Many men turn to Viagra for help getting aroused and maintaining an erection. So, if you're starting to see your interest in sex decline during perimenopause or menopause, you might be wondering: What does Viagra do to and for women? Can this type of medication help me too?
Low libido can be common during the menopausal transition, due to a combination of shifting hormones and brain chemicals. "Estrogen levels drop, progesterone and testosterone go down, and the things that stimulate desire are no more," says Dr. Rebecca Levy-Gantt, DO, OBGYN and Nationally Certified Menopause Practitioner. That can directly affect a woman's interest in intimacy. These shifts can also cause symptoms such as vaginal dryness, which can indirectly affect a woman's desire by making sex uncomfortable.
Levels of the feel-good neurotransmitter dopamine tend to decline during menopause as well. This can affect mood and ultimately lead to less interest in sexual activity, Dr. Levy-Gantt adds.
Taking Viagra may not address these concerns, she notes. But there are other options that can help boost your interest in intimacy and sex. Here's what you need to know.
How Does Viagra Work?
First, it helps to understand that desire for men has a physical basis, Dr. Levy-Gantt explains. "It comes from below. If blood can flow to the penis and he can sustain an erection, most men want to use that erection for sex."
Viagra works through these physical channels. Taking Viagra 30 to 60 minutes before sexual activity relaxes muscles in blood vessel walls, allowing more blood to flow to the penis, says Dr. Levy-Gantt. This helps a man achieve and maintain an erection, which in turn makes him want to have sex.
What Happens if a Woman Takes Viagra?
Women could take Viagra, says Dr. Levy-Gantt, though it hasn't been well-studied. The drug seemingly would have a similar effect on blood flow, relaxing the blood vessel walls and increasing blood flow to the genitals. "It could cause some kind of engorgement in the clitoral area," she explains. However, experts don't know the exact dosage a woman would need to take to achieve these effects.
Does Viagra Work for Women?
Even though Viagra may increase genital blood flow in women, it's unlikely to actually have a libido-boosting effect, Dr. Levy-Gantt says. "Most women see sexual desire and function as coming from the brain - a woman has to have the thought to want to have sex first. Desire doesn't come from engorgement of a body part, so Viagra doesn't work the same way in women," she explains.
In other words? Viagra may send more blood to your clitoris. But that increased physical sensitivity alone doesn't usually result in greater interest in sex. In some cases, the increased engorgement can actually be uncomfortable for women, Dr. Levy-Gantt says. "With Viagra, the dopamine hit isn't happening that makes a woman interested in sex. You have to put the dopamine back in play for the desire to happen," she explains.
Is There a Viagra for Women?
There are two FDA-approved drugs to treat hypoactive sexual desire disorder (HSSD), the official diagnosis for low libido in women. In Dr. Levy-Gantt's experience, one tends to be more effective than the other.
The first, flibanserin, was often called the "female Viagra" when it was first released in 2015. An oral medication designed to be taken daily, it aims to balance neurotransmitters in the brain (like dopamine) to enhance sexual desire. But it's not very effective, Dr. Levy-Gantt cautions. "In the clinical studies women maybe said they had one more sexual encounter over a month than they used to," she adds. "I've probably written three prescriptions for it total."
The second, bremelanotide, is a self-injectable medication designed to be used about 30 minutes before sex. It works through activating melanocortin receptors, which seem to be involved in many different brain functions including regulation of mood and thinking, but the mechanism by which it improves sexual desire and related distress is unknown. "It brings you something that feels like spontaneous desire, and if you go for it, most women will complete the act," says Dr. Levy-Gantt. Using bremelanotide for the first time often causes extreme nausea, however, but the side effect tends to decrease with subsequent use. "Women who try it tend to stick with it," Dr. Levy-Gantt says.
When considering either of these options a visit to your healthcare provider is required, as these are available by prescription only. As always, when considering the treatment of a new symptom, it’s always best to check in with your healthcare provider first to determine the option that is best for you.
Are There Any Products for Women’s Libido?
Natural supplements can also be helpful for enhancing desire and sexual satisfaction. Dr. Levy-Gantt often recommends Ristela®, which she describes as exerting a Viagra-like effect by increasing blood flow to the genital area. "I'll recommend it to my patients in combination with an injectable like bremelanotide, or if they're having vaginal dryness, Ristela plus vaginal estrogen," she explains. *Please note that Ristela is not indicated to treat hypoactive sexual desire disorder (HSDD).
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It's important to note that if you’d rather not rely on a treatment containing hormones, hormone-free vaginal moisturizers, like Revaree® Plus are also an option for effectively addressing vaginal dryness and its associated symptoms. As always, speak with your provider first to discuss your treatment options.
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Dr. Levy-Gantt warns against using testosterone supplements (either over-the-counter or prescribed) unless closely supervised by your healthcare provider. Taking the hormone may increase sexual desire in women. But "there are no standards for dosing; some potential side effects of excess testosterone can include acne, oily skin, deepening of the voice and disruptions in cholesterol levels," she cautions. It’s always important to speak with a healthcare professional first to determine what’s best for you.
How Can I Boost My Sex Drive Naturally, With Lifestyle Changes?
Though it might not sound the sexiest, making a conscious effort to have sex more can be one of the most effective ways at making yourself want to have sex more. "Women want a spontaneous arousing thought and they want the blood to flow. But you can also get the blood flowing first and then the brain starts to become aroused," Dr. Levy-Gantt says. "And if you move on to having a sexual act, most women do find it satisfying. It can just be hard to get started."
Making time for sex more can also make it easier to initiate it next time. "When you don't have sex, the vaginal tissues get drier because there's less blood flow," Dr. Levy-Gantt explains. "The actual act of having sex makes the area healthier and more lubricated, and it may stimulate something in your brain where you think, Why don't I do this more often?" If you're experiencing dryness or discomfort, adding a vaginal lubricant or moisturizer can help.
When Should You Talk to Your Healthcare Provider About Low Libido?
If you're unhappy with your sex drive, let your healthcare provider know. "You should seek care if it's causing distress or is beginning to become a relationship problem," Dr. Levy-Gantt says. The sooner you bring it up, the sooner you can start getting the support and care that you need.
