Pharmacological treatment of premature ejaculation

Abstract

Premature ejaculation (PE) is currently the most common male sexual complaint. Despite its frequency, there is a lack of universally accepted definition, etiology and treatment. Recently, however, new proposals for the DSM-V classification have been proposed. In 1960’s, premature ejaculation was considered a learned behavior that had to be treated by behavioral therapy, such as the so-called stop–start technique. The efficacy of this method was questioned. Physicians have always looked for medication that could delay ejaculation. Many studies, controlled and open label, have now clearly shown that PE can be treated quickly and effectively with clomipramine and SSRI’s. Clomipramine can be given in doses of 10–50 mg daily. Paroxetine can be prescribed as 10–20 mg daily. In certain cases, combination of both medications can be prescribed to patients. Daily dosing is preferred so as to promote spontaneity in sexual relations. Guidelines for the pharmacological treatment of PE were developed.