Benefit of vaginal sildenafil citrate in assisted reproduction therapy

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Talk with your healthcare professional to see if this medicine might be right for you. Sexual problems may be due to trouble with arousal, a lack of desire or both. Many factors can affect sexual desire in women. Many women find that the stresses of daily life lower their desire for sex. Highs and lows in sexual desire may go along with the beginning or end of a relationship or with major life changes, such as pregnancy or menopause.

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For some women, orgasm can be hard to reach. This can cause worries that lead to a loss of interest in sex. Desire often is linked to a sense of closeness between partners, as well as sexual issues from the past. Some chronic conditions, such as diabetes or multiple sclerosis, can cause changes in arousal or orgasm. If you have trouble with sexual desire or response, talk with a member of your healthcare team.

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You might want to talk to a sex therapist. Medicines, hormones, creams, lubricants, clitoral stimulation or other treatments sometimes can help. There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. Women’s health topics - straight to your inbox Get the latest information from our Mayo Clinic experts on women’s health topics, serious and complex conditions, wellness and more. Overview of sexual dysfunction in women: Management. Email Us: info@lupinepublishers.com Call Us: +1 (914) 407-6109 57 West 57th Street, 3rd floor, New York - NY 10019, USA Department of Obstetrics & Gynecology, Tanta University, Egypt Received: October 03, 2018; Published: October 09, 2018 Corresponding author: Mohamed Nabih EL-Gharib, Professor of Obstetrics & Gynecology, Faculty of Medicine, Tanta University, Egypt Sildenafil citrate (SC) is a medicinal drug used to treat male erectile dysfunction and pulmonary hypertension. Sildenafil is a selective and potent competitive inhibitor of the cyclic guanosine monophosphate (cGMP) -specific phosphodiesterase-type 5 (PDE-5) enzymes, which, by preventing the breakdown of cGMP, potentiate the action of NO in tissues that contain PDE-5. Thus, increasing vasodilatation and potentiating the effects of nitrous oxide (NO) on the vascular smooth muscle [1-2]. SC increases uterine blood flow and potentiates estrogen-induced chew sildenafil vasodilatation [3]. Sildenafil citrate is metabolized is in the liver by cytochrome P450, the metabolites are: N-desmethylsildenafil (about 50% potency for PDE5). The biological half-life is from 3 to 4 hours, it is excreted in feces and in urine [4]. Sildenafil is developing as a potential applicant for the treatment of intrauterine growth retardation and for premature labor [5]. Sildenafil has also been proposed as a potential therapeutic strategy to maintain placental function in pre-eclampsia [6].

Should sildenafil citrate possess vasodilatory effects in the feto-placental circulation, this would significantly enhance its therapeutic use in treating placental insufficiency.

Before taking this medicine

The limitation of this study is that it was conducted on only Egyptian patients, so further well-designed studies are needed to see if the same conclusions apply to other races. On the other hand, points of strength include among others, the good sample size and the prospective randomized double-blinded study design. Sildenafil citrate seems to improve orgasm in a sample of Egyptian females with sexual dysfunction. Desilva P (1995) Sexual dysfunction in S.J.E Lindsay and G.E.Powell, The hand book of lineal and adult psychology. London and New York rout ledge (2): 199-288.

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Jaafapour M, Khani A, Khajavikhan J, Suhrabi Z (2013) Female sexual dysfunction, prevalence and risk factor and Journal of clinical and diagnostic research 7(12): 2877-2880. (2006) Sildenafil improve sexual functioning in premenopausal women with type 1 diabetes who are affected by sexual arousal disorder. (2003) Safety and efficacy of sildenafil citrate for the treatment of female sexual arousal disorder. Journal of Urology 170(6): 2333-2338. (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.

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Diagnostic and Statistical Manual of Mental Disorders. (2014) Prevalence Survey of Sexual Dysfunction among Women in the Reproductive Age. (2007) Female sexual dysfunction in Lower Egypt. El Gelany S, Moussa O (2013) Reproductive health awareness among educated young women in Egypt. Spector IP, Carey MP and Steinberg L (1996) The sexual desire inventory: Development factor, structure, and evidence of reliability. SC has recently been demonstrated not to alter the contractile response to vasoconstrictors or to endothelial dependent vasodilators.

In non-pregnant females, SC causes uterine artery vasodilation therefore it also be employed to treat menstrual pain and muscle spasms [7]. SC is increasingly used in the pregnant patient for the treatment of pulmonary hypertension [8].

Its safety and efficacy combined with its lack of teratogenic or feto-toxic effects mean that its use for the treatment of pulmonary hypertension in pregnancy is likely to increase [9].

• Sildenafil citrate can be prescribed off-label for female sexual dysfunction.
• Consult a doctor before using sildenafil citrate tablets for women.
• Side effects in women may include headache, flushing, or nasal congestion.
• Sildenafil works by increasing blood flow to enhance female arousal.
• Dosage for women varies; always follow medical advice.
• Sildenafil tablets may interact with other medications, like nitrates.
• Not approved by FDA specifically for female sexual dysfunction.
• Use with caution in women with heart conditions or high blood pressure.
• Possible benefits include improved libido and vaginal blood flow.
• Sildenafil should be taken on an empty stomach for best results.
• Long-term safety of sildenafil in women is not well established.
• Store sildenafil citrate tablets in a cool, dry place out of children’s reach.

The most common adverse effects of sildenafil citrate use include: headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision.

• Remember that sildenafil is not designed specifically for women; evidence is ongoing.
• Consult your healthcare provider for personalized advice concerning usage.
• Be aware that psychological and physical factors both influence female libido.
• The medication can help improve vaginal blood flow during arousal.
• Regular use without medical supervision is not recommended.
• Some women may experience improved sexual confidence with sildenafil.
• Manage expectations by understanding that results vary widely.
• Do not suddenly stop other medications without doctor approval.
• Educate yourself about symptoms of potential adverse reactions.
• Maintaining overall health can enhance the effectiveness of sildenafil.
• Use caution if combining sildenafil with herbal supplements.
• Ensure comprehensive sexual health assessment before commencing treatment.

Some complained of blurriness and loss of peripheral vision. In July 2005, the FDA found that sildenafil could lead to vision impairment in rare cases [and several studies have linked sildenafil use with non-arteritic anterior ischemic optic neuropathy [10]. The FDA announced that all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss [11]. Vaginal sildenafil might be an interesting therapeutic option before conception in women with histories of reproductive failure [12].

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(2011) Sexual dysfunction and difficulties in Denemark: Prevelance and associated socio-demographic factors. Arch sex behave 40(1): 121-132. Abdallah I Y, AbdelrahmanSh (2014) female sexual dysfunction in relation to the age of marriage .thesis submitted for fulfillment of master degree in dermatology and Andrology in Banha city, Banha University, Egypt. Omidi A, Ahmedvand A, Najarzadan MR, Mehrzad F (2016) Compairing the effect of treatment with sildenafil and cognitive-behavioral therapy on treatment of sexual dysfunctioninwomen: arandomized controlled clinical trials. Chivers MI, Rosen RC (2010) Phosphodiesterase type 5 and female sexual response.

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J Sex Med 7(2): 858-872. Leddy LS, Yang CC, Stuckey BG, Sudworth M, Haughie S, et al. (2012) Influence of sildenafil on genital engorgement in women with female sexual arousal disorder. Sildenafil increases serum testosterone levels by a direct action on the testes. Lo Monte G, Graziano A, Piva I, Marci R (2014) Women taking the blue pill (sildenafil citrate) such big deal.

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(1999) Safety and efficacy of sildenafil in postmenopausal women with female sexual dysfunction. Given the success of medicines to treat trouble getting and keeping an erection, called erectile dysfunction, companies have looked for a medicine to help women with sex. Viagra even has been tried as a treatment for sexual dysfunction in women. But the U.S. Food and sildenafil oral jelly 100 mg Drug Administration (FDA) hasn't approved this use of Viagra. In addition, intravaginal sildenafil citrate tablets used as suppositories might be a new, interesting, safe antiabortive option in the treatment of threatened miscarriage in patients with a history of unexplained recurrent spontaneous abortion. The dose intravaginal sildenafil citrate is 25 tablets given 3- 4 times daily [13].

• Sildenafil may improve blood flow to the clitoris, aiding arousal.
• Use caution with grapefruit or grapefruit juice, which can affect drug levels.
• Document any pre-existing medical conditions before starting sildenafil.
• Sildenafil may cause dizziness; avoid activities requiring alertness.
• Women with liver or kidney impairment should consult a physician first.
• The drug is not a hormone; it works on blood vessels.
• Patients should report any sustained erections or discomfort.
• Combining sildenafil with certain antidepressants may alter effectiveness.
• Keep track of any changes in sexual satisfaction or function.
• Sildenafil should be used as part of a comprehensive treatment plan.
• Avoid using sildenafil with recreational drugs that affect the cardiovascular system.
• Always follow up with your healthcare provider for ongoing assessment.

Wareing M, Myers JE, O Hara M, Baker PN (2005) Sildenafil citrate (Viagra) enhances vasodilatation in fetal growth restriction. Zoma WD, Baker RS, Friedman A, Clark KE (2004) Sildenafil citrate (Viagra) increases uterine blood flow and potentiates estrogen-induced vasodilation.

What other information should I know?

For years there were no FDA-approved medicines for treating problems with sexual arousal or sexual desire in women. Yet 4 in 10 women report having sexual concerns. The FDA now has approved two medicines. The FDA has approved a daily pill called flibanserin (Addyi) to treat low sexual desire in women before menopause. This medicine started as a treatment for depression.

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Addyi may boost sex drive in women with low sexual desire. It's for women who are not happy with their low sex drive. Possible serious side effects include low blood pressure, dizziness and fainting. These side effects are more likely to happen if the medicine is mixed with alcohol. The FDA says not to drink alcohol if you take this medicine.

Increased genital blood flow

Experts suggest that you stop taking the medicine if your sex drive doesn't improve after eight weeks. The FDA also has approved a medicine given as a shot to treat low sexual desire in women before menopause. Bremelanotide (Vyleesi) is injected under the skin in the belly or thigh at least 45 minutes before having sex. It should not be used more than once a day or more than eight times a month. Side effects can include nausea, headache, vomiting and reactions at the site of lovegra sildenafil the shot. Webb DJ, Freestone S, Allen MJ, Muirhead, GJ (1999) “Sildenafil citrate and blood-pressure-lowering drugs: results of drug interaction studies with an organic nitrate and a calcium antagonist”.

• Sildenafil citrate tablets should be taken with water, not with food.
• Always follow the healthcare provider’s dosage instructions precisely.
• Use sildenafil only under medical supervision if you have health issues.
• Patients should start with lowest effective doses to assess response.
• Report any signs of allergic reactions like rash or swelling immediately.
• Regular check-ups can monitor for any cardiovascular changes.
• Always verify the legitimacy of the medication source.
• Sildenafil may cause hypotension in susceptible women.
• Consider lifestyle modifications to enhance sexual health benefits.
• The drug's effects typically last 4-6 hours.
• Be cautious of counterfeit sildenafil products available online.
• Educate yourself on potential drug interactions before use.