5 blocked, cGMP levels increase, causing blood vessels to relax and widen (vasodilation).

  3. 3

    Enhanced Blood Flow

    This vasodilation increases blood flow to specific areas—the penis in men (enabling erections) or the lungs in PAH patients (reducing pulmonary pressure).

  4. 4

    Sexual Stimulation Still Required

    Importantly, sildenafil doesn't cause arousal on its own. Sexual stimulation is still necessary to initiate the process that leads to an erection.

Why It Works Differently for Men vs. Women

In Men

Erections are primarily a blood flow issue. When blood flow to the penis is insufficient, sildenafil directly addresses this by increasing blood flow, enabling erections when sexually stimulated.

In Women

Female sexual dysfunction is usually more complex, often involving psychological factors, hormonal imbalances, or relationship issues. Simply increasing blood flow doesn't address low desire or difficulty achieving orgasm.

5 What Is Viagra Cost?

If you're curious about sildenafil pricing—whether for a male partner or for its FDA-approved uses—here's what you need to know about current costs:

Brand Name

Viagra

$70-85

per pill at retail pharmacies

BEST VALUE
Generic

Sildenafil

$1-15

per pill (online telehealth)

For PAH

Revatio

$8-20

per pill (generic available)

Source Price Per Pill Notes
Retail Pharmacy (Brand) $70-85 Requires prescription, not covered by most insurance for ED
Retail Pharmacy (Generic) $15-40 Same active ingredient, pharmacy markup
Online Telehealth $1-15 Most affordable, includes consultation
With GoodRx Coupon $10-25 Discount cards can reduce retail prices

Money-Saving Tip

Generic sildenafil contains the exact same active ingredient as brand-name Viagra and is FDA-approved. You can save up to 95% by choosing generic through a legitimate online telehealth service.

What About "Female Viagra" Costs?

For women interested in FDA-approved treatments for low sexual desire, here are the current costs:

Addyi (Flibanserin)

$400-800/month

Daily pill, some insurance coverage available. Generic now available at lower cost.

Vyleesi (Bremelanotide)

$300-400/dose

Self-injection as needed, limited to 8 doses/month. Copay programs available.

Key Takeaways

  • Sildenafil is NOT FDA-approved for treating female sexual dysfunction
  • Sildenafil IS FDA-approved for pulmonary arterial hypertension (PAH) in women
  • "Female Viagra" refers to Addyi or Vyleesi—different drugs that work on brain chemistry
  • Generic sildenafil costs $1-15/pill through telehealth vs. $70-85 for brand Viagra
  • Consult a healthcare provider for proper diagnosis and treatment of sexual health concerns

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Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any medication or treatment. The information provided here should not be used to diagnose or treat any health condition.