How a Topical Therapy May Improve Erectile Function in Young Men with Diabetes
Summary
- Erectile dysfunction (ED) is becoming increasingly common among men under 40, especially those living with type 2 diabetes.
- A pilot study from the University of Miami Miller School of Medicine led by Sonjia Kenya, Ph.D., and Manuel Molina, M.D., is testing a non‑prescription topical therapy, Eroxon® gel, as an add‑on treatment for young men already taking daily tadalafil.
- By including both men and their partners, the PLEASURE study aims to deliver insights that better reflect the lived experience of ED in young couples navigating diabetes.
Erectile dysfunction (ED) is becoming increasingly common among men under 40, especially those living with type 2 diabetes. For many, ED is not only a medical challenge. It can deeply affect relationships, emotional well‑being and overall quality of life.
A new pilot study from the University of Miami Miller School of Medicine led by Sonjia Kenya, Ph.D., and Manuel Molina, M.D., aims to address this growing need by testing a non‑prescription topical therapy, Eroxon® gel, as an add‑on treatment for young men already taking daily tadalafil.
Importantly, the study, PLEASURE (Pleasing Lovers, Efficacy, Arousal, Satisfaction, and Uptake Research on Eroxon), is intentionally designed to include men in committed relationships and to gather meaningful input from their partners. That dual‑perspective approach is essential, researchers say, because erectile dysfunction often affects both members of a couple, influencing confidence, intimacy and communication.
“Sexual functioning is usually a ‘we’ problem, not a ‘me’ problem,” said Dr. Kenya, a professor in the Miller School’s Department of Medicine. “Sexual communication is often more challenging than having sex, which is why more sexual functioning studies should involve partner communication opportunities.”
ED in Young Men with Diabetes
Type 2 diabetes has become more common in adults under 40, accompanied by a rise in associated vascular and urologic complications. ED is often one of the earliest signs of diabetes‑related damage. For younger men, it can stem from:
• Blood vessel dysfunction
• Nerve damage
• Impaired smooth muscle relaxation
• Hormonal imbalance
• Chronic inflammation
• Coexisting conditions like benign prostatic hyperplasia (BPH) or Peyronie’s disease (PD)
While PDE5 inhibitors such as tadalafil remain a first‑line treatment, they are less consistently effective in men with diabetes. Many still experience unreliable erections even with daily medication. Some hesitate to increase their dose due to cost, side effects or personal preference.
“The earlier ED shows up, the more profound the impact on self‑esteem and partnerships,” said Dr. Molina, a UHealth — University of Miami Health System urologist. “We need therapies that fit real‑life use, options that are accessible, rapid‑acting and acceptable to both partners.”
Why Bring Partners into the Research?
ED affects relationships, not just individuals, and the PLEASURE study requires participants to be in ongoing, committed partnerships. Partners are invited to:
• Attend study visits
• Complete validated surveys
• Provide feedback on changes in intimacy, confidence and satisfaction
Partners complete the Index of Sexual Life (ISL) questionnaire at baseline and after 12 weeks to assess whether they perceive meaningful improvements during sexual activity.
“Partners often carry their own emotional burden — worry, disappointment or uncertainty,” Dr. Kenya explained. “By engaging them directly, we obtain a fuller picture of how treatment impacts the couple, not just the patient.”
Inside the PLEASURE Study
The trial will enroll 30 men ages 18 to 40 with diabetes‑related ED who are in committed relationships and continue to experience symptoms despite taking daily tadalafil.
Participants are randomized into two groups:
• Tadalafil alone, or
• Tadalafil and Eroxon® gel, applied before each sexual encounter over a 12‑week period
At the beginning and end of the study, participants complete IIEF‑5 (erectile function) and MARS‑5 (medication adherence) surveys. Partners complete the ISL, which evaluates confidence that sexual stimulation will lead to a reliable erection and captures changes in sexual satisfaction over time.
Participants and partners meet with study staff together, when possible, making the study’s design relational and holistic.
“This joint approach helps us understand how ED and its treatment shape partnership dynamics, not just physiology,” Dr. Kenya said.
Sexual communication is often more challenging than having sex, which is why more sexual functioning studies should involve partner communication opportunities.
Dr. Sonjia Kenya
What the Researchers Hope to Learn
The central question is whether adding Eroxon® gel can produce meaningful clinical and personal differences for couples. Beyond measuring erectile function, the study will explore:
• Whether couples find the gel easy and acceptable to use
• How adherence patterns shape treatment outcomes
• Whether partner confidence and satisfaction improve alongside erectile function
• How relationship dynamics influence sexual health outcomes
Since this is a pilot study, the focus is on feasibility, trends and real‑world usability rather than definitive statistical conclusions.
Dr. Molina and Dr. Kenya have partnered for years on sexual‑health education and research. Their integrated expertise — urology, behavioral science and community engagement — shapes the study’s emphasis on accessible, patient‑centered care.
By including both men and their partners, the PLEASURE study aims to deliver insights that better reflect the lived experience of ED in young couples navigating diabetes. Ultimately, the researchers hope their work will contribute to more compassionate, comprehensive care, helping couples regain confidence, restore intimacy, and improve overall quality of life.
Tags: Department of Urology, Desai Sethi Urology Institute, Dr. Manuel Molina, Dr. Sonjia Kenya, erectile dysfunction, sexual health, urology