Can Viagra Cure Impotence?

This and other findings highlight new research on erectile dysfunction

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HealthDay Reporter

MONDAY, May 10, 2004 (HealthDayNews) -- Three new studies shed light on erectile dysfunction, including treatments for and health risks associated with the condition.

Two of the studies examined the effects of drug treatments for erectile dysfunction -- also known as impotence. The third confirmed previous research that erectile dysfunction is a risk factor for high blood pressure.

The findings were presented May 10 at the American Urological Association's annual meeting in San Francisco.

The first study, by Dr. Frank Sommer and colleagues from the University Medical Center Cologne, Germany, reported that many men with erectile dysfunction who take sildenafil (Viagra) daily can restore normal erectile function.

Sommer's team randomly assigned 76 men to receive Viagra every night or only on demand. Another group of patients did not receive Viagra.

After a year, the men were taken off Viagra, and the researchers found 59 percent of those who had taken Viagra nightly had normal erectile function after discontinuing the drug. In addition, 95 percent of these men continued normal function during six months of follow-up.

Dr. Hossein Sadeghi-Nejad, director of the Center for Male Reproductive Medicine at Hackensack University Medical Center in New Jersey, called the study's finding "an interesting hypothesis."

But, he added, the German researchers did not define the degree of erectile dysfunction that the patients had when they started the study. So the degree of improvement could not be determined.

Studies have shown spontaneous recovery of normal erectile function after the use of a placebo, Sadeghi-Nejad added.

"At the moment, based on this study, you couldn't recommend to patients that they take sildenafil in hopes of curing erectile dysfunction," he said.

Dr. Ira D. Sharlip is an assistant clinical professor of urology at the University of California, San Francisco, and a spokesman for the American Urological Association. "This study needs to be confirmed. I don't think it's definitive," he said.

Based on this study, "I don't think that we can say that men who have erectile dysfunction should take sildenafil every night," he added.

In the second study, U.S. researchers reported a new drug for erectile dysfunction called PT-141 was safe and effective among 271 patients who were randomly given PT-141 or a placebo.

"This drug raises the possibility of a new treatment option for erectile dysfunction," said lead researcher Dr. Hunter Wessells, an associate professor of medicine at the University of Washington, Seattle. "And one that's pretty patient-friendly," he added.

PT-141 is different from Viagra for several reasons, including the fact it's a nasal spray, not a pill, Wessells said.

The research team concluded that "PT-141 was shown to be safe and highly effective in inducing high-quality erections in men with erectile dysfunction."

Sadeghi-Nejad commented that "although the results of the study were good, the drug is not superior to sildenafil." In addition, the researchers did not account for the number of men who dropped out of the study due to nausea and vomiting, which can happen at high doses of PT-141, he added.

"This drug may turn out to be a viable alternative for patients who cannot tolerate sildenafil, but PT-141 is not superior to sildenafil," Sadeghi-Nejad said.

PT-141 is still be tested in clinical trials and has yet to receive U.S. Food and Drug Administration approval.

In the third study, Drs. Peter Sun and Ralph Swindle from the Eli Lilly Research Laboratory in Indianapolis confirmed findings from earlier studies that erectile dysfunction is a risk factor for high blood pressure.

Other studies have shown a relationship between erectile dysfunction and high blood pressure and other cardiovascular conditions, Sharlip said. Erectile dysfunction may be a marker for various forms of cardiovascular disease, he added.

The Lilly researchers collected data on 28 million people in 51 health insurance plans. They found that 41 percent of the men with erectile dysfunction had high blood pressure, compared with only 19 percent of the men without the problem.

Sun and Swindle concluded that "erectile dysfunction patients who have not been diagnosed with hypertension [high blood pressure] should monitor their blood pressure more closely because of the higher likelihood. Similarly, physicians and health plans could use erectile dysfunction as a hypertensive marker to detect and treat hypertensive patients earlier."

Sharlip added that "because there is a relationship between high blood pressure and erectile dysfunction, if a patient has erectile dysfunction but does not have high blood pressure, he should be monitored, because he is at high risk for developing high blood pressure."

"This is an important public health message," Sadeghi-Nejad added. "If you have a patient with erectile dysfunction who has not been diagnosed with high blood pressure, he should be evaluated for it."

More information

The National Institute of Diabetes and Digestive and Kidney Diseases can tell you more about erectile dysfunction. The American Foundation for Urologic Disease offers insights on dealing with impotence.

SOURCES: Ira D. Sharlip, M.D., spokesman, American Urological Association, and assistant clinical professor, urology, University of California, San Francisco; Hossein Sadeghi-Nejad, M.D., director, Center for Male Reproductive Medicine, Hackensack University Medical Center, and associate professor, urology, UMD New Jersey Medical School, Hackensack; May 10, 2004, presentations, American Urological Association annual meeting, San Francisco

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