Since its approval in 1997, the drug sildenafil citrate (viagra) has been a major contributor to sexual wellness; however, recent studies have cast doubt on whether or not the drug actually affects prostate-specific antigen (PSA) levels in men.
In most cases, PSA levels rise as men get older, with levels peaking in the 5 to 6 range for men in their 50s. Therefore, if you’re over 50 and your PSA levels are within the normal range, there’s no need to worry.
According to the Prostate Cancer Foundation, PSA testing is crucial for catching prostate cancer early. Unfortunately, it’s also highly invasive, which is why many men opt for watchful waiting instead of getting the test. If you do decide to get the test, make sure to consult with a doctor experienced in this area so that you can get an accurate reading.
A Closer Look At The Research
In February of this year, the Cochrane Collaboration released a new review of 27 studies on the effects of sexual drugs such as viagra on PSA levels in men. The results of the review were somewhat surprising, with only one study showing a statistically significant increase in PSA levels while the remaining studies demonstrated no difference or even a slight decrease in PSA levels with the use of viagra. The most recent study in the Cochrane review was published in 2017 and its results were in line with the previous ones. In this particular study, which looked at the use of sildenafil citrate (viagra) in 14 patients, there was no significant difference in PSA levels from before to after treatment.
The difference in these studies might be attributed to variations in how the studies were designed and conducted. The Cochrane review points out that most of the studies they included in their analysis used open-label design (patient self-reporting on treatment effect) and were therefore unable to control for placebo effects. In other words, the patients in these studies knew they were being tested for the effects of the drug and might’ve been more likely to give the drug a good rating simply because they wanted to prove its effectiveness. As a result, these studies might not have been able to tell how much of the observed effect was due to the actual drug and how much was down to the placebo effect.
Is There Evidence From Clinical Trials?
According to the U.S. Food and Drug Administration (FDA), there is no evidence supporting the claim that sildenafil citrate is responsible for an increase in PSA levels. Instead, the FDA cites two controlled studies that showed a slight decrease in PSA levels in men taking the drug. The first of these studies was published in the Journal of Urology in 2012 and enrolled 50 patients who had either BPH (benign prostatic hypertrophy) or prostatitis. After 12 weeks of treatment, the results of this study showed a significant decrease in PSA levels in the sildenafil group as compared to the placebo group. The corresponding decrease in PSA levels was also clinically significant.
The second study, also published in the Journal of Urology in 2012, was a 24-week, randomized, placebo-controlled trial that examined the effects of sildenafil citrate in men with BPH. In this particular study, 164 patients were randomized to receive either sildenafil citrate (60 mg three times daily) or placebo. The results of this study showed that the PSA levels decreased by 0.4 ng/ml in the sildenafil group and increased by 0.1 ng/ml in the placebo group. While this difference was not statistically significant, it was clinically relevant.
While these studies provide some evidence that sildenafil citrate might be able to reduce PSA levels in men with BPH or prostatitis, the evidence is still somewhat conflicting and further studies are needed to draw firm conclusions. What is clear is that neither drug has been approved by the FDA for the treatment of BPH, so it’s unclear whether or not these results would also apply to that condition.
What About Safety?
When the FDA approved viagra, it was approved for the specific use of treating erectile dysfunction. However, recent studies have shown that the drug might not be as safe for use as originally thought. In the Cochrane review, five studies examined the effects of sexual drugs such as viagra on cardiovascular (CV) events and found mixed results. While four of the studies demonstrated that the drug was relatively safe, one study found that patients who took viagra daily had an increased risk of developing a heart attack or stroke. The authors of this study noted that given the mixed results, more research is needed to determine whether or not these results would also apply to sildenafil citrate (viagra).
Overall, it seems that while sildenafil citrate (viagra) has been shown to be an effective treatment for erectile dysfunction, the risks associated with its use might not be worth it. As a result, if you’re deciding to try the drug, you might want to first discuss it with your doctor. He might have other therapies that would be more suitable given your specific health conditions.
In summary, given the conflicting results from initial studies on the effects of sexual drugs on PSA levels in men, more research is needed to determine whether or not these drugs would result in increased or decreased PSA levels. However, if you’re over 50 and your PSA levels are in the normal range, there’s no need to be concerned, as it seems that sildenafil citrate (viagra) is not likely to cause prostate cancer.