Phosphodiesterase Inhibitor (Sildenafil) in the Management of Honey Moon Impotence

Background and Aims: Honeymoon impotence or first night erectile dysfunction (ED) is one kind of psychogenic ED which is not uncommon. Prevalence of this kind of ED is higher in conservative communities especially the Muslim population. We assessed the role of Sildenafil, a phosphodiesterase inhibitor (PDE-5) in the management of honeymoon (psychogenic) impotence.

Methods: All patients having erectile dysfunction (ED) after marriage with normal nocturnal erections were enrolled in this prospective study from 01-09-2006 to 31-08-2008. Reassurance & Sildenafil 100 mg at bed time was given to every patient and dose reduced to 50 mg after 3 successful intercourses. Patients who did not respond to PDE-5 inhibitor (3 doses), were given intracavernosal injection alprostadil and shifted to PDE-5 inhibitor after successful intercourse.

Results: Total number of patients was 45 with age range of 20-39 years. Mean duration elapsed before seeking medical advice was 10±14 days. Eighty percent patients had successful intercourse on first dose of Sildenafil with 95% confidence interval (CI) and 13% patients responded to 2^nd dose of Sildenafil. Twelve percent patients suffered mild, well tolerable complications.

Conclusions: Honeymoon impotence is not an uncommon condition in some special population. Sildenafil proved to be effective, with high success rate and few tolerable complications.