Clomiphene Effects on Idiopathic Premature Ejaculation

Abstract

Background:Premature ejaculation (PE) is the inability to delay ejaculation, occurring sooner than they or their partner would like during sexual activities. PE is a challenging problem that can affect sexual enjoyment and may harm relationships of couples and affect their quality of life. In idiopathic PE, several helpful techniques and medicines are recommended, but none of them has yielded satisfactory results.Objectives:Our objective in this study was to evaluate the efficacy and safety of clomiphene as a selective estrogen receptor modulator on the treatment of idiopathic PE.Patients and Methods:In a randomized clinical trial, 178 married men with idiopathic PE defined according to the Diagnostic and Statistical Manual of Mental Disorders Third Revised Version (DSM-III-R) who referred to urology clinics over a 10-month period in 2012 were randomized into two groups, namely the study (clomiphene) and control (placebo) groups. They completed self-administered questionnaires that included intravaginal ejaculatory latency time (IELT), erectile dysfunction indexes, quality of life (QOL), sociodemographic characteristics, lifestyle, and medical illness. After 6 months of intervention, all data were compared with the baseline data and between the groups.Results:Within the 10-month study course, 126 patients (70.8%) completed this study. After intervention and comparison of the results between the two groups, IELT, sexual indexes, and QOL improved in the study group, but significant differences were observed only in the IELT and QOL findings.Conclusions:Clomiphene seems to be useful in the pharmacological treatment of PE compared to the placebo.

Clomiphene citrate treatment during perinatal development alters adult partner preference, mating behaviour and androgen receptor and vasopressin in the male mandarin vole Microtus mandarinus

“…Treatment of pups with clomiphene immediately after birth has a long‐term effect on the reproductive physiology and sexual behaviour of male rats (Pereira et al, 2003). Clomiphene citrate, which has an anti‐oestrogenic property, was not only utilized as an oestrogen receptor blocker in a study of molecular mechanisms of brain sexual differentiation (Getter et al, 2019; Giannakopoulou et al, 2001; Ketabchi, 2015) but also as anti‐oestrogen that reduces the expression of ERα and affects the formation of masculinized brains, which in turn leads to the formation of feminized brains (He et al, 2019; He & Zhang, 2013). Our result is consistent with a study in male rats, in which treatment with the anti‐oestrogen nitromifene citrate in the prenatal period decreased the intensity of the level of female‐oriented behaviour in a two‐choice stimulus situation (oestrous female vs. active male) (Matuszczyk & Larsson, 1995).…”

“…Treatment of pups with clomiphene immediately after birth has a long-term effect on the reproductive physiology and sexual behaviour of male rats (Pereira et al, 2003). Clomiphene citrate, which has an anti-oestrogenic property, was not only utilized as an oestrogen receptor blocker in a study of molecular mechanisms of brain sexual differentiation (Getter et al, 2019;Giannakopoulou et al, 2001;Ketabchi, 2015) but also as anti-oestrogen that reduces the expression of ERα and affects the formation of masculinized brains, which in turn leads to the formation of feminized brains (He et al, 2019;He & Zhang, 2013).…”

“…AR is expressed in areas that undergo sexual differentiation, including the mPOA, MeA, and BNST (Ciofi et al, 2007; Durazzo et al, 2007), including greater AR density and regional volume in males than in females (Zuloaga et al, 2008). Clomiphene citrate, which has an anti‐oestrogenic property, was not only utilized as an oestrogen receptor blocker in a study of molecular mechanisms of brain sexual differentiation (Getter et al, 2019; Giannakopoulou et al, 2001; Ketabchi, 2015) but also as anti‐oestrogen that reduces the expression of oestrogen receptor α (ERα) and affects the formation of masculinized brains, which in turn leads to the formation of feminized brains (He et al, 2019; He & Zhang, 2013). However, whether clomiphene citrate affects the distribution of AR in the BNST, MeA, and mPOA, and the difference in AR distribution in these brain regions in the same species males with female‐directed or male‐directed partner preferences and sexual behaviour has not been reported.…”