Ms. A was a 37-year-old Caucasian woman who was successfully treated for panic disorder without agoraphobia and for generalized anxiety disorder with sertraline, 100 mg/day, for over 2 years after difficulty tolerating trials of alprazolam and clonazepam. Unfortunately, she developed anorgasmia from the sertraline within 3 months of reaching this dose. A dose reduction to 50 mg/day led to relapse, although her anorgasmia improved. Sildenafil augmentation 1 hour before sexual activity reversed her anorgasmia but only at the 100-mg dose; the 50-mg dose was ineffective. The anorgasmia persisted if she forgot to take sildenafil. The cost, however, was prohibitive because the drug was not covered by her health insurance. She was interested in trying vardenafil instead because it cost less than sildenafil. She found that vardenafil in the 10-mg strength was not only effective in reversing anorgasmia but was also more affordable because she could break the 20-mg pills in half. Ms. A could not detect any difference in the onset of action, the duration of effect, or adverse reactions from vardenafil compared to what she felt while taking sildenafil. Vardenafil has continued to be effective when she uses it once or twice a week for 9 months to date without any difficulty tolerating it.