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Erectile dysfunction improvement: pistachio or placebo effect

International Journal of Impotence Research volume 23, page 180 (2011)Cite this article

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I read with interest the paper by Aldemir et al.1 They conducted a before and after study evaluating the pistachio diet on erectile function parameters and serum lipid profiles in patients with erectile dysfunction (ED). They concluded that pistachio diet improved erectile function parameters without any side effects in patients with ED. I think this study design is not appropriate for the evaluation of this relationship, because its main limitation is the lack of a control group, which makes it difficult to establish a causal relationship. The effect of pistachio on ED may be a placebo effect because de Araujo et al.2 showed that treatment of ED with oral placebo agents demonstrates clinical effects, improving erectile function and quality of erection. In addition, in recent years patients have more positive attitudes to complementary medicine.3 We see in our daily practice a large number of patients who think herbal medicine has more effect and lower adverse effect than conventional treatments. This positive attitude can increase the placebo effect of herbal medicine.

So, we should consider these methodological points while bringing this study results into our daily practice.

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References

  1. Aldemir M, Okulu E, Neþelio∂lu S, Erel O, Kayỳgil O . Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction. Int J Impot Res 2011; 23: 32–38.

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  2. de Araujo AC, da Silva FG, Salvi F, Awad MC, da Silva EA, Damião R . The management of erectile dysfunction with placebo only: does it work? J Sex Med 2009; 6: 3440–3448.

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  3. Fisher P, Ward A . Complementary medicine in Europe. BMJ 1994; 309: 107–111.

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Acknowledgements

I wish to thank Dr Shirin Irani for her valuable comments.

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  1. Department of Urology, Mashhad University of Medical Sciences, Mashhad, Iran

    B Shakiba

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  1. B Shakiba
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Correspondence to B Shakiba.

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Shakiba, B. Erectile dysfunction improvement: pistachio or placebo effect. Int J Impot Res 23, 180 (2011). https://doi.org/10.1038/ijir.2011.19

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