Combining Behavioral Therapy with Medication for PE

On-demand SSRI treatment of premature ejaculation: Pharmacodynamic limitations for relevant ejaculation delay and consequent solutions. J Sex Med 2005;2:121–31.

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An analysis of selfreported sexual behavior in a sample of normal males. Arch Sex Behav 1984;13:69–83. Incidence and prevalence of the sexual dysfunctions: A critical review of the empirical literature. Arch Sex Behav 1990;19:389–408. The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: Prevalence, comorbidities, and professional help-seeking.

When should I see a doctor about premature ejaculation?

Eur Urol 2007;51:816–23; discussion 824. Prevalence, characteristics and implications of premature ejaculation/rapid ejaculation. Etiology of ejaculation and pathophysiology of premature ejaculation. Prevalence of chronic prostatitis in men with premature ejaculation. Effects of a new type of 5-HT receptor agonist on male rat sexual behavior. Peripheral and central neurochemical effects of the selective serotonin reuptake inhibitors (SSRIs) in humans and nonhuman primates: Assessing bioeffect and mechanisms of action. Sprouse J, Braselton J, Reynolds L, Clarke T, Rollema H. Activation of postsynaptic 5-HT(1A) receptors by fluoxetine despite the loss of firingdependent serotonergic input: Electrophysiologicaland neurochemical studies. Sprouse J, Clarke T, Reynolds L, Heym J, Rollema H. Comparison of the effects of sertraline and its metabolite desmethylsertraline on blockade of central 5-HT reuptake in vivo. Anderson GM, Barr CS, Lindell S, Durham AC, Shifrovich I, Higley JD.

Time course of the effects of the serotonin-selective reuptake inhibitor sertraline on central and peripheral serotonin neurochemistry in the rhesus monkey. Waldinger MD, Zwinderman AH, Olivier B. On-demand treatment of premature ejaculation with clomipramine and paroxetine: A randomized, double-blind fixed-dose study with stopwatch assessment.

• Dapoxetine is a fast-acting medication approved for PE.
• Combining medications with therapy enhances results.
• Some pills contain PDE5 inhibitors, like sildenafil, for better control.
• Side effects of pills may include dizziness or nausea.
• Always check for drug interactions before taking PE pills.

Eur Urol 2004;46:510–5; discussion 516. Modi NB, Dresser MJ, Simon M, Lin D, Desai D, Gupta S. Single- and multiple-dose pharmacokinetics of dapoxetine hydrochloride, a novel agent for the treatment of premature ejaculation. Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WJ, Shabsigh R, Miloslavsky M, Kell S. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: An integrated analysis of two double-blind, randomised controlled trials.

Topical Numbing Agents and Non-Pharmacological Treatments

Pharmacol Biochem Behav 1981; 15:785–92. The role of the 5-HT2 receptor in the regulation of sexual performance of male rats. Waldinger MD, Berendsen HH, Blok BF, Olivier B, Holstege G. Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation: The involvement of the serotonergic system. Behav Brain Res 1998;92:111–8.

Cite this article

Effect of SSRI antidepressants on ejaculation: A double-blind, randomized, placebocontrolled study with fluoxetine, fluvoxamine, paroxetine, and sertraline. The selective serotonin re-uptake inhibitors fluvoxamine and paroxetine differ in sexual inhibitory effects after chronic treatment. Waldinger MD, Zwinderman AH, Olivier B. SSRIs and ejaculation: A double-blind, randomized, fixeddose study with paroxetine and citalopram. Waldinger MD, Zwinderman AH, Olivier B. McMahon CG, Touma K.

• Pills that increase serotonin tend to have longer-lasting effects.
• Men should discuss all medications with their healthcare provider.
• The placebo effect can sometimes influence perceived improvements.
• Overuse of delay pills may lead to decreased natural ability.
• PE pills are one part of a holistic approach including therapy and lifestyle.

Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single-blind placebo controlled crossover studies. Salonia A, Maga T, Colombo R, Scattoni V, Briganti A, Cestari A, Guazzoni G, Rigatti P, Montorsi F. A prospective study comparing paroxetine alone versus paroxetine plus sildenafil in patients with premature ejaculation. FDA proposes new warnings about suicidal thinking, behavior in young adults who take antidepressant medications. Available at NEW01624.html (accessed March 24, 2008). Rosen RC, Casey R, Levine SB, Mudumbi R, Tesfaye F, Hasmonay R. Treatment of premature ejaculation (PE) with dapoxetine (DPX) is not associated with suicidality.

A Holistic Path to Sexual Confidence

The use of phenoxybenzamine treatment in premature ejaculation. Effect of an alpha-blocking agent (phenoxybenzamine) in the management of premature ejaculation. Eaton H. Clomipramine in the treatment of premature ejaculation. Ejaculation-retarding properties of paroxetine in patients with primary premature ejaculation: A double-blind, randomized, dose-response study.

The pause-squeeze technique

Br J Urol 1997;79:592–5. Efficacy and safety of fluoxetine, sertraline and clomipramine in patients with premature ejaculation: A double-blind, placebo controlled study. Disorders of orgasm and ejaculation in men. J Sex Med 2004;1:58–65. Biri H, Isen K, Sinik Z, Onaran M, Kupeli B, Bozkirli I. Healy D, Whitaker C. Antidepressants and suicide: Risk-benefit conundrums. Girgis SM, El-Haggar S, El-Hermouzy S. A double-blind trial 100 sex tablet of clomipramine in premature ejaculation. Clomipramine as a treatment for rapid ejaculation: A double-blind crossover trial of fifteen couples. Effective daily treatment with clomipramine in men with premature ejaculation when 25 mg (as required) is ineffective. Maier U, Koinig G. Andrological findings in young patients under long-term antidepressive therapy with clomipramine. Mousavizadeh K, Ghafourifar P, Sadeghi-Nejad H. Calcium channel blocking activity of thioridazine, clomipramine and fluoxetine in isolated rat vas deferens: A relative potency measurement study.

Premature Ejaculation Treatment FAQs

Antidepressants and ejaculation: A double-blind, randomized, placebo-controlled, fixed-dose study with paroxetine, sertraline, and nefazodone. Jern P, Santtila P,Witting K, Alanko K, Harlaar N, Johansson A, von der Pahlen B, Varjonen M, Vikstrom N, Algars M, Sandnabba K. Premature and delayed ejaculation: Genetic and environmental effects in a population-based sample of Finnish twins. Penile sensitivity in patients with primary premature ejaculation. Somatosensory evoked potentials in patients with primary premature ejaculation.

Behavioral Techniques and Lifestyle Changes

Guidelines for the diagnosis and management of premature ejaculation. Dinsmore WW, Hackett G, Goldmeier D, Waldinger M, Dean J, Wright P, Callander M, Wylie K, Novak C, Keywood C, Heath P, Wyllie M. Topical eutectic mixture for premature ejaculation (TEMPE): A novel aerosol-delivery form of lidocaine-prilocaine for treating premature ejaculation. Berkovitch M, Keresteci AG, Koren G. Efficacy of prilocaine-lidocaine cream in the treatment of premature ejaculation. Tramadol HCL has promise in on-demand use to treat premature ejaculation. J Sex Med 2008;5:188–93. Safety and efficacy of tramadol in the treatment of premature ejaculation: A double-blind, placebo-controlled, fixed-dose, randomized study. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors.

Frequently Asked Questions about PE Medication

Serotonin and premature ejaculation: From physiology to patient management. Clomipramine and sexual function in men with premature ejaculation and controls. Giuliano F. 5-Hydroxytryptamine in premature ejaculation: Opportunities for therapeutic intervention. Giuliano F.

Topical Anesthetics: Sprays, Creams, and Wipes

Interview with Dr Francois Giuliano (by Christine McKillop). New avenues in the pharmacological treatment of premature ejaculation. Relevance of an evidence-based ejaculation time cutoff point for neurobiological research of premature ejaculation. Animal models of premature and retarded ejaculation. Waldinger MD, Schweitzer DH, Olivier B. Efficacy of type-5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation: A systematic review.

• Some pills may suppress ejaculation entirely if misused.
• Not all pills are suitable for men with certain health issues.
• Combining medication with pelvic exercises can enhance control.
• Expect gradual improvement; immediate effects are uncommon.
• Open communication with partner improves treatment outcomes.

Ejaculatory abnormalities in mice lacking the gene for endothelial nitric oxide synthase (eNOS-/-). Abdel-Hamid IA ENE, El Gilani A-H. Assessment of as needed use of pharmacotherapy and the pausesqueeze technique in premature ejaculation.

Drugs used to treat this and similar conditions

Morales A. Developmental status of topical therapies fildena online for erectile and ejaculatory dysfunction. Optimum usage of prilocaine-lidocaine cream in premature ejaculation. Topical anaesthetic use for treating premature ejaculation: A double-blind, randomized, placebo-controlled study. Clinical study of SS-cream in patients with lifelong premature ejaculation.

The Risks of Unregulated “Herbal” Pills

Althof S. The psychology of premature ejaculation: Therapies and consequences. Premature ejaculation: A review of 1130 cases. Aycock L. The medical management of premature ejaculation. Efficacy of sildenafil citrate in treatment of erectile dysfunction: Impact of associated premature ejaculation and low desire. Goldmeier D, Lamba H. Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation by Abdel-Hamid et al. Intracavernous medication for treatment of premature ejaculation. Chen J, Mabjeesh NJ, Matzkin H, Greenstein A. Efficacy of sildenafil as adjuvant therapy to selective serotonin reuptake inhibitor in alleviating premature ejaculation. A new combination treatment for premature ejaculation: A sex therapist’s perspective. Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, Abraham L, Crossland A, Morris M.

Development and validation of a premature ejaculation diagnostic tool. Azam U. Late-stage clinical development in lower urogenital targets: Sexual dysfunction. Taber MT, Wright RN, Molski TF, Clarke WJ, Brassil PJ, Denhart DJ, Mattson RJ, Lodge NJ.

Medication Summary

Sertraline in the treatment of premature ejaculation: A double-blind placebo controlled study. Sertraline as a treatment for premature ejaculation. Athanasios Z, Polyanthi P, George K. The efficacy of duloxetine in the treatment of premature ejaculation. Selective serotonin reuptake inhibitor-induced sexual dysfunction: clinical and research considerations.

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Utility of selective serotonin reuptake inhibitors in premature ejaculation. Curr Opin Invest Drugs 2004;5:743–7. Safarinejad MR. Safety and efficacy of escitalopram in the treatment of premature ejaculation: A doubleblind, placebo-controlled, fixed-dose, randomized study. Giuliano F, Clement P. Neurochemical, pharmacokinetic, and behavioral effects of the novel selective serotonin reuptake inhibitor BMS-505130. Pharmacol Biochem Behav 2005;80:521–8. Aloosh M, Hassani M, Nikoobakht M. Seminal plasma magnesium and premature ejaculation: A case-control study.