Psychogenic erectile dysfunction is a common problem among young men. Unlike forms caused by vascular, hormonal, or metabolic changes, psychogenic erectile dysfunction mainly stems from performance anxiety, stress, or other emotional factors. Although drugs such as tadalafil have been shown to be effective in improving erectile function, it was unclear whether they could be used as a temporary treatment in patients with psychogenic erectile dysfunction, allowing them to overcome the problem and subsequently maintain normal sexual function without the need for ongoing drug therapy.
To answer this clinical question, our researchers conducted a prospective study on 96 men under the age of 50 with psychogenic erectile dysfunction. All participants took 5 mg of tadalafil once a day and were followed up over time through clinical visits and telephone interviews. The primary objective of the study was to determine how many patients, after discontinuing the drug, were able to maintain normal erectile function spontaneously, without the need for pharmacological support.
The results obtained were extremely encouraging. Eighty-five percent of patients (82 out of 96) spontaneously recovered normal erectile function after discontinuing tadalafil. The median duration of treatment was only 3 months. Particularly relevant is the temporal dynamics of recovery: after just 3 months of treatment, almost half of the patients had recovered spontaneous erectile function; this percentage increased to 60% at 6 months and reached 72% after 12 months. The tolerability profile of the drug proved favorable, with headache reported as the only significant side effect in 9% of cases.
Statistical analysis identified age as the main predictor of therapeutic success: younger patients were more likely to spontaneously recover erectile function. Non-responders, on the other hand, were on average older, with a higher body mass index and more compromised baseline erectile function. The clinical implications of this study are significant: in young patients with psychogenic erectile dysfunction, daily tadalafil can be used as a short-term supportive therapy. The drug helps to break the vicious circle of performance anxiety, allowing patients to regain confidence in their sexual abilities and, subsequently, to maintain physiological erectile function without drug dependence.
Pozzi E, Corsini C, Bertini A, Belladelli F, Raffo M, Negri F, Cattafi F, Cilio S, Boeri L, Capogrosso P, d’Arma A, Ramasamy R, Montorsi F, Salonia A. Spontaneous erectile function recovery among young men with erectile dysfunction taking tadalafil 5 mg once a day. J Sex Med. 2024 Aug 1;21(8):671-675. doi: 10.1093/jsxmed/qdae064. PMID: 38894672.
