New agents in the treatment of premature ejaculation

Abstract

Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggest that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have "defi nite" PE, while men with IELTs between 1 and 1.5 minutes have "probable" PE. Although there is insuffi cient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors (SSRIs) offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains and is well tolerated. Investigational drugs such as the ejaculo-selective serotonin transport inhibitors (ESSTIs) such as dapoxetine and UK-390,957 represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, signifi cant improvements in IELT, ejaculatory control, and sexual satisfaction with minimal adverse effects.

Traditional, Complementary and Alternative Medicines in the Treatment of Ejaculatory Disorders: A Systematic Review

“…Forty-five full texts were assessed for eligibility, with 23 articles excluded, resulting in 22 articles included for qualitative analysis. Reasons for articles excluded at eligibility included no full-length clinical trial (n = 7) [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ], no TCAM intervention (n = 5) [ 42 , 43 , 44 , 45 , 46 ], no comparison group (n = 6) [ 47 , 48 , 49 , 50 , 51 , 52 ], no ejaculatory disorder cohort under investigation (n = 3) [ 53 , 54 , 55 ], and combined treatment with conventional medicine (n = 2) [ 56 , 57 ].…”

Premature ejaculation: a modern view at the problem

“…результаты исследований, проведенных на генетическом уровне, свидетельствуют о том, что к возникновению PE предрасполагает нарушение генетического контроля системы серотонинергической регуляции [25]. В другой работе отмечается, что у мужчин с PE отмечается унаследованная измененная чувствительность центральных рецепторов серотонина [22]. В работах последних лет, обращающих внимание на биологический фундамент PE, отмечается, что она опосредуется главным образом нарушениями серотонинергической нейротрансмиссии и определенными серотониновыми рецепторами и, в меньшей степени, окситоцинергической нейротрансмиссией в Цнс [29].…”

Serotonin transporter (5‐HTTLPR) genotypes and trinucleotide repeats of androgen receptor exert a combinatorial effect on hormonal milieu in patients with lifelong premature ejaculation

“…Regardless of its high prevalence, premature ejaculation is considerably under‐reported and undertreated because of the social stigma and misconception about the physiology of male sexual response. Epidemiological studies have reported its frequency up to 30% worldwide (McMahon et al ., ). PE is classified as primary or lifelong (LPE) and secondary or acquired PE (APE).…”