Sildenafil citrate for female sexual arousal disorder: a future possibility?

Nat Rev Urol. 2009 Apr;6(4):216-22. doi: 10.1038/nrurol.2009.25.


Female sexual arousal disorder (FSAD) is a common disorder encountered in clinical practice, with self-reported arousal difficulties reported in up to 26% of American women. Various oral therapies for FSAD have been studied, including sildenafil citrate, a phosphodiesterase inhibitor that is currently used to treat male erectile dysfunction. In vitro studies of sildenafil citrate have demonstrated smooth-muscle relaxation in clitoral tissue, and phosphodiesterase type-5 has been shown to be present in vaginal, clitoral and labial smooth muscle; these findings have led to theories that sildenafil citrate might be successful for treating FSAD. This Review discusses the data from clinical trials that have assessed sildenafil citrate for the treatment of FSAD; the trials show that sildenafil citrate is moderately effective. Sildenafil citrate may also be effective in women with FSAD secondary to multiple sclerosis, diabetes or antidepressant use; however, more trials in these patient populations are required to confirm these findings.

Publication types

  • Review

MeSH terms

  • Animals
  • Cyclic Nucleotide Phosphodiesterases, Type 2 / antagonists & inhibitors
  • Female
  • Forecasting
  • Humans
  • Libido / drug effects
  • Libido / physiology
  • Piperazines / pharmacology
  • Piperazines / therapeutic use*
  • Purines / pharmacology
  • Purines / therapeutic use
  • Randomized Controlled Trials as Topic / methods
  • Sexual Dysfunction, Physiological / drug therapy
  • Sexual Dysfunction, Physiological / enzymology
  • Sexual Dysfunctions, Psychological / drug therapy*
  • Sexual Dysfunctions, Psychological / enzymology
  • Sildenafil Citrate
  • Sulfones / pharmacology
  • Sulfones / therapeutic use*


  • Piperazines
  • Purines
  • Sulfones
  • Sildenafil Citrate
  • Cyclic Nucleotide Phosphodiesterases, Type 2