Skip to main content

Nasal congestion after visual sexual stimulation with and without sildenafil (Viagra®): a randomized placebo-controlled study

Abstract

Sildenafil (Viagra®) is a selective phosphodiesterase type 5 inhibitor (PDE5-I) approved for treatment of erectile dysfunction. Although relatively well-tolerated, sildenafil is associated with undesired effects including headache, flushing, dyspepsia, nasal congestion, and visual disturbances. In the present study we explored the impact of sildenafil on nasal airway parameters in young potent men. Eleven men (age 26.0 ± 1.8 years) with normal BMI (25.7 ± 0.5) and without nasal respiratory disorders were enrolled in a double-blind, crossover study. All men underwent evaluation of systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), SpO2%, acoustic rhinometry, and nasal endoscopy before and after placebo or sildenafil (50 mg) plus visual sexual stimulation (VSS). Nasal examination was performed using 0° rigid telescopes, 4 mm in diameter. A Student’s t test was used for direct comparisons, while the Kruskal–Wallis test (K–W) was utilized for multiple comparisons. After administration of sildenafil plus VSS, the minimum cross sectional area (MCA) was significantly lower that observed with either placebo (P = 0.03) or sildenafil alone (P = 0.003). However, the post-stimulation values did not demonstrate any significant differences among the different treatment arms (P = 0.48; DF = 2; K–W test). In contrast, endonasal volume (VOL) was significantly lower after sildenafil + VSS (P = 0.01), but not after placebo + VSS (P = 0.18). None of the other parameters monitored showed any significant variations. Rhinoscopy showed a characteristic increase of the volume of the inferior turbinates, with subjective differences between placebo and sildenafil. These preliminary results suggest that sildenafil reduces nasal volume, and that sexual stimulation may decrease nasal airflow by itself.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Fisher EW (1997) Acoustic rhinometry. Clin Otolaryngol Allied Sci 22(4):307–317

    PubMed  Article  CAS  Google Scholar 

  2. Hess A, Bloch W, Cocker J, Peters S, Stennert E, Addicks K, Michel O (2000) Detection of nitric oxide synthases in physiological and pathophysiological process of the nasal mucosa. HNO 48(7):489–495

    PubMed  Article  CAS  Google Scholar 

  3. Holmes TH, Goodel H (1950) The nose. An experimental study of reaction within the nose in human subjects during varying life experience. Thomas, Springfield

  4. Kang BH, Chen SS, Jou LS, Weng PK, Wang HW (2000) Immunolocalization of inducible nitric oxide synthase and 3-nitrotyrosine in the nasal mucosa of patients with rhinitis. Eur Arch Otorhinolaryngol 257(5):242–246

    PubMed  Article  CAS  Google Scholar 

  5. Kiroglu AF, Bayrakli H, Yuca K, Cankaya H, Kiris M (2006) Nasal obstruction as a common side-effect of sildenafil citrate. Tohoku J Exp Med 208(3):251–254

    PubMed  Article  CAS  Google Scholar 

  6. Marmor MF, Kessler R (1999) Sildenafil (Viagra) and Ophthalmology. Surv Ophthalmol 44(2):153–162

    PubMed  Article  CAS  Google Scholar 

  7. Moncada S (1992) The 1991 UIF von Euler Lecture. The l-arginine: nitric oxide pathway. Acta physiol Scand 145(3):201–227

    PubMed  CAS  Article  Google Scholar 

  8. Moreira SG, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED (2000) Side-effect profile of sildenafil citrate (Viagra) in clinical practice. Urology 56(3):474–476

    PubMed  Article  Google Scholar 

  9. Motamed M, Sandhu D, Murty GE (2003) Sildenafil and nasal obstruction. J Otolaryngol 32(4):259–261

    PubMed  Article  Google Scholar 

  10. Ng BA, Ramsey RG, Corey JP (1999) The distribution of nasal erectile mucosa as visualized by magnetic resonance images. Ear Nose Throat J 78(3):163–166

    Google Scholar 

  11. Straszek SP, Schlunssen V, Sigsgaard T, Pedersen OF (2007) Reference values for acoustic rhinometry in decongested school children and adults: the most sensitive measurement for change in nasal patency. Rhinology 45(1):36–39

    PubMed  Google Scholar 

  12. Taverner D, Bickford L, Latte J (2002) Validation by fluid volume of acoustic rhinometry before and after decongestant in normal subjects. Rhinology 40(3):135–140

    PubMed  Google Scholar 

  13. Watanabe M, Kakuta S (2002) Expression and localization of the inducible isoform of nitric oxide synthase in nasal polyps. Nippon Jibiinkoka Gakkai Kaiho 105(8):1873–1881

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Matteo Trimarchi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Trimarchi, M., Salonia, A., Bondi, S. et al. Nasal congestion after visual sexual stimulation with and without sildenafil (Viagra®): a randomized placebo-controlled study. Eur Arch Otorhinolaryngol 265, 303–306 (2008). https://doi.org/10.1007/s00405-007-0452-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-007-0452-4

Keywords

  • Nasal obstruction
  • Sildenafil
  • Turbinate
  • Endoscopy