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viagra for women

by Chris Steidle, MD

Viagra is what is known as a type five phosphodiesterase inhibitor. Preliminary studies in women are currently underway and while there is no answer at the present, there is information that indicates that, at least in a clinical setting, the results have been quite astounding. Some physicians have already admitted to using Viagra in women.

A Boston University study is currently underway to determine whether or not Viagra can help restore sexual pleasure among women who are taking it. Viagra’s manufacturer, Pfizer, Inc., is now in the midst of clinical trials in the United Kingdom. If studies prove successful, and many believe that they show great promise, these tests will be expanded to include thousands of women under the tough protocols required for FDA approval.

Even with Pfizer’s studies well underway, it is far too early to know anything about Viagra’s effectiveness for women or its side effects. The tests will not be completed for some time and it may be years before its approval for use in women is sought from the FDA.

Regardless of Pfizer’s results, Viagra will have no effect on a women’s libido and it is not the much-touted orgasm pill that some have claimed. ven so, there are reasons to believe that Viagra will have as profound an effect on women as it has had on men. In fact, many researchers are convinced that as prostate surgery and diabetes can lead to erectile dysfunction in men so can hysterectomies, high blood pressure and diabetes lead to circulatory problems and sexual dysfunction in women. The end result of these illnesses and conditions, researchers theorize, is that women have difficulty becoming aroused.

Here is where researchers believe Viagra will help. As in men when blood vessels in the penis become engorged with blood so that an erection occurs, it is true in women that when the blood vessels of the vagina become engorged with blood, the vagina becomes properly lubricated in preparation for intercourse. Perhaps women who have been unable to achieve orgasms may be able to climax with the help of Viagra.

Viagra is a selective inhibitor or blocker of Cyclic Guanosine Monophosphate (cGMP) specific phosphodiesterase type 5. This is a very complicated way of saying that Viagra works on an enzyme that resides in the corpus cavernosum, the spongy cylinder in the penis and the clitoris that serves as the erectile body. The difference between the penis and the clitoris is that there is a reduced ability in the clitoris to develop what is termed a veno-occlusive function. In other words, the clitoris doesn’t achieve the rigidity of the penis that turns into a structure with which to penetrate. Rather, it’s a structure that becomes swollen and helps support the protrusion of the inner structure known as the glans.

During sexual stimulation, nitric oxide is released which activates an enzyme called guanylate cyclase that acts to increase levels of cyclic GMP. The release of this enzyme causes the smooth muscles inside the spongy tissue to relax and allows blood to flow in. The end result is tumescence of the clitoris and increased vaginal blood flow. Interestingly, Viagra by itself has no effect on tissues isolated from the vagina and clitoris.

Viagra has not demonstrated any effect on bleeding or clotting in men. It does mildly inhibit phosphodiesterase type 6, the enzyme that aids in color vision by the retina. It is for this reason that a very small percentage of men will notice mild visual side effects, usually blue tinted vision, when taking Viagra. Rapidly absorbed in the blood stream when taken in pill form, Viagra levels peak in the human body plasma within one hour and often in as little as thirty minutes. When taken with a high fat meal, its clinical effectiveness is substantially reduced. In other words, the effect of the drug is severely diminished when taken with a heavy meal. When properly administered, however, Viagra proves to be remarkably effective, and significantly, it has a relatively long half-life, the length of time the drug remains in the body (up to four hours). Extensive studies on the drug conclude that it is broken down by the liver and most of it is then excreted from the body in the feces. Viagra has been studied extensively in elderly patients as well and no additional problems were noted. However, this population did exhibit higher serum levels of the drug and its metabolites due to more difficulties with excretion.

Viagra is available in two strengths, 50 and 100 mg. For most, a started dosage of 25 to 50 mg is recommended, although this dose may be reduced in elderly patients who have severe liver disease or renal failure. Additionally, patients who have been prescribed Erythromycin or Ketoconazole should probably start with lower doses. The drug metabolizes easier in some men than others and this is an important fact when considering the initial dosage. In any event, patients are strongly advised never to take any form of nitroglycerin prior to or especially during the period in which they are taking Viagra as results can be tragic and even fatal. Indeed, many of the deaths attributed to Viagra have been linked to the patient’s use of nitroglycerin. Be advised that those taking nitrate therapies in any form should steer away from taking Viagra.

References

1. Take pressure off your sex life. High blood pressure can contribute to sexual problems, as can some treatments for it. Harv Heart Lett, 2004. 15(2): 4.
2. Exercise can spice up your sex life, the American Council on Exercise says. 2005, Medical News Today.
3. Survey of literature. J Sex Med, 2005. 2(2): 279-282.
4. Althof, S.E., et al., Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction. J Sex Med, 2005. 2:793-800.
5. Althof, S.E., et al., Current perspectives on the clinical assessment and diagnosis of female sexual dysfunction and clinical studies of potential therapies: a statement of concern. J Sex Med, 2005. 2 Suppl 3: 146-53.
6. Basson, R., et al., Summary of the recommendations on sexual dysfunctions in women. J Sex Med, 2004. 1(1): 24-34.
7. Basson, R., et al., Assessment and management of women's sexual dysfunctions: problematic desire and arousal. J Sex Med, 2005. 2(3): 291-300.
8. Berman, J., L. Berman, and E. Bumiller, For women only: a revolutionary guide to overcoming sexual dysfunction and reclaiming your sex life. 2001, New York: Henry Holt and Company.
9. Berman, L., J. Berman, and A.B. Schweger, Secrets of the sexually satisfied woman: ten keys to unlocking ultimate pleasure. 2005, New York: Hyperion.
10. Block, J.D. and S.C. Bakos, Sex over 50. 1999, New York: Penguin Putnam Inc.
11. Bohlen, J.G., et al., Heart rate, rate-pressure product, and oxygen uptake during four sexual activities. Arch Intern Med, 1984. 144(9): 1745-8.
12. Bultrini, A., et al., Possible correlation between type 1 diabetes mellitus and female sexual dysfunction: case report and literature review. J Sex Med, 2004. 1(3): 337-40.
13. Cetel, N., Double menopause: what to do when both you and your mate go through hormonal changes together. 2002, Hoboken, NJ: John Wiley & Sons, Inc.
14. Comfort, A., The new joy of sex. 1991, New York: Crown Publishers, Inc.
15. Davis, S.R., et al., Endocrine aspects of female sexual dysfunction. J Sex Med, 2004. 1(1): 82-6.
16. Esposito, K., et al., The metabolic syndrome: a cause of sexual dysfunction in women. Int J Impot Res, 2005. 17(3): 224-6.
17. Farnham, A., Is sex necessary? 2003, Forbes.com.
    http://www.forbes.com/2003/10/08/cz_af_1008health_print.html
18. Gisquet, V., Better sex diet. 2005, Forbes.com.
    http://www.forbes.com/2005/03/17/cx_vg_0317feat_print.html
19. Goldstein, I., Sexual medicine treatment: lifestyle or life quality? The import of language. J Sex Med, 2006. 3(2): 191-3.
20. Goldstein, I., et al., Women's sexual function improves when partners are administered vardenafil for erectile dysfunction: a prospective, randomized, double-blind, placebo-controlled trial. J Sex Med, 2005. 2(6): 819-32.
21. Hakim, L.S. and D.M. Platt, The couple's disease: finding a cure for your "lost" love life. 2002, Delray Beach, FL: DHP Publishers, LLC.
22. Harrar, S. and J. VanTine, Extraordinary togetherness: a woman's guide to love, sex and intimacy. Prevention Health Books for Women. 1999, Emmaus, PA: Rodale Inc.
23. Hatzichristou, D., et al., Clinical evaluation and management strategy for sexual dysfunction in men and women. J Sex Med, 2004. 1(1): 49-57.
24. Hayes, R. and L. Dennerstein, The impact of aging on sexual function and sexual dysfunction in women: a review of population-based studies. J Sex Med, 2005. 2(3): 317-30.
25. Heinemann, L.A., et al., Scale for Quality of Sexual Function (QSF) as an outcome measure for both genders? J Sex Med, 2005. 2(1): 82-95.
26. Hitti, M., Weight loss may help your sex Life, in Medscape Today. 2005.
    http://www.medscape.com/viewarticle/514784
27. Hooper, A., Anne Hooper's Kama Sutra. 1994, London: Dorling Kindersley.
28. Hooper, A., K-I-S-S guide to sex. Keep It Simple Series, ed. J. Williams. 2000, New York: Dorling Kindersley Publishing, Inc.
29. Kaya, C., et al., Sexual function in women with coronary artery disease: a preliminary study. Int J of Impotence Research, 2006, 1-4.
30. Kendall, P., Nuts gaining heart-healthy image, in Nutrition News--Colorado State University Cooperative Extension. 2002.
    http://www.ext.colostate.edu/pubs/columnnn/nn020225.html
31. Laumann, E.O., A. Paik, and R.C. Rosen, Sexual dysfunction in the United States: prevalence and predictors. JAMA, 1999. 281(6): 537-44.
32. Leiblum, S.R. and R.C. Rosen, eds. Principles and practice of sex therapy: update for the 1990s. 2nd ed. 1989, The Guilford Press: New York.
33. Lewis, R.W., et al., Epidemiology/risk factors of sexual dysfunction. J Sex Med, 2004. 1(1): 35-9.
34. Martin, A.C., It's never too late to start: seven steps toward good health, in Topics in Advanced Nursing Practice eJournal. 2002.
    http://www.medscape.com/viewarticle/421471
35. Meston, C. and P. Trapnell, Development and validation of a five-factor sexual satisfaction and distress scale for women: the Sexual Satisfaction Scale for Women (SSS-W). J Sex Med, 2005. 2(1): 66-81.
36. Meston, C.M., Aging and sexuality. West J Med, 1997. 167(4): 285-90.
37. Munarriz, R., et al., A review of the physiology and pharmacology of peripheral (vaginal and clitoral) female genital arousal in the animal model. J Urol, 2003. 170(2 Pt 2): S40-4; discussion S44-5.
38. Nappi, R., et al., Clinical biologic pathophysiologies of women's sexual dysfunction. J Sex Med, 2005. 2(1): 4-25.
39. Oberg, K. and K. Sjogren Fugl-Meyer, On Swedish women's distressing sexual dysfunctions: some concomitant conditions and life satisfaction. J Sex Med, 2005. 2(2): 169-80.
40. Quirk, F., S. Haughie, and T. Symonds, The use of the sexual function questionnaire as a screening tool for women with sexual dysfunction. J Sex Med, 2005. 2(4): 469-77.
41. Salonia, A., et al., Chocolate and women's sexual health: an intriguing correlation. J Sex Med, 2006. 3: 476-482.
42. Seftel, A.D., et al., eds. Sexual dysfunction: male and female. 2004, Mosby: New York. 312.
43. Sheehy, G., Sex and the seasoned woman: pursuing the passionate life. 2006, New York: Random House.
44. Siebert, D., Sexual health: counseling in primary care, in Medscape Today - National Conference for Nurse Practitioners 2001. 2001.
    http://www.medscape.com/viewprogram/852_childindex
45. Somers, S., The sexy years: discover the hormone connection: the secret to fabulous sex, great health, and vitality, for men and women. 2004, New York: Crown Publishers.
46. Tariq, S.H. and J.E. Morley, Maintaining sexual function in older women: physical impediments and psychosocial issues. Women's Health in Primary Care, 2003. 6(3): 157-162.
47. Tikiz, C., et al., Sexual dysfunction in female subjects with fibromyalgia. J Urol, 2005. 174(2): 620-3.
48. Wagner, G., et al., Ethical aspects of sexual medicine. J Sex Med, 2005. 2(2): 163-8.
49. Weijmar Schultz, W., et al., Women's sexual pain and its management. J Sex Med, 2005. 2(3): 301-16.
50. Yassin, A.A., Brain sex--testosterone role in personality evolution; females and males are different? J Sex Med, 2006. 3 Suppl 2: 81-82.
51. Yu, S. and J.W.G. Yarnell, Exercise for the prevention of cardiovascular disease: how vigorous and how often? Cardiovasc Rev Rep, 2004. 25(6): 274-276.

Posted January 2000
Last Updated July 2008

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