Premature Ejaculation - Treatment

Treatment

When deciding the appropriate treatment, it is important for physician to distinguish PE as a "complaint" versus PE as a "syndrome". About 20 years ago, PE was classified into "lifelong PE" and "acquired PE". Recently, a new classification of PE was proposed based on controlled clinical and epidemiological stopwatch studies, and it included 2 other PE syndromes: "natural variable PE" and "premature-like ejaculatory dysfunction". Only men with lifelong PE with Intravaginal ejaculation latency time(IELT) <1 to 1.5 minutes should require medication as a first option, along with or without therapy. For men who fall into one of the other categories, treatment should consist of patient reassurance, behavior therapy, and/or psychoeducation to explain irregular early ejaculation is a normal variation.

Dapoxetine (Priligy) is a short-acting selective serotonin reuptake inhibitor (SSRI) marketed for the treatment of premature ejaculation. Dapoxetine is the only drug with regulatory approval for such an indication. Currently, it is approved in several European countries, including Finland, Sweden, Portugal, Austria and Germany. Dapoxetine is currently waiting for U.S. Food and Drug Administration (FDA) approval after concluding the Phase III study, which included participants from 25 other countries, including the United States. In this diverse population, dapoxetine significantly improved all aspects of PE and was generally well tolerated.

Tramadol (Ultram or Tramal) is an FDA approved atypical oral analgesic for mild pain. It is atypical because it is similar to an opioid, is an agonist at the mu receptor, but also is similar to an anti-depressant in that it increases levels of serotonin and norepinephrine. Tramadol also has few side effects, low abuse potential, and increases (IELT) 4-20 fold in greater than 90% of men.,

Clomipramine (Anafranil) is sometimes prescribed to treat PE. One side effect of the drug can help delay ejaculatory response. The side effect is described by the Mayo Clinic as "Increased sexual ability, desire, drive, or performance."

Desensitizing creams that are applied to the tip and shaft of the penis can also be used prevent premature ejaculation. Such creams are applied on an "as needed" basis and have fewer systemic side effects. However, use of these creams may lead to insensitivity in the penis, and reduction of sensation for the partner due to contamination.

One more method is entitled intracavernous pharmacotherapy. This is a method of injecting a drug known as a vasodilator directly into the penis to help men control premature ejaculation and maintain their erection. It has been proven to be effective in over seventy percent of test patients. This method is used by companies such as Florida Men’s Medical Clinic, Boston Medical Group and others.

Read more about this topic:  Premature Ejaculation

Famous quotes containing the word treatment:

    The treatment of the incident of the assault upon the sailors of the Baltimore is so conciliatory and friendly that I am of the opinion that there is a good prospect that the differences growing out of that serious affair can now be adjusted upon terms satisfactory to this Government by the usual methods and without special powers from Congress.
    Benjamin Harrison (1833–1901)

    The treatment of African and African American culture in our education was no different from their treatment in Tarzan movies.
    Ishmael Reed (b. 1938)

    I feel that any form of so called psychotherapy is strongly contraindicated for addicts.... The question “Why did you start using narcotics in the first place?” should never be asked. It is quite as irrelevant to treatment as it would be to ask a malarial patient why he went to a malarial area.
    William Burroughs (b. 1914)