Can Women Take Tadalafil? The Facts Explained

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What Is Tadalafil and How Does It Work?

Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor licensed in the UK for the treatment of erectile dysfunction in men [4]. It works by relaxing the smooth muscle in blood vessels, which increases blood flow to the penis during sexual stimulation. Tadalafil is available as on-demand tablets (10mg or 20mg taken at least 30 minutes before sexual activity) or as a daily low-dose option (2.5mg or 5mg) [4].

The medicine is also licensed for men with benign prostatic hyperplasia (an enlarged prostate) and pulmonary arterial hypertension under different brand names and doses [4]. However, none of these licences extend to women. The Medicines and Healthcare products Regulatory Agency (MHRA) has not approved tadalafil for any female indication, meaning prescribing it to women would be off-label use.

PDE5 inhibitors require sexual stimulation to work; they do not create arousal or desire on their own. Because the physiology of sexual response differs between men and women, the mechanism that helps men achieve erections does not necessarily translate to improved sexual function in women.

Why Can Women Take Tadalafil Off-Label in Some Cases?

Although tadalafil is not licensed for women, doctors can prescribe medicines off-label if they believe there is a clinical rationale and the potential benefits outweigh the risks. Off-label prescribing is legal and sometimes necessary when no licensed alternative exists. However, it places additional responsibility on the prescriber to ensure the patient is fully informed and that the use is evidence-based.

Some small studies have investigated whether tadalafil might help women with sexual arousal disorder, particularly those experiencing reduced genital blood flow. The theory is that improved blood flow to the genital area could enhance arousal and sensation. However, the results have been inconsistent, and larger, high-quality trials are lacking [12].

Other research has looked at tadalafil for women with sexual dysfunction related to antidepressant use (particularly selective serotonin reuptake inhibitors, or SSRIs), but again the evidence is not robust enough to support routine use. Because female sexual dysfunction is complex and influenced by psychological, hormonal, and relational factors, a single medication is unlikely to be a complete solution.

What Does the Current Evidence Say?

The evidence for tadalafil in women remains limited and inconclusive. Some small trials have suggested modest improvements in arousal or satisfaction scores, but these have not been replicated in larger populations. Importantly, regulatory bodies such as the MHRA and the US Food and Drug Administration (FDA) have not approved tadalafil for female sexual dysfunction due to insufficient evidence of efficacy and safety [12].

Female sexual health is influenced by many factors including hormones, mental health, relationship quality, and physical health. A medicine that works by increasing blood flow may not address the underlying causes of low desire, arousal difficulties, or pain during sex. For this reason, a holistic approach involving counselling, hormone assessment, and treatment of any underlying medical conditions is usually recommended.

When to get urgent help

• Sudden loss of vision or hearing after taking tadalafil
• Severe chest pain, dizziness, or fainting, especially if taking nitrates or blood pressure medicines
• Allergic reaction: swelling of face, lips, tongue, or difficulty breathing
• Persistent or worsening pelvic pain, abnormal bleeding, or other new symptoms

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

Can Women Take Tadalafil Safely? Potential Risks

The safety profile of tadalafil in women has not been established through the same rigorous clinical trials required for licensing. Common side effects in men include headache, flushing, indigestion, nasal congestion, and back pain [4]. These effects are likely to occur in women too, but the frequency and severity are not well documented.

More serious risks include a drop in blood pressure, particularly if tadalafil is taken with nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, riociguat, or recreational drugs known as 'poppers' (amyl or alkyl nitrites). This combination can cause a dangerous fall in blood pressure and is absolutely contraindicated [4]. Women taking alpha-blockers (such as doxazosin) or other blood-pressure-lowering medicines should also exercise caution, as the combination may cause dizziness or fainting.

Tadalafil is also contraindicated in people with a history of non-arteritic anterior ischaemic optic neuropathy (NAION), a rare cause of sudden vision loss, and in those with certain inherited retinal disorders [4]. Pregnant or breastfeeding women should not take tadalafil, as there is no safety data in these populations. Any woman considering off-label use must have a thorough consultation with a prescriber who can assess her full medical history and current medications.

What Are the Alternatives for Women with Sexual Health Concerns?

Women experiencing sexual difficulties should first see their GP or a sexual health specialist to identify any underlying causes. Conditions such as diabetes, thyroid disorders, depression, and menopause can all affect sexual function and may require specific treatment [1]. Relationship counselling or psychosexual therapy can be very effective, particularly when psychological or relational factors are involved.

Hormone replacement therapy (HRT) may help postmenopausal women experiencing vaginal dryness, discomfort, or reduced libido due to low oestrogen. Vaginal oestrogen creams, tablets, or rings can improve lubrication and tissue health without significant systemic absorption. Testosterone therapy is sometimes considered for postmenopausal women with low desire, though it is not widely licensed for this use in the UK and must be prescribed by a specialist.

Flibanserin and bremelanotide are two medicines licensed in the United States for low sexual desire in premenopausal women, but neither is currently available in the UK. Non-hormonal lubricants and moisturisers can help with dryness and discomfort. Pelvic floor physiotherapy may benefit women with pain or muscle tension. A multidisciplinary approach tailored to the individual is usually the most effective strategy.

When Should You See a Doctor?

Any woman experiencing persistent changes in sexual desire, arousal, or pain during sex should consult a healthcare professional. These symptoms can be early signs of underlying health conditions such as cardiovascular disease, diabetes, or hormonal imbalances [1]. A GP can arrange blood tests, review medications that may be contributing (such as antidepressants or blood pressure tablets), and refer to a specialist if needed.

It is important not to self-medicate with prescription medicines obtained online without a proper consultation. Off-label use of tadalafil or other PDE5 inhibitors should only be considered after a full assessment by a qualified prescriber who understands the risks and can monitor for side effects.

At a glance

Can Women Take Tadalafil Prescribed for Their Partner?

No, women should never take tadalafil that has been prescribed for someone else. Prescription medicines are tailored to an individual's medical history, current medications, and specific health needs. Taking someone else's medicine is unsafe and illegal. Even if a partner's tadalafil appears to be the same dose, the prescriber will not have assessed the woman's suitability, contraindications, or potential drug interactions.

Sharing prescription medicines can lead to serious harm. For example, a woman taking nitrates for chest pain, or certain antifungal or antiviral medicines, could experience a dangerous drop in blood pressure or other adverse effects if she took tadalafil without medical supervision [4]. Additionally, if a woman is pregnant, breastfeeding, or has certain eye or heart conditions, tadalafil could pose significant risks.

If a woman is interested in exploring whether tadalafil or another treatment might be appropriate for her, she should book a consultation with her GP or a specialist in sexual medicine. This ensures that any treatment is safe, legal, and based on a proper clinical assessment.

How Cured Pharmacy Can Help with Sexual Health

Cured Pharmacy is a GPhC-registered online pharmacy (GPhC 9012511) offering discreet consultations for a range of sexual health concerns. While our current service focuses on licensed treatments for erectile dysfunction in men, we understand that sexual health is important for everyone. All our prescription treatments, including tadalafil, sildenafil, vardenafil, and avanafil, are only supplied after an online consultation reviewed by a UK-registered prescriber.

If you are a woman seeking advice about sexual health, we recommend speaking with your GP or a specialist service. Your GP can arrange appropriate investigations, discuss treatment options, and refer you to a psychosexual therapist or gynaecologist if needed. For men experiencing erectile dysfunction, Cured Pharmacy offers a convenient, confidential service with access to a range of licensed treatments at transparent prices.

Our pharmacists are here to answer questions about medicines, side effects, and interactions. We encourage anyone with concerns about their sexual health to seek professional advice rather than attempting to self-treat. Effective, safe treatment starts with an accurate diagnosis and a personalised plan.

Accessing Support and Information

The NHS provides comprehensive information on sexual health for both men and women, including advice on common concerns and where to find specialist services [1]. Sexual health clinics offer confidential consultations, testing, and treatment for a wide range of conditions. Many areas also have dedicated menopause clinics or psychosexual therapy services available through the NHS or privately.

Charities such as the Sexual Advice Association and the British Association for Sexual Health and HIV (BASHH) offer reliable information and support. Remember, sexual health is an important part of overall wellbeing, and seeking help is a positive step.

In summary

• Tadalafil is not licensed for women in the UK and lacks strong evidence for female sexual dysfunction
• Off-label prescribing is possible but requires full medical assessment and informed consent
• Never take tadalafil prescribed for someone else; sharing medicines is unsafe and illegal
• Women with sexual health concerns should see a GP for proper diagnosis and personalised treatment
• Alternatives include hormone therapy, counselling, lubricants, and treating underlying health conditions

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