New study finds erections last more than twice as long with ED treatment

Erectile dysfunction is one of the most commonly occurring male sexual disorders and places a significant burden on male health and interpersonal relationships. Approximately 70% of males with erectile dysfunction have coexisting hypertension, hyperlipidaemia, diabetes mellitus or depression.

Dr John Cherry at the Perth Human Sexuality Centre says erectile function is tantamount to the mental health and well-being of any man.

"It is something totally intertwined with personality," he says.

"When there are issues in that area, depression can follow as well as self-esteem issues, so successful treatment is incredibly important for overall health."

There are three currently available pharmacological treatments for erectile dysfunction including:

• Vardenafil (Levitra);
• Sildenafil (Viagra); and
• Tadalafil (Cialis).

These medications were approved for use based on results obtained from patient diaries and questionnaires including:

• Erectile function domain of the International Index of Erectile Function (IIEF-EF);
• Sexual Encounter Profile (SEP); and
• Global Assessment Questionnaire (GAQ): "Has the treatment you have been taking over the past 4 weeks improved your erections?"

The ENDURANCE study is the first of its kind to incorporate the use of a novel stopwatch assessment tool to measure the duration of erection. This was defined as the time from erection perceived hard enough for penetration until withdrawal from the partner’s vagina. The ENDURANCE study investigated the relative effectiveness of 10 mg vardenafil, compared with placebo, in increasing the duration of erection leading to successful intercourse.

The study included males aged 18–64 in a stable heterosexual relationship (> 6 months duration) and experiencing erectile dysfunction for more than 6 months. 

The study design included a 4-week treatment free period in which participants were instructed to attempt intercourse on four separate days. Those who were unsuccessful more than half the time qualified for randomisation to either 10 mg vardenafil (taken 60 minutes prior to attempting intercourse) or placebo for 4 weeks. This was then followed by a 1-week wash out period. Patients were then crossed over to receive the alternate treatment for the remainder of the study.

One hundred and seventy five of the 201 participants completed the study. The average age of participants was 49. The participants had experience erectile dysfunction for an average of 3.9 years.

Treatment with vardenafil resulted in a erections lasting more than twice as long. This translated to an average 7.36 minute increase in the duration of the erection. In addition patients reported a statistically significant improvement in erectile function with vardenafil compared to placebo. More patients answered "yes" to the question "Has the treatment you have been taking over the past 4 weeks improved your erections?" when treated with vardenafil compared to placebo.

Dr Peter Lowy at the Sydney Centre for Men’s Health says the study findings accurately represent the patients he sees from day to day.

"While I’m not sure of specificities, as it can vary from patient to patient, it is certainly prolonging the erection duration," he says.

The medication safety and tolerability were assessed using several parameters. The majority of side effects where mild–moderate with headache (3%) and flushing (5%) being the most common. One patient discontinued treatment following an episode of moderate syncope while receiving vardenafil. There were no other relevant side effects.

Dr Lowy says he is not concerned about any serious side effects.

"There may be the usual headache or blocked nose as can happen with many medications, but there certainly isn’t anything serious."

The authors concluded that in a general population of men with erectile dysfunction vardenafil 10 mg produces a statistically superior duration of erection compared to placebo. The use of the stopwatch to assess erection duration was also considered a reliable method that would be suitable for use in future erection dysfunction treatment efficacy trials.

While some may consider erectile dysfunction to be a man’s problem, it is a couple’s concern, and effective treatment has the potential to restore both the man’s self-esteem and the couple’s relationship.

Dr Peter Lowy says it is critical men come to see their doctors about erectile dysfunction, especially because it can often be a sign of another underlying or succeeding condition.

"It is a window into the body and often precedes other conditions, so we’re taking a much more aggressive look at a patient who presents with erectile dysfunction."

For more information on erectile dysfunction, its types, causes and treatments, and tips for dealing with it, see Erectile Dysfunction.

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