Trials: Sildenafil (Viagra) and erectile dysfunction in MS

Xiao et al. Sildenafil citrate for erectile dysfunction in patients with multiple sclerosis. Cochrane Database Syst Rev. 2012 Apr 18;4:CD009427.

BACKGROUND: Erectile dysfunction (ED) is a common sexual disease in male MSers. Sildenafil citrate (Viagra) is considered as an effective drug in the treatment of male ED in the general population, but it has not been systematically reviewed in patients with MS.

OBJECTIVES: To assess the efficacy and safety of sildenafil citrate for ED in MSers.

MAIN RESULTS: Two randomised controlled trials involving a total of 420 MSers were identified. Both trials investigated the short-term efficacy and safety of sildenafil citrate for ED in MSers. MSers taking sildenafil citrate were more likely to improve their ability to achieve and maintain an erection measured by International Index of Erectile Function and achieve vaginal penetration ( (RR 1.28, 95%CI 0.92 to 1.78) and complete intercourse measured by Sexual Encounter Profile diary (RR RR 1.38, 95%CI 1.00 to 1.90). and receive A global well respond measured by Global Assessment Question (RR 2.72, 95%CI 1.40 to 5.28) was reported. One trial showed sildenafil citrate is effective in quality of life improvement, while the other trial did not find any significant difference between both groups. Both included trials were judged as high risk of attrition bias. Adverse events were also reported: the most common were headache, flushing, rhinitis, visual disturbances and dyspepsia. Two MSers suffered serious adverse events: one with coronary artery disease requiring triple bypass surgery and one with a cerebrovascular accident.

AUTHORS’ CONCLUSIONS: There is limited evidence to support sildenafil citrate as an effective treatment for ED in MSers. Future well designed randomised, double blinded, placebo-controlled trials with long-term duration are needed.

“Sexual dysfunction in MS, in both woman and men, is one the hidden disabilities that is seldom discussed. It is very common and disabling. I have little doubt that viagra and viagra-like drugs have an effect and help male MSers, both physically and emotionally. The biggest problem is recognising sexual dysfunction as a problem; most MSers don’t volunteer that they have a problem and most healthcare professionals avoid asking. We don’t, but the clinic environment we work in is not conducive to open discussion. Interestingly, at MS Life last weekend the sexual dysfunction session was massively over subscribed indicating that sexual dysfunction in a major, and an under recognised problem in MS. Don’t be embarrassed raise the issue with your MS nurse or neurologist.”


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6 thoughts on “Trials: Sildenafil (Viagra) and erectile dysfunction in MS”

  1. Hello,I used Viagra for about 10 years, it no longer helps me so I've moved onto more mechanical devices. It is a very difficult subject, well done to Prof G for mentioning it on the blog. Maybe this will bring the subject a little bit more into the open & will help everyone who suffers or is misunderstood. As I say on my twitter page 'Not the man I once was – blame it on secondary progressive multiple sclerosis'.

  2. As Patrick emphasizes, different ED treatments work differently depending on the person. If Viagra doesn't work, try another medication, or even an alternative treatment.

  3. Jojo P. said…One medicine would cure ED people but to other would not. Better consult your doctor first before taking another medicine for our safety.

  4. Vigra sales person said…I agree that erectile dyfunction is a serious issue and must be discussed with your doctor voluntarily…so that it can be treated.There is nothing to be embarrased in raising this issue.Its cure is very important for smooth relation between two souls.

  5. The purpose of the study was to study the safety and efficacy of Viagra. The results seem to concentrate on the ability to sustain an erection – an odd measure of safety. Participants are men, and the results skewed to erections – how can this be generalised to women? I am interested in this drug for blood flow to regions other than the genitals, any work done on blood flow per se?

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