Yohimbine has had questionable effects in men with organic erectile dysfunction. We conducted this study to better define the population of men responsive to yohimbine, because tobacco was thought to affect a regimen of yohimbine more than other risk factors. We measured nocturnal penile tumescence with the RigiScan™ monitor, hormone profiles, answers to the Florida Sexual Health Questionnaire, and clinical responses at baseline and after two different doses of yohimbine in 18 nonsmoking men with erectile dysfunction. Of the 18 men, nine (50%) were successful in completing intercourse in more than 75% of attempts. The yohimbine responders were men with less severe erectile dysfunction as manifested by improved increased rigidity on RigiScan™ testing, higher Florida Sexual Health Questionnaire scores, and slightly higher levels of serum testosterone. Yohimbine is an effective therapy to treat organic erectile dysfunction in some men with erectile dysfunction.
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Crenshaw TL, Goldberg JP . Sexual Pharmacology: Drugs that Affect Sexual Functioning. WW Norton: New York 1996 427–441.
Giuliano F, Rampin O . Alpha receptors in the central nervous system and its effects on erection. J Androl 1999 20: 683–687.
Murburg MM, Villacres EC, Ko GN, Veith RC . Effects of yohimbine on human sympathetic nervous system function. J Clin Endocrinol Metab 1991 73: 861–865.
Galitzky J et al. Pharmacodynamic effects of chronic yohimbine treatment in healthy volunteers. Eur J Clin Pharmacol 1990 39: 447–451.
Doherty PC . Oral, transdermal, and transurethral therapies for erectile dysfunction. In: Hellstrom WJ (ed). Male Infertility and Sexual Dysfunction. Springer-Verlag: New York 1997 452–466.
Freeman RR, Woodward S, Sabharwal SC . Alpha 2-adrenergic mechanism in menopausal hot flushes. Obstet Gynecol 1990 76: 573–578.
Montorsi F, Guazzoni G, Rigatti P, Pozza G . Pharmacological management of erectile dysfunction. Drugs 1995 50: 465–479.
Morales A, Heaton JP, Johnston B, Adams M . Oral and topical treatment of erectile dysfunction: present and future. Urol Clin North Am 1995 22: 879–886.
Traish AM, Kim NN, Goldstein I, Moreland RB . Alpha-adrenergic receptors in the penis: identification, character-ization, and physiological function. J Androl 1999 20: 671–682.
Margolis R, Leslie CH . Review of studies on a mixture of nux vomica, yohimbine and methyl testosterone in the treatment of impotence. Curr Ther Res 1966 8: 280–285.
Margolis R, Prieto P, Stein L, Chinn S . Statistical summary of 10 000 male cases using afrodex in treatment of impotence. Curr Ther Res 1971 13: 616–622.
Reid K et al. Double-blind trial of yohimbine in treatment of psychogenic impotence. Lancet 1987 2: 421–423.
Mann K et al. Effects of yohimbine on sexual experiences and nocturnal penile tumescence and rigidity in erectile dysfunction. Arch Sex Behav 1996 25: 1–16.
Jacobsen FM . Fluoxetine-induced sexual dysfunction and an open trial of yohimbine. J Clin Psychiatry 1992 53: 119–122.
Riley AJ, Goodman RE, Kellett JM, Orr R . Double blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sex Marital Ther 1989 4: 17–26.
Kunelius P, Häkkinen J, Lukkarinen O . Is high-dose yohimbine hydrochloride effective in the treatment of mixed-type impotence? A prospective, randomized, controlled double-blind crossover study. Urology 1997 49: 441–444.
Montague DK et al. Clinical guidelines panel on erectile dysfunction: summary report on the treatment of organic erectile dysfunction. J Urol 1996 156: 2007–2011.
Telöken C et al. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998 159: 122–124.
Morales A, Surridge DH, Marshall PG, Fenemore J . Nonhormonal pharmacological treatment of organic impotence. J Urol 1982 128: 45–47.
Sonda LP, Mazo R, Chancellor MB . The role of yohimbine for the treatment of erectile impotence. J Sex Marital Ther 1990 16: 15–21.
Susset JG et al. Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol 1989 141: 1360–1363.
Morales A et al. Is yohimbine effective in the treatment of organic impotence? Results of a controlled trial. J Urol 1987 137: 1168–1172.
Carey MP, Johnson BT . Effectiveness of yohimbine in the treatment of erectile disorder: four meta-analytic integrations. Arch Sex Behav 1996 25: 341–360.
Ernst E, Pittler MH . Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. J Urol 1998 159: 433–436.
Geisser ME et al. Reliability and validity of the Florida sexual history questionnaire. J Clin Psychol 1991 47: 519–528.
Geisser ME et al. Use of the Florida sexual history questionnaire to differentiate primary organic from primary psychogenic impotence. J Androl 1993 14: 298–303.
Boolell M, Gepi-Attee S, Gingell C, Allen M . Sildenafil (Pfizer UK-92,480), a novel orally active therapy for male erectile dysfunction. Eur Urol 1996 30: 158.
Bain CL, Guay AT . Reproducibility in monitoring nocturnal penile tumescence and rigidity. J Urol 1992 148: 811–814.
Bain CL, Guay AT . Letter. J Urol 1990 143: 1379.
Guay AT, Perez JB, Heatley GJ . Cessation of smoking rapidly decreases erectile dysfunction. Endocr Pract 1998 4: 23–26.
Vogel RA . Brachial artery ultrasound: a noninvasive tool in the assessment of triglyceride-rich lipoproteins. Clin Cardiol 1999 22: Suppl II II34–II39.
Wincze JP et al. A comparison of nocturnal penile tumescence and penile response to erotic stimulation during waking states in comprehensively diagnosed groups of males experiencing erectile difficulties. Arch Sex Behav 1988 17: 333–348.
Friesen K, Palatnick W, Tenenbein M . Benign course after massive ingestion of yohimbine. J Emerg Med 1993 11: 287–288.
Lenders JW, Golczynska A, Goldstein DS . Glucocorticoids, sympathetic activity, and presynaptic α2-adrenoceptor function in humans. J Clin Endocrinol Metab 1995 80: 1804–1808.
Goldstein DS, Grossman E, Listwak S, Folio CJ . Sympathetic reactivity during a yohimbine challenge test in essential hypertension. Hypertension 1991 18: Suppl III III40–III48.
Clark JT, Smith ER, Davidson JM . Testosterone is not required for the enhancement of sexual motivation by yohimbine. Physiol Behav 1985 35: 517–521.
Traish AM et al. A heterogeneous population of α1 adrenergic receptors mediates contraction of human corpus cavernosum smooth muscle to norepinephrine. J Urol 1995 153: 222–227.
Bancroft J . Effects of alpha-2 blockade on sexual response: experimental studies with delequamine (RS15385). Int J Impot Res 2000 12: Suppl 1 S64–S69.
Morales A . Yohimbine in erectile dysfunction: the facts. Int J Impot Res 2000 12: Suppl 1 S70–S74.
Montorsi F et al. Effect of yohimbine-trazodone on psychogenic impotence: a randomized, double-blind, placebo-controlled study. Urology 1994 44: 732–736.
The authors thank Gail Macey as research coordinator and Polly Zorolow and Lynda Charters for editorial assistance. This work was supported by a grant from the Ellithorpe Fund for Adrenal Research.
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Guay, A., Spark, R., Jacobson, J. et al. Yohimbine treatment of organic erectile dysfunction in a dose-escalation trial. Int J Impot Res 14, 25–31 (2002). https://doi.org/10.1038/sj.ijir.3900803
- organic erectile dysfunction
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