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Bedtime sildenafil oral suspension improves sexual spontaneity and time-concerns compared to on-demand treatment in men with erectile dysfunction: results from a real-life, cross-sectional study

L. Boeri, Fabrizio Palumbo, T. Cai, C. Miacola, C. Ceruti, Marco Bitelli, D. Di Trapani, A. Piasentin et al.

International journal of impotence research, 2025

40 participants · 1 citation

Abstract

Phosphodiesterase type 5 inhibitors (PDE5i) are among the first line treatment options in men with erectile dysfunction (ED). On-demand sildenafil has proved to be an effective PDE5i but with lower spontaneity scores compared to daily tadalafil treatment. We aimed to investigate the impact of on-demand sildenafil compared to bedtime use on efficacy and spontaneity scores in men with ED. We retrospectively analysed data from a cohort of men with mild/moderate ED treated for three months with on-demand sildenafil 50 mg oral suspension formulation (OSF) (group 1, n = 40), bedtime sildenafil 50 mg OSF (group 2, n = 40) and bedtime sildenafil 37.5 mg OSF (group 3, n = 40). After three months patients were evaluated with the International Index of Erectile Function-5 items (IIEF-5) and the Psychological and Interpersonal Relationship Scales-Short Form (PAIRS-SF) questionnaires. Propensity score matching was used to adjust for baseline confounders. The IIEF-5 and PAIRS-SF scores were compared between groups at follow-up with the repeated measures ANOVA test. Linear regression analyses tested the associations between study variables and spontaneity scores. After matching, median patient's age and ED duration were 56 (50-61) years and 18 (10-20) months, respectively. Compared to baseline, IIEF-5 scores significantly improved after sildenafil OSF treatment, irrespective of the therapeutic approach (all p < 0.01 vs. baseline). The PAIRS-SF spontaneity score was significantly better in…

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 40 participants or records.

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