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International Journal of Impotence Research (2014) 26, 146150 & 2014 Macmillan Publishers Limited All rights reserved 0955-9930/14
http://www.nature.com/ijir
Web End =www.nature.com/ijir
ORIGINAL ARTICLE
Changes in sexual inhibition and excitation during PDE5I therapy
CCJ Louizos1, B McCann2 and PK Knight1
The aim of this longitudinal study was to assess possible changes in sexual inhibition and excitation (measured using the Sexual Inhibition and Sexual Excitation Scales (SIS/SES)) in men being treated with PDE5 inhibitors (PDE5I) for ED. Established PDE5I users diagnosed with psychogenic ED completed the SES/SIS questionnaire at recruitment and 3 months later. On the basis of International Index of Erectile Function scores at recruitment, subjects were divided into two groups mildly affected (M) and mild-to-moderately affected (MM). SES scores were signicantly lower, and SIS1 scores were signicantly higher in Group MM at recruitment and at 3 months (Po0.001). In Group M, SES scores increased (Po0.005) and SIS1 (Po0.001) and SIS2 (P 0.01) scores
decreased over the 3 months of the study. In Group MM, ongoing decreases in SES and increases in SIS1 scores were observed (Po0.001). The results of multiple linear regression showed that SIS/SES variables were of little value in predicting erectile function (EF) at recruitment, or changes in EF during the study period. The results for Group M showed that men whose EF scores increased were more likely to experience increased SIS2 and decreased SES scores.
International Journal of Impotence Research (2014) 26, 146150; doi:http://dx.doi.org/10.1038/ijir.2013.54
Web End =10.1038/ijir.2013.54 ; published online 23 January 2014
Keywords: erectile dysfunction; phosphodiesterase type 5 inhibitor; SIS/SES
INTRODUCTIONDrugs of the PDE5 inhibitor (PDE5I) class have been widely used to treat ED, and are the rst-line oral therapy for patients experiencing ED regardless of its etiology.1 However, in order for PDE5Is to exert a therapeutic effect, sexual arousal is necessary.24
According to the Dual Control Model proposed by Bancroft and Janssen, sexual arousal is determined by the balance of inhibitory and excitatory mechanisms that act centrally in the brain.5 Low excitation or high inhibition are believed to increase the likelihood of an impaired sexual response.6 In a series of qualitative, semi-structured interviews Tomlinson and Wright showed that unsuccessful treatment with sildenal was associated with adverse psychological effects in patients, suggesting that failure to achieve normal erectile function (EF)...