Premature Ejaculation – new treatments and tips

I apologize for the technical glitch on the last posting. Enjoy.

Facts:

Premature Ejaculation affects close to 40% of men and it is the prominent type of sexual dysfunction
There is no real definition of Premature Ejaculation, but some general meanings exist as I will explain
The only class of drug approved for premature ejaculation is an SSRI, a category frequently used as an anti-depressant
No supplement that I know off helps
Generally, more than one type of treatment is necessary
Acupuncture may help
Counseling and psychotherapy also helps
All definitions and treatments are based on heterosexual male dysfunction

What is Premature Ejaculation?

Premature ejaculation does not have an official well accepted definition. Many argue that this should not be considered sexual dysfunction at all since all male upper mammalian species, including primates ejaculate almost immediately on penetration of the vagina. Products found at the Generic Shop Apotheke may be able to help with this.

An evidenced based definition has been offered by the International Society of Sexual Medicine (ISSM):

ejaculation which always or nearly always occurs prior to or within about 1 minute of vaginal penetration;
inability to delay ejaculation on all or nearly all vaginal penetrations;
negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual encounters.

Medical Treatments

Currently, there is one FDA drug approved for premature ejaculation, Dapoxtine (generic name) – Priligy (brand name). This drug is from the Selective Serotonin Reuptake Inhibitor (SSRI) category of drugs, typically used for depression. Side effects include, dizziness, headaches, diarrhea and nausea in a relatively small group of men.

Newest treatment in the pipeline

A new treatment is being studied in which penile nerve tissue is frozen to numb overactive nerves. Researchers tested the technique on 24 men who hadn’t been helped by standard treatments. They lasted an average of nearly two minutes over the three months they were followed, compared with 36 seconds before treatment. Four of the men reported a decrease in erectile hardness.

Still, there are several unknowns for this procedure; long-term side effects, how soon the treatment wears off, how often one needs to go back for a second treatment.

The price is projected to be $3500 for a 45 minute procedure.

In a nut shell: last two minutes longer, $3500 for a 45 minute procedure, long -term side are unknown, may a cause a decrease in hardness.

My take on this

Sex therapist are invaluable for this group of men. Just treating with SSRI may not be good enough. SSRI are often combined with PDE-5 inhibitors (Viagara, Cialis, Levitra) with some success.

I have had some men come to my office for premature ejaculation reporting to last 5 minutes. This is NOT premature ejaculation. Foreplay with manual and/or oral stimulation is of most importance.

A recent clinical research trial demonstrated that, although less effective than daily paroxetine (SSRI), acupuncture had a significantly stronger effect on delaying ejaculation compared with placebo. (Sunnay et al. 2011)

Bottom line: First figure out if this is really an issue – and if it is, multiple therapeutic approaches are necessary. Acupuncture is also a reasonable option without side effects. No supplement or herbal compound has shown to help with premature ejaculation to date.

In Optimal health,

Dr. Geo

Reference:

Sunay D, Sunay M, AydoÄŸmuÅŸ Y, BaÄŸbancÄ± S, Arslan H, Karabulut A, Emir L. Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial. Eur Urol. 2011 May;59(5):765-71. Epub 2011 Jan 18.