Self-esteem, confidence, and relationships in Brazilian men with erectile dysfunction receiving sildenafil citrate: a randomized, parallel-group, double-blind, placebo-controlled study in Brazil.
BACKGROUND
Psychosocial manifestations of erectile dysfunction (ED) differ across cultures. Understanding the treatment response to ED medications within cultural groups can aid in resource allocation and in developing treatment strategies.


OBJECTIVE
Evaluate the effect of sildenafil treatment on self-esteem, confidence, and sexual relationship satisfaction in Brazilian men with ED.


METHODS
The Self-Esteem and Relationship (SEAR) questionnaire, a validated, 14-question instrument developed to specifically address self-esteem and relationship issues within the context of ED.


METHODS
Men aged 18 years or older with a clinical diagnosis of ED (< or = 21 on the Sexual Health Inventory for Men) and in a stable relationship with a partner during the study were eligible. The primary end point was a change from baseline in the self-esteem subscale of the SEAR questionnaire. Thirteen Brazilian sites participated in a randomized, double-blind, placebo-controlled trial of sildenafil treatment for ED. Patients were randomized to receive either 50 mg of sildenafil (adjustable to 25 mg or 100 mg based on patient response) or matching placebo approximately 1 hour before anticipated sexual activity but not more than once a day.


RESULTS
At the end of double-blind treatment, 63 and 66 patients in the placebo and sildenafil groups, respectively, from 13 Brazilian sites were assessed for efficacy. Brazilian patients receiving sildenafil had significantly greater improvements in their scores on the SEAR self-esteem subscale (42.9 [95% confidence interval 35.7-50.0]) compared with placebo (21.1 [95% confidence interval 13.7-28.6]; P < 0.0001). Effect sizes ranged from 0.91 to 1.25 for individual SEAR components.


CONCLUSIONS
The psychosocial parameters in Brazilian men with ED assessed by the SEAR questionnaire showed significant improvements in self-esteem, confidence, and relationships after treatment with sildenafil.
Glina
Sidney
S
Instituto H. Ellis, São Paulo, Brazil. glinas@terra.com.br
Damião
Ronaldo
R
Abdo
Carmita
C
Afif-Abdo
João
J
Tseng
Li-Jung
LJ
Stecher
Vera
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D004311:Double-Blind Method; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011584:Psychology; D011687:Purines / Q000627:therapeutic use; D012649:Self Concept; D012720:Severity of Illness Index; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D055815:Young Adult
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate