Low-dose tadalafil improves sexual function in elderly patients with erectile function
Tadalafil appears to effectively improve sexual function with acceptable side effects in diabetic patients with erectile dysfunction (ED), according to a study. However, older patients fare better with the daily low-dose than the on-demand high-dose protocol.
The retrospective study included 63 diabetic patients (average age 60 years) with ED, of whom 31 had received 5-mg tadalafil once a day and 32 had been given 20-mg tadalafil on-demand four times a month over 3 months. Outcomes such as erectile function (assessed using the International Index of Erectile Function [IIEF]), erectile hardness (measured with erection hardness scale [EHS]), ejaculatory function (assessed using the Male Sexual Health Questionnaire [MSHQ]) and lower urinary tract symptoms (LUTS; evaluated using the International Prostate Symptom Score [IPSS]) were assessed at baseline and at months 1 and 3.
Both tadalafil protocols produced improvements in the IIEF scores in all patients aged <65 years but not in those aged ≥65 years. In other words, the mean IIEF score in patients ≥65 years improved with low-dose but with on-demand tadalafil.
On the other hand, both treatment protocols improved ejaculatory function, the quality of the hardness of an erection and LUTS independently of age.
Mean MSHQ scores increased from 13.7 at baseline to 16.8 at month 3 with low-dose tadalafil (p=0.001) and from 17.2 to 22.0 with on-demand high-dose tadalafil (p=0.02). Mean EHS scores increased from 1.9 at baseline to 2.9 at month 3 (p=0.001) and from 1.8 to 2.7 (p=0.001), respectively. Finally, mean IPSS scores improved from 12.9 at baseline to 11 at month 3 (p=0.002) and from 9.4 to 8.4 (p=0.03), respectively.
The findings suggest that although both tadalafil protocols equally improve sexual function, as well as the average urine flow rate, ejaculatory function and the quality of an erection, it may be beneficial to give the daily 5-mg dose to older patients who do not benefit from the on-demand 20-mg dose, researchers said.