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Use of PDE-5 inhibitors declines with age, data show

Atlanta-Despite media images depicting middle-aged and older men embracing the use of phosphodiesterase type-5 inhibitors to correct erectile dysfunction, actual interest and usage in this population has not been well studied.

Atlanta-Despite media images depicting middle-aged and older men embracing the use of phosphodiesterase type-5 inhibitors to correct erectile dysfunction, actual interest and usage in this population has not been well studied.

In reality, relatively few men in this age group actually use PDE-5 inhibitors, but whether it is because they accept ED as inevitable, they don't discuss it with their physicians, or their physicians balk at prescribing the drugs due to contraindications remains unknown, according to researchers led by John B. McKinlay, PhD, senior vice president and chief scientist, New England Research Institutes, Watertown, MA, who conducted the Massachusetts Male Aging Study (MMAS) follow-up.

Data on age, marital status, general health, heart disease, nitrate use, depression, sexual desire, attitude toward age-related sexual decline, and whether they have self-paid health insurance were collected for 553 randomly selected participants between 55 and 85 years of age from the most recent MMAS follow-up (2002-'04) who had at least minimal erectile dysfunction. These data were correlated with the men's reported use of PDE-5 inhibitors. They were also asked to rate their current quality of life.

In a multivariate model, men 75 years of age or older, those who reported complete ED, and those who experienced sexual desire less than once per week were significantly less likely to use PDE-5 inhibitors (p<.05). Among those who used PDE-5 inhibitors, four (5.4%) also used nitrates, compared with three (4.6%) who were not using ED drugs. Men using PDE-5 inhibitors ranked their quality of life higher than did non-users.

Researchers surmised that the men's reticence to use a highly effective drug indicates that physicians should consider taking a more patient-centered approach and should monitor use of PDE-5 inhibitors in follow-up visits, particularly in light of reports of their concomitant use with nitrates.

Further study of this population is planned, Dr. McKinlay said.

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