IIEF-EF Improvements are more Pronounced with Nutraceuticals Compared to Placebo Medications: A Systematic Review and Meta-analysis

Abstract

ABSTRACT Introduction Nutraceuticals are pharmacological alternatives to conventional medications that have been used to treat a variety of ailments or conditions however frequently these compounds are used without rigorous assessment of safety and efficacy. Objective Our goal was to assess the placebo and nutraceutical effect on erectile function as measured by the change in baseline international index of erectile function-erectile function (IIEF-EF) score. Methods The search terms ‘(erectile dysfunction OR erectile function OR sexual dysfunction) AND (placebo OR sham)’ were queried via Pubmed. For inclusion in analysis, studies had to be blinded, placebo controlled, and use the IIEF-EF to measure outcomes. Studies were excluded if data was missing, articles could not be retrieved, or if protocol was ambiguous or unblinded. Data was then extracted and analyzed via meta-analysis. Differences between groups were considered statistically significant if p<0.05. Results A total of 12 studies were identified that utilized a natural medication (“nutraceutical”) and placebo (“placebo”) control group with 602 patients receiving nutraceutical and 559 patients receiving placebo in total. A variety of different compounds were tested. While improvements in IIEF-EF were more pronounced in the nutraceutical group (16.6 increasing to 20.6, p=0.0008) the placebo control group also demonstrated a statistically significant increase (17.0 to 18.4, p=0.0021). Conclusions Studies demonstrate an increase in subjective measures of erectile function both in placebo and nutraceutical groups. Nutraceuticals did have a more pronounced effect despite not containing active drug compounds. The mechanism of response to placebo for erectile function is unclear however the increases in both nutraceutical and placebo group points towards a contributory psychological effect of the medications. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Compensated Reviewer for Oakstone Publishing, Medscape