Effects of 12 weeks of tadalafil treatment on ejaculatory and orgasmic dysfunction and sexual satisfaction in patients with mild to severe erectile dysfunction: integrated analysis of 17 placebo‐controlled studies

Abstract

What's known on the subject? and What does the study add? Disorders of ejaculation and orgasm are common, even in men with only mild erectile dysfunction (ED). Treatment with the phosphodiesterase type‐5 inhibitor tadalafil was associated with improvements in ejaculatory and orgasmic function. Patients with residual ejaculatory or orgasmic dysfunction experience reduced sexual satisfaction. These findings need to be corroborated in further clinical trials involving men without ED. Objectives To compare effects of tadalafil on ejaculatory and orgasmic function in patients presenting with erectile dysfunction (ED). To determine the effects of post‐treatment ejaculatory dysfunction (EjD) and orgasmic dysfunction (OD) on measures of sexual satisfaction. Patients and Methods Data from 17 placebo‐controlled 12‐week trials of tadalafil (5, 10, 20 mg) as needed in patients with ED were integrated. EjD and OD severities were defined by patient responses to the International Index of Erectile Function, question 9 (IIEF‐Q9; ejaculation) and IIEF‐Q10 (orgasm), respectively. Satisfaction was evaluated using the intercourse and overall satisfaction domains of the IIEF and Sexual Encounter Profile question 5. Analyses of covariance were performed to compare mean ejaculatory function and orgasmic function, and chi‐squared tests evaluated differences in endpoint responses to IIEF‐Q9 and IIEF‐Q10. Results A total of 3581 randomized subjects were studied. Treatment with tadalafil 10 or 20 mg was associated with significant increases in ejaculatory and orgasmic function (vs placebo) across all baseline ED, EjD, and OD severity strata. In the tadalafil group, 66% of subjects with severe EjD reported improved ejaculatory function compared with 36% in the placebo group (P < 0.001). Similarly, 66% of the tadalafil‐treated subjects (vs 35% for placebo; P < 0.001) with severe OD reported improvement. Residual severe EjD and OD after treatment had negative impacts on sexual satisfaction. Limitations of the analysis include its retrospective nature and the use of an instrument (IIEF) with as yet unknown performance in measuring treatment responses for EjD and OD. Conclusions Tadalafil treatment was associated with significant improvements in ejaculatory function, orgasmic function and sexual satisfaction. Proportions of subjects reporting improved ejaculatory or orgasmic function were ≈ twofold higher with tadalafil than with placebo. These findings warrant corroboration in prospective trials of patients with EjD or OD (without ED).

A systematic review of the correlates and management of nonpremature ejaculatory dysfunction in heterosexual men

“…In patients with ED, a pooled analysis of 17 placebo-controlled 12-week trials, treatment with tadalafil 10 or 20 mg was associated with significant improvement in ejaculatory and orgasmic function. In the tadalafil group, 66% of subjects with severe EjD or severe orgasmic dysfunction reported improvement compared with 35-36% in the placebo group [Paduch et al 2013]. A randomized, double-blind, placebo-controlled study of tadalafil 5 mg once daily for 12 weeks in men with LUTS/BPH, tadalafil treatment significantly improved ejaculation and orgasm compared with placebo or tamsulosin treatment [Giuliano et al 2013].…”

Experiences of Social Workers in Sexual Satisfaction Interventions

“…al., 2017;Soleimani, et. al., 2015) and therapeutic and organic medicines (Al-Sughayir, 2005;Nijland, Davis, Laan, & Schultz, 2006;Paduch, Bolyakov, Polzer, & Watts, 2013;Hong, Wu, & Fan, 2008;Raina, et. al., 2005) are the most widely recognized mediations for enhancing sexual fulfillment.…”

Penile rehabilitation after radical prostatectomy

“…Emerging data on daily use of tadalafil suggest there could be additional benefits in terms of libido and orgasmic function. 7 However, at this time clinical data supporting more than a modest benefit are lacking, and we recommend offering additional therapies to motivated patients.…”