Current Sexual Health Reports

, Volume 6, Issue 2, pp 65–80

Current Diagnosis and Management of Premature Ejaculation

MALE SEXUAL DYSFUNCTION AND DISORDERS (M KHERA AND SE ALTHOF, SECTION EDITORS)

DOI: 10.1007/s11930-014-0014-x

Cite this article as:
Bailey, G.C. & Trost, L.W. Curr Sex Health Rep (2014) 6: 65. doi:10.1007/s11930-014-0014-x
Part of the following topical collections:
  1. Topical Collection on Male Sexual Dysfunction and Disorders

Abstract

Premature ejaculation (PE) is a common sexual dysfunction characterized by reduced intravaginal ejaculatory latency time (IELT), inability to delay ejaculation, and personal distress. Increasing understanding of pathophysiologic mechanisms has yielded diverse and effective therapies. The current review discusses contemporary evaluation and management of PE, with a review of all randomized, controlled trials (RCT) performed. Therapies with RCT data include behavioral modification/psychotherapy, topical anesthetics, narcotic-like pain relievers, phosphodiesterase-5 (PDE-5) inhibitors, selective serotonin/norepinephrine reuptake inhibitors and receptor antagonists, tricyclic antidepressants, and surgery. As data are insufficient to define optimal therapies, treatment decisions are based on clinical factors (comorbid conditions, PE mechanism and patient preference), trial outcomes, and adverse event profiles. Combination therapies demonstrate superior efficacy to single agents, with concomitant use of behavioral/psychosexual modifications with pharmacotherapy recommended. The role of surgery in PE remains undefined, with additional data required. Further comparative RCTs are required to define optimal treatment algorithms.

Keywords

Erectile dysfunction Sexual dysfunction Early ejaculation Premature ejaculation Management Treatment Psychogenic EMLA TEMPE PSD502 Promescent Psychosexual Citalopram Clomipramine Dapoxetine Escitalopram Fluoxetine Mirodenafil Paroxetine Pindolol Sertraline Sildenafil Tadalafil Vardenafil PDE5 Tramadol 

Legend of Abbreviations

AD

Adverse events

CPPS

Chronic pelvic pain syndrome

ED

Erectile dysfunction

FDA

Food and Drug Administration

IELT

Intravaginal ejaculatory latency time

ISSM

International Society for Sexual Medicine

NO

Nitric oxide

OD

On demand

ODT

Orally disintegrating tablet

PC

Placebo controlled

PDE5

Phosphodiesterase-5 inhibitors

PE

Premature ejaculation

RCT

Randomized controlled trial

SD

Sexual dysfunction

SNRI

Serotonin-noreprinephrine reuptake inhibitor

SSRI

Selective serotonin reuptake inhibitor

TCA

Tricyclic antidepressant

Copyright information

© Springer Science+Business Media, LLC 2014

Authors and Affiliations

  1. 1.Department of UrologyMayo ClinicRochesterUSA

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