Womens Libido Arginine 60mg | Sildenafil 20mg | Theophylline 10mg

Applied topically to the external genitalia (clitoral and labial region) approximately 15–30 minutes before anticipated sexual activity. Apply a small, pea-sized amount directly to the external genitalia and gently massage in. Wash hands immediately after application. The transdermal base is formulated to enhance local mucosal absorption; avoid contact with the partner's skin to minimize inadvertent transfer of vasoactive agents.

Applied topically as needed, approximately 15–30 minutes before sexual activity. The preparation is intended for localized genital application; do not apply to other skin surfaces. Dosing frequency and amount are determined by the prescribing clinician. Prescriber should assess systemic absorption risk, particularly for sildenafil, in patients with cardiovascular disease or those taking nitrates or other vasodilators.

• Use no more frequently than directed by the prescriber
• Do not combine with systemic PDE5 inhibitors (e.g., oral sildenafil, tadalafil) without prescriber evaluation

• L-Arginine (60 mg): Serves as the endogenous substrate for endothelial nitric oxide synthase (eNOS) and neuronal NOS (nNOS) in genital tissues. Conversion of L-arginine to L-citrulline generates nitric oxide (NO) → activates soluble guanylate cyclase (sGC) → increases cyclic GMP (cGMP) → protein kinase G activation → smooth muscle relaxation in clitoral and vaginal vascular beds → vasodilation and engorgement.
• Sildenafil (20 mg): Selectively inhibits PDE5, the predominant phosphodiesterase isoform in genital smooth muscle, preventing hydrolysis of cGMP. This prolongs and amplifies the NO/cGMP vasodilatory signal already generated by L-arginine. Topical genital application is intended to achieve local pharmacologic effect with reduced systemic exposure compared to oral dosing.
• Theophylline (10 mg): Non-selective inhibitor of phosphodiesterase isoforms (PDE1, PDE2, PDE3, PDE4, PDE5), raising intracellular concentrations of both cAMP and cGMP. cAMP activates protein kinase A → smooth muscle relaxation through calcium-mediated mechanisms. Theophylline also antagonizes adenosine receptors and causes vasodilation through decreased vascular tone, providing a complementary vasodilatory action to the NO/cGMP-dominant pathways of arginine and sildenafil.

This triple-vasoactive combination targets the physiologic impairment underlying female sexual arousal disorder (FSAD): insufficient genital blood flow and inadequate clitoral and vaginal engorgement in response to sexual stimulation. By addressing the NO/cGMP pathway through three complementary mechanisms, the preparation aims to augment the physiologic arousal response.

Off-label compounding applications include FSAD, HSDD with arousal component, and post-menopausal vulvovaginal atrophy with arousal impairment, all under prescriber direction.

Monitoring considerations:

• Cardiovascular assessment before prescribing: sildenafil and theophylline are vasoactive; caution in patients with cardiac disease, hypotension, or structural cardiac abnormalities
• Concomitant nitrate use: contraindicated with topical sildenafil (risk of severe hypotension)
• Monitor for systemic sildenafil effects: headache, flushing, visual disturbances, hypotension
• Theophylline: assess for signs of systemic absorption (tachycardia, palpitations)
• Discuss realistic expectations; prescriber should evaluate underlying etiologies (hormonal, psychological, relational)

Contraindications:

• Concurrent use of nitrate medications (organic nitrates or nitric oxide donors): risk of severe, potentially fatal hypotension with sildenafil
• Concurrent use of systemic PDE5 inhibitors without prescriber evaluation
• Hypersensitivity to any component
• Severe cardiovascular disease or recent cardiovascular event
• Severe hypotension

Warnings & Precautions:

• Sildenafil systemic absorption via genital mucosa: although lower than oral dosing, monitor for systemic effects (headache, flushing, hypotension, visual changes)
• Theophylline cardiovascular effects: tachycardia, palpitations possible with systemic absorption; caution in arrhythmia history
• Avoid partner skin transfer; sildenafil and vasoactive agents may cause unintended effects in male partners if absorbed
• Use with caution in patients taking antihypertensives or alpha-blockers due to additive hypotension risk

Drug Interactions:

• Nitrates: absolute contraindication with sildenafil (severe hypotension)
• Alpha-blockers, antihypertensives: additive hypotension
• Systemic PDE5 inhibitors: additive effect; avoid concurrent use
• CYP3A4 inhibitors (e.g., ketoconazole, ritonavir): may increase systemic sildenafil exposure if absorbed

Common Side Effects: Local genital warmth, tingling, or erythema at application site; headache and flushing with systemic absorption of sildenafil; palpitations or tachycardia with systemic theophylline.

Store at room temperature (15–25°C); protect from heat, light, and freezing. Keep the container tightly sealed. Sildenafil is light-sensitive; store in the original opaque container as dispensed by Genesis Compounding. Use within the beyond-use date assigned by the pharmacy.

How does this cream work to improve sexual arousal?

Each ingredient works on a different step of the same pathway. L-arginine provides the raw material for nitric oxide production, which relaxes blood vessels. Sildenafil prevents nitric oxide's signal from breaking down prematurely. Theophylline adds additional vasodilation through a complementary mechanism. Together, they aim to increase blood flow to the clitoris and surrounding tissues to enhance the physical arousal response.

When should I apply this cream?

Apply it to the external genitalia approximately 15–30 minutes before anticipated sexual activity. Your prescriber will provide specific application instructions. Do not apply more often than directed.

Can I use this if I take other medications for sexual function?

You must inform your prescriber of all medications you take, including any oral PDE5 inhibitors (e.g., sildenafil, tadalafil) or heart medications. Use with nitrates (medications for chest pain) is contraindicated due to the risk of serious hypotension.

Will my partner be affected if this cream comes in contact with them?

There is a potential for transfer of vasoactive agents to a partner through skin-to-skin contact. Wash your hands immediately after application, and be aware that genital contact may transfer the cream. Inform your prescriber if this is a concern.

Is this FDA-approved?

No. This is a 503A compounded preparation by Genesis Compounding, prepared under a valid prescriber order for a specific patient. It is not FDA-approved as a compounded drug product. The clinical use of topical vasoactive agents for FSAD is supported by emerging research but remains off-label.