Arousal Formulas

The Arousal Formula is a customized prescription blend that may include ingredients such as; local vasodilators and/or blood flow enhancers that target the main symptoms of female sexual dysfunction. This formulation may help improve sensitivity, arousal and satisfaction. It is an odorless gel typically applied 30 minutes prior to sexual activity as needed.

What is the Arousal Formula?

The Arousal Formula combines prescription ingredients in a proprietary base developed specifically for vaginal applications. This nonirritating base is designed to be gentle on vaginal tissue, release drugs and maintain contact with the mucosa, all while providing a uniquely pleasant experience for patients. The Arousal Formula is specifically made without fragrance, gluten, wheat, milk, soy, nuts or eggs.

Common Ingredients


L-arginine, an amino acid, is the precursor to nitric oxide (NO), a potent vasodilator that causes blood vessels to dilate. L-arginine has been shown to dilate clitoral blood vessels, increasing flow to erogenous zones and helping to improve arousal


Pentoxifylline improves the flow of blood through blood vessels, which may lead to improved sexual arousal. Researchers have shown pentoxifylline improves microvascular blood flow in conditions of vascular insufficiency. The clinical benefits have been attributed to decreasing the viscosity of blood and thereby improving its flow.


Sildenafil improves the flow of blood through blood vessels, which may lead to improved sexual arousal. Sildenafil was found to be effective in enhancing vaginal engorgement during erotic stimulus conditions in healthy women.


Testosterone is naturally produced in the female body and declines with age. Research has shown topical testosterone replacement has significantly improved sexual desire, frequency of sex, receptivity, and initiation of sexual desire in menopausal women.

Frequently asked questions

What is a compounded medication?

One size doesn’t fit all and every patient is unique. Drug compounding is the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of a patient by a pharmacist as the result of a practitioner’s prescription drug order. While compounded medications are not FDA-approved, they serve an important patient need—especially when FDA-approved medication is not available for treatment. Our formulations are made to order in small batches to ensure freshness. The specific ingredients in your compounded formula will depend on your specific concerns and goals. It should be understood that your personal healthcare practitioner will make the final decision.

Are compounded medications FSA & HSA eligible?

Yes! All of our compounded formulations, regardless of ingredients, are eligible for Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA).

What is female sexual dysfunction?

Female sexual dysfunction (FSD) becomes more prevalent as women age, affecting nearly 40% of women. Common symptoms associated with FSD include diminished vaginal lubrication, pain and discomfort upon intercourse, decreased sense of arousal and difficulty in achieving orgasm. Only a small percentage of women seek medical attention.

When should I see improvement in my symptoms?

Based on research and patient testimonials, you may see improvement as early as 30 minutes to 1 hour; however, each patient is unique and time frames may differ.

How should I use the Arousal Formula?

  • The Arousal Formula is for vaginal use only. If this medicine gets in your eyes or mouth, rinse with water.

  • Follow all directions on your prescription label and read all medication guides or instruction sheets.

  • Wash your hands with soap and water before and after applying the medicine. Do not allow other people to get this medicine on their skin. If this happens, wash the area thoroughly with soap and water.

  • Apply a thin layer to the clitoris 30 minutes prior to sexual activity and rub in completely.

  • You may experience warmth, redness, or a tingling sensation, which is normal.

  • The Arousal Formula is not edible.

  • Do not cover treated skin with a bandage. Bandaging can increase the amount of drug absorbed through your skin and may cause harmful effects.

  • Call your doctor if your symptoms do not improve, or if they get worse while using the Arousal Formula.

Who should not use the Arousal Formula?

Do not start using the Arousal Formula if you have a history of hypersensitivity to any of the ingredients prescribed. Caution in patients with unusual vaginal bleeding, genital herpes viral infection and history of low blood pressure.

What happens if I miss a dose?

Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not apply two doses at one time.

How should I store this medication?

Store at room temperature away from moisture and heat between 68°F to 77°F (20°C to 25°C).

Safety Information

Research has shown, topically applied medications are less likely to cause the same systemic side effects or drug-to-drug interactions as oral medications; however, there is never an absolute zero chance that side effects or drug interactions will not occur. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

What should I avoid while using the Arousal Formula?

  • Do not take this by mouth.

  • Do not apply to an open skin wound, or on areas of infection, rash, burn, or peeling skin.

  • Do not use this formula if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate as these drugs can cause a sudden and serious decrease in blood pressure.

  • Avoid using other products that may contain sildenafil, arginine, or pentoxifylline.

  • Avoid using skin products that can cause irritation, such as harsh soaps, shampoos, or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime. Do not use other medicated skin products unless your doctor has told you to.

  • Do not use it if you are pregnant or breastfeeding a baby.

What are the common side effects of the Arousal Formula?

Common side effects may include application site reactions of:

  • Skin reactions (dermatitis)

  • Burning, stinging or warmth

  • Itching or tingling

  • Redness, dryness or peeling

  • Headache or dizziness

Get emergency medical help if you have signs of an allergic reaction: hives, severe itching; difficult breathing; swelling of your face, lips, tongue, or throat. These are not all of the possible side effects of the Arousal Formula. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider if you have any side effects that bother you or do not go away.

What happens if I overdose?

An overdose is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.


  • Allahdadi, K. J., Tostes, R. C., & Webb, R. C. (2009). Female sexual dysfunction: therapeutic options and experimental challenges. Cardiovascular & hematological agents in medicinal chemistry, 7(4), 260–269.

  • Laan E, van Lunsen RH, Everaerd W, Riley A, Scott E, Boolell M. The enhancement of vaginal vasocongestion by sildenafil in healthy premenopausal women. J Womens Health Gend Based Med. 2002 May;11(4):357-65. doi: 10.1089/152460902317585994. PMID: 12150498.

  • Pyke RE. Sexual Performance Anxiety. Sex Med Rev. 2020 Apr;8(2):183-190. doi: 10.1016/j.sxmr.2019.07.001. Epub 2019 Aug 22. PMID: 31447414.

  • Sonkin PL, Chen LE, Seaber AV, Hatchell DL. Vasodilator action of pentoxifylline on microcirculation of rat cremaster muscle. Angiology. 1992 Jun;43(6):462-9. doi: 10.1177/000331979204300602. PMID: 1595940.

  • AskMayoExpert. Sexual dysfunction in women. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.

  • Wein AJ, et al., eds. Sexual function and dysfunction in the female. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. Accessed Aug. 6, 2018.

  • Shifren JL. Overview of sexual dysfunction in women: Epidemiology, risk factors, and evaluation. Accessed Aug. 6, 2018.

  • Frequently asked questions. Women's health FAQ072. Your sexual health. American College of Obstetricians and Gynecologists. Accessed Aug. 6, 2018.

  • Fact sheet: Female sexual dysfunction. Hormone Health Network. Accessed Aug. 9, 2018.

  • Overview of female sexual function and dysfunction. Merck Manual Professional Version. Accessed Aug. 9. 2018.

  • Shifren JL. Overview of sexual dysfunction in women: Management. Accessed Dec. 9, 2020.

  • Santoro N, et al. Role of estrogens and estrogen-like compounds in female sexual function and dysfunction. The Journal of Sexual Medicine. 2016;13:305.

  • Cappelletti M, et al. Increasing women's sexual desire: The comparative effectiveness of estrogens and androgens. Hormones and Behavior. 2016;78:178.

  • Khamba B, et al. The efficacy of treatment of sexual dysfunction secondary to antidepressants. The Journal of Alternative and Complementary Medicine. 2013;19:862.

  • Effective treatments for sexual problems. The North American Menopause Society. Aug. 6, 2018.

  • FDA approves new treatment for hypoactive sexual desire disorder in premenopausal women. U.S. Food and Drug Administration. Accessed Dec. 9, 2020.

  • Vyleesi (prescribing information). Waltham, Mass.: AMAG Pharmaceuticals, Inc.; 2019. Accessed Dec. 9, 2020.


All prescription medications require a valid and complete online consultation prior to approval and final pricing is determined. All compounded medications in the U.S. are considered off-label use. Licensed healthcare practitioners have the ability to prescribe compounds for off-label treatment, if they believe that it is an appropriate course of treatment.

The drug and medical information provided on this website is not meant to cover all adverse effects, drug interactions, warnings, medical uses, directions and precautions. The information provided is a medical resource and the judgment of your physician and/or healthcare practitioner should not be substituted. Premier Pharmacy has made every effort to ensure the information on the website is accurate and current based on present medical literature.

Premier Pharmacy does not make any guarantees regarding the drug and medical information, and does not assume responsibility regarding the content. The drug safety and drug information contained on the website may be time sensitive and should not be utilized as a medical reference beyond the date hereof. The deficiency of a warning for prescription medications and vitamins provided on this website in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient.

If you have questions or concerns about your medications, please do not hesitate to contact us and/or your medical practitioner, including your pharmacist. Compound prescription products have not been tested or approved by the FDA for their intended use. No claims are made as to the safety, efficacy or use of this compound.