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Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time


Sildenafil is one of two oral drugs approved for first-line treatment of erectile dysfunction (ED). Anecdotally, some young healthy men who wish to enhance their sexual performance are requesting or abusing sildenafil. In this randomized double-blind, placebo-controlled clinical study, we investigated the effect of sildenafil in young men without ED. A total of 60 young healthy men age 20–40 y with no reported ED were enrolled for this single-dose home-use study. Subjects had used no medication in the 6 months prior to the study. All had been engaged in a stable relationship for at least 3 months. After completing the IIEF-5 questionnaire, patients were randomized in a double-blind fashion to receive either one 25 mg tablet of sildenafil (group 1) taken prior to intercourse, or an identical placebo tablet (group 2). All subjects completed a questionnaire relating to their erectile quality. There were no differences between the two groups in the reported improvement of erection quality, 12/30 sildenafil vs 10/30 placebo (Fisher's test, P=0.79). Sildenafil caused a significant reduction of the postejaculatory refractory time (12/30 vs 4/30) (χ2 test, P=0.04). Sildenafil does not improve erections in young healthy men. Sildenafil should not be given to young healthy men to improve their erections and patients should be advised against recreational abuse of the drug. In this limited single-dose home study, sildenafil appears to reduce the postorgasmic refractory time. Although controlled studies are needed to evaluate the efficacy of erection-enhancing drugs in premature ejaculation, it is possible that sildenafil might be useful for this indication.

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We thank Dr Eugenio Marro for Statistical analysis.

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Correspondence to N Mondaini.

Appendix A: Questionnarie

Appendix A: Questionnarie

Do you think that your sexual performance after the drug has been better? (YES/NO)

What aspects of your sexual performance do you believe improved?

  1. a)

    Easier erection?

  2. b)

    Erection more rigid?

  3. c)

    Erection lasted longer?

  4. d)

    More intense orgasm?

  5. e)

    A reduction of your *post-ejaculatory refractory time?

Did you have any side effects?

Would you take the drug again?

(*Refractory POST-EJACULATORY TIME: time to get another erection following ejaculation.)

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Mondaini, N., Ponchietti, R., Muir, G. et al. Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time. Int J Impot Res 15, 225–228 (2003).

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  • sildenafil
  • premature ejaculation
  • refractory time
  • IIEF
  • drug abuse

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