PDE-5 inhibitor may improve ejaculatory function

New data suggest the phosphodiesterase type-5 inhibitor tadalafil (Cialis) may be beneficial in helping men who have problems with ejaculation and orgasm, report researchers from New York-Presbyterian Hospital/Weill Cornell Medical Center, New York.

In their meta-analysis of 17 double-blind, placebo-controlled clinical trials of men with erectile dysfunction, the researchers concluded that approximately 70% of men who used tadalafil during sexual activity for 12 weeks were able to ejaculate most of the time and to reach orgasm, compared to 30% in the placebo group. Also, these benefits were seen despite the level of a man's ED severity.

For the study, which was published in BJU International (2013; 111:334-43), senior author Darius Paduch, MD, PhD, and colleagues examined data from 17 placebo-controlled 12-week trials of tadalafil, given at different doses. These studies included 3,581 participants with a mean age of 54.9 years, including 1,512 men with severe ejaculatory dysfunction (EJD) and 1,812 with severe orgasmic dysfunction (OD). In some cases, patients with one or both of these conditions reported only mild or moderate ED.

The authors examined study participants' responses on questionnaires about the effect tadalafil had on ED, EJD, and OD, among other measures of sexual satisfaction. The original questionnaire was primarily focused on the effects of tadalafil on ED, but provided valuable additional information.

They found that treatment with tadalafil (10 mg or 20 mg taken as needed) was associated with significant increase in ejaculatory and orgasmic function across all levels of severity of ED, EJD, and OD, compared to use of a placebo.

For example, 66% of men with severe EJD and 66% with severe OD who used tadalafil reported improved ejaculatory function, compared with 36% and 35%, respectively, in the placebo group. Also, patients with moderate dysfunction also experienced significant improvements with tadalafil, Dr. Paduch reported.

"More study is needed, but we are hopeful our findings may lead to a treatment for many men who cannot now achieve sexual satisfaction," Dr. Paduch said.

The study was funded by Eli Lilly and Co. Dr. Paduch and one of his co-authors are funded study investigators and consultants for Eli Lilly. In addition, two of Dr. Paduch’s co-authors are employees of, and minor shareholders in, Eli Lilly.