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Management of premature ejaculation: a clinical guideline from the Italian Society of Andrology and Sexual Medicine (SIAMS)

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Abstract

Premature ejaculation (PE) is the most prevalent male sexual dysfunction, and the most recently defined. PE is often mistakenly considered a purely psychosexological symptom by patients: the lacking awareness in regards to the pathophysiology and treatments often lead to resignation from the patients’ side, making PE the most underdiagnosed sexual complaint. However, an ever-growing body of evidence supporting several organic factors has been developed in the last decades and several definitions have been suggested to encompass all defining features of PE. In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), we propose 33 recommendations concerning the definition, pathophysiology, treatment and management of PE aimed to improve patient care. These evidence-based clinical guidelines provide the necessary up-to-date guidance in the context of PE secondary to organic and psychosexological conditions, such as prostate inflammation, endocrine disorders, and other sexual dysfunctions, and suggest how to associate pharmacotherapies and cognitive-behavioral therapy in a couple-centered approach. New therapeutic options, as well as combination and off-label treatments, are also described.

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Funding

This paper is partially supported by the PRIN Grant #2017S9KTNE_002.

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Authors and Affiliations

  1. Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy

    A. Sansone, E. Limoncin & E. A. Jannini

  2. Department of Experimental and Clinical Medicine, University of Catanzaro Magna Graecia, Catanzaro, Italy

    A. Aversa

  3. Endocrinology Unit, Medical Department, Azienda-Usl, Maggiore-Bellaria Hospital, Bologna, Italy

    G. Corona

  4. Andrology, Women’s Endocrinology and Gender Incongruence Unit, Florence University Hospital, Florence, Italy

    A. D. Fisher

  5. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

    A. M. Isidori

  6. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

    S. La Vignera

  7. Endocrinology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy

    M. Maggi

  8. Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Padua, Italy

    M. Merico

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AS, AA, GC, ADF, AMI, SLV, MMa and MMe declare no competing interests for the present article. EL is or has been paid consultant and/or speaker for Pfizer and Shionogi. EAJ is or has been paid consultant and/or speaker for Bayer, Ibsa, Lundbeck, Otsuka, Meniarini, Pfizer and Shionogi.

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Sansone, A., Aversa, A., Corona, G. et al. Management of premature ejaculation: a clinical guideline from the Italian Society of Andrology and Sexual Medicine (SIAMS). J Endocrinol Invest 44, 1103–1118 (2021). https://doi.org/10.1007/s40618-020-01458-4

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