Men with erectile dysfunction (ED) and lower urinary tract symptoms suggestive of an enlarged prostate (LUTS/BPH) may see more improvement in erectile function, ejaculation, orgasm, intercourse satisfaction, and overall sexual satisfaction when taking tadalafil rather than tamsulosin, researchers report.
Tadalafil and tamsulosin are two different types of drugs. Tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, is typically prescribed to treat ED and signs and symptoms of BPH. Tamsulosin is an alpha-blocker used to treat signs and symptoms of BPH, but not ED.
The randomized, double-blind, placebo-controlled study, conducted by European and American scientists, involved 310 sexually active men who were age 45 or older and had LUTS/BPH and ED. The participants were a subset of a larger study that assessed each drug in relation to LUTS/BPH.
In the present study, researchers wanted to see how each drug affected a man’s sexual function. The men were divided into three groups. The first included 105 men who were given a placebo. The second comprised 106 men who took 5 mg of tadalafil once daily. The third, made up of 99 men, took 0.4 mg of tamsulosin once daily. The study period lasted for twelve weeks.
To assess sexual function, the researchers administered the International Index of Erectile Function (IIEF) at the start of the study and at 4-, 8-, and 12-week follow up points.
The researchers focused on Questions 9 and 10 of the IIEF to evaluate orgasmic function:
• Question 9: Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you ejaculate?
• Question 10: Over the past 4 weeks, when you had sexual stimulation or intercourse, how often did you have the feeling of orgasm with or without ejaculation?
The research team found that when compared to the placebo group, the men who took tadalafil saw improvement in their erections, orgasms, and ejaculation. They also reported improved intercourse satisfaction and overall sexual satisfaction.
On the other hand, the men who took tamsulosin had no significant improvement in intercourse satisfaction or erectile function. Their IIEF scores for ejaculation, orgasm, and overall sexual satisfaction were worse than those of the placebo group.
The researchers were not certain why the men taking tadalafil had better results. “The mechanism by which tadalafil and other PDE5 inhibitors may improve ejaculation remains unclear but is likely multifactorial,” they wrote.
They added that future studies should use tools specifically designed to assess ejaculation, as the IIEF is intended specifically for erectile function, not ejaculation or orgasm.
The study was published online in January in The Journal of Sexual Medicine.
The Journal of Sexual Medicine
Giuliano, François, MD, PhD, et al.
“Tadalafil Once Daily Improves Ejaculatory Function, Erectile Function, and Sexual Satisfaction in Men with Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia and Erectile Dysfunction: Results from a Randomized, Placebo- and Tamsulosin-Controlled, 12-Week Double-Blind Study”
(Full-text. First published online: January 24, 2013)