A paper presented earlier this week at the annual meeting of the American Urological Association in Atlanta suggests that a drug called cabergoline may have the ability to induce the return of orgasm in men with anorgasmia (the persistent or frequent absence of orgasm after normal sexual arousal). The available data suggests that the patients included men with anorgasmia as a consequence of radical prostatectomy.
Hsieh et al. report data from a series of 107 men treated with cabergoline (o.5 mg twice a week) at a single, specialized andrology clinic (click here and search for abstract no. 1495) . Additional information about this study is available on the MedPage Today web site.
Of these 107 men, 35 were excluded from the analysis because they received cabergoline for treatment of conditions other than anorgasmia.
Analysis of data from the remaining 72 men, all treated for anorgasmia, showed the following:
- 50/72 anorgasmic patients (69 percent) showed improvement of orgasm.
- 26/50 men who responded to cabergoline therapy (52 percent) returned to having normal orgasms after therapy.
- Duration of cabergoline therapy and duration of concomitant testosterone replacement therapy were associated with a significant response to treatment (p = 0.02 and 0.03, respectively).
- Average (mean) duration of therapy for non-responders and responders to cabergoline was 214 and 296 days, respectively.
- No differences in efficacy were found between topical and injectable forms of testosterone replacement therapy.
- Neither patient age nor prior radical prostatectomy influenced outcome of cabergoline treatment (p = 0.9 and 0.42, respectively).
Adverse effects of cabergoline therapy include psychological effects as well as drug-related and post-prostatectomy sequela, and a surge in prolactin levels has been observed during the post-ejaculatory refractory period, decreasing erectile and ejaculatory potential.
Hsieh et al. suggest that the inhibitory effect of cabergoline on prolactin levels may be a desired endpoint in the treatment of male anorgasmia.
As far as The “New” Prostate Cancer InfoLink is aware, this is the first report of cabergoline (or any drug) having activity as a treatment for male anorgasmia — let alone male anorgasmia in patients after radical prostatectomy.
It will be apparent that these data come from a small, non-randomized case series, and therefore should be interpreted as “hypothesis generating.” A great deal more data would be necessary to provide clear evidence that cabergoline + testosterone replacement therapy might be an effective and safe form of treatment for anorgasmia after radical prostatectomy.