Male Viagra Use and Its Effects on Their Female Partners

The Viagra (sildenafil) treatment of male erectile dysfunction will be a pharmaceutical event for the history books. This is a drug that effectively treats a male's inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Is it a widespread problem? It is estimated that 39% of men 40 years of age and 67% of men 70 years of age have this problem.

A recent collaborative study looked at the efficacy of this treatment--Goldstein I et al.: Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med 1998;338:1397- 1404. Various dose regimens were used, but overall in men, it improved erectile function (equivalent to the arousal phase in women with clitoral swelling and vascular swelling) by almost 100%. It improved orgasmic function by about 20% and it had ZERO effect on sexual desire. The overall intercourse satisfaction increased by 100%. The major side effects increased as dose increased and were predominantly headache, flushing (both about 20-30%) and stomach upset (about 10%). Interestingly the side effects were only a small proportion of the reasons for discontinuing the study (7-15%, at different doses, stopped participating in the study).

Why should we write about this at Woman's Diagnostic Cyber? Because there will be a significant impact on women whose partners use Viagra. There will be more frequent demands for sexual intercourse which may or may not be welcome. Many women who are menopausal report a decreased sexual desire even if they are on estrogen replacement therapy. If women are having any vaginal dryness, they may fear pain with sexual relations and that certainly turns off libido. Even if women are on estrogen replacment and have good vaginal lubrication, if they are having vaginal intercourse less frequently than once per two weeks, they will have loss of vaginal elasticity that can cause discomfort or pain when they first start to increase the frequency of sexual relations.

Sexual desire is a very complex subject-- see previous news:

Decreased Sexual Desire - Its Many Causes

There are many different components to possible sexual desire barriers.

• Fear of pain or discomfort with sexual intercourse
• Lack of, or numbness to, arousal by normal physical sexual stimuli
• Lack of, or numbness to, arousal by normal visual or verbal sexual stimuli
  Aversion to intimacy with one's partner due to:
  • Hygiene problems
  • Lovemaking skills
  • Anger at one's partner for current or past behavior
• Medications that lessen sexual desire
• Physical disabilities or pain affecting lovemaking

The list could probably go on and on with different problems that will demand different solutions or treatments. I predict that this Viagra epidemic will cause epidemics in women:

• asking for Viagra to improve their sexual arousal
• seeking treatment for vaginal dryness, pain and bleeding related to more frequent sexual intercourse
• seeking androgen (male hormone) therapy to improve sexual desire
• with more major, stressful reactions involving their long-standing partners

On the up side, there will be many more relationships in which the intimacy happiness level goes up. That is good!