PDE -5 inhibitors’ implications in women: Are they of help?

Abstract

Introduction: Introduction of the oral phosphodiesterase isoenzyme-5 inhibitors (PDE5-Is) has revolutionized sexual medicine by affording effective treatment for erectile dysfunction. PDE5 hydrolyses cyclic GMP specifically to 5′-GMP. Since its launching, PDE5-Is have stimulated scientific interest for their impending benefits in various implications for the welfare of the human beings. Aim: To highlight the possible potential implications of PDE5-Is in women. Participants and methods: A systematic review was carried out till June 2017 based on a search of concerned articles in Medline, medical subject heading databases, Scopus, The Cochrane Library, Embase, and CINAHL databases without language restriction. Keywords used to assess that outcome and concerned associations were PDE5 inhibitors, sildenafil, tadalafil, vardenafil, avanafil, women, and females. Main outcome measures: Different implications for PDE5-Is in women. Results: Oral PDE5-Is have beneficial medical implications in women. Sexual implications include female sexual dysfunction, female sexual arousal disorder, antidepressant-associated sexual dysfunction, and affected relationship. Gynecological implications include endometrial thickness, abortion, preeclampsia, fetal growth restriction, clitoral engorgement, primary dysmenorrhea, uterine blood flow, oligohydramnios, poor ovarian response, ovarian ischemia/reperfusion, and uterine contractility. Urological implications include overactive bladder and interstitial cystitis, whereas dermatological implications include systemic sclerosis and cellulite. In addition, PDE5-Is proved to be beneficial in pulmonary arterial hypertension, coronary dysfunction, esophageal motility, and some metabolic effects. Conclusion: Oral PDE5-Is are an eye-catching therapeutic class of agents with beneficial effects for women, which could be potentially applied after well-designed clinical trials.