Surprise! Viagra Fixes 2 Pelvic Problems for the Price of One

Some folks might say that erectile dysfunction (ED) can lead to a broken heart. On the other hand, in 1989 the physical feeling of a “broken heart” (heart-related chest pain) accidentally led to a treatment for ED. When pharmaceutical giant Pfizer was researching medication for angina, a painful heart condition, their researchers discovered sildenafil, now known by the brand name Viagra.

Today, sildenafil can still be used to ease high blood pressure in lung arteries—a source of chest pain, shortness of breath, tiredness and other symptoms. However, it is most commonly prescribed to treat ED. It works by blocking an enzyme that the body normally uses to “switch off” an erection after orgasm, but that same enzyme can interfere with getting an erection to begin with. The enzyme is called phsophodiesterase-5 (PDE-5). By inhibiting PDE-5, Viagra allows the erection program to proceed.

“The little blue pill” is highly successful

ED, or impotence, means the inability to achieve an erection sufficient for penetration. The percentage of men who experience frequent ED increases with aging. A 1994 landmark study of impotence, The Massachusetts Male Aging Study, reported that about 40% of men have some degree of ED at age 40 but this increases to 70% at age 70. Viagra, or “the little blue pill”, does not cure ED, but rather is used on demand as needed. When taken as directed (about 1 hour before sex) followed by sexual stimulation (it won’t work without it), 94% of men report they are satisfied with it.[i]

Lower urinary tract symptoms (LUTS)

There’s another male problem that occurs with aging: lower urinary tract symptoms (LUTS). A man’s personal plumbing can wear out in much the same way as household pipes eventually clog or leak. In the majority of cases, male urinary problems are the result of prostate enlargement or inflammation. Symptoms range from mildly inconvenient to annoying to disruptive of one’s quality of life (QoL).

LUTS commonly shows up as either obstruction issues (poor urine stream, difficulty starting, dribbling, incomplete bladder emptying, etc.) or storage issues (increased urgency, needing to urinate more often, leaking, disrupted sleep due to need to urinary, urge incontinence, etc.).

LUTS and ED

LUTS are embarrassing, stressful, and wreak havoc on a man’s dignity as well as his daytime and nighttime lifestyle. It’s no wonder, then, that many men with LUTS also experience ED due to the psychological impact of LUTS. Even ED medication may not work well because of the pressures generated by bladder and prostate difficulties. On the other hand, studies show that when their urinary symptoms are successfully resolved, their sex life also improves.  Makes sense, right?

 

It may come as a surprise, then, to find that a drug that improves ED also appears to improve LUTS. This unexpected finding occurred as the result of scientific curiosity on the part of a team of British researchers. They wondered if treating ED using Viagra would ease urinary symptoms in men who had both problems. Before embarking on their own study, Sairam, et al. (2002)[ii] could find “…no published evidence exploring the relationship between men presenting with ED and their LUTS. In addition, it is unknown if treatment of their ED improves or worsens their LUTS.”

 

Viagra fixes two problems for the price of one

Thus, the Sairam team designed a study to explore what happens to LUTS when a man’s ET is treated with oral medication. They offered Viagra to 112 men whose main complaint was ED but who also had lower urinary tract symptoms. Both conditions were assessed at baseline using two questionnaires:

  1. International Index of Erectile Function (IIEF)
  2. International Prostate Symptom Score (IPSS) including QoL self-assessments

Then, during the study, the participants used Viagra on demand before sexual activity and kept a diary. Their cases were reviewed and the questionnaires administered again at 1 and 3 months.

 

As expected, the majority of patients (81%) had improved erections when using Viagra, but it was effect on LUTS that came as a surprise. At 3 months, all patients with severe LUTS shifted down to moderate, and 60% of those with moderate LUTS shifted down to mild. The authors wrote:

After treating the ED with sildenafil there was in improvement in the IPSS [urinary function score] which was accompanied by an improvement in the QoL scores. The changes in the IPSS and QoL scores were significantly correlated with the IIEF variables after treatment (at 3 months) suggesting that it was the change in sexual function caused by sildenafil that brought about the improvement in the urinary symptom scores.

 

This correlation was hypothesized to be the physical effect of the drug on the relaxation of isolated bladder and urethral smooth muscle, as well as modulation of prostatic smooth muscle tone when PDE-5 is blocked. In short, Viagra may not only relax penile tissues allowing the improved blood flow and congestion needed for an erection, but it may also offer smooth muscle relaxant properties in the lower urinary tract. If their theory is correct, Viagra indeed solves two problems for the price of one.

 

The authors acknowledge that more research is needed, with studies designed to evaluate physiological details not tracked in their observational study. Nonetheless, they “recommend treating patients who present with ED and concomitant LUTS with sildenafil” as long as no co-existing condition bars Viagra use. The pleasure of this small study is the good news it offers men as they age.

 

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] McMurray JG, Feldman RZ, Auerbach SM, DeRiesthal H et al. Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction. Ther Clin Risk Manag. 2007 Dec; 3(6): 975–981.

[ii] Sairam K, Kulinskaya E, McNicholas TA, Boustrad GB, Hanbury DC. Sildenafil influences lower urinary tract symptoms. BJU International. 2002;90:836-39.

This site uses cookies to analyze traffic and user behavior, protect your privacy, and provide you with the best user experience. Learn more.
close-image

How can we help?

Contact us to discuss your prostate health and plan your path to wellness.

close-link