Related Experiment Video
Updated: Mar 21, 2026

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
Efficacy of Tadalafil De-Escalation in the Treatment of Psychogenic Erectile Dysfunction
Guangyu Li1, Haiyan Lan, Jihong Liang
1Department of Andrology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Objectives:
To assess the efficacy of tadalafil de-escalation in the therapeutic effects of psychogenic erectile dysfunction (ED) during the 3 months extension phase.
Methods:
A total of 90 men with mild to severe psychogenic ED were randomly divided into 2 groups: tadalafil 5 mg group and tadalafil de-escalation group. Efficacy assessments included the 5-item version of International Index of Erectile Function (IIEF-5), the Sexual Encounter Profile (SEP) questionnaires, Psychological and Interpersonal Relationship Scales (PAIRS), Erection Hardness Score (EHS).
Results:
Compared with the baseline, tadalafil 5 mg and de-escalation groups enhanced all efficacy outcomes. Patients receiving tadalafil 5 mg and de-escalation experienced a significant mean improvement in the psychogenic erectile function domain of the IIEF-5 from the baseline (p < 0.01). The mean change from baseline was significantly higher for the tadalafil de-escalation group than for the tadalafil 5 mg group (p < 0.05). Response to SEP3, PAIRS and EHS was significantly higher in the tadalafil de-escalation group than in the tadalafil 5 mg group (p < 0.05). The severity of ED in the tadalafil de-escalation group had reduced after treatment. It was also significantly better than those in the tadalafil 5 mg group (p < 0.05).
Conclusion:
Tadalafil de-escalation significantly improved the erectile function among psychogenic ED patients. This implies that tadalafil de-escalation treatment for psychogenic ED is worthy of further clinical practice and research.
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