Do Topical Viagra Creams Work?

For years, sexual wellness research has largely centered around men, especially with the rise of Viagra as the go-to solution for erectile dysfunction. Thankfully, science is finally starting to center female sexual pleasure, too (about time). 

Some research suggests that sildenafil, the same active ingredient in Viagra, may also support female sexual arousal and pleasure, especially when applied to the vulva and vagina. Enter the world of “topical Viagra creams” — also playfully known as “scream creams” — and a new era of options for women seeking more satisfaction. 

These topical creams have gained a lot of interest since hitting the market (understandably), but do they actually work? While there are early signs of promise, it’s far from proven. Let’s dig into what the science says.

How does topical sildenafil cream work?

Topical sildenafil works by inhibiting the enzyme phosphodiesterase type 5 (PDE5) in genital tissues, leading to increased levels of cyclic guanosine monophosphate (cGMP). This promotes smooth muscle relaxation, resulting in enhanced blood flow to the vulvovaginal area. As a result, it can improve clitoral engorgement (boosting sensitivity and orgasm) and enhance vaginal lubrication, facilitating more comfortable and pleasurable penetration. In plain English? It dilates blood vessels to stimulate blood flow to the genitals. More blood flow = more sensation and better physical arousal.

The mechanism is similar to how Viagra works in men, but instead of targeting the penis, topical sildenafil enhances blood flow to areas like the clitoris, labia, and vaginal tissues. (An obvious disclaimer here: just because it works for men, doesn’t mean it works for women.)

What does the research say?

The current evidence on topical sildenafil cream for Female Sexual Arousal Disorder (FSAD) is still very limited — and honestly, a bit mixed.

The largest study on the topic found no significant difference between topical sildenafil and a placebo when it came to improving arousal in premenopausal women. But there were a few big caveats. Many participants also had genital pain or other sexual issues that could have muddied the results. Plus, the cream itself wasn’t formulated with a permeation enhancer — basically, an ingredient that helps the medicine sink deeper into the tissue. Without it, the sildenafil probably couldn’t reach the smooth muscle where it needs to act to improve blood flow and sensation.

Another issue? The study excluded postmenopausal women and anyone taking common antidepressants like SSRIs or SNRIs, both of which are known to affect sexual function.

That said, a smaller follow-up study offered some glimmers of hope. In women with FSAD alone — or FSAD combined with low desire but no orgasm difficulties — researchers saw improvements in arousal, sexual desire, and orgasm intensity. Still, the sample size was tiny (33 women on sildenafil, 32 on placebo), and the participants were pretty diverse in their experiences, making it hard to draw firm conclusions. So while there’s potential, it’s far from clinical proof.

Earlier research using thermal imaging has also hinted at benefits. A 2020 study looked at women aged 25 to 55 without diagnosed sexual dysfunction. After watching a 30-minute erotic film, those who used the cream reported feeling much more aroused than those who didn’t. This is interesting, but again, larger and more targeted studies are needed to really know if it works for FSAD.

Bottom line: There’s some early promise, especially for women with FSAD without pain or orgasm issues, but topical sildenafil is not a proven treatment. So far, the data doesn’t show clear benefits over placebo, and the FDA has not approved it for treating female sexual dysfunction. Until more research is done, it remains experimental.

Can "scream cream" help with low libido or vaginal dryness from menopause?

Right now, it’s hard to say. Most of the research on topical sildenafil cream has been in premenopausal women, so we don’t know yet if it’s effective or safe for people in menopause or beyond.

If your main issue is genital arousal — meaning you feel desire but struggle with getting physically aroused or lubricated — then topical sildenafil might help by increasing blood flow to the vulva and vaginal tissues. That increased circulation could make everything feel more responsive and pleasurable. But we don’t have solid evidence yet.

If you’re just dealing with vaginal dryness, a good-quality lube like Vella’s Intimate Elixir can work just as well, without needing sildenafil.

For low libido or hormonal vaginal dryness caused by menopause, topical sildenafil on its own probably won’t do much. Those symptoms usually need hormonal treatments like topical estrogen, hormone replacement therapy (HRT), or other therapeutic options tailored to your needs.

Is topical viagra worth trying?

If you're a premenopausal woman who feels desire but struggles with physical arousal, topical sildenafil cream (3.6%) might be worth exploring, especially if your main issue is FSAD and first-line treatments haven’t worked.

That said, it’s important to know that this isn’t a clinically proven solution. Most of the research shows either no clear effect or only suggests potential benefits in very specific groups. Plus, we still need more studies, not just with better participant selection, but with better cream formulations that actually deliver the medication where it needs to go.

In the meantime, there are other options. For example, Vella’s Women’s Pleasure Serum offers a science-backed approach to enhancing arousal and intimacy. It’s designed to increase blood flow and sensation in the vulva using biotech-driven nanotechnology to support easier, longer, more intense, and more satisfying orgasms. While it doesn’t contain sildenafil, it works similarly to help improve sexual sensation, lubrication, and responsiveness, especially for women dealing with arousal challenges.

Despite the headlines, topical sildenafil isn’t a magic fix for every sexual concern, because arousal is complex and influenced by so much more than biology. If you’re experiencing low desire, that might be rooted in stress, relationship dynamics, emotional well-being, or body image, so a holistic approach to sexual health is essential.

At the end of the day, sexual wellness is deeply personal, and what works for one woman may not work for another. But knowing your options — and how they work — helps you make informed, empowered choices for your body and your pleasure.

FAQ

What is "scream cream"?

“Scream cream” is a catchall term for arousal creams that contain sildenafil, the same active ingredient found in Viagra. It's often referred to as “libido cream” because it can make it easier for women to reach orgasm by enhancing blood flow and sensitivity. These types of creams are designed specifically for women who experience difficulty with sexual arousal. Instead of affecting your entire system, like oral medications do, this cream is applied locally, so the effects are more targeted and the risk of side effects is lower.

Is topical sildenafil cream FDA-approved for women?

Currently, topical sildenafil creams aren’t FDA-approved. However, some physicians prescribe them off-label, and certain telehealth companies offer creams made through compounding pharmacies. The clinical evidence is still emerging, and so far, there’s no definitive proof that topical sildenafil works across a broad population of women. If you're curious about ways to enhance arousal and sensation with fewer unknowns, Vella’s science-backed, non-prescription products offer a promising place to start.