Sexual Satisfaction in Men with Erectile Dysfunction: Correlates and Potential Predictors


  • Previous presentation: Data from a number of the studies analyzed in this study (internal study identifiers LVBN, LVCE, LVCQ, LVDJ, LVCO, LVBK, LVCR, LVDI, LVDW, LVDX, LVDY, LVDZ, LVEF, LVEG, LVEL, LVEI, LVEH, LVEK, and LVCI) have been presented, published, and/or are posted at or

Stanley E. Althof, PhD, Urology, Case Western Reserve University School of Medicine, Center for Marital and Sexual Health of South Florida, 1515 N. Flagler Drive, Suite 540, West Palm Beach, FL 33401, USA. Tel: 561-822-5454; Fax: 561-822-5458; E-mail:


Introduction.  Sexual satisfaction is an important treatment objective for men with erectile dysfunction (ED).

Aims.  To evaluate potential associations between International Index of Erectile Function (IIEF) satisfaction at study endpoint and a range of baseline, on-treatment, and endpoint variables.

Methods.  An exploratory analysis was conducted involving 3,935 subjects with ED randomized to on-demand tadalafil (N = 2,824) or placebo (N = 1,111) in randomized, controlled trials across 28 countries. Patients achieving scores ≥16 on IIEF questions 7, 8, 13, and 14 at study endpoint were operationally defined as satisfied (vs. <16, not satisfied). Multivariate logistic regression and other analyses were conducted to ascertain correlates and potential predictors of improvements in the IIEF-erectile function domain (IIEF-EF).

Main Outcome Measures.  Satisfaction on the IIEF at study endpoint, on-treatment improvements in IIEF-EF, and endpoint sexual frequency.

Results.  Patients who were satisfied with sexual function were on average younger and had less severe ED, a shorter history of the condition, and no history of vascular disorders, hypertension, or diabetes mellitus/insulin use at baseline (P < 0.01 vs. not satisfied for each). Satisfied patients were also more likely to experience a ≥4-point increase on the IIEF-EF domain on treatment (adjusted odds ratio [OR] = 22.4; 95% CI = 17.6–28.5; P < 0.0001) or IIEF-EF ≥26 at endpoint (adjusted OR = 41.0; 95% CI = 33.6–50.2; P < 0.0001). Satisfaction emerged as a strong correlate of a ≥4-point increase in the IIEF-EF on treatment; however, as a correlate of endpoint sexual frequency, baseline sexual frequency was stronger than endpoint satisfaction.

Conclusions.  Satisfaction is associated with certain baseline, on-treatment, and endpoint variables in ED patients. Further studies are needed to confirm these preliminary findings and explore their meaning for female partners. Althof SE, Buvat J, Gutkin SW, Belger M, Stothard DR, and Fugl-Meyer AR. Sexual satisfaction in men with erectile dysfunction: Correlates and potential predictors. J Sex Med 2010;7:203–215.