Arousal Cream
A prescription topical designed to support genital blood flow, sensitivity, and physical arousal — applied in the moment, not taken daily. Compounded and prescribed off-label after clinician review.
Arousal cream uses
- A compounded topical that may support genital blood flow and physical arousal response.
- Applied topically before sexual activity.
- Prescribed after a cardiovascular and medication review.
Good to know
- Volume. 30 mL.
- Formulation. Compounded sildenafil, L-arginine, and nifedipine; prescription-only, prescribed off-label.
- Not safe with nitrates or certain heart conditions. A clinician reviews your history first.
- Medication guide. Read the medication guide (PDF).
Clinician-guided care for physical arousal
Explore care for the physical side of intimacy.
Desire and arousal aren’t the same thing
You can want to be intimate and still feel like your body is slow to catch up. Physical arousal depends on blood flow, sensitivity, and lubrication — and all of those can shift with hormones, age, medications, stress, and time. When the physical response lags behind how you feel, it’s easy to assume the problem is your desire, when it may really be your body’s physical response that needs support. Arousal Cream focuses on exactly that.
- Feel more where it counts. Designed to support genital sensitivity and physical responsiveness.
- Support your body’s natural response. Designed to support local blood flow to genital tissue — the foundation of physical arousal.
- Only when the moment calls for it. Applied before intimacy — not one more daily prescription to remember.
- Topical, not a pill. Works right where you apply it — nothing to swallow, nothing to schedule.
A formulation, not just an ingredient list
Arousal Cream isn’t one drug in a tube — it’s a compounded topical that brings together three ingredients chosen for how they relate to local circulation and blood flow. Because it’s applied topically, it’s designed to act locally, right where you apply it, so it fits into the moment instead of a daily routine.
- Sildenafil. A well-studied medicine that supports blood flow by helping blood vessels relax.
- L-arginine. An amino acid the body uses to make nitric oxide, which helps blood vessels open.
- Nifedipine. Helps relax the smooth muscle in vessel walls to support circulation.
Arousal Cream is compounded and prescribed off-label. Evidence for topical formulations like this is limited, and individual results vary.
Made for the moment
Apply a thin layer to clean, dry skin before intimacy, as directed on your prescription label. That’s the whole routine — use it when you want it, not on a schedule.
Full application, storage, and safety steps come with your Medication Guide.
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Order a test
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Collect a sample
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See a doctor
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Get treated
Read your medication guide
Review the full medication guide for additional product and safety information.
Frequently asked questions
What is Arousal Cream designed to help with?
It’s for women who have a persistent, bothersome difficulty with genital arousal, sensation, or lubrication, and want to support the physical side of that response. A licensed clinician confirms whether it’s appropriate for you based on your symptoms, health history, and current medications.
How does it work?
It combines three ingredients that each affect blood flow by a different mechanism — sildenafil, L-arginine, and nifedipine — applied directly to the genital area. The intent is to support local blood flow and physical arousal response. Evidence for topical treatments of this kind is limited, response varies from patient to patient, and benefit is not guaranteed.
Is this the same as taking oral Viagra (sildenafil)?
No. Arousal Cream is applied topically to act locally where it's applied, so it isn't absorbed the same way as an oral tablet, and the amount of sildenafil differs from oral sildenafil prescribed for erectile dysfunction. Do not take oral sildenafil unless a clinician has prescribed it for you.
When do I use it?
Before sexual activity, following the timing on your prescription label and your clinician’s instructions. It’s used as needed, not on a daily schedule.
How often can I use it?
Use Arousal Cream before sexual activity and only as directed by your clinician and your prescription label — not more often than prescribed. If you have questions about how often to use it, ask your care team.
Is it safe to use before oral sex?
Sildenafil is a prescription medication and should not be taken by mouth. If oral contact may occur, gently wipe the treated area clean first, and follow your clinician's guidance.
Where do I apply it?
Apply Arousal Cream to the area specified on your prescription label, as directed by your clinician. Use it only as instructed, and keep it away from your eyes, mouth, broken or irritated skin, and active infections.
How does the process work?
Complete an online health questionnaire about your medical history, current medications, and treatment goals. A licensed clinician reviews your information and determines whether treatment is appropriate. If prescribed, you’ll receive treatment instructions and can complete checkout for medication delivery.
Do I need a video appointment?
Eligible patients can receive care through an online questionnaire and messaging, without scheduling a video call. Your clinician may recommend a live or in-person visit if additional evaluation is needed.
Which states are eligible for online questionnaire-based visits?
Our asynchronous visits are currently available in:
Arizona, California, Colorado, Florida, Illinois, Iowa, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin, and Wyoming.
Availability is confirmed during intake. Eligibility also depends on your medical history and the medication requested. If your state isn’t listed, asynchronous care is not currently available there.
Is a prescription guaranteed?
No. A prescription is issued only when a licensed clinician determines that treatment is appropriate for you. Completing the questionnaire does not guarantee a prescription.
What is a compounded medication?
A compounded medication is prepared by a pharmacy according to a prescription to meet an individual patient’s needs. Compounded medications are not FDA-approved, and the FDA does not review their safety, effectiveness, or quality before they are marketed.
How will I receive my medication?
After your prescription is approved and payment is completed, our licensed partner pharmacy processes your order and ships it to the address confirmed at checkout. You’ll receive tracking information by text or email once it ships. Preparation and delivery times can vary.
Can I use insurance for my medication?
Medication costs and prescription coordination fees are self-pay and are not billed to insurance. You’ll see a breakdown of these costs before confirming payment.
How do refills work?
Refills require a valid prescription and remaining authorized refills. Depending on your medication, you may need to complete a health check-in before a refill can proceed. When your prescription expires or you run out of authorized refills, a new clinical evaluation may be required.
Can I change or cancel automatic refills?
Yes. Use the “Manage refills” link in your refill notification or patient portal to manage upcoming refills, update shipping or payment details, or cancel automatic refills. Make changes before the scheduled charge date.
Who can I contact with questions?
Contact your Paloma care team with questions about your treatment or prescription. For help with orders, shipping, or refills, email contact@palomahealth.com.
Important safety information
Arousal Cream is compounded and used off-label. It is not FDA-approved for female sexual arousal difficulty or for any other use.
Do NOT use this cream if you take nitrate medicines in any form — including nitroglycerin, isosorbide, or recreational "poppers" (amyl or butyl nitrite) — or if you take riociguat. Combining these with a medication in this cream can cause a sudden, dangerous drop in blood pressure.
Tell your clinician if you take any other blood-pressure medicine, an alpha-blocker, or an oral erectile-dysfunction medication such as sildenafil, tadalafil, or vardenafil, and if you have a history of low blood pressure, fainting, or heart disease.
Do not use if you are pregnant, trying to become pregnant, or breastfeeding. This medication is for adults 18 and older.
The cream can transfer to a partner during contact. Talk with your clinician about precautions before sexual activity, and tell them if a partner develops irritation or any other reaction.
Stop use and seek urgent care for chest pain, fainting, severe shortness of breath, or a sudden change in vision or hearing.
Active ingredients
- Sildenafil
- L-arginine
- Nifedipine
Inactive ingredients
- Compounded topical cream base, as prepared by the pharmacy
- Burning, stinging, irritation, or redness where the cream is applied
- Headache
- Flushing
- Dizziness or lightheadedness
- Irritation in an exposed partner
Store at room temperature, away from heat, moisture, and direct sunlight. Keep the container tightly closed when not in use.
For external use only, applied as directed by your clinician. Do not use with nitrates in any form (including "poppers") or with riociguat. Do not use during pregnancy, while trying to become pregnant, or while breastfeeding. Do not use if you are under 18. Avoid contact with the eyes and mouth. Do not apply to broken, irritated, or infected skin. Stop use and contact your clinician for severe burning, rash, swelling, sores, genital pain, or bleeding — in yourself or an exposed partner. Keep out of reach of children and pets.
Read your medication guide
Review the full medication guide for additional product and safety information.
Compounded medications
More options for your care.
Explore additional options for hair, skin, sexual wellness, and more—alongside the thyroid, HRT, and weight loss care we provide through live visits.
Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the FDA. Rx Required.
