Evaluation of sildenafil citrate effect on semen parameters, testosterone, insulin like-3 and inhibin-b levels

Background Phosphodiesterase enzyme 5 inhibitors are effective treatments for erectile dysfunction. Many men are now using phosphodiesterase enzyme 5 inhibitors in their reproductive years. This study aimed to investigate sildenafil citrate effect on semen parameters, Leydig and Sertoli cell function. Patients and methods A total of 40 patients who complained of erectile dysfunction were classified into two groups, each including 20 individuals; group І: received oral 100 mg sildenafil citrate on-demand twice weekly, and group II: received oral 50 mg sildenafil citrate daily for 3 months. The international index of erectile function, semen parameters, total testosterone, insulin like-3 (INSL3), and inhibin-b level were evaluated before and after treatment. Results No significant changes in total testosterone, semen parameters when comparing the values after treatment to the basal values, neither in group I nor in group II ( P >0.05). Inhibin-b and INSL3 showed a significant increase after treatment in both groups ( P value 0.007 and 0.001 in group I and 0.012 and 0.009 in group II, respectively). Conclusion The results pointed to the absence of side effects of sildenafil use on the seminogram, but it may improve the testicular functions through stimulating INSL3 and inhibin-b secretion.