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Alternate-Day Tadalafil in the Management of Honeymoon Impotence


Rany Shamloul, MD, Andrology, Sexology & STDs, Cairo University, 16 road 299 New Maadi, Cairo 11742, Egypt. Tel: (613)633-6432; Fax: (613)533-6412; E-mail:


Introduction.  Sildenafil has been used successfully in the treatment of honeymoon impotence. However, no study investigated the potential effect of tadalafil in the treatment of honeymoon impotence.

Aim.  The aim of this study is to evaluate the effectiveness of alternate-day tadalafil therapy in the management of unconsummated marriages.

Methods.  This is a descriptive study comprised of a series of 45 patients. The time frame for the study was 2 years. Forty-five consecutive patients underwent a complete medical and sexual history as well as a focused physical examination. Education about the male and female genital anatomy and the sexual response cycle was carried out. Alternate-day tadalafil 10-mg therapy was administered for 2 weeks with the duration extended as needed.

Main Outcome Measures.  Primary efficacy endpoints were successful vaginal intromission and change in the abridged version of the International Index of Erectile Function (IIEF-5).

Results.  Of 45 patients included in our study, 41 (91%) were able to achieve vaginal intromission and perform sexually. Thirty-four patients (76%) needed tadalafil for less than 1 month, five (11%) for up to 3 months, and two (4%) for more than 3 months. Four patients (9%) were unsuccessful. IIEF-5 improved significantly with alternate-day tadalafil treatment in this subgroup of patients (P < 0.001). Treatment failures were managed by intracavernous injection therapy, combined with psychosexual therapy, depending on the cause.

Conclusions.  Tadalafil therapy was safe and effective in the short-term management of this selected group of honeymoon impotence patients. Controlled studies are needed to further confirm these findings. Ghanem H, El-Dakhly M, and Shamloul R. Alternate-day tadalafil in the management of honeymoon impotence. J Sex Med 2008;5:1451–1454.