From the Research
Sildenafil cream is not recommended for women with female sexual arousal disorder (FSAD) due to limited scientific evidence supporting its effectiveness and lack of FDA approval. The most recent and highest quality study, published in 2024 1, found that topical sildenafil cream, 3.6%, was safe and well-tolerated among healthy premenopausal women with FSAD, but this study was focused on safety rather than efficacy. Other studies, such as those published in 1999 2, 2002 3, 2006 4, 2009 5, have shown inconsistent results, with some suggesting possible benefits for women with FSAD caused by certain diseases or medications, but these findings are not conclusive.
Key points to consider:
- There is no FDA-approved sildenafil cream specifically formulated for women with FSAD
- Topical formulations of sildenafil for women remain largely experimental
- Theoretical mechanism involves increasing genital blood flow to enhance arousal and lubrication
- Women seeking treatment for sexual dysfunction should consult healthcare providers about FDA-approved options like flibanserin (Addyi) or bremelanotide (Vyleesi)
- Off-label compounded sildenafil creams may be available, but lack standardized dosing, formulation, and robust clinical evidence for safety and efficacy
In clinical practice, it is essential to prioritize the use of evidence-based treatments and to exercise caution when considering off-label or experimental therapies. Therefore, sildenafil cream should not be recommended as a first-line treatment for women with FSAD, and alternative FDA-approved options should be considered.