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Relationship between erectile function and sexual self-confidence: a path analytic model in men being treated with tadalafil


Sexual self-confidence has been shown to be associated with erectile function (EF) in men receiving PDE-5 inhibitor therapy; however, few studies have investigated the pathways (for example, sexual satisfaction, communication, time concerns and spontaneity) through which improvements in sexual self-confidence occur. This study examined this relationship using a path analysis model in men with ED enrolled in an open-label clinical trial of 20 mg tadalafil, administered on-demand over 12 weeks. International Index of Erectile Function and Psychological and Interpersonal Relationship Scales data were used to assess improvement in EF, sexual confidence and mediating variables. Controlling for baseline measures and covariates, the model indicated that change in sexual self-confidence was significantly associated with changes in EF (P<0.0001), sexual communication conflict (P=0.01), time concerns (P<0.0001) and spontaneity (P<0.0001). The total effect of EF on sexual self-confidence was 0.85, with 0.08 of this relationship indirectly mediated through time concerns and spontaneity. These data suggest that improved sexual confidence in men receiving treatment with a long-acting PDE-5 inhibitor occurs both directly via improved EF and indirectly via improved spontaneity and diminished time concerns.

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We acknowledge New England Research Institutes employees May Yang, MPH and Heather Litman, PhD for statistical analysis and interpretation and Andre Araujo, PhD for scientific consultation on the statistical analysis plan and data interpretation. We also acknowledge Stephanie Brillhart of PharmaNet/i3 for writing and editorial support for the manuscript. This study was sponsored by Eli Lilly.

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Correspondence to A Sontag.

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Dr Sontag is an employee of and stockholder in Eli Lilly. Dr Ni is an employee of and stockholder in Eli Lilly. Dr Althof has consulted for Abbott, Bayer, Eli Lilly, Palitan Pharmaceuticals and Promenescent. Dr Rosen has consulted for Auxilium, Bayer Healthcare, Eli Lilly and Palatin Pharmaceuticals.

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Sontag, A., Ni, X., Althof, S. et al. Relationship between erectile function and sexual self-confidence: a path analytic model in men being treated with tadalafil. Int J Impot Res 26, 7–12 (2014).

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