Alice,

My girlfriend is interested in all kinds of sexual experimentation, and she's recently been wondering what it would be like for a woman to take Viagra. I know it is intended to increase blood flow in a man. What would it do to a woman? Also, what are the side effects? Would they be any different for a woman? And is there any safe and legal way for a woman to obtain Viagra? I'd like to support my girlfriend's curiosity, but I don't want to see her hurt herself.

Thanks!

Dear Reader,

If your girlfriend is down for all kinds of sexual exploration, it's understandable that she’s curious about Viagra (also called sildenafil). After all, it’s highly sought after, thanks to its ability to temporarily treat erectile dysfunction (ED) and impotence. While it was originally launched for those assigned male at birth with erectile dysfunction, some assigned female at birth have been prescribed the drug — primarily to treat a variety of sexual arousal disorders — and many have experienced increased blood flow to the vagina and clitoris, enhancing sensitivity to sexual pleasure! Additionally, some women are turning to a newer drug on the market, Addyi (also called flibanserin), which has been commonly dubbed the “female Viagra”. However, it’s crucial to note that sildenafil and flibanserin are very different from one another, and each comes with their own share of side effects — most of which have only been tracked in women with sexual dysfunctions. Learning a bit more about these drugs and encouraging your partner to speak with a medical professional will likely provide some guidance as she decides whether to take this route in the future or not.

Despite both intending to treat sexual dysfunction, sildenafil and flibanserin bear few similarities regarding how they work and their side effects. On one hand, sildenafil is effective for almost everyone, works by enhancing blood flow to a person’s genitals and usually takes 30 to 60 minutes to have noticeable effects. As such, it can be conveniently taken as soon as you get in the mood. Additionally, drinking alcohol while using sildenafil won’t pose any serious health risks. Its minor side effects include nausea, headache, flushing, and hay fever. More serious side effects include abnormal vision, chest pain, and shortness of breath. On the other hand, flibanserin is effective for one in ten women, works by targeting neurotransmitters in the brain, and needs to be reliably taken every day (sometimes for a month or two to have any noticeable effects). Unlike sildenafil, using alcohol at the same time is not advised. This is because there is a risk of severely low blood pressure and loss of consciousness when using the drug alone. This risk increases when using alcohol at the same time. Moreover, the long-term health risks aren’t known at this time. Its minor side effects include nausea, fatigue, tingling or numbness in the limbs, and muscle aches. More serious side effects include blurred vision, dizziness, chest pains, and shortness of breath.

Although sildenafil has been FDA-approved for men, physicians report prescribing it off-label to women, primarily for those with some sort of sexual dysfunction. For those with these types of diagnoses, many report experiencing burdensome personal distress or strained sexual relationships with their partner. And, after taking it, research has demonstrated that some users expressed greater sexual satisfaction, sexual arousal, sexual confidence, and less anxiety towards sexual activity. Yet, it has been noted that these positive effects may vary by dysfunction, and the person’s age. Outside of prescription medications though, there are non-medical treatments for sexual dysfunction, which can include practicing healthy lifestyle habits (e.g., adequate amounts of quality sleep, being physically active, reducing alcohol consumption), using lubricant, trying a device such as a vibrator, or speaking to a mental health professional that specializes in sex and relationships.

As it seems like your partner is interested in sildenafil solely for pleasure, it’s worth reiterating that health care providers and researchers have primarily monitored each drugs’ side effects only in those with some kind of sexual dysfunction. Thus, if your girlfriend doesn’t have a dysfunction, she may experience different or heightened side effects than those previously mentioned. As such, her health care provider may not recommend either drug for her.

If you and your girlfriend continue to consider sildenafil or flibanserin, it's imperative to shop wisely. Unfortunately, people have tried to capitalize on their popularity at the expense of health of the consumers. Specifically, some mail-order and internet pharmacies have tried to cash in on the popularity of ED medications by offering fake sildenafil or other unregulated "natural" or "herbal" equivalents without a prescription. Additionally, these drugs may not be appropriate or safe for some people, and these mail-order services may not be able to provide guidance on the safety of these medications for a given person based on their health history, current health status, or any other conditions they may have. Some who have obtained a drug from these types of pharmacies have found themselves consuming impure products or experiencing unpredictable side effects. In order to avoid this experience, your girlfriend can meet with their health care provider for a prescription of the drug and have it filled by a trusted pharmacy.

After learning all of this, if she decides to hold off on sildenafil, rest assured that there are still plenty of other ways to spice up your sex life! Perhaps you could consider adding sex toys, role-playing, or watching erotic videos for some extra inspiration. For even more ideas, you and your girlfriend may also want to check out the Go Ask Alice! Sexual and Reproductive Health archives.

Alice!

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