Whether Adding Vitamin D to Tadalafil 5 mg Treatment Is Useful in Patients with Erectile Dysfunction and Vitamin D Deficiency?

Abstract

<b><i>Introduction:</i></b> Numerous factors such as endothelial disease and hormonal disorder cause the development of erectile dysfunction (ED). However, the relationship between vitamin D deficiency (VDD) and ED is unclear. Moreover, the benefit of vitamin D replacement on ED patients with VDD is uncertain. As far as we know, there is no study yet in the literature regarding the addition of vitamin D to phosphodiesterase type 5 inhibitors in the treatment of ED patients with VDD. In this study, we investigated whether adding vitamin D to daily tadalafil treatment would be beneficial in ED patients with VDD. <b><i>Methods:</i></b> A total of 111 patients with VDD accompanying ED were retrospectively evaluated between January 2016 and December 2019. Patients were divided into 2 groups according to the treatment they received. Group 1 (<i>n</i> = 58) was treated with daily oral tadalafil 5 mg, while group 2 (<i>n</i> = 53) received oral tadalafil 5 mg and 4,000 IU vitamin D3. Total International Index of Erectile Function-15 (IIEF-15) scores and vitamin D levels of the groups were compared at the end of the study. <b><i>Results:</i></b> The mean vitamin D level was increased statistically significant in group 2, but no difference was seen in group 1 (<i>p</i> < 0.001 and <i>p</i> > 0.05, respectively). There was a significant increase in median erectile function, orgasmic function, sexual desire, sexual satisfaction, and overall satisfaction scores in both groups (<i>p</i> < 0.001). However, the increase in median erectile function and sexual desire scores was significantly higher in group 2 compared to group 1 at the end of the study (<i>p</i> = 0.01 and <i>p</i> < 0.001, respectively). <b><i>Conclusion:</i></b> We found that adding vitamin D to 5 mg oral daily tadalafil treatment may have an additional positive effect on erectile function and sexual desire in ED patients with VDD.

Analysis of the Impact of Clinical Factors on Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction

“…On average, men with ED are approximately 60 years old and suffer from chronic comorbidities in approximately 80% of cases, while 94% have a regular comedication intake [22]. In fact, 88% receive pharmacological treatment for their ED, mainly PDE5is such as tadalafil [22][23][24]. Unfortunately, 37% of patients do not notice any effects of PDE5is, while 49% discontinue the treatment because of side effects or ineffectiveness [25].…”

Mechanisms Suggesting a Relationship between Vitamin D and Erectile Dysfunction: An Overview

“…To date, only a few studies have evaluated vitamin D administration as a possible therapeutic strategy to treat patients with ED [ 164 , 165 ]. Indeed, a retrospective study demonstrated a greater improvement in erectile function in patients with ED treated with tadalafil and vitamin D (4000 IU/day) compared to those treated with tadalafil alone [ 164 ].…”

The effect of vitamin D replacement in patients with lower urinary tract complaint/erectile dysfunction resistant to Tadalafil 5 mg treatment: A pilot clinical study

“…In a study, the relationship between the effect of Sildenafil 100 mg and Vitamin D level was evaluated and it was concluded that a 25(OH) vitamin D level in the normal range was important for the success of Sildenafil (Mostafa et al, 2019). In another study, Tadalafil 5 mg + Vitamin D replacement therapy was shown to have better results compared to the patients taking Tadalafil 5 mg alone (Demirci et al, 2021). The present study differs in that patients who did not respond to Tadalafil 5 mg treatment were included in the present study.…”

“…It was found that patients who did not respond to sildenafil citrate treatment, which is another PDE-5 inhibitor, had lower Vitamin D levels (Mostafa et al, 2019). In the recent study, it was reported that Vitamin D supplementation with Tadalafil 5 mg had positive results on ED (Canguven et al, 2017;Demirci et al, 2021). The effect of Vitamin D supplementation has not been evaluated in patients who do not respond to Tadalafil treatment.…”