Suppose you’ve heard about the FDA’s decision to allow over-the-counter sales of sildenafil citrate (Viagra). In that case, you might think this is an exciting development for women like me who suffer from sexual dysfunction. I’m a woman in my late 30s, and I’ve been sexually super active for most of my life. When I was younger, I had no issues with libido—I wasn’t always in the mood. But as time went on and my stress levels increased, it became harder to feel like having sex without some help from pharmaceuticals or alcohol (or both).
You may have heard that sildenafil citrate is getting “rolled out” as an over-the-counter treatment for female sexual dysfunction. The drug is meant to be taken by women who suffer from low libido, lack of arousal, and/or difficulty achieving orgasm. It functions by loosening up the body’s blood arteries, which boosts blood flow to the genitalia (this can also lead to increased vaginal lubrication).
The FDA has approved several different products containing sildenafil citrate: Zenegra (brand name), Flibanserin (brand name), and Viagra (brand name).
According to a National Institutes of Health research, women are nearly twice as likely as males to suffer from depression: 9.5% of women will have an episode of major depression in their lifetime, compared to just 5% of men. But why? While there may be many factors at play here (some of which we’ll discuss below), it’s worth noting that the disparity between mental health issues in men and women has remained consistent over time, even in countries where gender equality is increasing. In addition, social stigma against mental illnesses like depression has waned.
We also know that women are more likely to have sexual dysfunction than their male counterparts, which can impact their overall satisfaction with life. For example, a meta-analysis published by researchers at Harvard Medical School found that female sexual dysfunction was associated with lower self-esteem and quality of life compared to males who reported similar levels of physical activity during intercourse (i.e., having sex).
So what gives? Why do so many more women struggle with physical issues, such as low libido or poor erections, as well as emotional ones, including depression?
There are some indications that women may be more vulnerable to the effects of sildenafil citrate (Viagra) than men. The “blue pill” is a drug used to treat erectile dysfunction in men and pulmonary arterial hypertension. It works by inhibiting the PDE5 enzyme, which causes blood vessels to relax and dilate, allowing them to fill with more blood. This allows for better blood flow into the penis, resulting in an erection during sexual stimulation.
Some researchers have suggested this might be because of sex differences in neurotransmitter function and the fact that, in women, brain regions involved in mood are more interconnected.
Stress is a significant cause of depression, and women may be more susceptible.
Stress can come from many sources: work, family life, relationships, money troubles, or other financial issues. If a woman is struggling with stressors in her life, she might experience a depressive episode. The effects of stress on the body are cumulative; each stressful event impacts how one copes with future stressors. This means that if multiple problems are happening at once, it becomes more challenging to adapt effectively to each one individually without feeling overwhelmed.
Compared to women without depression, individuals with depression are more likely to report sexual problems.
In one study, 62% of women with moderate to severe depression had some form of sexual dysfunction, compared to only 36% of those who were not depressed. The study also found that women who experience depression seem more likely to have sexual dysfunction than men. Additionally, women with anxiety disorders may experience higher rates of sexual dysfunction compared with men with these same conditions (though there aren’t enough studies on this topic).
One reason women should be aware of the potential mood and sexual side effects of taking sildenafil citrate is that women and men have different neurotransmitters, which affect how our brains work.
For example, serotonin is a critical neurotransmitter that regulates mood. In men with heart disease or diabetes who take Viagra (or other drugs), sildenafil citrate tends to raise their serotonin levels in the brain; this could help explain why these men often feel less depressed after taking Viagra than they did before. However, there’s not enough research yet to say whether or not this same effect would happen in women who take Viagra.
In addition to serotonin, dopamine influences motivation and reward. Research suggests that some people with low dopamine levels might be more likely than others to experience stress-induced depression—especially when they’re under long-term stress–and thus may also be vulnerable if they take sildenafil citrate regularly over time because it increases levels of dopamine in their brains as well as those around them (due to its impact on blood flow). Suppose you already suffer from depression or anxiety that worsens during stressful periods like midterms or tax season. In that case, you may want to avoid using Viagra regularly to avoid exacerbating any existing symptoms during those times unless you are talking about your concerns with a doctor first.”
It’s important to note that the data on this subject is still limited. Further research and clinical trials will be needed before we can truly understand how sildenafil citrate affects women’s mental health, but at least now you know what’s at stake. In the meantime, talk to your doctor about any questions or concerns about taking the drug.