Viagra (sildenafil) is not a treatment for pregnancy and should only be used in pregnancy under close medical supervision. It is not primarily a women's medicine, but it has been studied in specific high-risk situations — such as severe pre-eclampsia and fetal growth restriction — where it may improve fetal growth and maternal blood pressure. Studies in small numbers of pregnant women do not suggest it causes preterm birth or low birth weight, though a rare newborn complication has been reported. Any use in pregnancy must be decided by a doctor.
The topic is easy to misunderstand, because sildenafil is famous as an ED drug. In pregnancy its role is entirely different — it acts on circulation, not sexual function — so this is a question of maternal-fetal medicine, not ED.
Sildenafil and fertility
Sildenafil is mainly used to treat erectile dysfunction in men, but its effects extend beyond that. There is no clear evidence that it reduces fertility in women or men; an in vitro study found no effect on sperm motility even at concentrations roughly 4,000 times the peak after the highest recommended dose. In fact, by increasing the frequency of sexual encounters, sildenafil-based drugs can have an indirect positive effect on fertility.
| Context | What is known |
|---|---|
| Pulmonary hypertension | Use reliable contraception; consult a doctor before conceiving |
| Preterm birth / low weight | Small studies do not suggest sildenafil causes these |
| Rare complication | PPHN reported in some newborns |
| Fetal growth restriction | May improve fetal growth in select high-risk cases |
Pulmonary hypertension and contraception
Sildenafil is also used to treat pulmonary hypertension, high blood pressure in the arteries of the lungs. If you have pulmonary hypertension and are trying for a baby, you should use reliable contraception and consult your doctor, because pregnancy can carry serious risks in this condition. Planning with a healthcare professional is essential when sildenafil is part of the picture.
Risks and precautions in pregnancy
Pregnant women considering sildenafil should be aware of certain risks. Studies of small numbers of pregnant women taking it do not currently suggest it causes preterm birth or low infant birth weight. However, a few cases have reported a rare complication called persistent pulmonary hypertension of the newborn (PPHN) in babies born to women who took sildenafil during pregnancy. This is why the medicine is only used when clearly justified and under supervision.
Potential benefits in high-risk pregnancies
On the other side, sildenafil has shown potential to improve fetal growth under suboptimal conditions in the womb. A meta-analysis supports that it improves fetal growth and maternal blood pressure regulation in fetal growth restriction (FGR) and pre-eclampsia pregnancies — though this benefit is not seen in healthy pregnancies. Despite limited use, there are no reports of teratogenicity, and growing evidence suggests it may help in select situations, such as severe pre-eclampsia or restricted fetal growth.
The need for medical guidance
Given these varying effects, it is absolutely essential to consult a healthcare professional before using sildenafil during pregnancy. Doctors can weigh the potential risks and benefits and tailor any use to the individual, prioritizing the safety of both mother and baby. In short, sildenafil has shown potential benefits in certain high-risk pregnancies, but its use must be carefully considered and monitored — never started on your own.
On the medicine generally, read what sildenafil is and how it is used. On painful sex, see causes and symptoms of painful sex. And on surgical sexual-health effects, read life after prostate removal.
Frequently asked questions
- Is Viagra safe during pregnancy?
- Only under medical supervision. It is used in select high-risk situations, not as a general treatment, and a doctor must decide.
- Does sildenafil cause preterm birth?
- Small studies do not suggest it does, but a rare newborn complication (PPHN) has been reported in some cases.
- Can it help in pregnancy?
- In high-risk cases like severe pre-eclampsia or fetal growth restriction, it may improve fetal growth and maternal blood pressure.
- Does it affect fertility?
- There is no clear evidence it reduces fertility in men or women; it may even raise it indirectly by increasing sexual frequency.
For the full picture of causes and treatments, return to the erectile dysfunction and male sexual health hub.