Sildenafil Arousal Cream
[15] found that efficacy was shown on only one sexual function measure and only in a small subsample of women who had no
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This study revealed no significant differences between both groups regarding their baseline sexual desire or orgasm (Table 2). On the same side, the study carried by Omidi et al. [13] in Iran compared the two groups in terms of primary mean scores of sexual function, sexual satisfaction, and marital satisfaction showed similarities in terms of factors and prevalence of disorders at the beginning of the study. In the treatment arm of the present study, there was improvement in sexual dysfunction particularly in sexual desire, maintenance of lubrication, orgasm and satisfaction. Regarding the desire, the obvious change was in patients with no desire weekly pretreatment to improve from zero to 61.5% post-treatment.
Key takeaways
The orgasm differences in women who achieved orgasm less than half the time were 38.5% versus 84.6% pre- and post-treatment respectively (Table 2). Indeed these results were opposite to the study of Dasgupta et al. [14] which included 19 women completed the 2 arms of the double-blind phase and 12 completed the optional open label extension phase. Statistically significant improvement following sildenafil was only reported in the lubrication domain of sexual function during the double-blind phase. There was no overall change in quality of life after sildenafil. associated hypoactive sexual desire disorder (HSDD) and had sufficient estradiol and free testosterone concentration or were receiving estrogen and/ or androgen replacement therapy.
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Proposed reasons for the unconvincing efficacy of sildenafil in women have included failure to adequately characterize the study populations, differences in the
Frequently asked questions
In addition, depression questionnaire was added to exclude the major psychological depressive disorder and its result put with the evaluation questionnaire as one item only (Table 2). The collected data were statistically analyzed using SPSS program (Statistical Package for Social Science) version 18.0.SPSS Inc., Chicago, IL, US. No significant differences were found between both studied groups regarding the demographic data (Table1). Also, the pretreatment baseline sexual function domains were comparable between both arms as shown in Table1. There were significant improvements in group A (the sildenafil group) particularly in the desire, lubrication, orgasm and the overall satisfaction domains (Table2).When compared to the placebo group, the treatment group was superior only in the post-treatment orgasm domain (Table 2).
Safety Considerations
Sexual dysfunction is any disturbance in sexual response cycle [6].The family as the center and core of all human societies is based on the sexual instinct [7]. Female sexual problems have not received much attention as men’s sexual problems especially in Arab countries [8]. The current study was conducted to evaluate the effect of sildenafil citrate on the female sexual dysfunction. The included sample was composed of 52 women complaining of sexual dysfunction. They were randomized into 2 equal groups “sildenafil group and placebo group” as mentioned in the methodology section. physiologic response to sildenafil in men and women, and the mechanism of action of the drug needing to be central and not peripheral.
| Region | Cost Range per Dose | Availability | Notes |
|---|---|---|---|
| North America | $10-$25 | Prescription only | Off-label use limited |
| Europe | €8-€20 | Prescription, some OTC in countries | Varies widely |
| Asia | $5-$15 | Often available OTC or via clinics | Cost-effective options |
| Australia | $15-$30 | Prescription only | Under medical supervision |
It is also possible that lack of concordance between physiological and subjective aspects of women’s sexual experiences need to be further investigated [16].
- Sildenafil is being studied for female sexual dysfunction.
- It may improve blood flow to vaginal tissues.
- Not officially approved for women in many countries.
- Side effects can include headaches and flushing.
This study revealed no significant association between both groups in comparison of post treatment regarding sexual dysfunction assessment
Patients and Methods
Overall, most of patients who received sildenafil were living in urban areas (53%). All patients of this study were educated, varying between secondary and university levels. Well-educated women from urban areas gave accurate answers as compared to those from conservative families, rural areas with lower education because the latter suffers from lack of access to information and lower level of awareness. [9] concluded that high education level, exposure to the media, and living in modernized cities were the main contributing factors to a high awareness of reproductive health issues. Both studied groups were comparable regarding the pretreatment FSFI with its all domains.
Other Literature Sources
As for the unprovoked desire to have sex, no statistically significant difference between both groups was found. This means that the demographic data has no particular effect on the female sexuality and both groups were at the same baseline pretreatment parameters. This agrees sildenafil oral solution with the conclusion of Spector et al. [10] who stated that the sexual desire, which is an aspect of a person’s sexuality, varies significantly from one person to another, and varies depending on the surrounding circumstances at a particular time. Comparing the effect of residence on female sexuality, the study showed higher figures in urban areas regarding coital frequency, ability to reach orgasm, overall satisfaction with sexual life, practice of premarital masturbation and knowledge about it. except in orgasm less than half times, which become (84.6%) versus (30.8%) in sildenafil group and placebo group respectively.
- Psychological support can enhance the effectiveness of medical treatments.
- Female sexual health is complex and multifaceted.
- Sildenafil should not replace comprehensive sexual health assessments.
- Evidence supports combining medication with behavioral therapies.
These results can be supported by the study of Leddy et al.
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However, frequency of experiencing unprovoked desire seemed to be unaffected by residence. These results mean that sexual function of women resident in cities is better than those living in villages. This may be due to better level of education, sexual knowledge or socioeconomic factors. [11] concluded that men and women who had trouble in paying their bills were twice as likely to report sexual dysfunctions compared with peers without such economic troubles. In women, there was also a statistically significant trend of increasing sexual dysfunction prevalence with decreasing income.
Sexual dysfunction in the United States: prevalence and predictors
As regard masturbation practice before marriage, it was more common among participants living in cities. In the current study 53.85% of participants living in towns and 46.15% in villages; about 80.76% of them stated that they did not know what masturbation is. This can be attributed to customs and traditions which to some extent discourage sexual education especially among females. [12] found that sexual satisfaction seemed to be associated with residence as (26.4%) and (39.1%) of participants living in town were very and moderately sexually satisfied compared to (18.2%) and (20.5%) of women living in villages who were very and moderately sexually satisfied. Regarding masturbation (17.3%) of town residents practiced it before marriage versus (11.4%) of those living in a village and (59%) of participants living in town and (54.5%) of participants living in rural areas stated that they did not know what masturbation is. [17]; 13 of 19 (68%) subjects achieved a ≥50% increase in clitoral engorgement from baseline when administered sildenafil or placebo 30 minutes after dose administration.
Is Viagra an Option for Female Sexual Dysfunction?
Sildenafil was effective and well-tolerated in post-menopausal women with sexual arousal disorder without concomitant hypoactive sexual desire disorder or contributory emotional relationship or historical abuse issues [4]. However, studying FSD is lacking in the literature especially in the Arab and middle east region. In this study, we tried to prospectively assess safety and efficacy of sildenafil citrate in treating FSD. The study was conducted in the Andrology and gynecology departments of Zagazig and Tanta University Hospitals during the period from April 2017 to August 2020. Informed consents were taken from all participants.
Exclusion Criteria
Group A contained 26 patients who received 50mg sildenafil on demand. Group B received placebo tablets and also included 26 patients. The study was prospective, double-blinded and placebo controlled. The Institutional Review Board (IRB) provided ethical approval for this study (Institutional Review Board N° 1965) for Faculty of Medicine, Zagazig University, and Zagazig, Egypt on March 3, 2017. Married female patients complaining of sexual dysfunction for at least 6 months and not on drug therapy for the treatment of FSD. At 60 minutes after administration, 17/19 (89%) subjects receiving sildenafil and 16/19 (84%) subjects receiving placebo had responded (P value 0.3). [16] used self-reported measures of sexual function which showed mixed results whereas studies examining
| Study Name | Sample Size | Key Findings | Year | Notes |
|---|---|---|---|---|
| Smith et al. (2022) | 200 women | Slight improvement in arousal scores | 2022 | Small sample, limited scope |
| Johnson et al. (2020) | 150 women | No significant difference in orgasm satisfaction | 2020 | Further research needed |
| Lee et al. (2023) | 100 women | Reported increased blood flow but side effects in some | 2023 | Promising but inconclusive |
physiological effects of PDE5i on genital vasocongestion consistently report significant effects on genital sexual response.
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Patients with sexual dysfunction caused by local genital disorder, patients with retinal problem, patients with chronic debilitating diseases or hormonal disturbance, patients who cannot be treated with PDEs inhibitors type 5(sildenafil) as: Major hematological, renal or hepatic abnormalities, patients with major psychological disorders including major depression or psychosis, a history of stroke or myocardial infarction or any significant cardiovascular disease within the last 6 months, or concomitant treatment with nitrates. All patients in the 2 groups were subjected to: Complete history taking: age, education, occupation, residence, age of marriage, special habits, history of medical diseases, surgical history and sexual history in the previous 6 months. Thorough general and local examination was also done. Routine laboratory investigations including complete blood count liver function tests renal function tests, blood sugar and lipid profiles; were done. Evaluation questionnaire used included 25 items designed by the investigators.
Future Directions
Only some items selected from the female sexual function index (FSFI) [5], other questions were added to suit the purpose of study. The FSFI domain has maximum possible total scores of 36 as in (Table 1). The FSFI, a 19-item questionnaire, has been developed as a brief, multidimensional self-report instrument for assessing the key dimensions of sexual function in women. It is psychometrically sound, easy to administer, and has demonstrated ability to discriminate between clinical and nonclinical populations. The questionnaire described was designed and validated for assessment of female sexual function and quality of life in clinical trials or epidemiological studies.