Complementary and Alternative Medicine for Management of Premature Ejaculation: A Systematic Review

Abstract

IntroductionPremature ejaculation (PE) is defined as ejaculation within 1 minute (lifelong PE) or 3 minutes (acquired PE), inability to delay ejaculation, and negative personal consequences. Management includes behavioral and pharmacologic approaches.AimTo systematically review effectiveness, safety, and robustness of evidence for complementary and alternative medicine in managing PE.MethodsNine databases including Medline were searched through September 2015. Randomized controlled trials evaluating complementary and alternative medicine for PE were included.Main Outcome MeasuresStudies were included if they reported on intravaginal ejaculatory latency time (IELT) and/or another validated PE measurement. Adverse effects were summarized.ResultsTen randomized controlled trials were included. Two assessed acupuncture, five assessed Chinese herbal medicine, one assessed Ayurvedic herbal medicine, and two assessed topical “severance secret” cream. Risk of bias was unclear in all studies because of unclear allocation concealment or blinding, and only five studies reported stopwatch-measured IELT. Acupuncture slightly increased IELT over placebo in one study (mean difference [MD] = 0.55 minute, P = .001). In another study, Ayurvedic herbal medicine slightly increased IELT over placebo (MD = 0.80 minute, P = .001). Topical severance secret cream increased IELT over placebo in two studies (MD = 8.60 minutes, P < .001), although inclusion criteria were broad (IELT < 3 minutes). Three studies comparing Chinese herbal medicine with selective serotonin reuptake inhibitors (SSRIs) favored SSRIs (MD = 1.01 minutes, P = .02). However, combination treatment with Chinese medicine plus SSRIs improved IELT over SSRIs alone (two studies; MD = 1.92 minutes, P < .00001) and over Chinese medicine alone (two studies; MD = 2.52 minutes, P < .00001). Adverse effects were not consistently assessed but where reported were generally mild.ConclusionThere is preliminary evidence for the effectiveness of acupuncture, Chinese herbal medicine, Ayurvedic herbal medicine, and topical severance secret cream in improving IELT and other outcomes. However, results are based on clinically heterogeneous studies of unclear quality. There are sparse data on adverse effects or potential for drug interactions. Further well-conducted randomized controlled trials would be valuable.

Premature Ejaculation in Cotonou

“…Several treatment approaches have been proposed taking into account the different theories supporting the occurrence of PE. Behavioral, psychological and medicinal therapies [4,17]. During our study, 17.1% (or 52) of respondents and 28.1% (or 36) of those who identify themselves as PE (or 128) underwent at least once a treatment to improve their IELT.…”

“…Its diagnosis involves several parameters such as intravaginal ejaculatory latency time, personal satisfaction and the impact on the couple [3]. The difficulty of obtaining unanimity in the definition of premature ejaculation explains the poverty of epidemiological data on this affection [3,4]. It is a very embarrassing medical condition which is based on the patient's medical history and self-diagnosis.…”

Use of Topical Berberine to Manage Premature Ejaculation and/or Erectile Dysfunction: Restoration of Endothelial Homeostasis.

“…PE is defined as ejaculation within 1 minute (lifelong PE) or 3 minutes (acquired PE), inability to delay ejaculation, and negative personal consequences (Cooper et al 2017). However, we adopted Waldinger et al (Waldinger et al 2005) definition and those "men with intravaginal ejaculatory latency time (IELT) less than two minutes" were considered potential participants for our observational studies and we will also adopt it for the clinical trial.…”

“…The holy grail of this quest is to find or develop an effective product with minimal side effects and without compromising spontaneity during sexual intercourse (Mohee and Eardley 2011). Notably, several clinical trials have been conducted to test complementary and alternative medicine management of this common masculine disorder (Cooper et al 2017).…”

The Effectiveness of Auriculotherapy on Women's Sexual Function: A Randomized Controlled Trial

“…Non-medicinal methods like herbal medicines, psychological methods and also use of complementary and alternative medicine (CAM) have been used to improve sexual function. Beside Training and counseling, different CAM interventions including reflexology, acupuncture, and auriculotherapy (AT) have been used to deal with sexual dysfunctions and were utilized with the aim to improve quality of sexual life ( 22 - 25 ).…”