title: Self-esteem, confidence, and relationships in men treated with sildenafil citrate for erectile dysfunction: results of two double-blind, placebo-controlled trials.
abstract: BACKGROUND
  Men with erectile dysfunction (ED) often have low self-esteem, confidence, and sexual relationship satisfaction.
  
  
  OBJECTIVE
  We evaluated the impact of sildenafil citrate and its generalizability across cultures on self-esteem, confidence, and sexual relationship satisfaction in men with ED using the Self-Esteem And Relationship (SEAR) questionnaire.
  
  
  METHODS
  Pooled analysis of 2 double-blind, placebo-controlled, flexible-dose trials of sildenafil with identical protocols: 1 was conducted in the United States and the other in Mexico, Brazil, Australia, and Japan.
  
  
  METHODS
  Men > or = 18 years old with ED.
  
  
  METHODS
  The impact of treatment on psychosocial factors associated with ED was determined by patient responses to the SEAR questionnaire. Erectile function was determined using the International Index of Erectile Function (IIEF) and a global efficacy question. Successful sexual intercourse attempts were derived from event logs of sexual activity. Treatment effect sizes were calculated for all study outcomes.
  
  
  RESULTS
  Compared with patients who received placebo (n = 274), patients who received sildenafil (n = 279) reported significantly greater improvements (P < .0001) in self-esteem, confidence, sexual relationship satisfaction, and in all sexual function domains of the IIEF. Treatment effect sizes were large (range, 0.7 to 1.2) for all SEAR components, and improvement in psychosocial measures showed moderate to high correlations (range, 0.50 to 0.83, P < .0001) with improvement in erectile function, percentage of successful intercourse attempts, and global efficacy.
  
  
  CONCLUSIONS
  In men with ED from 5 different nations, sildenafil produced substantial improvements in self-esteem, confidence, and sexual relationship satisfaction. Improvements in these psychosocial factors were observed crossculturally and correlated significantly and tangibly with improvements in erectile function.
authors.affiliation: Case Western Reserve University, Cleveland, OH, USA. sxa6@po.cwru.edu
authors.forename: Stanley E
authors.initials: SE
authors.lastname: Althof
authors.forename: Michael P
authors.initials: MP
authors.lastname: O' Leary
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Cappelleri
authors.forename: Sidney
authors.initials: S
authors.lastname: Glina
authors.forename: Rosie
authors.initials: R
authors.lastname: King
authors.forename: Li-Jung
authors.initials: LJ
authors.lastname: Tseng
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Bowler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines; D012649:Self Concept; D012725:Sexual Behavior / Q000187:drug effects / Q000523:psychology*; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate