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Original Research

Open Access

Treating erectile dysfunction with sildenafil alone versus combined with vitamin D3 in patients with low serum 25-hydroxy vitamin D3: a prospective randomized controlled open trial

  • Kang Yang1,2
  • Hui Jiang3,*,
  • Xiansheng Zhang1,*,

1Department of Urology, The First Affiliated Hospital of Anhui Medical University, 230000 Hefei, Anhui, China

2Department of Urology, Anqing Hospital of PLA Navy, 246003 Anqing, Anhui, China

3Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Peking University First Hospital, 100034 Beijing, China

DOI: 10.22514/jomh.2023.036 Vol.19,Issue 5,May 2023 pp.7-13

Submitted: 07 October 2022 Accepted: 17 January 2023

Published: 30 May 2023

*Corresponding Author(s): Hui Jiang E-mail: jianghui@bjmu.edu.cn
*Corresponding Author(s): Xiansheng Zhang E-mail: zhangxiansheng@ahmu.edu.cn

Abstract

This study aimed to compare the efficacy and risk of adverse events of sildenafil plus vitamin D3 versus sildenafil alone in improving erectile dysfunction (ED) in ED patients with low serum 25-hydroxy vitamin D3 (25-(OH)D3). The clinical data of ED patients with low serum 25-(OH)D3 treated at our center from December 2015 to December 2020 were retrieved, and the patients (n = 157) were randomly divided into an experimental group (n = 80) or a control group (n = 77). The experimental group was treated with 1 capsule of vitamin D3 (400u) daily for a month and advised to use 100 mg sildenafil (po) within 1 hour before sexual intercourse, while the control group was only given 100 mg sildenafil (po) 1 hour before sexual intercourse. The indexes of international erectile function (IIEF-5), serum 25-(OH)D3 level, testosterone (T) level and adverse events between the two groups were compared before and after treatment. The results showed that the IIEF-5 values of the two groups were significantly higher after treatment than before treatment (p < 0.05). However, the serum levels of 25-(OH)D3 and T in the experimental group were significantly higher than before treatment (p < 0.05), while no significant differences were observed in the same markers in the control group before and after treatment (p > 0.05). The overall effective rate, serum 25-(OH)D3 level and T level in the experimental group were significantly higher than the control group (p < 0.05). During the treatment, no significant difference in adverse events was observed between the two groups (p > 0.05), which mostly comprised mild and tolerable headache, dyspepsia, back pain and muscle soreness, not requiring any medical intervention. Although both methods could effectively treat ED patients with low 25-(OH)D3, the efficacy of sildenafil plus vitamin D3 was significantly superior to sildenafil alone, and the adverse reactions are mild and tolerable, which is worthy of clinical application.


Keywords

Sildenafil; Vitamin D3; Erectile dysfunction; 25-hydroxy vitamin D3


Cite and Share

Kang Yang,Hui Jiang,Xiansheng Zhang. Treating erectile dysfunction with sildenafil alone versus combined with vitamin D3 in patients with low serum 25-hydroxy vitamin D3: a prospective randomized controlled open trial. Journal of Men's Health. 2023. 19(5);7-13.

References

[1] Shamloul R, Ghanem H. Erectile dysfunction. The Lancet. 2013; 381: 153–165.

[2] Valiquette L, Montorsi F, Auerbach S; Vardenafil Study Group. First-dose success with vardenafil in men with erectile dysfunction and associated comorbidities: RELY-I. International Journal of Clinical Practice. 2006; 60: 1378–1385.

[3] Banks E, Joshy G, Abhayaratna WP, Kritharides L, Macdonald PS, Korda RJ, et al. Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLoS Medicine. 2013; 10: e1001372.

[4] Shah NP, Cainzos-Achirica M, Feldman DI, Blumenthal RS, Nasir K, Miner MM, et al. Cardiovascular disease prevention in men with vascular erectile dysfunction: the view of the preventive cardiologist. The American Journal of Medicine. 2016; 129: 251–259.

[5] Chung RY, Chan D, Woo J, Kwok T, Leung JCS, Lai FTT, et al. Erectile dysfunction is associated with subsequent cardiovascular and respiratory mortality in cohort of 1,436 Chinese elderly men. The Journal of Sexual Medicine. 2015; 12: 1568–1576.

[6] Maas R, Schwedhelm E, Albsmeier J, Böger RH. The pathophysiology of erectile dysfunction related to endothelial dysfunction and mediators of vascular function. Vascular Medicine. 2002; 7: 213–225.

[7] Vlachopoulos C, Rokkas K, Ioakeimidis N, Stefanadis C. Inflammation, metabolic syndrome, erectile dysfunction, and coronary artery disease: common links. European Urology. 2007; 52: 1590–1600.

[8] Jackson G, Montorsi P, Adams MA, Anis T, El-Sakka A, Miner M, et al. Cardiovascular aspects of sexual medicine. The Journal of Sexual Medicine. 2010; 7: 1608–1626.

[9] Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. Sexual function in men older than 50 years of age: results from the health professionals follow-up study. Annals of Internal Medicine. 2003; 139: 161–168.

[10] Park SG, Yeo JK, Cho DY, Park MG. Impact of metabolic status on the association of serum vitamin D with hypogonadism and lower urinary tract symptoms/benign prostatic hyperplasia. The Aging Male. 2018; 21: 55–59.

[11] Lutsey PL, Michos ED. Vitamin D, calcium, and atherosclerotic risk: evidence from serum levels and supplementation studies. Current Atherosclerosis Reports. 2013; 15: 293.

[12] Sorenson MB, Grant WB. Does vitamin D deficiency contribute to erectile dysfunction? Dermato-Endocrinology. 2012; 4: 128–136.

[13] Rosen RC, Allen KR, Ni X, Araujo AB. Minimal clinically important differences in the erectile function domain of the international index of erectile function scale. European Urology. 2011; 60: 1010–1016.

[14] Barassi A, Pezzilli R, Colpi GM, Corsi Romanelli MM, Melzi d’Eril GV. Vitamin D and erectile dysfunction. The Journal of Sexual Medicine. 2014; 11: 2792–2800.

[15] Saad F, Gooren LJ, Haider A, Yassin A. A Dose-response study of testosterone on sexual dysfunction and features of the metabolic syndrome using testosterone gel and parenteral testosterone undecanoate. Journal of Andrology. 2008; 29: 102–105.

[16] Mannikarottu AS, Hypolite JA, Zderic SA, Wein AJ, Chacko S, Disanto ME. Regional alterations in the expression of smooth muscle myosin isoforms in response to partial bladder outlet obstruction. The Journal of Urology. 2005; 173: 302–308.

[17] Corona G, Petrone L, Fisher AD, Mansani R, Bandini E, Boddi V, et al. Six-month administration of 1 testosterone gel is able to restore erectile function in hypogonadal patients with erectile dysfunction. Arch Ital Urol Androl. 2008; 80: 103–108.

[18] Mirone V, Costa P, Damber J, Holmes S, Moncada I, Van Ahlen H, et al. An Evaluation of an alternative dosing regimen with tadalafil, 3 times/week, for men with erectile dysfunction: SURE study in 14 European countries. European Urology. 2005; 47: 846–854.

[19] Kloner RA. Novel phosphodiesterase type 5 inhibitors: assessing hemodynamic effects and safety parameters. Clinical Cardiology. 2004; 27: 20–25.

[20] Hatzichristou D. Phosphodiesterase 5 inhibitors and nonarteritic anterior ischemic optic neuropathy (NAION): coincidence or causality? The Journal of Sexual Medicine. 2005; 2: 751–758.

[21] Balakumar P, Chakkarwar VA, Krishan P, Singh M. Vascular endothelial dysfunction: a tug of war in diabetic nephropathy? Biomedicine & Pharmacotherapy. 2009; 63: 171–179.

[22] Martínez-Miguel P, Valdivielso JM, Medrano-Andrés D, Román-García P, Cano-Peñalver JL, Rodríguez-Puyol M, et al. The active form of vitamin D, calcitriol, induces a complex dual upregulation of endothelin and nitric oxide in cultured endothelial cells. American Journal of Physiology-Endocrinology and Metabolism. 2014; 307: E1085–E1096.

[23] Stach K, Kalsch Al,Nguyen XD, Elmas E, Kralev S, Lang S, et al. 1α,25-dihydroxy vitamin D3 attenuates platelet activation and the expression of VCAM-1 and MT1-MMP in human endothelial cells. Cardiology. 2011; 118: 107–115.

[24] Weng S, Sprague JE, Oh J, Riek AE, Chin K, Garcia M, et al. Vitamin D deficiency induces high blood pressure and accelerates atherosclerosis in mice. PLoS One. 2013; 8: e54625.

[25] Marampon F, Gravina GL, Festuccia C, Popov VM, Colapietro EA, Sanità P, et al. Vitamin D protects endothelial cells from irradiation-induced senescence and apoptosis by modulating MAPK/SirT1 axis. Journal of Endocrinological Investigation. 2016; 39: 411–422.

[26] Forman JP, Williams JS, Fisher NDL. Plasma 25-hydroxyvitamin D and regulation of the renin-angiotensin system in humans. Hypertension. 2010; 55: 1283–1288.

[27] Burgaz A, Orsini N, Larsson SC, Wolk A. Blood 25-hydroxyvitamin D concentration and hypertension: a meta-analysis. Journal of Hyperten-sion. 2011; 29: 636–645.

[28] Al-Shoumer KA, Al-Essa TM. Is there a relationship between vitamin D with insulin resistance and diabetes mellitus? World Journal of Diabetes. 2015; 6: 1057–1064.

[29] Pittas AG, Sun Q, Manson JE, Dawson-Hughes B, Hu FB. Plasma 25-hydroxyvitamin D concentration and risk of incident type 2 diabetes in women. Diabetes Care. 2010; 33: 2021–2023.

[30] Di Rosa M, Malaguarnera G, De Gregorio C, Palumbo M, Nunnari G, Malaguarnera L. Immuno-modulatory effects of vitamin D3 in human monocyte and macrophages. Cellular Immunology. 2012; 280: 36–43.

[31] Hansen D, Rasmussen K, Rasmussen LM, Bruunsgaard H, Brandi L. The influence of vitamin D analogs on calcification modulators, N-terminal pro-B-type natriuretic peptide and inflammatory markers in hemodialysis patients: a randomized crossover study. BMC Nephrology. 2014; 15: 130.


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