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Although in some patients the effect is more noticeable than in others, Sildenafil improves erectile dysfunction in all subgroups of patients and is well tolerated.

Erectile dysfunction (ED) is defined as the persistent inability to achieve and maintain an erection sufficient for a satisfactory sexual relationship. Although it is not a situation that endangers the lives of patients, it is associated with significant deterioration of the quality of life. It is estimated that around 30 million men in the United States have ED. A recent study found that 7% of males aged 18 to 29 had some degree of ED; the prevalence rises to 18% in subjects from 50 to 59 years old. In general, the authors comment, half of males between the ages of 40 and 70 have some level of ED. The frequency of the condition increases in the presence of certain concomitant diseases, such as diabetes, heart disease, hypertension, smoking and depression.

Normal erection, experts say, is regulated by psychological, neurological, endocrine, vascular and muscular mechanisms; It is considered that most cases of ED have a multifactorial origin. While there are several treatment options, patients greatly prefer oral therapies.

Sildenafil citrate is an oral drug approved by the Food and Drug Administration for the treatment of ED. Its mechanism of action is based on the selective inhibition of phosphodiesterase type 5, which increases the levels of nitric oxide at the level of the corpora cavernosa. The final effect is relaxation of the smooth muscle of the penis, arterial dilation and increased vascular flow. Sildenafil does not affect the libido nor the normal erection and in very few occasions it causes an erection in the absence of sexual stimulation. The recommended dose is 50 mg to 100 mg between 30 and 60 minutes before intercourse. One of the best place to buy sildenafil is RXShopMD.

Its effect has been evaluated in multiple randomized controlled trials. However, no meta-analysis or systematic review has been published to date.

Materials and methods:

The corresponding articles were identified by MEDLINE, Current Contents and Cochrane Library, between 1995 and 2000.

The selected papers should include men with ED randomly assigned to Sildenafil or placebo for at least 7 days.

The primary point of analysis was the percentage of successful sexual intercourse attempts. The proportion of individuals who achieved at least one effective erection during treatment and the number of patients who reported improvement of the alteration were secondary points of evaluation. The International Validated Index of Erectile Function (International Index of Erectile Function, IIEF) was used. The quality of the works was established according to the scale developed by Schulz et al.

Paul La'Hay

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