Although no large scale studies are yet available in women, many case reports have provided convincing evidence for the use of Viagra in women. In men, Viagra appears to enhance primarily potency, the ability to have and maintain an erection. It has not been marketed as being able to arouse sexual desire. Preliminary reports in women show that Viagra is capable of enhancing all four phases of the sexual response cycle: desire for sex, excitement and enjoyment during sex, intensity of orgasm and during the resolution phase, the ability to be re-excited easily and achieve multiple orgasms.

In a case from my own medical practice, a 46 year old pre-menopausal woman found that after taking 50 mg of Viagra, she experienced increased desire within just 30 to 45 minutes. Sexual excitement and orgasm were dramatically heightened. Bartlik and colleugues (1) reported a case of a 30-year-old married woman who had never achieved orgasm despite numerous attempts over many years, both with a partner or alone. Treatment with 50 mg of Viagra enabled this patient to achieve orgasm with 10 minutes of clitoral stimulation from her husband. After several successful uses of Viagra, she was then able to achieve orgasm without the drug.

In another case from Dr. Bartlik, a 32-year-old married woman was unable to achieve orgasm for two years, taking paroxetine for major depression. Even prior to taking the antidepressant drug, she only achieved orgasm about half the time. One hour after taking Viagra, she was easily cabable of achieving orgasm both by masturbating and through sex with her husband. She achieved orgasm every time on Viagra while also taking paroxetine. She then stopped using paroxetine, and reported that she could achieve orgasm practically every time she had sex without using Viagra. As with the previous case, it appears that Viagra has an "entraining" effect on its users. Successful results were also obtained from older menopausal women, though these women tended to require a higher dose of Viagra, 100 mg. A topical genital cream containing Viagra also enhanced sexual functioning.

Cardiac patients on nitrate drugs cannot use Viagra since this can be fatal. A person with very low blood pressure may also not tolerate this drug, since blood pressure can fall further. People report that the drug causes a temporary blue tinge to the eyesight. Since Viagra has only recently been marketed, long term safety is unknown. Therefore, casual use for long periods by those having relatively normal sexual functioning should be strongly discouraged. However, as the above cases indicate, some users may benefit from strictly short term use.