No question about it, the erectile dysfunction drugs known as PDE5 inhibitors have completely revolutionized the field of male impotence (E.D.). Their ability to not just increase blood flow to the penis but also elevate mood has made these drugs a total game changer for men suffering with low libido, anxiety, and depression.
While all the drugs in this class have been shown to combat sexual dysfunction, sildenafil (the active ingredient in Viagra) is undoubtedly the most popular PDE5 inhibitor on the market. Thus, it’s fair to say that Viagra, and its cousins, have changed the way we look at E.D. as a whole.
But what about the much more common scenario where a woman is taking the drug? How does Viagra affect her overall health and wellbeing? Let’s dive into the science.
How Does Viagra Work?
As we mentioned above, Viagra works by increasing blood flow to the penis. But how exactly does it do this? What is the molecular mechanism of action?
Well, let’s take a minute and explore the biology behind this question.
To start with, sildenafil and related compounds have a unique chemical structure that allows them to interact with several proteins found in the walls of blood vessels. These proteins are known as cGMP-specific phosphodiesterases (PDEs). PDEs are enzymes that speed up the metabolism of cyclic guanosine monophosphate (cGMP), a molecule that functions as a “chemical messenger” in the body. In other words, cGMP is what initiates most of the biological responses to nerve stimulation in the body, including blood vessel dilation.
While it’s not entirely clear how sildenafil and its close cousin tadalafil (the active ingredient in Cialis) interact with PDEs, it’s known that both of these molecules are potent inhibitors of PDE5. This suggests that both can increase cGMP and, as a result, cause blood vessel dilation.
What Are The Risks And Side Effects Of Viagra?
Viagra, like any other medication, comes with some potential risks. Most of these are associated with sexual activity and overdose. The former can occur if a man takes too much Viagra and presses down on his urethra during sexual arousal. This can cause bladder incontinence in men and, in extreme cases, lead to impotence. Overdose is much more serious and can result in toxic effects, including liver damage and even death. There’s also the risk of stroke or heart attack if a man takes Viagra and has preexisting cardiovascular conditions.
These are risks that you need to be aware of, but otherwise, the drug seems fairly safe. Like any other medication, side effects tend to be mild and only occur in a small percentage of patients. The most common side effects of sildenafil include headache, flushing, and upset stomach. Tadalafil is associated with facial flushing and diarrhea, while vardenafil (the active ingredient in Levitra) is known to cause headaches, upset stomach, and abnormal clotting (which can lead to heart attack and stroke).
Does Viagra Prevent Or Treat A Premature Ejaculation?
Again, Viagra is not a cure for male sexual dysfunction, but it does have some unique properties that make it a bit different from other ED drugs. One such difference is its unique prevention scheme. While other drugs in this class (e.g., vardenafil) work best in combination with behavioral therapies (such as sexual counseling) to prevent E.D., sildenafil has been shown to effectively do the job by itself. This has made it a much more attractive option for men looking for an easier and more convenient way to prevent E.D. in cases where regular counseling is not advisable or available.
In general, Viagra is considered to be the first-line treatment for E.D., though its mechanisms of action mean that it also has the potential to be a viable treatment option for women with E.D. as well. In fact, studies have shown that PDE5 inhibitors—including sildenafil—are more effective at treating erectile dysfunction in men than pharmacological treatments such as alpha-blockers and papaverine. What’s more, men on sildenafil have been shown to experience significant improvements in their libido and mental wellbeing.
For these reasons, the American College of Physicians (ACP) has published guidance on the treatment of ED, recommending that doctors consider PDE5 inhibitors as the first-line therapy for the condition. Furthermore, the ACP specifically mentions that sildenafil and tadalafil are approved for use in women and that studies have shown them to be as effective as Viagra in treating female sexual dysfunction. As a result, this medication could be a great option for women with low libido, wanting to improve their chances of getting aroused during sex or simply wanting to enjoy a better sex life.
Can Viagra Help Women With Hot Flushes?
Another very interesting property of Viagra is its ability to reduce menopausal symptoms in women. As we’ve mentioned above, PDE5 inhibitors—including sildenafil—can significantly improve erectile function in men. One curious (and very rare) side effect of this medication is an exacerbation of menopausal symptoms in women. But, again, this is a side effect that occurs in a very small percentage of patients. In those people, it can lead to acute anxiety and panic attacks, especially during times of stress or when the drugs are taken in conjunction with alcohol.
While researchers are still working to fully understand this phenomenon, it is known that PDE5 inhibitors can help mitigate vasomotor symptoms, including hot flushes and night sweats, in women. And what’s more, they appear to do this without aggravating menopausal symptoms in those already suffering from the condition. In other words, PDE5 inhibitors may be a great option for women looking for a less invasive and more natural way to improve their sex life and quality of life during menopause. They also have the advantage of being potentially safer than HRT or other medications used to treat menopausal symptoms (such as selective serotonin reuptake inhibitors, or SSRIs).
Can Viagra Help Women With Fertility Issues?
Just like men, women can be affected by erectile dysfunction, mainly evidenced in cases of low libido or extreme vasculature disease. In fact, women are more likely to present with this issue than men. But, again, Viagra (and its related medications) have the potential to improve female fertility in cases where the cause of the dysfunction is purely physiological, such as in the case of polycystic ovary syndrome (PCOS).
It is well established that PCOS is one of the major causes of female infertility. And it has been shown that PDE5 inhibitors can help improve insulin resistance and reduce inflammation, both of which are conditions that frequently coincide with PCOS. As a result, these medications could potentially help women with PCOS get pregnant. There is also an animal model for PCOS, where it has been demonstrated that PDE5 inhibitors (including sildenafil) improve reproductive function in premenopausal rats (i.e., those still able to get pregnant). What’s more, these drugs did not seem to adversely affect the health of the animals’ offspring, suggesting that they may be safe for pregnancy. While this is still just preclinical data, it does provide some very promising signs for those suffering with PCOS and wishing to try conception naturally.
Can Viagra Help Men With Premature ejaculation?
Another rather unique feature of Viagra is the ability to help men with premature ejaculation. As we mentioned above, Viagra is not a cure for E.D., but it does have some properties that make it a viable option in the management of this condition. One of these is its ability, as discussed above, to increase the time it takes for a man to ejaculate. In other words, it can decrease the ejaculation threshold. While this is something rather rare in and of itself, it is worth noting that Viagra (and its related medications) are approved for use in both men and women. Thus, this medication could be a great option for men who want to try and prolong their ejaculation for the sake of their partner’s pleasure. In addition, a man on this medication can sometimes experience side effects that are quite similar to those that occur with PDE5 inhibitors in females, including upset stomach and headache. In this case, too, it is quite possible that this drug could be an option for women who want to experience a better sex life with their partner.