Sildenafil Citrate in the Treatment of Primary Pulmonary Hypertension in Women

Thin endometrium can be due to various reasons, mainly surgical procedures such as cervical dilation and curettage (D and C), radiotherapy, recurrent infections, congenital Müllerian anomalies, and use of clomiphene citrate.

[9] The D and C leads to intrauterine adhesions (IUAs), and the Asherman syndrome is a severe degree of IUA. Patients who receive radiotherapy below the diaphragm are more vulnerable. Radiotherapy can lead to disruption of uterine blood vasculature and reduced uterine size.

Chronic endometritis reduced endometrial receptivity and altered uterine contractility leading to infertility. [10] It can be due to various reasons such as infections due to tuberculosis or chlamydia or intrauterine devices.

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Basically they were testing it on women who didn't have any desire or couldn't have an orgasm. Late in the game they realized that they can't lump all female sexual disorders together. Once Pfizer realized that viagra only worked on a tiny subgroup of women whose sexual dysfunction was caused by vascular problems, they decided not to pursue it because it just wasn't profitable for them.Pfizer...the world's largest pharmaceutical company and maker of Viagra has been studying the effects of Viagra on women, through double blind, placebo controlled, clinical studies almost as long as they have been manufacturing the drug for the male ED market.There is little if any clinical evidence that supports ANY claim that it helps women in any way.Its true that it has not been proven to be effective via large clinical trials, but many sexual medicine expert do use it in cases they deem appropriate. Unfortunately there isn't any medication currently available for women with any type of sexual dysfunction. Therefore physicians are trying to use what they have.I will be the first one to discourage medication use unless it is something that can't be dealt with via other mechanisms.

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Seeing a sex therapist can be very helpful for many people because sexual dysfunction often has non-organic causes that cannot be solved by medication. That is not to say that pharmaceuticals do not have a place in the management of sexual dysfunction. That is why it is important to talk to a physician (better a sexual health physician) to discuss these matters.BTW, off-label use of medication is not uncommon at all. Every physician does it all the time. Just pointing out that its not something that is a rarity. Clomiphene citrate used for ovulation induction can lead to thin endometrium because of its luteal phase defect (antiestrogenic effect on endometrium), which reduces the chances of implantation. A previous study has reported that a thin endometrium is characterized by high blood flow impedance of uterine radial artery, poor epithelial growth, decreased expression of VEGF, and poor vascular development.

Hence, adjuvant medications causing vasodilation have been suggested to be beneficial in women with thin endometrium. Several agents such as antithrombotic agents, aspirin,[11] and heparin have been evaluated by several groups.

Patients and Methods

Because of these biological properties, it is a potential candidate for female infertility, especially in the management of thin endometrium, which leads to low implantation and pregnancy rates. An updated electronic search was performed through PUBMED, MEDLINE, and COCHRANE and focused on peer-reviewed, randomized controlled trials, and observational cohort or case-control studies for the role of sildenafil in thin endometrium. Systematic search through all the clinical studies showed favorable results. They documented the beneficial role of sildenafil citrate in the treatment of thin endometrium in failed in vitro fertilization-embryo transfer cycles, assisted intrauterine insemination cycles, or resistant endometrium, where it increased the uterine receptivity. Successful pregnancy requires sildenafil 100mg lowest price adequate growth of the endometrium to support the ovum implantation during menstrual cycle.

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Endometrial thickness (EM) is one of the strongest predictors of implantation. The pregnancy rates are higher when the endometrium thickness is >9 mm[1] and endometrial lining <7 mm had low pregnancy rates because of poor support for implantation. The endometrium is the special epithelial lining of the uterine cavity above the level of internal os. It has two layers: A superficial functional layer and a deeper basal layer. The endometrial growth is reliant on the uterine blood flow and angiogenesis. Heparin was found to improve pregnancy rates among women with thrombophilia and recurrent abortions. [1314] Sildenafil, a phosphodiesterase 5 (PDE-5) inhibitor is now one of the standard treatments for erectile dysfunction (ED) since decades. [15] Beyond its urological scope, new therapeutic applications are being explored because of its vasodilatory property.

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[2] Uterine blood flow is closely related with the vascular development of endometrium. Basal one-third layer is supplied by small, straight, and short arteries and superficial two-third of endometrium is supplied by coiled arteries, branch of uterine artery. [3] The average EM is about 8-10 mm in the secretory phase. Angiogenesis plays a significant role in the development of a dominant follicle, formation of a corpus luteum, and growth of endometrium. [4] Angiogenesis is essential to support endometrial growth after menstruation and to provide a vascularized receptive endometrium for implantation.

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Endometrial growth is regulated by the hormones (estrogen and progesterone) and growth factors such as vascular endothelial growth factor (VEGF). [6] Some of these factors are produced locally and act via paracrine mechanisms; others have to be transferred to the endometrium. Sufficient uterine blood supply is required for these factors to reach the endometrium, especially to its functional layer. [7] Estrogen-induced endometrial proliferation after menstruation is mainly dependent on blood flow to the basal endometrium. [8] Estrogen regulates the proliferative phase and estrogen-primed endometrium produces progesterone receptors, which are necessary for the secretory phase endometrial growth regulated by progesterone. Hence, here is an attempt to review the effect of sildenafil on the EM, which increases the pregnancy outcome, i.e.

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Only a fraction of men using viagra actually have ED. Many men have other issues like low arousal, PE, etc. But most doctors give them viagra.Freedom is just another word for nothing left to lose - Kris Kristofferson and Fred Foster (sung by Janis Joplin)Comment Reply to Aging women, sex and hormonesAcesup I’m really happy to read this update. But because for the first time in a while I’m hearing something...05-20-2026, 07:41 PM By JonnyR Acesup I’m really happy to read this update. But because for the first time in a while I’m hearing something..

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Reply to Aging women, sex and hormonesHeard it again over the weekend. This negative messaging from other women reinforcing this idea that my wife has subscribed to, just giving up at perimenopause,...05-18-2026, 10:16 AM By Acesup This negative messaging from other women reinforcing this idea that my wife has subscribed to, just giving up at perimenopause,.. Reply to Aging women, sex and hormonesThanks for the update Kitty. Really happy you are OK and that you are able to continue on the hormones. I know that of...05-08-2026, 12:07 PM By Acesup Really happy you are OK and that you are able to continue on the hormones. its utility in the management of female infertility.

• 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.

Sildenafil (compound UK-92,480) was synthesized by Pfizer scientists Andrew Bell, David Brown, and Nicholas Terrett. It was initially studied for use in hypertension and angina pectoris.

Further information

Reply to Aging women, sex and hormonesHad my follow-up and was all good news. Will continue with the doses and timing as we were for now, nothing of any concern on the ultrasound....05-06-2026, 10:03 PM By atskitty2 Had my follow-up and was all good news. Will continue with the doses and timing as we were for now, nothing of any concern on the ultrasound. This sounds like a stupid question from a guy like me. But my wife tells me I have an anxiety problem and make too big deal a deal out of things like...04-09-2026, 10:30 AM By Acesup This sounds like a stupid question from a guy like me.

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But my wife tells me I have an anxiety problem and make too big deal a deal out of things like.. Endometrial thickness (EM) is one of the strongest predictors of implantation rate and ongoing pregnancy success rate. The endometrial growth is dependent on the uterine blood flow and angiogenesis. Recently, some reports discussed the possible beneficial effects of sildenafil citrate on EM. Sildenafil citrate leads to smooth muscle relaxation and vasodilation. The Phase I clinical trials conducted in Morriston Hospital in Swansea suggested the drug had little effect on angina, but it could induce marked penile erections.

• Sildenafil citrate is a phosphodiesterase type 5 inhibitor.
• It may help women with sexual arousal disorder by increasing blood flow.
• Discuss mental health factors affecting libido with a healthcare specialist.
• Be aware of possible nasal congestion after taking sildenafil.
• Avoid using expired medication, as effectiveness may diminish.
• The effectiveness varies among women; results are individual.
• Use sildenafil responsibly to minimize potential adverse effects.
• Women should inform providers of all medications taken regularly.
• Sildenafil is not a cure for sexual dysfunction, only a symptomatic aid.
• Adequate sexual education can improve understanding and expectations.
• Proper dosage and timing are important for safety and efficacy.
• Sex therapy or counseling may complement medication use effectively.

[16] Following this, Pfizer therefore decided to market it for ED, rather than for angina. The drug was patented in 1996; On March 27, 1998, the Food and Drug Administration approved sildenafil citrate for the treatment of ED. Sildenafil citrate (marketed as Viagra) is manufactured by Pfizer Pharmaceuticals, New York, became the first oral drug available for ED. Nitric oxide causes smooth muscle relaxation by generating intracellular cyclic guanosine monophosphate (cGMP) by stimulating the enzyme guanylate cyclase. cGMP promotes dephosphorylation of myosin light chain kinase, thereby interfering with myosin interaction with actin, leading to smooth muscle relaxation and increase in blood flow.

• Remember that sildenafil is not designed specifically for women; evidence is ongoing.
• Consult your healthcare provider for personalized advice concerning usage.
• Be aware that psychological and physical factors both influence female libido.
• The medication can help improve vaginal blood flow during arousal.
• Regular use without medical supervision is not recommended.
• Some women may experience improved sexual confidence with sildenafil.
• Manage expectations by understanding that results vary widely.
• Do not suddenly stop other medications without doctor approval.
• Educate yourself about symptoms of potential adverse reactions.
• Maintaining overall health can enhance the effectiveness of sildenafil.
• Use caution if combining sildenafil with herbal supplements.
• Ensure comprehensive sexual health assessment before commencing treatment.

[19] Sildenafil being a selective PDE5 isoenzyme inhibitor enhances the effect of nitric oxide by inhibiting PDE5, which is responsible for degradation of cGMP [Figure 1]. [20] Nitric oxide synthase isoforms have been identified in the vascular muscles of both human endometrium and myometrium. [21] With the use of sildenafil, cGMP remains elevated, which leads to vascular relaxation and increased blood flow to the endometrium.

• Proper storage extends the shelf life of sildenafil tablets.
• Use caution when combining sildenafil with blood pressure medications.
• Female response to sildenafil can depend on psychological factors.
• Always disclose all health conditions before starting therapy.
• The medication may help improve quality of sexual experiences.
• Some women may experience no noticeable change; individual variation exists.
• Sildenafil can create a temporary sense of increased arousal.
• Keep a journal to track effects and side effects.
• Use sildenafil as part of a broader approach to sexual health.
• Avoid taking more than the recommended dose.
• Some evidence indicates sildenafil may reduce sexual pain in women.
• Considering alternative therapies may be beneficial if sildenafil is ineffective.