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Updated: Feb 11, 2026

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
Published on: May 30, 2025
[Effects of different medications with tadalafil on erectile dysfunction in males with primary sexual failure]
Wen-Ji Li1, Ming-Xi Xu1, Jian-Hua Guo1
1Department of Urology and Andrology, The Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China.
Objective:
To evaluate the effects of three different medications with tadalafil on erectile dysfunction (ED) in young men with primary sexual failure.
Methods:
This study included 76 male ED patients aged 21-35 years who had primary sexual failure but normal nocturnal penile tumescence and rigidity and failed to respond to psychotherapy. We randomly assigned them to receive oral tadalafil once daily, on demand, or once-daily + on-demand. After 2-3 months of treatment, we evaluated the effects based on the scores of the patients in the five domains of the International Index of Erectile Function (IIEF-5).
Results:
After medication, all the patients showed significantly increased scores in the four domains of IIEF-5, namely, erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction. The on-demand group achieved even higher scores in erectile and orgasmic functions but a lower score in sexual desire than the once-daily group. However, the patients in the once-daily + on-demand group exhibited more significant improvement than those in the other two in all the five domains.
Conclusions:
Once-daily + on-demand medication with tadalafil can significantly enhance the therapeutic effect on psychogenic ED in young men with primary sexual failure.
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