Invited Speaker

Premature Ejaculation. Pharmacological Treatment
Fernandez Lozano
Spain

Premature ejaculation is a male sexual dysfunction defined as ejaculation

- which always or nearly always occurs prior to or within about one minute of vaginal penetration, and,
- inability to delay ejaculation on all or nearly all vaginal penetration, and,
- negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.

10th Congress of the European Society for Sexual Medicine. Lisboa. Nov.2007.

Prevalence on premature ejaculation is not well known but certainly high (around a 25% of men). Nevertheless an increasing number of patients demand in our urology offices a treatment for their sexual desorder.

There is a large group of men requiring treatment for a condition that deprives them of pleasent sexual relations.

For years the prevailing opinion was that rapid ejaculation was a psychological or learned condition. However, a series of biological investigations has begun to unravel the physiological underpinnings of the ejaculatory process, leading theorist to speculate about organic contributions to this disorder.

Pharmacological treatments for delaying or impeding ejaculation consist of antidepressant medications, topical ointments, PDE5I or combinations of de above. Using strict dosages in carefully selected populations, have repeatedly demonstrated that these agents are efficacious in delaying ejaculation. The principal controversy in treating premature ejaculation concerns the method of dosing, daily versus as needed.

The hopefulness generated by the recent flurry of pharmacological studies has generated a renewed enthusiasm for studying rapid ejaculation. A new on demand SSRI is available in some countrys and seems like more patients are aware that efficacious treatments exist. Successful treatment is achieved by clinicians who appreciate the benefits and limitations of any psychological or pharmacological intervention.