Although the variety and extant of sexual dysfunctions in women seem to be greater than in men, their pathophysiologies and treatments are poorly understood. It is recognized that diabetes is detrimental to female sexuality and is likely multifactorial, including both psychologic and physiologic dimensions. The most common class of female sexual dysfunctions is arousal disorder; physiologically, this is accompanied by vasodilation and engorgement of the female external genitalia . In light of this, Caruso et al undertook a placebo-controlled, double-blinded trial of 100 mg sildenafil in type 1 diabetic women with sexual dysfunction. Of the 28 women who completed the trial, significant improvement was seen in both subjective and objective parameters. Subjectively, arousal, orgasm and dyspareunia were all improved in those taking sildenafil in comparison to baseline and those taking placebo. Color Doppler ultrasonography was performed on the clitoral arteries, revealing an increase in blood flow in these women. However, it should be noted that the use of ultrasonography in the evaluation of women with sexual dysfunction is not routine and these results should be cautiously interpreted.