Benefit of vaginal sildenafil citrate in assisted reproduction therapy

Roh CR, Budhraja V, Kim HS, Nelson DM, Sadovsky Y (2005) “Microarraybased identification of differentially expressed genes in hypoxic term human trophoblasts and in placental villi of pregnancies with growth restricted fetuses,” Placenta 26(4): 319-328. (2004) Hypothesis: selective phosphodiesterase-5 inhibition improves outcome in preeclampsia. Warnes CA (2004) Pregnancy and pulmonary hypertension.

Sher G, Fisch JD (2002) Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. (2001) “Monitoring of fetuses with intrauterine growth restriction: a longitudinal study,” Ultrasound Obstet Gynecol 18 (6): 564-570. Jerzak M, Kniotek M, Mrozek J, Baranowski W (2008) Sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage. El Far M, El Motwally Ael G, Hashem IA, Bakry N (2009) Biochemical role of intravaginal sildenafil citrate as a novel antiabortive agent in unexplained recurrent spontaneous miscarriage: first clinical study of four case reports from Egypt. (2009) A randomised, double-blinded, placebo-controlled study of the phosphodiesterase type 5 inhibitor sildenafil for the treatment of preeclampsia.

What special dietary instructions should I follow?

[8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically within twenty minutes sildenafil citrate 100mg tablets and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [8] Caution is advised in those with cardiovascular disease. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis.

Complementary and Alternative Options for Low Libido

[8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal. [8] It also results in dilation of the blood vessels in the lungs. Pfizer originally discovered the medication in 1989 while looking for a treatment for angina.

Related treatment guides

[11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication. [15][16] In the United Kingdom, it is available as a pharmacy medicine. The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse). Kaplan SA, Reis RB, Kohn IJ (1999) Safety and efficacy of sildenafil in postmenopausal women with sexual dysfunction. Basson R, McInnes R, Smith MD (2000) Efficacy and safety of sildenafil in estrogenized women with sexual dysfunction associated with female sexual arousal disorder. Rosen R, Riley A, Wagner G (1999) The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Mark E SmithBio chemistryUniversity of Texas Medical Branch, USA Lawrence A PresleyDepartment of Criminal JusticeLiberty University, USA Thomas W MillerDepartment of PsychiatryUniversity of Kentucky, USA Gjumrakch AlievDepartment of MedicineGally International Biomedical Research & Consulting LLC, USA Christopher BryantDepartment of Urbanisation and AgriculturalMontreal university, USA Robert William FrareOral & Maxillofacial PathologyNew York University, USA Rudolph Modesto NavariGastroenterology and HepatologyUniversity of Alabama, UK Andrew HagueDepartment of MedicineUniversities of Bradford, UK George Gregory ButtigiegMaltese College of Obstetrics and Gynaecology, Europe Emilio Bucio-CarrilloRadiation ChemistryNational University of Mexico, USA Casey J GrenierAnalytical ChemistryWentworth Institute of Technology, USA Hany AtalahMinimally Invasive SurgeryMercer University school of Medicine, USA Abu-Hussein MuhamadPediatric DentistryUniversity of Athens , Greece The annual scholar awards from Lupine Publishers honor a selected number Read More.. Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension.

[4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] It is unclear if it is effective for treating sexual dysfunction in females. [8] It can be taken orally (swallowed by mouth), intravenously (injection into a vein), or through the sublingual route (dissolved under the tongue). [8][10] Onset when taken orally is typically within twenty minutes sildenafil citrate 100mg tablets and lasts for about two hours. Common side effects include headaches, heartburn, and flushed skin. [8] Caution is advised in those with cardiovascular disease.

Patients and Methods

[4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours. [4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels.

Effects on sexual dysfunction

The use of sildenafil and an α1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least 4 hours apart. Concomitant use of nitric oxide donors, organic nitrites and nitrates,[30] such as: nitroglycerinisosorbide mononitrateisosorbide dinitratesodium nitroprussidealkyl nitrites (commonly known as "poppers") Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors. Sildenafil's popularity with young adults has increased over the years. [32] Sildenafil's brand name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use. [33] The reasons behind such use include the belief that the drug increases libido, improves sexual performance,[33] or permanently increases penis size.

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[34] Studies on the effects of sildenafil when used recreationally are limited, but suggest it has little effect when used by those who do not have erectile dysfunction. In one study, a 25 mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time. [35] This study also noted a significant placebo effect in the control group. Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs. [36] Sildenafil is sometimes used to counteract the effects of other substances, often illicit. [8] Rare but serious side effects include vision problems, hearing loss, and prolonged erection (priapism) that can lead to damage to the penis. [8] Sildenafil should not be taken by people on nitric oxide donors such as nitroglycerin, as this may result in a serious drop in blood pressure. Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. [8] It requires sexual arousal to work, and does not by itself cause or increase sexual arousal.

[8] It also results in dilation of the blood vessels in the lungs.

What other information should I know?

Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus. Tentative evidence suggests that sildenafil may help males who experience antidepressant-induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more generally in Raynaud's was not clear.

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Sildenafil has shown some potential for improving exercise performance at high altitudes. However, its overall efficacy is not clear. Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication. In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia).

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[24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina. Patients thus taking the drug may experience colorvision abnormalities. In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of sildenafil softgel capsule post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use. Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. Pfizer originally discovered the medication in 1989 while looking for a treatment for angina. [11] It was approved for medical use in the United States and in the European Union in 1998. [5][8][11][12] In 2023, it was the 151st most commonly prescribed medication in the United States, with more than 3 million prescriptions. [13][14] It is available as a generic medication. [15][16] In the United Kingdom, it is available as a pharmacy medicine.

MeSH terms

[33] Some users mix it with methylenedioxymethamphetamine (MDMA, ecstasy), other stimulants, or opiates in an attempt to compensate for the common side effect of erectile dysfunction, a combination known as "sextasy", "rockin' and rollin'", "hammerheading", or "trail mix". The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete sexual intercourse). Its use is now one of the standard treatments for erectile dysfunction, including for males with diabetes mellitus. Tentative evidence suggests that sildenafil may help males who experience antidepressant-induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension, it does not appear to affect the risk of death or serious side effects. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon;[9][21] these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. [9] As of 2016,[update] their role more generally in Raynaud's was not clear. Sildenafil has shown some potential for improving exercise performance at high altitudes.

Chemical synthesis

Roh CR, Budhraja V, Kim HS, Nelson DM, Sadovsky Y (2005) “Microarraybased identification of differentially expressed genes in hypoxic term human trophoblasts and in placental villi of pregnancies with growth restricted fetuses,” Placenta 26(4): 319-328. (2004) Hypothesis: selective phosphodiesterase-5 inhibition improves outcome in preeclampsia. Warnes CA (2004) Pregnancy and pulmonary hypertension. Sher G, Fisch JD (2002) Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. (2001) “Monitoring of fetuses with intrauterine growth restriction: a longitudinal study,” Ultrasound Obstet Gynecol 18 (6): 564-570.

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Jerzak M, Kniotek M, Mrozek J, Baranowski W (2008) Sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage. El Far M, El Motwally Ael G, Hashem IA, Bakry N (2009) Biochemical role of intravaginal sildenafil citrate as a novel antiabortive agent in unexplained recurrent spontaneous miscarriage: first clinical study of four case reports from Egypt. (2009) A randomised, double-blinded, placebo-controlled study of the phosphodiesterase type 5 inhibitor sildenafil for the treatment of preeclampsia. Kaplan SA, Reis RB, Kohn IJ (1999) Safety and efficacy of sildenafil in postmenopausal women with sexual dysfunction. Basson R, McInnes R, Smith MD (2000) Efficacy and safety of sildenafil in estrogenized women with sexual dysfunction associated with female sexual arousal disorder.

Viagra Oral Jelly

Rosen R, Riley A, Wagner G (1999) The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Mark E SmithBio chemistryUniversity of Texas Medical Branch, USA Lawrence A PresleyDepartment of Criminal JusticeLiberty University, USA Thomas W MillerDepartment of PsychiatryUniversity of Kentucky, USA Gjumrakch AlievDepartment of MedicineGally International Biomedical Research & Consulting LLC, USA Christopher BryantDepartment of Urbanisation and AgriculturalMontreal university, USA Robert William FrareOral & Maxillofacial PathologyNew York University, USA Rudolph Modesto NavariGastroenterology and HepatologyUniversity of Alabama, UK Andrew HagueDepartment of MedicineUniversities of Bradford, UK George Gregory ButtigiegMaltese College of Obstetrics and Gynaecology, Europe Emilio Bucio-CarrilloRadiation ChemistryNational University of Mexico, USA Casey J GrenierAnalytical ChemistryWentworth Institute of Technology, USA Hany AtalahMinimally Invasive SurgeryMercer University school of Medicine, USA Abu-Hussein MuhamadPediatric DentistryUniversity of Athens , Greece The annual scholar awards from Lupine Publishers honor a selected number Read More.. Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. [4][8] It is also sometimes used off-label for the treatment of certain symptoms in secondary Raynaud's phenomenon. [9] It is unclear if it is effective for treating sexual dysfunction in females. However, its overall efficacy is not clear. Sildenafil has been studied for high-altitude pulmonary edema (HAPE), but its use is currently not recommended for that indication. In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, indigestion, nasal congestion, and impaired vision, including photophobia and blurred vision. [4] Some sildenafil users have complained of seeing everything tinted blue (cyanopsia). [24] This cyanopsia can be explained because sildenafil, while selective for PDE5, does have some affinity for PDE6, which is the phosphodiesterase found in the retina. Patients thus taking the drug may experience colorvision abnormalities. In July 2005, the US Food and Drug Administration (FDA) updated labeling for tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) to reflect a small number of sildenafil softgel capsule post-marketing reports of sudden vision loss, while acknowledging that "...it is not possible to determine whether these oral medicines for erectile dysfunction were the cause of the loss of eyesight or whether the problem is related to other factors such as high blood pressure or diabetes, or to a combination of these problems. "[25] A careful review of pooled data from clinical trials containing well documented information about the dose and duration of exposure to the drug for a large number of patients, yields no evidence for an increased risk of non-arteritic anterior ischemic optic neuropathy or other adverse ocular events associated with PDE5 inhibitor use.

• Sildenafil citrate tablets are typically taken 30-60 minutes before intimacy.
• Monitoring by a healthcare professional is recommended for women.
• Use sildenafil cautiously if you have a history of stroke or heart attack.
• Combining sildenafil with other ED medications is dangerous.
• Pregnancy and breastfeeding considerations should be discussed with a doctor.
• Sildenafil does not induce arousal but enhances physiological responses.
• Not suitable for women with or at risk of abnormal heart rhythms.
• Potential for psychological as well as physical benefits exists.
• Ensure trusted pharmacy sources when purchasing sildenafil for women.
• Sildenafil is available in various dosages, such as 25 mg, 50 mg, 100 mg.
• Discontinue use if adverse effects like chest pain occur.
• A comprehensive sexual health evaluation can determine if sildenafil is appropriate.

Rare but serious adverse effects found through postmarketing surveillance include prolonged erections, severe low blood pressure, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss. [4] In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss. Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects. Those using protease inhibitors are recommended to limit their use of sildenafil to no more than one 25 mg dose every 48 hours. [4] Other drugs that interfere with the metabolism of sildenafil include erythromycin and cimetidine, both of which can also lead to prolonged plasma half-life levels.

• Sildenafil citrate tablets should be taken with water, not with food.
• Always follow the healthcare provider’s dosage instructions precisely.
• Use sildenafil only under medical supervision if you have health issues.
• Patients should start with lowest effective doses to assess response.
• Report any signs of allergic reactions like rash or swelling immediately.
• Regular check-ups can monitor for any cardiovascular changes.
• Always verify the legitimacy of the medication source.
• Sildenafil may cause hypotension in susceptible women.
• Consider lifestyle modifications to enhance sexual health benefits.
• The drug's effects typically last 4-6 hours.
• Be cautious of counterfeit sildenafil products available online.
• Educate yourself on potential drug interactions before use.

The use of sildenafil and an α1 blocker (typically prescribed for hypertension or for urologic conditions, such as benign prostatic hypertrophy) at the same time may lead to low blood pressure, but this effect does not occur if they are taken at least 4 hours apart. Concomitant use of nitric oxide donors, organic nitrites and nitrates,[30] such as: nitroglycerinisosorbide mononitrateisosorbide dinitratesodium nitroprussidealkyl nitrites (commonly known as "poppers") Concomitant use of soluble guanylyl cyclase stimulators, such as riociguat Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors. Sildenafil's popularity with young adults has increased over the years. [32] Sildenafil's brand name, Viagra, is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use. [33] The reasons behind such use include the belief that the drug increases libido, improves sexual performance,[33] or permanently increases penis size. [34] Studies on the effects of sildenafil when used recreationally are limited, but suggest it has little effect when used by those who do not have erectile dysfunction. In one study, a 25 mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time. [35] This study also noted a significant placebo effect in the control group. Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs. [36] Sildenafil is sometimes used to counteract the effects of other substances, often illicit. [33] Some users mix it with methylenedioxymethamphetamine (MDMA, ecstasy), other stimulants, or opiates in an attempt to compensate for the common side effect of erectile dysfunction, a combination known as "sextasy", "rockin' and rollin'", "hammerheading", or "trail mix".