Association between neuropathic pain, pregabalin treatment, and erectile dysfunction

J Sex Med. 2014 Jul;11(7):1816-22. doi: 10.1111/jsm.12458. Epub 2014 Feb 25.

Abstract

Introduction: The pathophysiology of erectile dysfunction (ED) may be vasculogenic, hormonal, anatomical, neurogenic, drug-induced and/or psychogenic in origin. Neuropathic pain (NP) may facilitate ED, because it is frequently associated with anxiety, depression, and its drug, pregabalin, may also contribute ED.

Aim: The objective of this study was to determine whether pregabalin treatment for patients with neuropathic pain promotes erectile dysfunction.

Methods: The study sample consisted of a total of 102 male subjects that were subdivided into three groups. Group 1 patients (n = 31) had a pre-existing diagnosis of NP and was treated with 300 mg/day of pregabalin for at least 3 months. Group 2 patients (n = 34) were diagnosed with NP for at least 3 months; however, neither were they treated with pregabalin nor did they received physical therapy throughout the study. Lastly, healthy age-matched control subjects comprised group 3 (n = 37).

Main outcome measures: Patients in all groups completed the International Index for Erectile Function (IIEF) questionnaire.

Results: Mean age and mean body mass index did not differ significantly between each of the three groups. The cause of NP and the mean duration of having a diagnosis of NP did not differ significantly in groups 1 and 2. However, IIEF scores were significantly lower for group 1 when compared to group 2 in terms of erectile function, orgasmic function, overall satisfaction and total score. Yet groups 1 and 2 did not diverge significantly in the intercourse satisfaction and sexual desire scores. Overall IIEF scores for group 3 were significantly higher than those of group 2 except for mean erectile function scores.

Conclusion: Taking pregabalin for the treatment of neuropathic pain poses an increased risk for developing ED in male patients. Thus, clinicians prescribing pregabalin to patients diagnosed with neuropathic pain should assess for ED before and during treatment with this medication.

Keywords: Erectile Dysfunction; Neuropathic Pain; Pregabalin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesics / adverse effects*
  • Coitus / physiology
  • Depression / etiology
  • Erectile Dysfunction / chemically induced*
  • Erectile Dysfunction / drug therapy
  • Humans
  • Libido / drug effects
  • Male
  • Neuralgia / drug therapy*
  • Patient Satisfaction
  • Pregabalin
  • Surveys and Questionnaires
  • Treatment Outcome
  • gamma-Aminobutyric Acid / adverse effects
  • gamma-Aminobutyric Acid / analogs & derivatives*

Substances

  • Analgesics
  • Pregabalin
  • gamma-Aminobutyric Acid