title: The utility of tamsulosin in the management of orgasm-associated pain: a pilot analysis.
abstract: BACKGROUND
  Orgasmic pain is an infrequently reported but distressing problem for the patients who experience it. No consensus exists as to its etiology however bladder neck/pelvic floor spasm may play a role. This analysis was conducted to assess the effect of the alpha-blocking medication, tamsulosin on post-orgasmic pain.
  
  
  METHODS
  In a prospective, non-placebo controlled study, patients with orgasmic pain were interviewed and administered tamsulosin 0.4 mg po qhs for at least 4 weeks. Outcome measures included libido, pain and continence and these were evaluated using the International Index of Erectile Function (IIEF), a visual analog scale (VAS) for pain and an incontinence scale respectively pre and post treatment. Patients were separated into groups based on etiology of the problem (radical prostatectomy, radiation therapy, and other) for statistical analysis.
  
  
  RESULTS
  98 patients were enrolled. Pain was located predominantly in the penis (72%), with other sites including testis, rectum and abdomen. Most patients (52%) experienced pain for less than 5 minutes post-orgasm. 76/98 (77%) patients reported significant improvement in pain (>/=2 points on pain VAS) and 12/98 (12%) noted complete resolution of their pain. The VAS for pain reflected a statistically significant decrease in pain for all groups in response to tamsulosin treatment. The entire group had a decrease of 2.7 points between pre and post-treatment phases. The IIEF libido domain increased significantly (mean of 2.4 points) for all treatment groups.
  
  
  CONCLUSIONS
  Tamsulosin decreases orgasmic pain intensity in patients with orgasmic pain. These data support the hypothesis that orgasmic pain is related to bladder neck and/or pelvic floor muscle spasm.
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York Presbyterian Hospital, 525 E 68th Street, Starr 900, NY 10021, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Barnas
authors.forename: Marilyn
authors.initials: M
authors.lastname: Parker
authors.forename: Patricia
authors.initials: P
authors.lastname: Guhring
authors.forename: John P
authors.initials: JP
authors.lastname: Mulhall
mesh_terms: D000005:Abdomen; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D006801:Humans; D007989:Libido / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009948:Orgasm / Q000502:physiology*; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology*; D010147:Pain Measurement / Q000187:drug effects; D010413:Penis; D010865:Pilot Projects; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects; D011878:Radiotherapy / Q000009:adverse effects; D012007:Rectum; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D013737:Testis; D016896:Treatment Outcome
chemical_list: D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin