Can Women Take Cialis? What Is Approved and What Is Not

Cialis (tadalafil) is a medication best known for treating erectile dysfunction (ED) in men. Over the years, researchers and clinicians have asked whether tadalafil might help women—particularly for sexual difficulties or other conditions. Below, we review what the U.S. Food and Drug Administration (FDA) has approved, what remains off-label, what the research shows, and the potential benefits and risks.

1. What Is Cialis (Tadalafil)?

Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor. It works by relaxing smooth muscle and dilating blood vessels, improving blood flow to certain tissues. In men, this mechanism helps produce and maintain an erection when sexually stimulated.

Key points:

• Developed in the late 1990s; FDA-approved for men in 2003.
• Available in daily (2.5 mg or 5 mg) and on-demand (10 mg or 20 mg) dosing.
• Common side effects include headache, flushing, indigestion, back pain and muscle aches.

2. FDA-Approved Uses of Tadalafil

Currently, tadalafil is FDA-approved for three main indications:

1. Erectile Dysfunction (ED) in men
2. Signs and symptoms of benign prostatic hyperplasia (BPH) in men
3. Pulmonary arterial hypertension (PAH) in adults of any gender

Pulmonary arterial hypertension is a serious condition marked by high blood pressure in the lungs’ arteries. Tadalafil helps lower pulmonary artery pressure, improving exercise capacity. For this indication, both men and women may take tadalafil under a doctor’s supervision.

3. What Is Not FDA-Approved for Women

As of today, tadalafil is not FDA-approved for:

• Female sexual interest/arousal disorder (FSIAD) or hypoactive sexual desire disorder (HSDD)
• Female orgasmic disorder or difficulties with lubrication
• Any gynecologic condition such as painful intercourse (dyspareunia)
• Use in pregnancy or breastfeeding

No pharmaceutical company has submitted well-controlled clinical trial data to the FDA demonstrating safety and efficacy of tadalafil for women’s sexual problems.

4. Overview of Research on Women and Cialis

Though not approved, tadalafil has been studied off-label in women. Results have been mixed:

• Small pilot studies (n=20–100) explored uses in:
– Female sexual dysfunction (FSD) related to arousal and lubrication
– Women with diabetes experiencing sexual side effects
– Women with endometriosis or pelvic pain

• Some women reported mild improvements in genital blood flow and lubrication.
• Others saw no meaningful change in satisfaction, desire or pain.
• Side effects in women mirrored those in men: headache, flushing and low blood pressure.

A 2015 review in the Journal of Sexual Medicine concluded that existing trials were too small and heterogeneous to support routine use of PDE5 inhibitors in women. More rigorous, large-scale research is needed.

5. Potential Benefits and Limitations

While it’s tempting to repurpose a male ED drug for women, consider:

Benefits (Hypothetical/Under Study)

• Increased clitoral and vaginal blood flow
• Improved lubrication and potential reduction in discomfort
• Possible enhancement of genital sensation

Limitations and Unknowns

• Lack of consistent improvements in sexual desire or overall satisfaction
• No established dosing guidelines for women
• Unclear long-term safety profile in females

6. Safety Considerations

If a woman takes tadalafil—whether off-label or by misunderstanding—she should be aware of potential risks:

• Low blood pressure (hypotension): May cause dizziness if combined with nitrates or certain blood pressure drugs.
• Headache and flushing: Common and usually mild, but can be bothersome.
• Back and muscle pain: Often occur 12–24 hours after a dose; usually resolve in 48 hours.
• Vision changes: Rare, but report any sudden vision loss or color changes immediately.
• Priapism: Extremely rare in women, but any prolonged genital erection or swelling requires urgent care.

7. Alternatives for Female Sexual Dysfunction

Women experiencing sexual distress have several approved and well-studied options:

• Non-hormonal lubricants and moisturizers: First-line for dryness and discomfort.
• Topical estrogen or hormone therapy: For menopausal women with vaginal atrophy.
• Flibanserin (Addyi®): FDA-approved for premenopausal women with HSDD.
• Bremelanotide (Vyleesi®): FDA-approved for premenopausal women with HSDD.
• Psychotherapy and sex therapy: Address psychological and relational factors.

8. Practical Takeaways

• Can women take Cialis?
  – They can, but only under a doctor’s guidance for PAH.
  – It’s not approved or recommended for female sexual issues.

• What should you do if you’re curious?
  – Talk openly with your healthcare provider about your concerns.
  – Consider a free, online symptom check, using the doctor approved Ubie Symptom Checker.

9. When to Seek Medical Help

Always seek immediate medical attention if you experience:

• Sudden chest pain, dizziness or fainting
• Vision changes or hearing loss
• An erection lasting longer than four hours (even though rare in women)
• Any life-threatening or severe reactions

For non-urgent concerns about sexual function or other symptoms, speak to your doctor. They can help you weigh the risks and benefits, consider approved treatments and determine the best path forward.

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Remember, while tadalafil has well-defined benefits for men with ED and for adults with pulmonary hypertension, its use in women for sexual dysfunction remains experimental. Always consult a healthcare professional before starting—or stopping—any medication. If in doubt, speak to a doctor about anything that could be life-threatening or serious.