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While FDA-approved only for ED, Viagra might help with some sexual performance symptoms
In movies, TV shows and romance novels, people seem to be “ready to go” anytime, anyplace. But in reality, we know that sex can be much more complicated and nuanced.
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There’s the chemistry that piques your interest (or doesn’t). There are the distractions like kids, pets and dirty dishes piled up in the sink. There’s stress. Tiredness. Body image concerns. Physical conditions, like lubrication and blood flow. And so much more that needs to all come together for the mood to be right and the fireworks to set off.
Concerns about our sex drive and sexual performance are extremely common. Ob/Gyn Salena Zanotti, MD, sees this all the time in her practice. “It’s probably one of the top problems people bring up in my office, and it’s common in adults of all ages,” she says.
If you’re nodding along, Dr. Zanotti reassures you that there’s nothing wrong with you. Sex is much more complex than a Hollywood rom-com would have you believe.
TV, movies and pharmaceutical commercials might also have you thinking there’s a little blue pill that solves it all. And it’s tempting to want that one cure-all for the things that can get in the way of magic between the sheets.
But is Viagra® the fix for sexual dysfunction? We know Viagra can help some people with erectile dysfunction. But what about the rest of it? And what does Viagra do for women and people assigned female at birth (AFAB)?
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We talked with Dr. Zanotti about sex drive, sexual performance and the little blue pill.
Sexual desire is a matter of your mind and your environment. Performance during sex is a physical action, Dr. Zanotti clarifies.
Let’s break that down more.
Sexual performance refers to all the physical things that happen during sex. That’s the stuff like muscle tension, blood flow, lubrication and the like.
The build-up to a sexual encounter and sexual act (whether with a partner or through masturbation) typically moves through four phases, called the sexual response cycle.
The phases don’t necessarily happen in order and aren’t always present in every encounter. But in most cases, it starts with the building of excitement and physical changes like increased blood flow to the genitals and an increased heart rate. Things continue to build until orgasm is achieved or the encounter otherwise discontinues. Your body then begins to return to its normal level of functioning.
Sexual desire (aka libido or sex drive) is more dependent on your mental state and factors that are competing for your attention.
Low sex drive can also be called hypoactive sexual desire disorder. And it’s about more than your body’s physical reactions.
There are a lot of things that can keep you from wanting to have sex, and they may change from day to day, even moment to moment. They include factors like:
Viagra works for some people on the sexual performance front, but it doesn’t address the sexual desire part.
Viagra also goes by the generic name sildenafil. It was the first oral drug approved by the U.S. Food and Drug Administration (FDA) to treat erectile dysfunction, or ED (the inability to achieve and sustain an erection). It’s since been followed by similar drugs.
Viagra works by blocking an enzyme that regulates blood flow. That allows increased blood flow to the genitals and other parts of the body. That increased blood flow allows the penis to stiffen in preparation for sex.
Viagra helps some people achieve and sustain an erection, sure. But as for the multitude of other dynamics that factor into sexual desire and performance? Not so much.
The FDA approves Viagra for treating erectile dysfunction. That’s all.
But it’s possible that the effects of Viagra could result in more blood flow to the vulva in women and people AFAB. That may help with sexual performance issues like vaginal lubrication (“wetness”), sensitivity and feelings of pleasure, Dr. Zanotti says.
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But in clinical studies, Viagra hasn’t proven to be the answer for sexual dysfunction outside of its primary purpose.
Even still, some healthcare providers sometimes prescribe it off-label for sexual performance issues beyond erectile dysfunction.
So yes, women and people AFAB can take Viagra. But will it help? Eh, maybe…
According to at least one study, if you have low libido as a side effect of taking selective serotonin reuptake inhibitors (SSRIs), a common type of antidepressant, you may get a sexual boost from Viagra. But other studies have shown that Viagra alone probably isn’t going to do the trick. For that reason, many providers consider it a last-resort treatment.
Viagra increases blood flow in your body, which can cause:
Although Viagra isn’t known to cause heart attacks, some people do experience an irregular heartbeat. And if you have low blood pressure or you’re taking blood pressure medication, Viagra can cause a further drop in blood pressure, leading to dizziness and even fainting.
And mixing Viagra and alcohol is a big no-no for anyone using this drug because it can make the side effects worse, Dr. Zanotti warns.
If Viagra isn’t the answer for you, you might be wondering if there’s a medication that can improve your sexual desire and performance.
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While no pill is going to make sure the laundry is done, the kids are asleep, and that you’re feeling confident in yourself and your relationship, Dr. Zanotti says there are a few drugs that may help increase your interest in sex.
But she also notes that while Viagra has proven effective at treating ED, no other pill has come close to matching its effects for other issues of sexual desire or performance.
Addyi® (flibanserin) is FDA-approved for treating low sexual desire in people who haven’t yet reached menopause. It’s a pill you take every day, and the side effects are similar to Viagra. As with Viagra, it can lower blood pressure and shouldn’t be taken with alcohol.
Vyleesi® (bremelanotide) is a medication you inject into your abdomen or thigh within an hour before sex. It’s only approved for people who haven’t gone through menopause and for people whose low libido isn’t related to a medical condition.
Wellbutrin® (bupropion) is an antidepressant that’s sometimes prescribed off-label for low sex drive, regardless of whether a person is living with depression.
Hormone replacement therapy can have an indirect positive effect on treating low sex drive. If you’ve reached menopause, this option may be worth discussing with your care provider, Dr. Zanotti suggests.
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Improving your libido depends on what’s at the root of your low sex drive. It may be a combination of sexual performance and sexual desire.
If your desire is being affected by things like past sexual trauma or negative body image, Dr. Zanotti suggests engaging with a mental health professional.
Other factors that affect sexual performance, such as pain during sex, may have a simple fix. Extra lubrication can make sex more pleasurable, particularly if you’re past menopause. That’s because as you get older, the tissues of your vagina become drier and less elastic, which can cause pain. Trying pelvic floor exercises and talking to a professional who specializes in pelvic floor physical therapy can help.
It’s important to be proactive with your sexual health, especially as you age, Dr. Zanotti encourages, so don’t be shy about talking with a healthcare provider about your concerns.
Sure, it would be nice to simply pop a pill and get your sexual groove back. Sadly, that magic pill doesn’t seem to exist … yet. But there are plenty of things you can try, and a conversation with a healthcare provider is a great place to start.
Learn more about our editorial process.
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