Prevalence of Premature Ejaculation among Patients with Type 2 Diabetes in a Tertiary Health Institution: A Cross-Sectional Study

Understanding and treating ejaculatory dysfunction in men with diabetes mellitus

“…72,82 Supporting this, are reports from a recently published cross-sectional study finding a greater than fourfold prevalence of PE in those who had DM-related ED than those without ED. 83 Given that the majority of ED in DM is attributed to DM-related neuropathy and endothelial dysfunction, it supports the aetiological role of neuropathy in DM-related EjD. Hence, in diabetic patients who report ED (the more frequently reported sexual dysfunction in DM), EjD should also be actively enquired about.…”

“…82 However, another cross-sectional study found no correlation although this study involved a much smaller sample size. 83…”

“…For example, one of the theories behind this close association is that these men may subconsciously try to hasten sexual activity and intercourse to mitigate against the failure to maintain an erection because of their DM-related ED. 83,94 The PE, in turn, adds to future performance anxiety and can worsen the ED/PE by adding to the psychogenic component of these sexual disorders. Conversely, others have suggested men with PE may try to offset/prolong the early IELT by trying to reduce sexual arousal and hence this may inadvertently lead to detumescence and failure to maintain an erection, further compounding the ED.…”

“…Age EL-Sakka, 82 Majzoub et al 72 Those >50 years twice as likely to have PE Olamoyegun et al 83 Failed to find association between age and rate of PE EL-Sakka 82 HbA1c >7 resulted in OR of 9.6 in having PE Glycaemic control Bellastella et al 86 Significant negative correlation between HbA1c and IELT (r = -0.3; p = 0.01) Olamoyegun et al 83 Higher fasting blood glucose in PE than those without Fedder et al 12 Found no difference in HbA1c between diabetics with and without RE High blood glucose variability and LBGI…”

Ejaculatory dysfunction in men with diabetes mellitus

“…Hence, it is important to diagnose any associated comorbidity such as ED, depression, prostatitis, or hyperthyroidism as they should be treated first or at the same time as PE[ 120 ]. Therefore, the treatment may involve numerous interventions as per the kind of mechanism that would cause such condition: (1) The initial management for PE is controlling the patient’s blood glucose that in some cases may allow recover the normal ejaculatory function[ 91 , 93 ]; (2) Amelioration of glycemic variability would improve PE in type 1 diabetes patients[ 96 ]; (3) In cases of concomitant ED and PE, ED should receive phosphodiesterase type 5 inhibitors before, or at least at the same time as, PE[ 91 , 93 , 94 ]. The efficacy of the combined use of phosphodiesterase type 5 inhibitors and dapoxetine in males with comorbid PE and ED are supported by some studies[ 121 - 123 ]; (4) DM-related PE patients had a worse response to 30-60 mg oral dapoxetine treatment compared to non-diabetic PE patients.…”