Cochrane Review of Erectile Dysfunction Drugs For Men With Diabetes

Impotence and Diabetes

General Information
Erectile Dysfunction and Diabetes
What to do if Erectile Dysfunction Develops
Treatment Options
Cochrane Review of Erectile Dysfunction Drugs For Men With Diabetes
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Cochrane Review of Erectile Dysfunction Drugs For Men With Diabetes

There are three popular drugs to treat erectile dysfunction – sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis), known as PDE-5 inhibitors. They have been found to be quite effective in the general population and now a Cochrane Review investigated whether these drugs are a safe and effective option for men with diabetes. The Review showed that although diabetes can cause a number of other chronic complications, such as heart disease and high blood pressure, these erectile dysfunction drugs were shown not to cause many adverse reactions in men with diabetes. The most common side effects were headache, flushing and upper respiratory tract complaints and flu-like symptoms.

The Cochrane Collaboration is an international organisation which evaluates research and draws evidence-based conclusions to inform medical practice. In this case the Cochrane reviewers analysed eight studies that compared the effectiveness of the three PDE-5 medications to placebo. 1,759 men were involved with about half randomised to receive PDE-5 inhibitor therapy for 12 weeks in most studies and the rest to the placebo group. Overall, 80 percent of the participants had type 2 diabetes and the others had type 1 diabetes.

At the end of the studies men who took PDE-5 inhibitors showed improvements on all measures of erectile function, with an average difference of 26.7% more “successful intercourse attempts” compared to placebo groups. However, the Cochrane reviewers caution that men should use PDE-5 inhibitors only as directed by their physicians and should discuss interactions with other drugs that may be being taken and specific contraindications. The reviewers also warn that there is no concrete evidence that these medications are safe for the long term.

NHS Availabilty
All three are available on NHS prescription to men with diabetes but this is limited to four tables per month.

Other forms of treatment

Transurethral therapy
This is a needle-free form of treatment where a small pellet of a drug is introduced into the urethra [the tube that urine passes through] with a special applicator. The drug is absorbed through the urethra walls into the erectile tissue giving an erection in 5-10 minutes.

Intercavernosal injection therapy
The man and/or his partner are taught how to inject a drug directly into the penis. An erection usually occurs within 15 minutes.

Vacuum devices
These devices produce an erection using a hand or battery operated vacuum pump attached to a plastic cylinder.

Penile prosthesis
These are like splints that are surgically inserted into the penis. This causes destruction of the erectile tissue and should not be considered until other treatments have been tried.