Relationship between erectile function and sexual self-confidence: a path analytic model in men being treated with tadalafil

• Published in: International journal of impotence research Vol. 26; no. 1; pp. 7 - 12
• Main Authors: Sontag, A, Ni, X, Althof, S E, Rosen, R C
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2014; Nature Publishing Group
• Subjects: 692/699/2768/1575; 692/700/565; Adult; Aged; Carbolines - pharmacology; Carbolines - therapeutic use; Confidence; Erectile dysfunction; Erectile Dysfunction - drug therapy; Erectile Dysfunction - psychology; Humans; Impotence; Male; Medicine; Medicine & Public Health; Middle Aged; Models, Theoretical; original-article; Patient Satisfaction; Penile Erection - drug effects; Penile Erection - psychology; Phosphodiesterase 5 Inhibitors - pharmacology; Phosphodiesterase 5 Inhibitors - therapeutic use; Psychiatric research; Psychological aspects; Reproductive Medicine; rology; Self Concept; Self-confidence; Surveys and Questionnaires; Tadalafil; Treatment Outcome; Urology; United States > US; PDE-5 inhibitor; tadalafil; sexual self-confidence; path analytic model; ED
• ISSN: 0955-9930; 1476-5489
• DOI: 10.1038/ijir.2013.31

Sexual self-confidence has been shown to be associated with erectile function (EF) in men receiving PDE-5 inhibitor therapy; however, few studies have investigated the pathways (for example, sexual satisfaction, communication, time concerns and spontaneity) through which improvements in sexual self-confidence occur. This study examined this relationship using a path analysis model in men with ED enrolled in an open-label clinical trial of 20 mg tadalafil, administered on-demand over 12 weeks. International Index of Erectile Function and Psychological and Interpersonal Relationship Scales data were used to assess improvement in EF, sexual confidence and mediating variables. Controlling for baseline measures and covariates, the model indicated that change in sexual self-confidence was significantly associated with changes in EF ( P <0.0001), sexual communication conflict ( P =0.01), time concerns ( P <0.0001) and spontaneity ( P <0.0001). The total effect of EF on sexual self-confidence was 0.85, with 0.08 of this relationship indirectly mediated through time concerns and spontaneity. These data suggest that improved sexual confidence in men receiving treatment with a long-acting PDE-5 inhibitor occurs both directly via improved EF and indirectly via improved spontaneity and diminished time concerns.