Nasal congestion after visual sexual stimulation with and without sildenafil (Viagra): a randomized placebo-controlled study

Eur Arch Otorhinolaryngol. 2008 Mar;265(3):303-6. doi: 10.1007/s00405-007-0452-4. Epub 2007 Sep 29.


Sildenafil (Viagra) is a selective phosphodiesterase type 5 inhibitor (PDE5-I) approved for treatment of erectile dysfunction. Although relatively well-tolerated, sildenafil is associated with undesired effects including headache, flushing, dyspepsia, nasal congestion, and visual disturbances. In the present study we explored the impact of sildenafil on nasal airway parameters in young potent men. Eleven men (age 26.0 +/- 1.8 years) with normal BMI (25.7 +/- 0.5) and without nasal respiratory disorders were enrolled in a double-blind, crossover study. All men underwent evaluation of systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), SpO2%, acoustic rhinometry, and nasal endoscopy before and after placebo or sildenafil (50 mg) plus visual sexual stimulation (VSS). Nasal examination was performed using 0 degrees rigid telescopes, 4 mm in diameter. A Student's t test was used for direct comparisons, while the Kruskal-Wallis test (K-W) was utilized for multiple comparisons. After administration of sildenafil plus VSS, the minimum cross sectional area (MCA) was significantly lower that observed with either placebo (P = 0.03) or sildenafil alone (P = 0.003). However, the post-stimulation values did not demonstrate any significant differences among the different treatment arms (P = 0.48; DF = 2; K-W test). In contrast, endonasal volume (VOL) was significantly lower after sildenafil + VSS (P = 0.01), but not after placebo + VSS (P = 0.18). None of the other parameters monitored showed any significant variations. Rhinoscopy showed a characteristic increase of the volume of the inferior turbinates, with subjective differences between placebo and sildenafil. These preliminary results suggest that sildenafil reduces nasal volume, and that sexual stimulation may decrease nasal airflow by itself.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cross-Over Studies
  • Double-Blind Method
  • Humans
  • Male
  • Nitric Oxide Synthase / metabolism
  • Nose Diseases / chemically induced*
  • Phosphodiesterase Inhibitors / adverse effects*
  • Piperazines / adverse effects*
  • Purines / adverse effects
  • Sildenafil Citrate
  • Sulfones / adverse effects*
  • Vasodilator Agents / adverse effects*


  • Phosphodiesterase Inhibitors
  • Piperazines
  • Purines
  • Sulfones
  • Vasodilator Agents
  • Sildenafil Citrate
  • Nitric Oxide Synthase