Scolaris Content Display Scolaris Content Display

Flow chart showing the number of citations retrieved by individual searches and number of studies included
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Figure 1

Flow chart showing the number of citations retrieved by individual searches and number of studies included

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Comparison 1 PDE inhibitors versus placebo, Outcome 1 Sexual function using IIEF‐5.
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Analysis 1.1

Comparison 1 PDE inhibitors versus placebo, Outcome 1 Sexual function using IIEF‐5.

Comparison 1 PDE inhibitors versus placebo, Outcome 2 Sexual function using IIEF‐15.
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Analysis 1.2

Comparison 1 PDE inhibitors versus placebo, Outcome 2 Sexual function using IIEF‐15.

Comparison 1 PDE inhibitors versus placebo, Outcome 3 Headache.
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Analysis 1.3

Comparison 1 PDE inhibitors versus placebo, Outcome 3 Headache.

Comparison 1 PDE inhibitors versus placebo, Outcome 4 Improvement in erectile function.
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Analysis 1.4

Comparison 1 PDE inhibitors versus placebo, Outcome 4 Improvement in erectile function.

Comparison 2 Zinc versus placebo, Outcome 1 Serum testosterone.
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Analysis 2.1

Comparison 2 Zinc versus placebo, Outcome 1 Serum testosterone.

Comparison 2 Zinc versus placebo, Outcome 2 Improvement of libido.
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Analysis 2.2

Comparison 2 Zinc versus placebo, Outcome 2 Improvement of libido.

Comparison 2 Zinc versus placebo, Outcome 3 Plasma FSH.
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Analysis 2.3

Comparison 2 Zinc versus placebo, Outcome 3 Plasma FSH.

Comparison 2 Zinc versus placebo, Outcome 4 Plasma LH.
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Analysis 2.4

Comparison 2 Zinc versus placebo, Outcome 4 Plasma LH.

Comparison 2 Zinc versus placebo, Outcome 5 Frequency of intercourse.
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Analysis 2.5

Comparison 2 Zinc versus placebo, Outcome 5 Frequency of intercourse.

Comparison 2 Zinc versus placebo, Outcome 6 Total/partial impotence.
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Analysis 2.6

Comparison 2 Zinc versus placebo, Outcome 6 Total/partial impotence.

Comparison 2 Zinc versus placebo, Outcome 7 Variations in libido.
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Analysis 2.7

Comparison 2 Zinc versus placebo, Outcome 7 Variations in libido.

Comparison 2 Zinc versus placebo, Outcome 8 Nocturnal penile tumescence (NPT).
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Analysis 2.8

Comparison 2 Zinc versus placebo, Outcome 8 Nocturnal penile tumescence (NPT).

Comparison 3 Vitamin E versus placebo, Outcome 1 Prolactin.
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Analysis 3.1

Comparison 3 Vitamin E versus placebo, Outcome 1 Prolactin.

Comparison 3 Vitamin E versus placebo, Outcome 2 Plasma LH.
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Analysis 3.2

Comparison 3 Vitamin E versus placebo, Outcome 2 Plasma LH.

Comparison 3 Vitamin E versus placebo, Outcome 3 Plasma FSH.
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Analysis 3.3

Comparison 3 Vitamin E versus placebo, Outcome 3 Plasma FSH.

Comparison 3 Vitamin E versus placebo, Outcome 4 Serum testosterone.
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Analysis 3.4

Comparison 3 Vitamin E versus placebo, Outcome 4 Serum testosterone.

Table 1. Other outcomes related to sexual dysfunction as reported in the included studies

Study ID

N

 

Intervention

Outcome

Mean ± SD (treatment group or baseline value) or RR (95% CI)

Mean ± SD (control group or after treatment)

Antoniou 1977

8

 

Oral zinc versus placebo

Testosterone concentration (ng/mL)¹

8.00 ± 3.50

3.20 ± 2.00

LH (mU/mL)¹

85.30 ± 81.00

47.30 ± 26.90

FSH (mU/mL)¹

24.00 ± 24.30

33.00 ± 8.70

Bellovich 2000

14

 

Sildenafil citrate

IIEF ‐ Frequency of penetration

 3.85 ± 3.10

4.43 ± 2.92

IIEF ‐ Maintenance of erection penetration

4.43 ± 2.69

4.93 ± 2.32

Brook 1980

14

 

Zinc chloride versus placebo to dialysate

Improvement of libido

1.00 (0.08 to 13.02)

NA

Plasma testosterone (nmol/L)²

9.00 ± 4.23

12.00 ± 1.32

Mahajan 1982

20

Oral zinc acetate versus placebo

Total/partial impotence

0.13 (0.02 to 0.82)

NA

Decreased libido

0.11 (0.01 to 1.83)

NA

Decreased frequency of intercourse

0.22 (0.06 to 0.78)

NA

Increased plasma testosterone³

5.20 ± 1.58

3.00 ± 0.95

Decreased plasma FSH³

25.00 ± 22.14

35.00 ± 15.81

Decreased plasma LH³

49.00 ± 82.22

38.00 ± 25.3

Mahon 2005

13

Sildenafil citrate versus placebo

Global efficacy question

2.50 (1.05 to 5.96)

NA

Muir 1983

14

Bromocriptine versus placebo

Testosterone (nmol/L)¹

16.80 ± 4.49

17.00 ± 4.11

Sharma 2006

32

Sildenafil citrate versus placebo

Global efficacy question

4.33 (2.07 to 9.08)

 

Blood urea nitrogen (mg/dL)²

18.3 ± 7.6

17.9 ± 51.0

Creatinine (mg/dL)²

1.48 ± 0.4

1.4 ± 0.4

Haemoglobin (g/dL)²

12.3 ± 1.5

13.2 ± 1.4

Wabrek 1982

8

Oral zinc versus placebo

Tumescence episodes

0.75 (0.07 to 7.73)

NA

Yeksan 1992

24

Vitamin E versus placebo*

Prolactin (ng/mL)

15.00 ± 4.28

56.23 ± 15.66

LH (mU/mL)

4.66 ± 1.80

11.43 ± 5.70

FSH (mU/mL)

4.23 ± 1.83

4.88 ± 2.94

Testosterone (pg/mL)

11.79 ± 4.16

4.79 ± 1.82

¹ significance not reported; ² P value not significant; ³ P value < 0.05; * Data pre and post vitamin E treatment only is reported; IIEF ‐ International Index of Erectile Function; LH ‐ luteinizing hormone; FSH ‐ follicular stimulating hormone; SD ‐ standard deviation; RR ‐ relative risk; NA ‐ not applicable or not available.

Figures and Tables -
Table 1. Other outcomes related to sexual dysfunction as reported in the included studies
Comparison 1. PDE inhibitors versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Sexual function using IIEF‐5 Show forest plot

4

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Total score

2

101

Mean Difference (IV, Random, 95% CI)

10.65 [5.34, 15.96]

1.2 Erection frequency

3

149

Mean Difference (IV, Random, 95% CI)

1.54 [1.14, 1.93]

1.3 Erection quality (Q2)

3

165

Mean Difference (IV, Random, 95% CI)

1.78 [1.04, 2.53]

1.4 Penetration ability (Q3)

3

165

Mean Difference (IV, Random, 95% CI)

1.70 [1.16, 2.24]

1.5 Maintenance frequency of penetration (Q4)

4

193

Mean Difference (IV, Random, 95% CI)

1.60 [1.02, 2.18]

1.6 Maintenance of erection after penetration (Q5)

4

193

Mean Difference (IV, Random, 95% CI)

1.83 [1.17, 2.50]

1.7 Erection confidence (Q15)

3

165

Mean Difference (IV, Random, 95% CI)

1.39 [0.84, 1.95]

2 Sexual function using IIEF‐15 Show forest plot

2

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Overall satisfaction

1

41

Mean Difference (IV, Random, 95% CI)

2.64 [1.32, 3.96]

2.2 Erectile function

2

80

Mean Difference (IV, Random, 95% CI)

10.64 [5.32, 15.96]

2.3 Orgasmic function

1

41

Mean Difference (IV, Random, 95% CI)

1.70 [0.35, 3.05]

2.4 Intercourse satisfaction

1

41

Mean Difference (IV, Random, 95% CI)

1.71 [0.11, 3.31]

2.5 Sexual desire

1

41

Mean Difference (IV, Random, 95% CI)

0.49 [‐0.67, 1.65]

3 Headache Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

4 Improvement in erectile function Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figures and Tables -
Comparison 1. PDE inhibitors versus placebo
Comparison 2. Zinc versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Serum testosterone Show forest plot

3

42

Std. Mean Difference (IV, Random, 95% CI)

0.70 [‐1.05, 2.45]

1.1 Zinc in dialysate

2

22

Std. Mean Difference (IV, Random, 95% CI)

0.21 [‐2.14, 2.55]

1.2 Oral zinc

1

20

Std. Mean Difference (IV, Random, 95% CI)

1.62 [0.58, 2.66]

2 Improvement of libido Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

3 Plasma FSH Show forest plot

2

28

Mean Difference (IV, Random, 95% CI)

‐9.69 [‐23.72, 4.34]

4 Plasma LH Show forest plot

2

28

Mean Difference (IV, Random, 95% CI)

18.80 [‐26.16, 63.76]

5 Frequency of intercourse Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

6 Total/partial impotence Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

7 Variations in libido Show forest plot

2

34

Risk Ratio (M‐H, Random, 95% CI)

0.11 [0.01, 1.83]

8 Nocturnal penile tumescence (NPT) Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

Figures and Tables -
Comparison 2. Zinc versus placebo
Comparison 3. Vitamin E versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Prolactin Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

2 Plasma LH Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

3 Plasma FSH Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

4 Serum testosterone Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Totals not selected

Figures and Tables -
Comparison 3. Vitamin E versus placebo