In romance novels, television shows, and movies, it seems that people are “ready to go”, anywhere, anytime. In reality, sex is much more nuanced and complex.
The chemistry is what piques (or does not) your interest. Distractions such as kids, pets and dirty plates in the sink are common. There’s stress. Tiredness. Concerns about body image. Physical conditions like lubrication or blood flow. There are so many other factors that need to come together to create the right mood and set off the fireworks.
It is not uncommon for people to be concerned about their sexual drive or performance. Ob/Gyn Zanotti MD sees it all the time. It’s one of the most common problems that people present to her office.
Dr. Zanotti assures you that you are fine if you nod along. Sex is more complicated than Hollywood’s rom-coms would lead you to believe.
You might be tempted to believe that there is a magic blue pill. Maybe you’ve seen it on TV or in pharma commercials. It’s tempting to think that there is a magic pill that will solve all your problems.
Is Viagra(r), the cure for sexual dysfunction, really effective? Viagra is known to help some men with erectile problems. What about the rest? What does Viagra do to women and those born with a female gender?
We spoke with Dr. Zanotti on sex performance, sex desire and the little pill.
Sexual drive vs. sexual performance
Sexual desire is determined by your environment and your mental state. Dr. Zanotti clarifies that performance during sex involves a physical act.
Let’s take a closer look at that.
Sexual performance is the collective term for all physical actions that occur during sex. This includes things like blood flow, muscle tension, lubrication, and so on.
The sexual response cycle describes the four stages that are usually involved in the build-up of a sexual act or encounter (whether it is with a partner, or masturbation).
Phases don’t happen in a specific order, and they are not always present at every encounter. In most cases it begins with excitement and physical changes, such as increased blood flow in the genitals or an increased heartbeat. The excitement continues to increase until the orgasm occurs or the encounter ends. The body begins to function normally again.
Sexual desire, also known as libido and sex-drive, is largely dependent on the mental state of your mind and other factors competing for your attention.
Hypoactive sexual desire disorder is another name for low sex drive. It’s more than just your physical reactions.
You may feel sexy one day and not the next. This can change even from moment to moment. These factors include:
Body Image
Hormonal changes
Fatigue.
Ailment or medical issues
Medication side effects.
Sexual trauma or negative sexual experiences.
Pain during sex.
Relationship problems.
Stress.
What is the mechanism of Viagra?
Viagra is effective for some, but does not address sexual desire.
Viagra is also known by its generic name, sildenafil. The FDA approved the first oral medication to treat erectile dysfunction, also known as ED (the inability of a man to maintain an erection). Since then, similar drugs have been developed.
Viagra works by blocking the enzyme that controls blood flow. This allows for increased blood flow in the genitals as well as other parts of the human body. This increased blood flow helps the penis stiffen up in preparation for sexual activity.
Viagra can help some people maintain and achieve an erection. What about the other factors that influence sexual desire and performance, such as gender? Not at all.
Can women take Viagra?
FDA approved Viagra to treat erectile disorder. That’s all.
It’s possible, however, that Viagra can increase blood flow in the vulva of women and people AFAB. This may improve sexual performance problems such as vaginal wetness (“wetness”) and sensitivity, says Dr. Zanotti.
In clinical studies, Viagra is not the solution to sexual dysfunction.
Some healthcare providers prescribe it for other sexual issues than erectile problems.
Women and people AFAB are allowed to take Viagra. Will it work? Eh, maybe…
At least one study suggests that if you suffer from low libido due to taking SSRIs, a type of common antidepressant medication, you could benefit from Viagra. Other studies show that Viagra is unlikely to be the answer. Many providers view it as a treatment of last resort.
What are the side-effects of taking Viagra for women or people AFAB?
The blood flow increases in the body when you take Viagra.
Flushing.
Headaches.
Nausea.
Viagra does not cause heart attacks. However, some people experience irregular heartbeats. If you already have low blood-pressure or are taking blood-pressure medication, Viagra may cause an even greater drop in blood-pressure, resulting in dizziness and fainting.
Dr. Zanotti says that mixing alcohol with Viagra can worsen the side effects.
What are the medications that women and people with AFAB can take to increase their libido levels?
You might wonder if you can get better sexual performance and desire without Viagra.
Dr. Zanotti believes that while no pill can guarantee that the laundry will be done, that the children are asleep and that you feel confident about yourself and your relationship. There are some drugs that could increase your interest for sex.
She also points out that, while Viagra is effective in treating ED and other sexual issues such as desire or performance, no other pill comes close to its effectiveness.
Addyi (r) (flibanserin), FDA-approved, is used to treat low sexual desire among women who are not yet menopausal. The side effects of Addyi are the same as Viagra. It is a daily pill that you take. It can lower blood-pressure and should not be taken with alcohol.
Vyleesi (r) (bremelanotide), is a medication that you inject in your abdomen or thigh an hour before sexual activity. Only women who haven’t experienced menopause or whose low libido has no medical cause are eligible to use it.
Wellbutrin (r) (bupropion), an antidepressant, is sometimes prescribed for low sexual drive without regard to whether the person has depression.
Hormone replacement therapy may have a positive indirect effect on low sexual drive. Dr. Zanotti says that if you have reached menopause this is an option worth discussing with your doctor.
What can women and people AFAB else do to reduce low sex?
Your low sexual drive will determine how you can improve your libido. Sexual performance and sexual desire may combine to cause low libido.
Dr. Zanotti recommends that you speak to a mental health specialist if your desire has been affected by past sexual trauma or a negative body image.
There are simple solutions to other factors that can affect your sexual performance. For example, pain during sex. Extra lubrication makes sex more enjoyable, especially if you are past menopause. As you age, your vaginal tissues become less elastic and drier, which can lead to pain. Talking to a pelvic physical therapist who specializes in pelvic therapy and doing pelvic exercises can help.
Dr. Zanotti says it’s crucial to be proactive about sexual health as you age. Don’t hesitate to talk with your healthcare provider about any concerns.
It would be great to just pop a pill to get your sexual mojo back. Unfortunately, the magic pill does not seem to exist… yet. There are many things you can do, and talking to a doctor is the best place to begin.
