Evolving therapeutic strategies for premature ejaculation: The search for on-demand treatment – topical versus systemic

Authors

  • Alvaro Morales Queen’s University, Kingston, ON

DOI:

https://doi.org/10.5489/cuaj.19

Abstract

Premature ejaculation (PE) is a common sexual dysfunction affecting20% to 30% of men worldwide. Definitions of PE vary, but itis typically characterized by short intravaginal ejaculatory latencytime (IELT) with concomitant sexual dissatisfaction and distress.PE may be lifelong or acquired, but its etiology remains unclear.Treatment of PE typically involves pharmacotherapy, particularlywhen lifelong. Although there are numerous reports on the offlabeluse of selective serotonin reuptake inhibitors (SSRIs) andother compounds, only 2 treatments have been evaluated in randomizedcontrolled phase 3 clinical trials: PSD502 and dapoxetine(SSRI). Both significantly improved IELT and patient-reportedoutcome domains of ejaculatory control, sexual satisfaction, anddistress as measured by the index of premature ejaculation (IPE),compared with placebo. They constitute the focus of this review.Evidence demonstrated that PSD502, dapoxetine and other SSRIsall significantly improve the symptoms of PE. Systemic use of SSRIspresents risks associated with the known pharmacology of thisclass. PSD502 allows for topical on-demand treatment appliedapplied immediately before intercourse, and is not associated withsystemic adverse events.

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Author Biography

Alvaro Morales, Queen’s University, Kingston, ON

Queen’s University, Kingston, ON

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Published

2012-12-05

How to Cite

Morales, A. (2012). Evolving therapeutic strategies for premature ejaculation: The search for on-demand treatment – topical versus systemic. Canadian Urological Association Journal, 6(5). https://doi.org/10.5489/cuaj.19