Relationship between plasma melatonin levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation

Abstract

Abbreviations & AcronymsObjectives: To examine the relationship between premature ejaculation and plasma melatonin levels, and assess the efficacy of selective serotonin reuptake inhibitors in treating premature ejaculation. Methods: A total of 60 men with lifelong premature ejaculation and 40 healthy male controls were included in the present study. For each participant, a medical history was obtained, a physical examination was carried out, and intravaginal ejaculation latency time and melatonin levels were measured. Premature ejaculation patients were randomly categorized into three treatment groups: group 1 received fluoxetine (20 mg/day), group 2 received paroxetine (20 mg/day) and group 3 received sertraline (50 mg/day). Results: The mean baseline plasma melatonin levels in men with premature ejaculation were significantly lower than in the healthy controls (5.34 vs 14.84 pg/mL). After 4 weeks of treatment, the mean intravaginal ejaculation latency time scores for all of the premature ejaculation treatment groups showed a significant improvement from the baseline values. The plasma melatonin levels were also significantly increased (P < 0.05) from baseline (5.34 pg/mL) to 9.50 pg/mL, 10.24 pg/mL or 13.30 pg/mL for groups 1, 2 and 3, respectively. Conclusions: Our findings show that premature ejaculation is associated with decreased plasma melatonin levels. After treatment with selective serotonin reuptake inhibitors, an increased plasma melatonin level can retard ejaculation, presumably by both central and peripheral mechanisms. This is the first study to evaluate the possible role of serotoninergic interactions on the melatoninergic system in premature ejaculation.

Editorial Comment from Dr Sato to Relationship between plasma melatonin levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation

“…Although recent research has expanded our understanding of the mechanism of ejaculatory function, the entire mechanism of PE is still unclear. 1 The present study highlighted the interesting relationship between PE and plasma melatonin level. 2 The authors' hypothesis is new and might suggest a novel treatment approach for PE.…”

“…Actually, I was surprised by the clear difference of serum melatonin level between the PE and control group. Although melatonin might have various physiological actions that include sexual functions, to my knowledge, there is no report that describes such a clear relationship between serum melatonin and ejaculatory function in the human male . Putative reasons for lower serum melatonin level in PE patients are unclear.…”

“…Premature ejaculation (PE) is a common sexual dysfunction. Although recent research has expanded our understanding of the mechanism of ejaculatory function, the entire mechanism of PE is still unclear …”

Editorial Comment from Dr Amano to Relationship between plasma melatonin levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation

“…One of the most promising treatments for PE is selective serotonin reuptake inhibitors (SSRI). The present study reported a relationship between plasma melatonin levels and the efficacy of SSRI in PE patients . It is very interesting, and the findings that the mean plasma melatonin levels in men with PE were significantly lower than that in healthy controls are important.…”

Urinary sulphatoxymelatonin as a biomarker of serotonin status in biogenic amine-deficient patients

“…At 5 years of age, she showed high urine aMT6s values, which suggested that the combination of all these drugs may have led to this result. In fact, it has been suggested that some SSRI drugs may increase plasma melatonin values 21 . Patients 25 and 26 undertook only 5HTP therapy, and both showed normal aMT6s excretion, which supports the hypothesis that this serotonin precursor is effective in increasing urinary aMT6s excretion.…”