Compare Womenra (Sildenafil) with Alternatives: What Works Best for Women?

Womenra, a brand name for sildenafil, is sometimes prescribed off-label for women with low sexual desire - even though it was originally designed for men with erectile dysfunction. But is it the best option? And what else is out there? Many women are searching for answers because they’re tired of feeling like their sex drive is broken, or that they have to just accept it. The truth? There are other options - some FDA-approved, some off-label, and some with better safety profiles for women.

What is Womenra, really?

Womenra contains sildenafil citrate - the same active ingredient as Viagra. It works by increasing blood flow to the genital area. For men, that helps with erections. For women, the idea is that improved blood flow might enhance arousal, lubrication, and sensation. But here’s the catch: clinical trials for sildenafil in women have shown mixed results. A 2014 study published in The Journal of Sexual Medicine found only a small, statistically insignificant improvement in sexual satisfaction among women taking sildenafil compared to placebo. Another trial in 2019 showed no meaningful difference in desire or arousal.

That doesn’t mean it doesn’t work for anyone. Some women report feeling more responsive, more connected during intimacy. But those are anecdotal. The science doesn’t strongly support it as a reliable solution for low libido in women.

Why sildenafil isn’t the go-to for women

Sildenafil targets physical arousal - blood flow, lubrication, sensitivity. But for many women, low sexual desire isn’t about blood flow. It’s about stress, hormones, relationship dynamics, mental health, or life stage. Postpartum fatigue, perimenopause, antidepressants, chronic pain - these are common root causes. Sildenafil doesn’t touch any of those.

Also, side effects are real. Headaches, flushing, dizziness, nausea. Some women report blurred vision or low blood pressure. And because it’s not FDA-approved for women, there’s no standardized dosage. Some take 25mg, others 50mg or even 100mg. That’s risky without medical supervision.

Flibanserin (Addyi): The first FDA-approved pill for low desire in women

In 2015, the FDA approved flibanserin (brand name Addyi) specifically for premenopausal women with hypoactive sexual desire disorder (HSDD). Unlike sildenafil, flibanserin works on brain chemistry - it balances dopamine, serotonin, and norepinephrine to boost sexual interest.

How effective is it? In clinical trials, women taking flibanserin reported about 1.5 more satisfying sexual events per month compared to placebo. That’s not a miracle, but it’s measurable. About 1 in 3 women saw a meaningful improvement. It takes 4 to 8 weeks to work, and you have to take it daily - not on-demand like sildenafil.

Big downside? Alcohol is strictly off-limits. Mixing flibanserin with alcohol can cause severe low blood pressure and fainting. You also can’t take it with certain antidepressants or liver enzyme inhibitors. And it’s expensive - often over $100 a month without insurance.

Bremelanotide (Vyleesi): The injectable option

Approved in 2019, bremelanotide (Vyleesi) is another FDA-approved treatment for HSDD in premenopausal women. It’s self-injected under the skin 45 minutes before sexual activity. It activates melanocortin receptors in the brain, which are linked to sexual arousal.

Studies show women using Vyleesi had about 1.5 more satisfying sexual events per month - similar to flibanserin. But unlike flibanserin, it’s taken as needed. No daily pill. No alcohol restrictions. Side effects include nausea (up to 40% of users), flushing, headache, and injection site reactions.

One advantage? It’s more flexible. You don’t need to plan your day around it. You take it when you want to be intimate. But the injection can be a barrier for some. And it’s also pricey - around $900 for a four-pack without insurance.

Testosterone therapy: The hidden option many doctors don’t mention

Low testosterone can play a big role in female sexual desire, especially after menopause. While testosterone isn’t FDA-approved for women in the U.S., many endocrinologists prescribe it off-label in low doses - as creams, gels, or pellets.

A 2020 meta-analysis in The Lancet found that transdermal testosterone significantly improved sexual desire, arousal, and satisfaction in postmenopausal women with HSDD. Effects were noticeable within 12 weeks. Side effects are rare at low doses: minor acne, hair growth, voice changes. These are usually reversible if you stop.

Most gynecologists won’t touch testosterone because of outdated fears about virilization. But endocrinologists and menopause specialists know the data. If you’re postmenopausal and have low libido, ask for a blood test to check your free testosterone levels. It’s simple. And if they’re low, testosterone therapy might be more effective than any pill designed for blood flow.

Non-pharmaceutical options: Often overlooked, often more effective

Medication isn’t the only path. Many women find lasting improvement without pills or injections.

• Cognitive behavioral therapy (CBT) for sexual health: Studies show CBT improves desire and satisfaction more consistently than sildenafil. It helps reframe negative thoughts about sex, reduce performance anxiety, and reconnect with pleasure.
• Sex therapy: A trained therapist helps couples communicate about intimacy, rebuild emotional connection, and explore what arousal means for them - not just physical response.
• Hormone replacement therapy (HRT): For perimenopausal and postmenopausal women, estrogen (and sometimes progesterone) can restore natural libido. Vaginal estrogen creams or rings also help with dryness, which can make sex painful and discourage desire.
• Lifestyle changes: Sleep, stress reduction, exercise, and reducing alcohol intake all have direct impacts on libido. One 2021 study found that women who exercised 3+ times a week reported 30% higher sexual satisfaction than sedentary peers.

What should you try first?

If you’re considering Womenra or any other option, here’s a practical path:

1. Rule out medical causes: Thyroid issues, diabetes, depression, and certain medications (like SSRIs) can kill libido. Get blood work done - TSH, cortisol, testosterone, estrogen, vitamin D.
2. Ask about hormone levels: Especially if you’re over 40. Low testosterone or estrogen might be the real issue.
3. Try therapy before pills: CBT or sex therapy has fewer side effects and longer-lasting results than any drug.
4. If you want medication, compare options: For daily use, flibanserin. For on-demand, bremelanotide. For low testosterone, talk to a menopause specialist about topical testosterone.
5. Avoid off-label sildenafil unless supervised: It’s not designed for women. Risks outweigh benefits for most.

Bottom line: Womenra isn’t the answer most women need

Womenra (sildenafil) was never meant for women. It treats a physical symptom - low blood flow - but most women’s low desire comes from deeper places: emotional disconnect, hormonal shifts, mental fatigue, or unaddressed trauma. No pill that only increases blood flow can fix that.

The real breakthroughs for women’s sexual health aren’t in pills marketed as ‘female Viagra.’ They’re in hormone testing, targeted therapy, and listening to what the body is really saying. If you’re struggling with low libido, you’re not broken. You just haven’t found the right solution yet - and there are better ones than Womenra.

Next steps if you’re considering options

Don’t start with a pill. Start with a conversation - with your doctor, your partner, or a therapist. Ask for blood work. Ask about hormone levels. Ask if therapy might help. You don’t have to accept low desire as normal. There are real, science-backed paths forward - and most of them don’t involve taking a drug designed for men.