Men with spinal cord injuries appear to have better erectile function when they take tadalafil, according to a report published in Archives of Neurology (JAMA/Archives), November 2007 issue.
Spinal cord injuries are much more common than many people realize; globally about 10.4 to 83 people per million are affected by spinal cord injuries annually, say the authors. “Throughout the world, spinal cord injury occurs most often in young men, resulting in negative physical, social and psychological consequences. Erectile dysfunction, defined as the inability to attain and maintain penile erection sufficient for satisfactory sexual performance, is a common complication in men with spinal cord injury.”
The authors point out that only about one quarter of men with spinal cord injuries manage to have an erection adequate for having sexual intercourse.
Francois Giuliano, M.D., Ph.D., Raymond Poincare Hospital, Garches, France, and team, carried out a randomized, double-blind study on 197 men with spinal cord injuries; their average age was 38. First of all they were all monitored, without treatment for erectile dysfunction. Then 142 of them were randomly selected to receive tadalafil, while 44 received a placebo. The treatment lasted 12-weeks – the participants were asked to take their medication whenever they needed it; before sexual activity, maximum dose one per day. The tadalafil group were given a 10-milligram dose initially, and then 20-milligrams four weeks later, depending on their response to the initial treatment.
The researchers used the International Index of Erectile Function questionnaire. It consists of 15 questions; if a person scores lower than 25 he is deemed as someone who suffers from varying degrees of erectile dysfunction. At the beginning of the study the participants’ average score was 13.4. At the end of the twelve week period the average score for the tadalafil group went up to 22.6. The placebo group’s score rose slightly to 13.6.
Those on tadalafil managed to successfully achieve penetration 75.4% of the time, while successfully attempting intercourse for 47.6% of the time. The participants on the placebo managed to successfully achieve penetration 41.1% of the time while successfully attempting intercourse for 16.8% of the time.
The researchers wrote “Tadalafil was safe and well tolerated with few treatment-emergent side effects,” the authors write. Fifty (35%) of patients in the tadalafil group and 15 (34%) of those in the placebo group experienced at least one adverse effect. Among those taking tadalafil, the most common side effects were headache (8.5% of patients) and Urinary Tract Infection (7.7% of patients). As in other erectile dysfunction studies that include patients who were difficult to treat owing to pre-existing conditions (e.g., prostatectomy, diabetes mellitus), tadalafil was efficacious for the treatment of erectile dysfunction after a traumatic spinal cord injury,” the authors write. “On-demand treatment with tadalafil (10 milligrams or 20 milligrams) may help improve the sex lives of patients with erectile dysfunction and spinal cord injury and their partners.”
“Efficacy and Safety of Tadalafil in Men With Erectile Dysfunction Following Spinal Cord Injury”
François Giuliano, MD, PhD; Antonio Sanchez-Ramos, MD; Dieter Löchner-Ernst, MD; Giulio Del Popolo, MD; Natalio Cruz, MD; Albert Leriche, MD; Giuseppe Lombardi, MD; Susanne Reichert, MD; Palle Dahl, MSc; Albert Elion-Mboussa, MS; Joaquin Casariego, MD
Arch Neurol. 2007;64:(doi:10.1001/archneur.64.11.nct70001).
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Written by: Christian Nordqvist
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