Study assesses real-world outcomes with intranasal vardenafil for ED

In this video, Melissa Hadley Barrett discusses real-world outcomes and tolerability of intranasal vardenafil for men with persistent erectile dysfunction (ED) despite prior standard therapy.¹ Hadley Barrett is a nurse practitioner, sexologist, and founder of Restorative Health Clinic in Western Australia.

Hadley Barrett describes the rationale for evaluating intranasal vardenafil, highlighting limitations of oral phosphodiesterase type 5 inhibitors (PDE5is), including adverse effects and the need to plan sexual activity around medication timing. In a retrospective cohort study, researchers evaluated patient-reported outcomes among men prescribed intranasal vardenafil at a specialist men's health clinic between January and December 2025. Of 505 men prescribed the medication, 147 returned outcome forms and were included in the analysis. The mean age was 65.6 years, and participants had extensive prior treatment exposure.

Overall, 68% of participants (100 of 147) reported improved Erection Hardness Score (EHS) and/or penetrative rigidity, while 53% (78 of 147) achieved penetration during intercourse. Among men with baseline EHS scores of 0 to 1, 31% (32 of 102) experienced an improvement of at least 2 points.

According to Hadley Barrett, outcomes were particularly favorable among the 45 men who switched to intranasal vardenafil because of adverse effects or inconvenience with oral PDE5is, with 93% reporting a favorable response. Treatment-emergent events were common, affecting 137 of 147 participants, but were generally mild to moderate and transient, with a median duration of 15 minutes.

These findings suggest that intranasal vardenafil may offer an alternative for selected men who remain dissatisfied with existing ED treatments. However, the retrospective design, reliance on patient-reported outcomes, and limited return of outcome forms constrain interpretation of the results. The authors emphasized that prospective controlled studies are needed to further characterize efficacy, tolerability, and the patient populations most likely to benefit.

REFERENCE

1. Hadley Barrett M, Chung E, Whyatt D, Strange G. Real-World Outcomes and Tolerability of Intranasal Vardenafil in Treatment-Experienced Men with Persistent Erectile Dysfunction. Presented at: 27th Annual Fall Scientific Meeting of SMSNA. October 8-11, 2026. Orlando, Florida. Abstract #158