For many men it is still a taboo: inability to have an erection intense and long-lasting enough to maintain a complete and satisfying sexual relationship. In Spain, it is estimated that around 19% of men between 25 and 70 years old (between 1.5 and 2 million men) suffer from some degree of erectile dysfunction. A prevalence that increases significantly with age up to 50% among those over 70 years of age.
It is not just a sexual problem, in more than half of cases it presents itself as a side effect of other pathologies major diseases such as diabetes, vascular, neurological or urological problems. In other cases, the roots of the problem are found in the mind: fear of failure, feelings of guilt, insecurity…
There is already a pharmacological treatment for this condition, such as the well-known Viagra, but it does not work in all patients. For these cases, the Department of Urology of the Clínica Universidad de Navarra has initiated a study that seeks to reverse erectile dysfunction with an injection of Onabotulinumtoxin A (botulinum) in the corpora cavernosa of the penis. The goal, according to Dr. José Enrique Robles, specialist in Urology, is to find “an effective, safe and long-lasting treatment. “We are confident that its effectiveness can be maintained for at least six months after the injection.”
The clinical trial, which will have more than 100 patients refractory to conventional treatmentswill include a control group that will be given a placebo. The procedure is outpatient, without side effects and practically painless.
The main advantage of this new study treatment compared to those already known is that it avoids taking drugs every day or before sexual activity. Botox is known for its safety and effectiveness, as it has been applied in various fields of medicine. «Botox relaxes the smooth muscle tissues of the penis. increasing blood flow and thus providing the proper conditions to achieve and maintain an erection,” says Dr. Vanessa Talavera, resident physician in the Department of Urology.
This clinical trial is of an academic nature – not linked to industry – and was promoted by the Clínica Universidad de Navarra itself, which considers its objectives to be of general interest to society. “Erectile dysfunction is an alteration whose risk factors are fundamentally vascular and characterized by considerable difficulty in achieving and maintaining an erection during sexual activity,” explains Dr. Fernando Ramón de Fata.
People interested in participating in the study can contact the Department of Urology of the Clínica Universidad de Navarra via email (urologiainvestigacion@unav.es).
What are some common misconceptions about erectile dysfunction that lead to stigma?
Interview between Time.news Editor and Dr. José Enrique Robles on Erectile Dysfunction
Time.news Editor (TNE): Welcome, Dr. Robles, and thank you for joining us today. Erectile dysfunction is often a taboo topic among men. Can you shed some light on why this stigma persists?
Dr. José Enrique Robles (Dr. Robles): Thank you for having me. The stigma around erectile dysfunction (ED) is rooted in cultural perceptions of masculinity. Many men equate their sexual performance with their identity, which can lead to feelings of shame or inadequacy when they experience issues. This fear often prevents them from seeking help, creating a cycle of silence around a common medical condition.
TNE: Indeed, it must be challenging for those affected. In Spain, as you’ve noted, around 19% of men aged 25 to 70 face some level of erectile dysfunction. Could you explain what common factors contribute to this condition?
Dr. Robles: Certainly. Erectile dysfunction is multifactorial. In more than half of the cases, ED is linked to other major health conditions—such as diabetes, vascular diseases, or neurological disorders—which can affect blood flow and nerve function. In addition to these physical causes, psychological factors like anxiety, depression, and fear of failure play significant roles as well.
TNE: That highlights the complexity of the issue. While treatments like Viagra have been game changers, they don’t work for all patients. Can you elaborate on your ongoing research into the use of botulinum toxin A for treating erectile dysfunction?
Dr. Robles: Absolutely. Our study at the Clínica Universidad de Navarra aims to explore a new avenue for treating ED. We are investigating the injection of Onabotulinumtoxin A—commonly known as botulinum toxin—into the corpora cavernosa of the penis. Our goal is to provide a treatment option that is not only effective but also safe and long-lasting for patients who do not respond to traditional pharmacological approaches.
TNE: That sounds promising! What are the potential benefits of this treatment compared to existing options?
Dr. Robles: The primary advantage is the mechanism of action. Botulinum toxin works by inhibiting the contractions of smooth muscle, which could enhance blood flow and improve erectile function. In preliminary studies, we observed positive results. This could represent a more sustainable solution for patients who experience limited success with other medications.
TNE: Fascinating! As this research progresses, how do you think we can further destigmatize erectile dysfunction within society?
Dr. Robles: Open conversations are essential. Platforms like this can raise awareness and educate the public about the medical nature of ED. Encouraging men to talk about their experiences and seek help without fear of judgment can shift the narrative. Healthcare providers also play a crucial role; we must approach this condition with sensitivity and support.
TNE: Wise words, Dr. Robles. Before we wrap up, what would you say to men who are hesitant to address their erectile dysfunction?
Dr. Robles: I would emphasize that erectile dysfunction is a medical condition, not a reflection of one’s masculinity. Seeking assistance is a courageous step toward regaining sexual health and overall well-being. There are various treatment options available; the key is to consult a healthcare provider to find the right one.
TNE: Thank you, Dr. Robles, for your insights and for breaking down this critical topic. We look forward to hearing more about your research and its impact on men’s health.
Dr. Robles: Thank you for having me. It’s been a pleasure to discuss this important issue.