Methods of treatment of Premature Ejaculation by PEhomepage.com Editorial Team
Among the methods of treatment of PE are desensitizing anesthetic agents and off-label use of antidepressants and of PDE-5 inhibitors. Off label use of a medicine means that a medicine outside of what it was approved for by the FDA (the US Food and Drug Administration) or any other regulatory (government) body. Because PE could
be a consequence of an over sensitive penile area (among other possible reasons), local anesthetics can desensitize the penile area and increase the ejaculatory latency time. Studies have revealed that topical anesthetics like lidocaine and prilocaine have been found successful in increasing the value of IELT (the intravaginal ejaculatory latency time). Although clearly effective, these local creams are inconvenient to some men and their partners and can interfere with the spontaneity of the sexual act. Another disadvantage of local anesthetics has been discovered through a study conducted on 40 men with PE. The results showed that 40% of them experienced loss of erection and a sense of numbness for them and their partners. So, even though these anesthetic agents can help with the desensitizing of the penile area and increase the value of IELT, they might not improve the overall sexual act. Recent publications show that natural desensitizing anesthetic agents could be more appropriate for local use because of their weaker anesthetic though effective impact on latency time.
The selective serotonin reuptake inhibitors antidepressants, also known as SSRI are being prescribed off-label for the treatment of PE. Examples of SSRI that are being prescribed by doctors are Prozac (fluoxetine), Paxil (paroxetine) and Zoloft (sertraline) . These drugs contain serotonin, a neurotransmitter that is thought to affect ejaculation.
By treating PE with SSRI antidepressants the ejaculation process was shown to be delayed. A placebo-controlled study, in which the subjects and the doctors were unaware of the treatment the patients are receiving, compared the three antidepressants mentioned above by supplying a daily dosage to men with PE and with a value of IELT of 1 minute or less. The study revealed that paroxetine was the strongest of the group, having had the strongest influence on IELT while fluoxetine was the weakest of the bunch. Paroxetine is effective when used as needed, few hours before sexual intercourse but only after a steady period of dosing every day. Likewise, sertraline is also efficacious when used as needed. In conclusion, in order for SSRI antidepressants to show signs of effectiveness they have to be taken for a long period of time. Unfortunately, these drugs have side effects. They can also inhibit libido and cause Erectile Dysfunction (ED), as well as other side effects such as nausea, diarrhea, vomiting headaches etc. Therefore they are not considered an optimal method of treatment. Furthermore, due to the fact that the studies were conducted on small groups of people and are clearly inconclusive, a dosing system has not been yet completely established. Anew SSRI is currently being developed to treat PE. It is a short actinge SSRI called dapoxetine
( Priligy ™ ). Studies have shown that it could be taken only when needed with no need for daily dosing, but it is not available as it was not approved for use yet.
A third method of treatment of PE is the off-label use of tricyclic antidepressant clomipramine. Although showing effectiveness as much as 64% of the patients that have taken clomipramine have experienced side-effects, in particular dry mouth and nausea.
An additional approach to PE has been the usage of PDE-5 inhibitors (such as Viagra, Levitra and Cialis , ad TM). These can be taken alone or in combination with SSRI antidepressants. It is hard to say if this approach will benefit people who do not suffer from both ED and PE. So far results have been unclear; Therefore, the Use of these drugs for PE is not generally recommended.
Many alternative medicines have shown to be effective in treating PE, among them are natural antidepressants, Chinese herbal medicines, homeopathic treatments and many more. As these treatments are most often not associated with side effects, they could be tried first before the PE patients is being exposed to stronger drugs with higher risk for side effects.
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