Female Sexual Dysfunction (FSD) is an umbrella term covering low sexual desire (Hypoactive Sexual Desire Disorder, HSDD), arousal disorders (decreased lubrication, blunted physical response despite mental interest), orgasm difficulties, and pain disorders. The clinical picture is heterogeneous and the evidence base for pharmacotherapy is much thinner than for male erectile dysfunction. This is NOT vaginal dryness due to menopause — for that physical tissue change see our Behandeling van vaginale droogte category.
What we stock. Two PDE5 inhibitors marketed for off-label use in female arousal disorder:
Cenforce FM (sildenafil 100 mg) — Centurion Laboratories. PDE5 inhibition increases vasocongestion in vaginal and clitoral tissue, which may improve arousal-related lubrication and sensation in some women.
Femalefil (tadalafil 10 mg) — same mechanism with the longer duration profile of tadalafil.
Important caveat. The clinical evidence for PDE5 inhibitors in women is mixed. Trials have shown benefit in subgroups (women with arousal disorder following SSRI treatment, women with autonomic neuropathy, post-menopausal women with arousal complaints) but neither sildenafil nor tadalafil are FDA-approved for FSD in the general population. Use is genuinely off-label. They will not increase desire — they affect physical arousal only. If your primary issue is low libido, PDE5 inhibitors are unlikely to help.
FDA-approved alternatives we do not stock. Flibanserin (Addyi) and bremelanotide (Vyleesi) are approved in the US for premenopausal HSDD. Neither is currently stocked at MedsBase. If you have HSDD specifically, we recommend speaking to a women’s health specialist about these options.
How to start (if appropriate). A single 25-50 mg sildenafil or 5-10 mg tadalafil dose 30-60 minutes before sexual activity. Lower doses are usually adequate for women — the typical 100 mg sildenafil dose is for male ED. Side effects (headache, flushing, nasal congestion, mild GI upset) follow the standard PDE5 inhibitor profile. Do not combine with nitrates (nitroglycerin, isosorbide). Avoid in unstable cardiovascular disease.
When to seek specialist care. Pain with intercourse that started after menopause, after childbirth, or with a new partner. Total absence of desire that came on suddenly. Symptoms that started after a new medication (especially SSRIs, SNRIs, antihypertensives) — the medication itself may be the cause. Relationship factors, depression, and chronic stress are common drivers and respond better to therapy than to drugs.
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