Pharmacologic treatment of premature ejaculation

Pharmacologic modulation of ejaculatory threshold represents a novel and refreshing approach to the treatment of PE and a radical departure from the psy-chosexual model of treatment, previously regarded as the cornerstone of treatment. The introduction of SSRIs has revolutionized the approach to, and treatment of, PE. Selective serotonin reuptake inhibitors encompass five compounds—citalopram, fluoxetine, fluvoxamine, paroxetine and sertraline—with a similar pharmacologic mechanism of action. Although the methodology of the initial drug treatment studies was rather poor, later doubleblind and placebo-controlled studies replicated the genuine effect of clomipramine and SSRIs to delay ejaculation. In spite of a development towards more evidence-based drug treatment research, the majority of studies still lack adequate design and methodology [44]. A recent meta-analysis of all drug treatment studies demonstrated that only 14.4% had been performed according to the established criteria of evidence-based medicine, and that open design studies and studies using subjective reporting or questionnaires showed a higher variability in ejaculation delay than double-blind studies in which

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No. weeks

Fig. 16.2 Selective serotonin re-uptake inhibitors produce ejaculatory delay within 5 to10 days [46].

No. weeks

Fig. 16.2 Selective serotonin re-uptake inhibitors produce ejaculatory delay within 5 to10 days [46].

the ejaculation delay was prospectively assessed with a stopwatch [44].

5 Secrets to Lasting Longer In The Bedroom

5 Secrets to Lasting Longer In The Bedroom

How to increase your staying power to extend your pleasure-and hers. There are many techniques, exercises and even devices, aids, and drugs to help you last longer in the bedroom. However, in most cases, the main reason most guys don't last long is due to what's going on in their minds, not their bodies.

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