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The Use of Impotence Drugs beyond Impotence

November 9, 2007

- International Journal of Impotence Research: The Journal of Sexual Medicine -

Thanks to their high effectiveness and tolerability rates PDE-5 inhibitors, which are widely used nowadays in the treatment of erectile dysfunction throughout the world, show great promise in the treatment of the other health disorders beyond erectile dysfunction. The first official confirmation of the PDE-5 inhibitors’ potential in treating illnesses other than impotence appeared in 2005, when sildenafil (active ingredient of Viagra) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of pulmonary hypertension.

Below is the summary of the potential future indications of PDE-5 inhibitors, based on the review published in the recent issue of the International Journal of Impotence Research.

Pulmonary Hypertension

For the time being, the use of PDE-5 inhibitors in treating pulmonary hypertension is the most well established one. In fact, the medication called Revatio with sildenafil as the active ingredient was officially approved for this indication in 2005.

Scientists believe that it is due to the ability of sildenafil to counteract with the production of nitric oxide in human body this medication can reduce vascular resistance in the pulmonary circulation and lower pressure in the pulmonary arteries. There were many studies conducted to evaluate the use of sildenafil for treating pulmonary hypertension. For example, the SUPER-1 study showed that this medication can significantly increase exercise capacity, functional class and hemodynamic parameters; besides, it was well tolerated by the majority of participants.

Heart Failure

Several studies conducted during last years revealed potential benefits of PDE-5 inhibitors use in preventing the heart failure. Though scientists cannot still explain in details how exactly PDE-5 inhibition works with heart muscle, they pay much attention to this issue and conduct further studies and researches.

Basically, it is said that sildenafil may provide vasodilating effect on the arteries that supply heart muscle with oxygen. Besides, due to the ability of PDE-5 inhibitors to significantly relax smooth pulmonary muscles, use of these medications can reduce the work load on the right ventricle of the heart.

Even more exciting study results were presented by Dr. Takimoto in 2005. He said that sildenafil completely suppressed cardiac hypertrophy in laboratory mice. However, such dramatic effect still requires serious researching.

Raynaud's disease

The use of PDE-5 inhibitors may be beneficial for patients with Raynaud’ disease, a condition characterized with the feeling of numbness and coolness in fingers, toes, ears or tip of the nose in response to cold temperatures or stress. This condition is believed to be caused by the disorders of blood vessels, which supply blood to skin.

The effects of the PDE-5 inhibitor, namely vardenafil (active ingredient of Levitra), on clinical symptoms and peripheral blood flow in patients with Raynaud's phenomenon were evaluated by a group of scientists (Caglayan E, Huntgeburth M, Karasch T, Weihrauch J, Hunzelmann N, Krieg T et al) in 2004.

The said study showed that vardenafil improved peripheral blood flow in 75% of all patients, whereas 25% of the patients did not respond. Such results allowed scientists to claim vardenafil to be capable of improving peripheral blood flow and reducing clinical symptoms of Raynaud's disease in some patients.

Memory Problems

Though the modern science lacks sufficient amount of data from the human studies, some animal studies showed the potential of sildenafil and vardenafil in improving memory performance and information processing.

It was demonstrated in 2002 that oral administration of the PDE5 inhibitors sildenafil and vardenafil immediately after training effectively improved the memory performance of rats in object recognition tasks.

Stroke

Though the clinical data on the PDE-5 inhibitors role in eliminating the disabling consequences of acute stroke is very controversial, scientists do believe that further research may show the ways to use this class of medications in treating patients after stroke.

It was shown in one of the animal studies that sildenafil improved recovery of rats after acute stroke. Although there was no difference in the volume of dead brain cells between the treated and untreated groups, sildenafil stimulated cell proliferation, which resulted in the increase of immature neurons amount.

Premature Ejaculation

Premature or rapid ejaculation is a common male sexual disorder with no treatment options available nowadays. It is usually managed with the help of antidepressants, local anesthetics or psychological counseling.

During several studies patients with premature ejaculation were treated with PDE-5 inhibitors, such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis). However, in spite of very promising outcomes of those studies, their results are doubtful because of the unofficial status of those trials. There was only one official study of PDE-5 use in patients with rapid ejaculation, and it showed no improvement in the time of ejaculation. On the other hand, patients participated in this study reported significantly increased ejaculatory control and increased ejaculatory confidence, which can still be treated as the benefits of PDE-5 therapy.

Female Sexual Dysfunction

In fact, there are two types of female sexual dysfunction: female sexual arousal disorder (FSAD) and hypoactive sexual desire disorder (HSDD). Since PDE-5 inhibitors work by increasing the blood flow, resulting in penis erection in men, in women such mode of action ensures the increase of vagina arousal.

The conducted studies proved the effectiveness of PDE-5 inhibitors in treating female sexual arousal disorder, which, by the way, is a common complication of diabetes in women, but showed no benefits in treating women with the low sex drive or decreased sexual desire.

Nick

External resources
http://www.nature.com/ijir/journal/v19/n6/full/3901577a.html
http://www.mayoclinic.com/health/raynauds-disease/DS00433
http://www.mayoclinic.com/health/female-sexual-dysfunction/DS00701