Management Of Premature Ejaculation Research Articles

Pharmacological treatment of premature ejaculation.

Ejaculatory dysfunction is the most common male sexual disorder and premature ejaculation the most common presentation of ejaculatory dysfunction. Convincing data are lacking from controlled clinical studies to support sustainable long term efficacy of psychosexual counselling in the management of premature ejaculation. The pharmacological treatment of premature ejaculation is now receiving increased attention from both physicians with an interest in sexual medicine and from the pharmaceutical industry.

A critical review of selective serotonin reuptake inhibitor-related sexual dysfunction; incidence, possible aetiology and implications for management.

There is a high incidence of sexual dysfunction in the general population and sexual dysfunction is often an integral symptom of a depressive disorder. In addition, all antidepressants have effects on sexual functioning, as the result of side-effects of these medications and as a reflection of therapeutic success. The selective serotonin reuptake inhibitors (SSRIs) are clearly associated with delayed ejaculation, inability to ejaculate and absent or delayed orgasm. Furthermore, the incidence of sexual dysfunction obtained by patient self-report does not appear to reflect the true incidence of sexual dysfunction associated with antidepressant therapy and systematic inquiry is needed as sexual dysfunction may be an unrecognized cause of noncompliance. The SSRIs may have advantageous effects on sexual functioning and these may also be underreported due to the same factors resulting in an under-reporting of sexual side-effects in general. In addition, studies have suggested a role for the SSRIs in the management of premature ejaculation. The effects of SSRIs on sexual functioning are clearly dose-related and may vary amongst the group due to their relative effects on the serotonin and dopamine systems and the extent to which plasma levels of these drugs accumulate in the body over time. A variety of strategies have been found useful in the management of SSRI-induced sexual dysfunction including waiting for tolerance to develop, dosage reduction, drug holidays, switching to a different antidepressant and various augmentation strategies with 5-HT2, alpha2 adrenergic receptor antagonists and dopamine receptor agonists.

Gluttons, sentimentalists and other metaphors of premature ejaculation

Abstract On close examination, standard explanations and promises of easy solutions regarding premature ejaculation (PE), are found to be doubtful. A critical review of the PE literature is thus highly needed. This investigation is based on clinical work, and uses concepts such as metaphor, drama and sentimentality, borrowed from literary criticism. Unlike the ideas of unconscious aggression, critical learning and lack of awareness of the approaching orgasm, the alternative notions of sentimentality, anticipatory arousal (anticlimax) and tension release (gluttony)—have clear therapeutic implications. A multi-faceted typology of PE is constructed to serve as a tool for diagnosis and therapy planning. General issues in therapy management of PE are addressed. New interventions—the techniques of inoculation, amendment and deprogramming—are presented along with other measures for change.