Sildenafil for Sexual Dysfunction in Women Taking Antidepressants

Nurnberg, H. George; Hensley, Paula L.; Parker, Lynda M.; Keith, Samuel J.

doi:10.1176/ajp.156.10.1664

Cited by 24 publications

(7 citation statements)

References 2 publications

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“…Step Four: First-Line Therapies for Women's Sexual Dysfunction During the fourth step, the healthcare provider works with the menopausal woman to consider using a drug or medical device to help manage her sexual complaint. First-line therapies include hormone therapy such as androgen therapy [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] and/or estrogen therapy (local and/or systemic) and/or progesterone therapy [60][61][62][63][64], dopamine agonists [65][66][67], phosphodiesterase type 5 inhibitors [68][69][70][71][72][73], topical vasodilators [74,75], and use of a vacuum clitoris therapy device [76][77][78].…”

Section: Figurementioning

confidence: 99%

“…An important point in treating women with arousal concerns is that an adequate sex steroid (androgen and estrogen) hormonal milieu is critical in order to benefit from selective phosphodiesterase type 5 inhibitor treatment. Several studies did assess safety and efficacy of selective phosphodiesterase type 5 inhibitors in subjects with a normal hormonal milieu [69–73].…”

Section: Case Studymentioning

confidence: 99%

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Current Management Strategies of the Postmenopausal Patient with Sexual Health Problems

Goldstein¹

2007

The Journal of Sexual Medicine

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Introduction Sexual health concerns of menopausal women include decreases in sexual interest, arousal, lubrication, and orgasm, and increases in sexual pain, all of which may be associated with distress. Aim To review a step-care progression of sexual healthcare management: identification of the sexual health problem; education of the patient and the partner; modification of reversible causes; first-line therapies consisting of devices and medications; and second-line therapies with more invasive treatments including surgery. Methods The healthcare provider is presented with a clinical diagnosis and treatment paradigm that engages mind, body, and relationship issues proceeding step-wise in a rational and cost-effective fashion. Main Outcome Measure Literature review in women's sexual health. Results Women's health, including sexual health, is a fundamental human right. Supported by evidence-based data, a step-care approach to diagnosis and management of women with sexual health problems is advised. Multidisciplinary interventions should be considered as needed. Identification of sexual health concerns engages diagnostic components of psychologic consultation, history, physical examination, and laboratory testing as appropriate. Key to clinical assessment is the detailed sexual, medical, and psychosocial history. No agreement exists on necessary laboratory tests. Patient (and partner) education improves understanding of treatment options and expectations, and promotes a trusting patient–physician partnership. Modification of reversible causes includes sex therapy, lubricants, altering medications, modifying lifestyle and physical therapy for pelvic floor disorders. First-line therapies should be administered based upon diagnosis, needs, expectations, risks, benefits, and cost, and include medical devices and drugs such as hormones, vasoactive agents, dopamine agonists, topical steroids, anti-infectious agents, and analgesic agents. Second-line therapies, such as surgery, are initiated upon failure, insufficient response, or adverse side effects associated with one or more of the first-line therapies or patient preference. Conclusions For postmenopausal women with sexual dysfunction, a rational clinical management strategy begins with treatment options that are most reversible and least invasive and costly.

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Section: Figurementioning

confidence: 99%

Section: Case Studymentioning

confidence: 99%

Current Management Strategies of the Postmenopausal Patient with Sexual Health Problems

Goldstein¹

2007

The Journal of Sexual Medicine

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“…In anecdotal case reports, the following antidotes have been reported: the alpha2-adrenergic receptor antagonist, yohimbine [34]; the 5-HT2 receptor antagonists, nefazodone [35] and cyproheptadine [36]; the 5-HT3 receptor antagonist, granisetron [37]; the dopamine agonists, amantadine [38] and bupropion [39]; psychostimulants [40]; and other agents, such as ginkgo biloba [41] and sildenafil citrate [42,43]. In uncontrolled trials, response rates greater than 50% have been reported for many of these agents [44].…”

Section: Antidepressant-induced Sexual Dysfunctionmentioning

confidence: 99%

Sexual dysfunction and depression

Seidman

Roose

2001

Curr Psychiatry Rep

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Sexual functioning is generally impaired during depression. Interest in the relationship between sexual dysfunction and depression has risen substantially, prompted primarily by 1) the 1998 Food and Drug Administration approval of sildenafil citrate as the first oral therapy of erectile dysfunction, and 2) the widespread clinical use of selective serotonin reuptake inhibitors, which prominently impair orgasm, and possibly libido and arousal. In this paper, we first review the phenomenology of sexual dysfunction and important contributing factors, such as age and illness, and then focus on the clinical assessment and therapeutic interventions used for sexual dysfunction in depressed individuals.

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“…They found a non-significant improvement of sexual functioning, as assessed by questionnaire, in 25% of participants compared with baseline. Nurnberg et al 14 showed an improvement in orgasmic functioning and sexual desire with sildenafil in female patients on selective serotonin re-uptake inhibitors. An open-label study of 48 women with sexual arousal disorder, by Berman et al 15 demonstrated significant physiological increases in genital blood flow and increased genital sensation with 100 mg sildenafil compared with baseline, also significantly increased subjective desire, arousal, lubrication and satisfaction after six weeks of sildenafil use as assessed by questionnaire.…”

Section: Literature Reviewmentioning

confidence: 99%

A literature review and case reports series on the use of phosphodiesterase inhibitors in the treatment of female sexual dysfunction

Foster¹,

Mears

Goldmeier

2009

Int J STD AIDS

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The term 'female sexual dysfunction' (FSD) encompasses a number of different disorders, and while their aetiologies are not fully understood, the sub-classifications of this broad umbrella term are increasingly becoming more established and accepted. However, there is less consensus regarding the optimal treatment of these conditions. While it is known that phosphodiesterase (PDE5) is involved in the female sexual response, the clinical and research evidence supporting the unlicensed use of PDE5 inhibitors (PDE5i) in women is inconclusive and at times contradictory. In this article we explore this further by means of a comprehensive literature review on the use of PDE5i in the treatment of FSD and we also present our clinical experience of using these drugs in this context.

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Sildenafil for Sexual Dysfunction in Women Taking Antidepressants

Cited by 24 publications

References 2 publications

Current Management Strategies of the Postmenopausal Patient with Sexual Health Problems

Current Management Strategies of the Postmenopausal Patient with Sexual Health Problems

Sexual dysfunction and depression

A literature review and case reports series on the use of phosphodiesterase inhibitors in the treatment of female sexual dysfunction

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