1. ¹Sydney Centre for Sex and Relationship Therapy, Sydney, New South Wales, Australia
2. ²Klinikum der Christian-Albrechts-Universität zu Kiel, Kiel, Germany
3. ³Pfizer Inc, New York, NY, USA
4. ⁴Contractor to Pfizer Inc, New York, NY, USA

Correspondence: Dr R King, Sydney Centre for Sex and Relationship Therapy, 21B Covelee Circuit, Middle Cove, NSW 2068, Australia. E-mail: king.rosie@gmail.com

Received 24 August 2006; Revised 17 December 2006; Accepted 26 December 2006; Published online 15 March 2007.

Abstract

To explore relationships between erection hardness and other outcomes in men with erectile dysfunction (ED). Pooled analyses were conducted on 27 randomized, double-blind, placebo-controlled trials and six open-label trials from the worldwide sildenafil database. Outcomes included erection hardness graded subjectively, hardness and sexual satisfaction questions from the International Index of Erectile Function, general and sexually-specific emotional well-being from the self-esteem and relationship questionnaire, and the erectile dysfunction inventory of treatment satisfaction. Hardness outcomes improved (with a possible dose–response relationship for the achievement of fully hard and rigid erections) and correlated positively with the other outcomes. Sildenafil 100 mg produced optimal erection hardness (fully hard and rigid erections) in a substantial proportion of men with ED. Because optimal erection hardness correlated positively with some emotional well-being and satisfaction outcomes, sildenafil 100 mg may be the most appropriate dosage for treatment of ED for most men.