Treatments for Premature Ejaculation

[Nelson Vergel]

According to the International Statistical Classification of Diseases and Related Health Problems (World Health Organization,
1994) endorsed by the 43rd World Health Assembly in May 1990 and used in WHO Member States since 1994, PE is defined as “the inability to delay ejaculation sufficiently to enjoy lovemaking, which is manifested by either an occurrence of ejaculation before or very soon after the beginning of intercourse (if a time limit is required: before or within 15 seconds of the beginning of intercourse) or ejaculation occurs in the absence of sufficient erection to make intercourse possible.”


I got this great table from this good reference: Pharmacology for the Treatment of Premature Ejaculation

 

[Dr.V.P.C.]

Beside this drugs, Tramadol ( used on demand ) is also very effective .
Dapoxetine is not avaliable here in Brazil yet.

 

[Dave Barry]

Tramadol is an opioid analgesic that is used to treat pain. Sure, if you take any pain-killer, it will take away some of the sensation and make the guy less likely to prematurely ejaculate. But, at the same time, that's an easy way to become dependent, regardless, if it is not as addictive as many other pain-killers.

 

[Austinite]

Tramadol is an opioid analgesic that is used to treat pain. Sure, if you take any pain-killer, it will take away some of the sensation and make the guy less likely to prematurely ejaculate. But, at the same time, that's an easy way to become dependent, regardless, if it is not as addictive as many other pain-killers.

Yes. Repetitive use could also lead to full blown sexual anhedonia as well.

 

[Gene Devine]

I understand that Trimix is used successfully in men with PE.

 

[EmpowerPharmacy]

Most urologists I know don't recommend taking a medication orally for the treatment of Premature Ejaculation as it will affect the patient systemically. Simply look at the side effects listed with most of the medications on that list. No one wants to treat their PE just to be given an even worse problem of decreased libido or erectile dysfunction as is the case when taking SSRIs.

The easiest and least expensive way to treat PE is the use of a condom to add a layer of desensitization or by using "squeeze" or "start/stop" techniques. If that is not helpful then I recommend using a topical anesthetic like the Lidocaine/Prilocaine 2.5/2.5% Cream that can be made by a compounding pharmacy or a FDA approved product that was recently released called Promescent, which is a 10% Lidocaine Spray Gel. Just make sure you wash off any excess cream/gel after it's taken it's affect to prevent the transmission to your partner, or wear a condom afterwards to double the desensitization and prevent its transference.

 

[SoCalSurfer]

I found out accidentally that half of a Hydrocodone while taking Viagra makes you last a very long time. On a weekend get away and hurt my knee, hydrocodone for the knee pain and took Viagra that night and turned into the energizer bunny.

 

[johncutt]

premature Ejaculation is always found in teens. Only Viagra can treat is as well. Viagra having much power for ED treatment but for teens, they have to take minimum amount of Viagra tablets & That 1 should be FDA approved and trusted pharmacies like http://www.bluepharmacyrx.com & http://www.kamagrarx.com
Give me feed back if I am wrong.

 

[Nelson Vergel]

Johncutt

Viagra actually makes the penis more sensitive. I orgasm more quickly.

 

[Nelson Vergel]

Paroxetine vs Dapoxetine in the treatment of premature ejaculation

 

[Nelson Vergel]

Clomiphene Effects on Idiopathic Premature Ejaculation.
Ketabchi AA. Nephrourol Mon. 2015.



Abstract
BACKGROUND: Premature ejaculation (PE) is the inability to delay ejaculation, occurring sooner than they or their partner would like during sexual activities. PE is a challenging problem that can affect sexual enjoyment and may harm relationships of couples and affect their quality of life. In idiopathic PE, several helpful techniques and medicines are recommended, but none of them has yielded satisfactory results.

OBJECTIVES: Our objective in this study was to evaluate the efficacy and safety of clomiphene as a selective estrogen receptor modulator on the treatment of idiopathic PE.

PATIENTS AND METHODS: In a randomized clinical trial, 178 married men with idiopathic PE defined according to the Diagnostic and Statistical Manual of Mental Disorders Third Revised Version (DSM-III-R) who referred to urology clinics over a 10-month period in 2012 were randomized into two groups, namely the study (clomiphene) and control (placebo) groups. They completed self-administered questionnaires that included intravaginal ejaculatory latency time (IELT), erectile dysfunction indexes, quality of life (QOL), sociodemographic characteristics, lifestyle, and medical illness. After 6 months of intervention, all data were compared with the baseline data and between the groups.

RESULTS: Within the 10-month study course, 126 patients (70.8%) completed this study. After intervention and comparison of the results between the two groups, IELT, sexual indexes, and QOL improved in the study group, but significant differences were observed only in the IELT and QOL findings.

CONCLUSIONS: Clomiphene seems to be useful in the pharmacological treatment of PE compared to the placebo.

 

[Nelson Vergel]

Interventions To Treat Premature Ejaculation



BACKGROUND: Premature ejaculation (PE) is commonly defined as ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it. PE can be either lifelong and present since first sexual experiences (primary), or acquired (secondary), beginning later (Godpodinoff ML. Premature ejaculation: clinical subgroups and etiology. J Sex Marital Ther 1989;15:130-4). Treatments include behavioural and pharmacological interventions.

OBJECTIVE: To systematically review evidence for clinical effectiveness of behavioural, topical and systemic treatments for PE.

DATA SOURCES: The following databases were searched from inception to 6 August 2013 for published and unpublished research evidence: MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health Literature; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane Controlled Trials Register, Database of Abstracts of Reviews of Effects and the Health Technology Assessment database; ISI Web of Science, including Science Citation Index, and the Conference Proceedings Citation Index-Science. The US Food and Drug Administration website and the European Medicines Agency (EMA) website were also searched.
METHODS: Randomised controlled trials (RCTs) in adult men with PE were eligible (or non-RCTs in the absence of RCTs). RCT data were extrapolated from review articles when available. The primary outcome was intravaginal ejaculatory latency time (IELT). Data were meta-analysed when possible. Other outcomes included sexual satisfaction, control over ejaculation, relationship satisfaction, self-esteem, quality of life, treatment acceptability and adverse events (AEs).

RESULTS: A total of 103 studies (102 RCTs, 65 from reviews) were included. RCTs were available for all interventions except yoga.

The following interventions demonstrated significant improvements (p < 0.05) in arithmetic mean difference in IELT compared with placebo: topical anaesthetics - eutectic mixture of local anaesthetics (EMLA((R)), AstraZeneca), topical eutectic mixture for PE (Plethora Solutions Ltd) spray; selective serotonin reuptake inhibitors (SSRIs) - citalopram (Cipramil((R)), Lundbeck), escitalopram (Cipralex((R)), Lundbeck), fluoxetine, paroxetine, sertraline, dapoxetine (Priligy((R)), Menarini), 30 mg or 60 mg; serotonin-noradrenaline reuptake inhibitors - duloxetine (Cymbalta((R)), Eli Lilly & Co Ltd); tricyclic antidepressants - inhaled clomipramine 4 mg; phosphodiesterase-5 (PDE5) inhibitors - vardenafil (Levitra((R)), Bayer), tadalafil (Cialis((R)), Eli Lilly & Co Ltd); opioid analgesics - tramadol (Zydol SR((R)), Grunenthal).

Improvements in sexual satisfaction and other outcomes compared with placebo were evident for SSRIs, PDE5 inhibitors and tramadol.

Outcomes for interventions not compared with placebo were as follows: behavioural therapies - improvements over wait list control in IELT and other outcomes, behavioural therapy plus pharmacotherapy better than either therapy alone; alpha blockers - terazosin (Hytrin((R)), AMCO) not significantly different to antidepressants in ejaculation control; acupuncture - improvements over sham acupuncture in IELT, conflicting results for comparisons with SSRIs; Chinese medicine - improvements over treatment as usual; delay device - improvements in IELT when added to stop-start technique; yoga - improved IELT over baseline, fluoxetine better than yoga.
Treatment-related AEs were evident with most pharmacological interventions.
LIMITATIONS: Although data extraction from reviews was optimised when more than one review reported data for the same RCT, the reliability of the data extraction within these reviews cannot be guaranteed by this assessment report.

CONCLUSIONS: Several interventions significantly improved IELT. Many interventions also improved sexual satisfaction and other outcomes. However, assessment of longer-term safety and effectiveness is required to evaluate whether or not initial treatment effects are maintained long term, whether or not dose escalation is required, how soon treatment effects end following treatment cessation and whether or not treatments can be stopped and resumed at a later time. In addition, assessment of the AEs associated with long-term treatment and whether or not different doses have differing AE profiles is required.

Cooper K, Martyn-St James M, Kaltenthaler E, ****inson K, Cantrell A. Interventions to treat premature ejaculation: a systematic review short report. Health Technol Assess 2015;19(21):1-180, v-vi.

 

[fmalianos]

How about some daily simple kegle exercises

 

[Nelson Vergel]

Background: Few data have looked at the occurrence and clinical correlates of self-reported shorter than desired ejaculation latency (rapid ejaculation, RE) and its related distress in the general population.

Aim: To determine the prevalence and clinical correlates of self-reported RE and RE- related distress in middle age and older European men.

Methods: Subjects were recruited from population samples of men aged 40-79 years across 8 European centers.

Outcomes: Self-reported RE and its related distress were derived from the European male Aging Study (EMAS) sexual function questionnaire (EMAS-SFQ). Beck's depression Inventory (BDI) was used for the quantification of depressive symptoms, the Short Form 36 health survey (SF-36) for the assessment of the quality of life, the International Prostate Symptom Score (IPSS) for the evaluation of lower urinary tract symptoms.

Results: About 2,888 community dwelling men aged 40-79 years old (mean 58.9 ± 10.8 years) were included in the analysis. Among the subjects included, 889 (30.8%) self-reported RE. Among them, 211 (7.3%) claimed to be distressed (5.9% and 1.4% reported mild or moderate-severe distress, respectively). Increasing levels of RE-related distress were associated with a progressive worse sexual functioning, higher risk of ED and with couple impairment, along with a higher prevalence of depressive symptoms (all P < 0.05). Furthermore, a worse quality of life and higher IPSS score were associated with RE-related distress (all P < 0.05). The aforementioned results were confirmed even when patients using drugs possibly interfering with ejaculation or those without a stable relationship were excluded from the analysis.

Clinical implications: RE is a frequent condition in men from the general population; however, its related distress is relatively modest. Nonetheless, men with any degree of self-reported RE show increasing levels of depression, worse quality of life and worse couple satisfaction.

Strengths & limitations: This is the first study estimating the prevalence of self-reported RE and its related distress, along with their biological and psychological correlates, in a population sample of European middle age and older men. However, is should be recognized that the diagnosis of RE was derived from patient reports and not supported by Intra-ejaculatory-Latency-Time (IELT) measurements.

Conclusion: Self-reported RE is relatively common in European men aged more than 40 years. The reported limited RE-related distress may explain the relatively low number of medical consultations for RE. RE-related distress is associated with worse sexual function, couple impairment, and more LUTS resulting in a worse quality of life and mood disturbances.

Corona G, Rastrelli G, Bartfai G, et al. Self-Reported Shorter Than Desired Ejaculation Latency and Related Distress-Prevalence and Clinical Correlates: Results From the European Male Ageing Study. J Sex Med Rev 2021

Keywords: Couple; Distress; Erectile Dysfunction; Premature Ejaculation; Quality of Life.

 

[Bennytrt]

Who has used tramadol with dapoxetine and what was your experience?

 

[Nelson Vergel]

Understanding and Managing Men’s Orgasmic Difficulties

INTRODUCTION This review discusses 2 ejaculation disorders that represent disturbances in psychosexual responding, premature ejaculation (PE) and delayed/ inhibited ejaculation (DE). Both disorders are related to the timing/occurrence of ejaculation (ie, ejaculation latency [EL]) during...

www.excelmale.com

 

[ScSc123]

7mg Daily Cialis cured my PE. Just my experience, others may differ but it’s worth a try