Could Viagra Be an Antidote for Women's Sexual Dysfunction?

Antidepressants can disrupt a woman's sex life. New research suggests Viagra could counteract that.

A viagra tablet along with three other white tablets.
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Viagra might be more than a man's drug after all. Four years after Pfizer abandoned trials seeking FDA approval of its use as a potential treatment for female sexual arousal disorder, new research suggests that the diamond-shaped pill may help some women overcome sexual side effects caused by antidepressants.

Sexual problems, especially orgasm delay, are common consequences of treatment with certain antidepressants—selective and nonselective serotonin reuptake inhibitors—in both men and women. These two classes of drugs are the most heavily prescribed of all antidepressants, constituting 90 percent of the 180 million antidepressant prescriptions filled in the United States, according to background information in the new study, which appears in this week's Journal of the American Medical Association (and was supported by a Pfizer grant). Such side effects may partly explain why more than half of patients with major depression prematurely stop taking their medication, says lead author H. George Nurnberg, professor of psychiatry at the University of New Mexico School of Medicine. "That's dangerous," he says.

Nurnberg's team has now shown that Viagra eases antidepressant-related sexual side effects for a select group of healthy, premenopausal women; it significantly improved their orgasm delay, compared with placebo. A prior trial that Nurnberg led showed a similar benefit in men taking antidepressants. "We are basically giving back to people what the medication [took away]," he says, adding that any of the Viagra-like drugs, such as Cialis or Levitra, should have similar effects.

Does the finding mean Viagra could change the treatment of female sexual dysfunction? Not necessarily. First of all, the drug may have no effect on sexual function in women who aren't like those in the new study. Second, "[Viagra] is probably going to help orgasm, it will probably increase vaginal lubrication and blood flow, but how much that matters to the average woman is unclear," says Robert Taylor Segraves, a professor of psychiatry at Case Western Reserve University who specializes in sexual disorders.

In his own practice, for women with antidepressant-associated sexual dysfunction, Segraves has prescribed Viagra, which the FDA allows but doesn't endorse. But he hasn't been overwhelmed by its success: Only five of 30 or so patients have responded, and even then, the results weren't dramatic. "It's not going to make you suddenly desire your overweight husband who is sitting on the couch, drinking beer and watching football," he says. "It doesn't have any effect on libido."

That's because Viagra and Viagra-like drugs aren't thought to cross into the brain, the hub of sexual desire, explains Anita Clayton, a professor of psychiatry at the University of Virginia who studies sexual dysfunction associated with illness and treatment. A woman can have all the physical signs of arousal yet not desire sex. (For more about treatments for low libido in women, click here.) Still, she says, it's another thing to add to the treatment cache. "There are options," she says. "Women don't just have to live with side effects like sexual dysfunction in order to be effectively treated for depression."

Importantly, doctors and patients need to have an open discussion about possible side effects before treatment with antidepressants, so patients know that things can be done to manage them should they arise. An antidepressant, Nurnberg notes, is a potentially lifesaving medication. If Viagra can help keep patients on their depression medications, then it is no longer a "lifestyle drug" but one of "medical necessity."

Fortunately, for women taking antidepressants, there are alternatives to Viagra. Here are four.

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