Sexual Function and Satisfaction in Heterosexual Couples When Men Are Administered Sildenafil Citrate (Viagra®) for Erectile Dysfunction: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

A man's sexual problems including erectile dysfunction (ED) may directly and adversely affect his partner's sexual function. In order to learn whether and how sildenafil (Viagra®) improves sexual function and satisfaction in heterosexual couples, the investigators evaluated 180 men with ED and their partners, most of them postmenopausal women, for whom sexual intercourse initially was satisfactory no more than half the time. A wide range of tests measuring the frequency of sexual intercourse, sexual function, satisfaction, and—for men—self-esteem and quality of the relationship were administered. The male partners took sildenafil in a dose of 25, 50, or 100 mg or placebo, as needed, over 12 weeks. The intention-to-treat population included 85 men taking sildenafil and 91 placebo recipients. The partners of men taking sildenafil found intercourse to be satisfactory more often than those of men taking placebo. Compared with placebo couples, those that were actively treated had higher rates of successful intercourse, better sexual function, greater satisfaction with their sexual activity, and greater satisfaction with treatment. Orgasmic function and sexual desire were unchanged in men taking sildenafil. At the end of treatment, nearly half the men taking sildenafil (46%) but only 15% of those taking placebo were free of ED. Substantially more of the actively treated men reported that they were better able to have intercourse. In addition, they exhibited increased confidence and self-esteem. In general, when one member of a couple improved, the partner also improved. Sildenafil was, in general, well tolerated; there were only 2 severe side effects, rhinitis in a man taking sildenafil and headache in a placebo recipient. These findings underscore the interdependence of sexual function and sexual satisfaction in couples consisting of a man with ED and a sexually healthy woman who is not frequently satisfied with sexual intercourse. They also demonstrate the need to include partners in any discussions about the treatment of ED. Further studies of this sort may help to identify couples, both of whose partners would be expected to benefit if the male partner takes sildenafil as treatment for ED.