A drug target for erectile dysfunction to help improve fertility, sexual activity, and wellbeing: mendelian randomisation study

AbstractObjectiveTo investigate the association of genetically proxied (using a surrogate biomarker) inhibition of phosphodiesterase 5 (PDE5), an established drug target for erectile dysfunction, with fertility, sexual behaviour, and subjective wellbeing.DesignTwo sample cis-mendelian randomisation study.SettingSummary data on genetic associations obtained from the International Consortium for Blood Pressure and UK Biobank.ParticipantsIndividuals of European ancestry from the International Consortium for Blood Pressure (n=757 601) for estimating PDE5 inhibition (using the surrogate biomarker of diastolic blood pressure reduction), and UK Biobank (n=211 840) for estimating the fertility, sexual behaviour, and subjective wellbeing outcomes in male participants.InterventionGenetically proxied PDE5 inhibition.Main outcome measuresNumber of children fathered, number of sexual partners, probability of never having had sexual intercourse, and subjective wellbeing.ResultsGenetically proxied PDE5 inhibition was associated with male participants having 0.28 (95% confidence interval 0.16 to 0.39) more children (false discovery rate corrected P<0.001). This association was not identified in female participants. No evidence was found of an association between genetically proxied PDE5 inhibition and number of sexual partners, probability of never having had sexual intercourse, or self-reported wellbeing in male participants.ConclusionsThe findings of this study provide genetic support for PDE5 inhibition potentially increasing the number of children fathered by male individuals. Absence of this association in female participants supports increased propensity for sustained and robust penile erections as a potential underlying mechanism. Further studies are required to confirm this, however, and these findings should not promote indiscriminate use of PDE5 inhibitors, which can also have harmful adverse effects. Read Original Article: A drug target for erectile dysfunction to help improve fertility, sexual activity, and wellbeing: mendelian randomisation study »