Premature ejaculation
Searched over 200M research papers for "premature ejaculation"
Summary
10 papers analyzed
These studies suggest that premature ejaculation is a common male sexual dysfunction with significant negative effects on quality of life, and treatments such as serotonergic antidepressants, topical anesthetics, and tramadol show promise but require further research for confirmation.
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Introduction
Premature ejaculation (PE) is a prevalent male sexual dysfunction characterized by rapid ejaculation, often leading to distress and interpersonal difficulties. The condition is influenced by various physiological, psychological, and neurochemical factors, and its treatment has been the subject of extensive research.
Key Insights
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Prevalence and Impact:
- PE affects 20-30% of men and significantly impacts the quality of life and sexual satisfaction for both men and their partners .
- Men with PE report higher levels of sexual anxiety, personal distress, and interpersonal difficulties .
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Definitions and Diagnostic Criteria:
- There is no universally accepted definition of PE, but it is often characterized by ejaculation within one minute of vaginal penetration and lack of control over ejaculation .
- The International Society for Sexual Medicine (ISSM) has proposed an evidence-based definition focusing on rapid ejaculation, lack of control, and negative personal consequences.
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Etiology and Pathophysiology:
- PE is associated with disturbances in serotonergic neurotransmission and certain serotonin (5-HT) receptors .
- Secondary PE can be caused by physical, pharmacological, and psychological factors, including stress and anxiety .
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Pharmacological Treatments:
- Selective serotonin reuptake inhibitors (SSRIs) like paroxetine, clomipramine, sertraline, and fluoxetine are effective in delaying ejaculation, with paroxetine showing the strongest effect .
- On-demand SSRIs, such as dapoxetine, offer convenience but have less consistent efficacy compared to daily use .
- Tramadol and topical anesthetics are also used to manage PE, with ongoing research into new topical solutions .
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Psychological and Behavioral Therapies:
- Psychological counseling and behavioral therapy play a valuable role in managing PE, focusing on improving ejaculatory control, sexual satisfaction, and reducing anxiety .
- Behavioral therapies are most effective when combined with pharmacological treatments.
Conclusion
Premature ejaculation is a common and complex male sexual dysfunction with significant psychological and interpersonal impacts. Effective management often requires a combination of pharmacological treatments, such as SSRIs and topical anesthetics, and psychological therapies. Despite the progress in understanding and treating PE, there remains a need for standardized diagnostic criteria and more reliable, controlled studies to develop new and effective therapies.
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