Have you ever wondered if Viagra has a beneficial effect on women? Would it make it easier for them achieve orgasm? Would a female Viagra enhance a woman's sex drive?

Anecdotal reports regarding the beneficial use of silendafil (the active ingredient in Viagra) for females abound. Most famously, a 1999 episode of Sex In The City stoked hopes that Viagra truly acts to heighten a woman's pleasure.

A recent study in the Journal of the American Medical Association has revived hopes that an equivalent of Viagra for women to treat sexual dysfunction in might eventually make its way into your neighborhood pharmacy. The 2008 JAMA study showed that Viagra can improve sexual satisfaction for women on antidepressants. [Source = http://jama.ama-assn.org/cgi/content/abstract/300/4/395 ]

Several companies are also working on various hormone patches and creams for women that may lead to a breakthrough. The above article reviews those efforts and offers online resources for those seeking more information. Readers should note that recent studies and commercial drug development efforts show that a "female Viagra" pill is probably a long way off.

Viagra (made by Pfizer), and its competitors Cialis (Eli Lilly) and Levitra (Bayer), spawned a multibillion-dollar market for men with erectile dysfunction. But more women than men suffer from some kind of sexual dysfunction.

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The Market Outlook for "Pink Viagra" or "Viagra for Women"

The market for a so-called "Pink Viagra" is huge. About 43 percent of women have lowered libido, lack of vaginal lubrication, lack of orgasm or some other roadblock to sex, compared to 31 percent of men, according to a 1999 study in JAMA. [Source = http://www.nytimes.com/2004/02/28/business/28viagra.html?ei=5007&en=eccf3ce764e04dd3&ex=1393390800&partner=USERLAND&pagewanted=print&position= ]

Therefore any drug or treatment that offered even modest improvement in female sexual dysfunction would likely be a huge success. However, efforts so far have seen mixed or modest results.

The 2008 JAMA study looked at women who were taking antidepressants. Those drugs, also known as selective serotonin reuptake inhibitors, commonly have the side effect of reducing sexual desire or ability to orgasm in patients who take them. Forty-nine women in the study were randomly assigned to take either Viagra or a placebo before sex.

They were compared to 49 women who took neither product. The researchers found that there was a statistical association of reduced negative sexual side effects in the group of women who took Viagra, compared to those who did not take it. The study was a small one - just 98 subjects, and only 24 or so women actually took Viagra, so it is not very statistically significant.

But anecdotal reports from women who have taken Viagra (known by its generic name, sildenafil) suggest that the drug has some ability to heighten sexual pleasure.

Robert Taylor Segraves, a professor of psychiatry at Case Western Reserve University who specializes in sexual disorders, told U.S. News & World Report, "[Viagra] is probably going to help orgasm, it will probably increase vaginal lubrication and blood flow, but how much that matters to the average woman is unclear."

Viagra's chemical action in the body promotes blood flow. In men, sildenafil (the generic name of the drug) inhibits an enzyme that degrades cyclic guanosine monophosphate (cGMP). cGMP is triggered by nitric oxide during arousal, and creates smooth muscle relaxation, allowing blood to flow more freely into the penis. [Source = http://www.pfizer.com/files/products/uspi_viagra.pdf ]

Women do not have the corresponding body parts, but the effect of improved blood flow in the vagina, labia and clitoris may make those organs more sensitive or more easily stimulated during sex.

Researchers are almost unanimous, however, in their assessment that while improved blood flow for men is all that is required to regain their interest in sex, it's different for women.

True, clitoral stimulation is usually associated with the female orgasm. But, our research demonstrates that the orgasmic experience in females is more than chemistry or physiology. Is there such a thing as an erect clitoris and could PDE-5 Inhibitors such as Viagra, Levitra (vardenafil) or Cialis (tadalafil) elicit this phenomenon?

Arousal and sexual satisfaction in women is a combination of psychological and physical factors. Women may have a healthy sex drive but not the required level of vaginal lubrication to make sex possible. Or they may enjoy sex but be unable to reach orgasm. The various dysfunctions are divided into five categories: [Source = http://health.discovery.com/encyclopedias/illnesses.html?article=2058 ]

• lack of sexual interest or decreased libido.
• lack of vaginal lubrication, or "female sexual arousal disorder."
• painful intercourse, or dyspareunia.
• painful, involuntary contractions of the vaginal muscles, or vaginismus.
• inability to reach orgasm.

Female sexual dysfunction may also be a product of hypertension, heart disease, diabetes, thyroid disorders, neurological diseases or autoimmune disorders, as well as side effects of drugs such as antidepressants or anti-hyperintensives. It is unlikely that a single drug can treat this range of symptoms. This is probably why Pfizer gave up researching the use of Viagra in women in 2004. [Source = http://www.nytimes.com/2004/02/28/business/28viagra.html?ei=5007&en=eccf3ce764e04dd3&ex=1393390800&partner=USERLAND&pagewanted=print&position= ]

Pharmaceutical research so far has focused on three main areas:[Source = http://health.discovery.com/centers/womens/viagra/viagra.html ]

L-arginine amino acid cream: Used by athletes for muscle growth, it also allegedly improves bloodflow and thus may have some effect on the female genitals. The cream is applied to the genitals before sex. It is often marketed as Vigel, frequently by nonreliable sources. [Source = http://www.dailymail.co.uk/health/article-395083/Cream-boost-womens-sex-drive.html ]

Dehydroepiandrosterone (DHEA): A male hormone that converts into testosterone and estrogen. It can be purchased in diet supplement stores. A 1999 study in the New England Journal of Medicine found an increase in sexual interest among users, but the study was a small one. Side effects can include heart attacks, breast cancer and facial hair growth, so consult your doctor before using. [Source = http://content.nejm.org/cgi/content/abstract/341/14/1013 ]

Testosterone: Both men and women have testosterone in their bodies, but men have more of it. It is closely associated with the generation of desire and libido. Applying a testosterone cream to the skin has shown some improvement in female libido strength. But there are side effects. They include facial hair and a deepening of the voice - which is irreversible.

Procter & Gamble Pharmaceuticals successfully brought to market a testosterone patch in Europe under the brand name Intrinsa for hypoactive sexual desire disorder. [Please see: http://www.intrinsa.com/](The U.S. FDA rejected the proposal.) The product has been available from the British National Health Service since 2007. [Source = http://www.guardian.co.uk/lifeandstyle/besttreatments/2009/mar/03/testosterone-not-female-viagra-after-all ]

A 2009 review of Intrinsa studies in the Drug and Therapeutics cast doubt on its efficacy, however. [Source = http://dtb.bmj.com/cgi/content/abstract/47/3/30 ]

A good summary of the study's data - written in plain English - can be found here:"Review Nixes 'Female Viagra' Patch After Surgical Menopause" ( http://www.medpagetoday.com/OBGYN/HRT/13154) Among the findings in the study, according to Med Page Today, were:

"Relatively low effectiveness, large placebo responses, and lack of long-term safety data."

"Unwanted androgenic effects -- including acne, hirsutism, alopecia, breast pain, weight gain, insomnia, voice deepening, and migraine -- occurred in between one in 10 and one in 100 women on the transdermal testosterone patch."

"Although typically mild, the androgenic effects reported in the two pivotal trials did not fully resolve for 27% of patients with acne, 57.5% with hirsutism, 39% with alopecia and 40% with voice deepening."

Noven Pharmaceuticals is working jointly with P&G Pharma to bring a low-dose testosterone patch for hypoactive sexual desire disorder to market in the U.S. The company is also developing what it calls a "follow-on" product for the same condition. [Source = http://industry.bnet.com/pharma/1000491/will-pg-pharma-auction-end-the-companys-pursuit-of-viagra-for-women/] FDA approval for that effort is likely years away.

Similarly, BioSante Pharmaceuticals is developing a testosterone gel, LibiGel, that can be applied to a patient's arm. [Source = http://www.biosantepharma.com/LibiGel.php ]

Early studies show some improvement in libido but, like the Noven patch, the product is years away from FDA approval.

In the meantime, some doctors are willing to mix low-dose testosterone creams by hand for their female patients. However, those doctors caution that until the FDA approves a product they cannot say for sure that testosterone cream use for low libido is safe. [Source = http://www.cleveland.com/medical/plaindealer/index.ssf?/base/news/1236673951178760.xml&coll=2 ]

There are several non-prescription, over-the-counter products that can help. They include:

Johnson & Johnson's KY Warming Liquid (and a range of associated products), which is the company's traditional KY lubricant coupled with ingredients that make the liquid feel warm to the skin. Ingredients include Propylene Glycol, Glycerin, Acacia Honey Type O, and Methylparaben. http://www.k-y.com/index_us.jsp?gclid=CJqiirqLtZkCFQHHGgodFlSM7A

Semprae Labs' Zestra, a botanical lubricant containing borage seed oil, evening primrose oil, angelica extract, coleus extract, vitamin C and vitamin E. http://www.zestra.com/index.php?option=com_simplefaq&Itemid=103

Berkeley Premium Neutraceuticals' Avlimil, an herbal pill. Consumers should be careful ordering product from Berkeley because the company has previously been the subject of Federal Trade Commission actions and its founder was imprisoned for defrauding customers.

The company continues under new management. Avlimil's ingredients include cayenne pepper and valerian root, suggesting they work by making users feel flushed. Increasing blood flow to the skin, including the genitals, is part of arousal.

This Page was Last Updated: 9/30/2009