Does Viagra Affect Fertility in Women? What to Know About Viagra as a Possible Fertility Treatment

Viagra (sildenafil) is a well-known medication that’s prescribed for erectile dysfunction (ED) in men. But it’s also sometimes prescribed off-label to support fertility in women. Exactly how does Viagra affect fertility? And is it safe for women to take Viagra as part of their fertility treatment? Here’s what you should know.

How does Viagra affect fertility in women?

Some studies show that Viagra may help improve fertility in women through its effects on the endometrium and the immune system.

Viagra and endometrial thickness

The endometrium is the tissue lining the inside of the uterus. A healthy endometrium is necessary for an embryo to attach and grow properly (known as implantation). If it’s too thin (less than 7 mm), the chances of implantation go down.

This is where Viagra may be helpful for some women. Viagra seems to improve blood flow to the uterus, which helps thicken the endometrium.

Some women taking Viagra saw higher pregnancy rates compared to those who took a placebo (sugar pill) in clinical studies. But the results are mixed:

• Some studies suggest Viagra may improve pregnancy rates for women using assisted reproductive technologies (ART), such as in vitro fertilization (IVF) or intrauterine insemination (IUI). 

• Other studies show Viagra helps improve fertility in women using timed intercourse to become pregnant, but no benefit of using Viagra along with ART.

• Viagra may be more effective if it’s combined with other fertility medications, such as clomiphene (Clomid) and estradiol valerate.

Overall, Viagra seems to show promise at improving endometrial thickness, which may make a successful pregnancy more likely. But more research is needed to confirm when and how it works best.

Viagra and the immune system

Another way Viagra may support pregnancy is by changing the body’s immune response in the uterus. The uterus contains natural killer cells, which are immune system cells that typically defend against infections. But sometimes, they may attack a fertilized egg by mistake.

Viagra may help reduce natural killer cell activity. This can make the uterus more receptive to a fertilized egg. This could be especially helpful for women who have experienced multiple pregnancy losses.

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What dose and forms of Viagra are used during fertility treatments?

Studies on Viagra for female infertility typically use one of two dosage forms:

• Vaginal suppositories (most common)

• Oral tablets

Vaginal suppositories are often preferred because they deliver medication directly into the bloodstream near the uterus. This may help improve how much of the drug gets into the endometrium. But studies also show benefits with oral Viagra tablets.

Since Viagra isn’t approved for female infertility, there isn’t a standard recommended dosage. Most studies use Viagra doses between 25 mg and 100 mg once daily. In most cases, you’ll only use Viagra from day 1 or day 7 of your menstrual cycle through ovulation. Your fertility team will provide dosage instructions that are specific to your personal needs if they decide to include Viagra as part of your fertility treatment.

Where can you get Viagra suppositories?

Viagra suppositories aren’t commercially available. Instead, they must be made by a compounding pharmacy. To get your suppositories from a compounding pharmacy, you’ll need a valid prescription written for compounded Viagra suppositories. It should include the dose, quantity, and instructions for use.

It’s important to know that compounded medications may not be covered by insurance. Your fertility clinic may be able to recommend compounding pharmacies that prepare Viagra suppositories. It’s a good idea to compare prices, as costs can vary between pharmacies.

Can Viagra help treat endometriosis?

Viagra hasn’t been researched as an endometriosis treatment. So we don’t know whether or not it may affect endometriosis symptoms.

Can Viagra help treat menstrual cramps?

One small study looked at sildenafil vaginal suppositories for severe menstrual cramps (dysmenorrhea). The 25 women who completed the study reported that the 100 mg sildenafil suppositories reduced their period pain significantly. But the study wasn’t completed and included a small number of participants, so more research is needed.

Are other treatments available to help increase endometrial thickness during fertility treatment?

Yes, there are other treatment options available that may help increase endometrial thickness. Examples include:

• Estrogen (oral, transdermal, or vaginal)

• Growth hormone

• Human chorionic gonadotropin (HCG) 

• Gonadotropin-releasing hormone agonists, such as leuprolide (Lupron)

• Tamoxifen

• Low-dose aspirin

• Vitamin E

• Platelet-rich plasma injections into the uterus

Alternative treatments, such as acupuncture and massage, are also an option. But there’s less evidence about their effectiveness.

Your fertility team should consider your specific health status and needs and help find the best fertility treatments for you. Reach out to them with any questions about the available options.

Is Viagra for fertility treatment covered by insurance?

As mentioned, Viagra for fertility is considered an off-label treatment. Since it’s not FDA approved for fertility, insurance is less likely to cover it. This is especially true when it comes to compounded Viagra suppositories.

If you’re taking Viagra tablets, a lower-cost generic is available. GoodRx can help you save over 90% off the cost of generic Viagra tablets. You can pay as little as $8.56 for 10 sildenafil tablets with a free GoodRx discount. 

Some fertility clinics may offer discounts or financing options for your fertility medications. They may also partner with certain fertility specialty pharmacies to offer special pricing. Don’t hesitate to ask your fertility team about any assistance they can provide.

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Written by:

Jill Barat, PharmD

Jill Barat, PharmD has nearly 10 years of experience as a pharmacist, including serving as the pharmacist in charge at an independent sterile and non-sterile compounding pharmacy. She also worked as the head of medical content for a telemedicine company.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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