Premature Ejaculation: From Physiology to Treatment
,
Abstract
Objective: To review in literature about the concept of premature ejaculation from physiology to treatment.
Materials and methods: A literature search conducted with Pubmed and Cochrane.
Results: An accurate clinical history is the best diagnostic method, and in the majority of the cases it is enough to differentiate between primary and acquired premature ejaculation. Nowadays the treatment is not curative but is effective in increasing the Intravaginal Ejaculatory Latency Time, improving the couple’s sexual satisfaction.
Conclusion: Although PE is the most frequent sexual dysfunction, it is still sub-diagnosed. Combining behavioural techniques with pharmacotherapy is the best way of treatment.
1. Parnham A, Serefoglu EC. Classification and definition of premature ejaculation. Transl Androl Urol 2016; 5: 416-23.
2. Martin C, Nolen H, Podolnick J, Wang R. Current and emerging therapies in premature ejaculation: Where we are coming from, where we are going. Int J Urol 2017; 24: 40-50.
3. Clement P, Giuliano F. Physiology and Pharmacology of Ejaculation. Basic Clin Pharmacol Toxicol 2016; 119 Suppl 3: 18-25.
4. Educational Committee of the ESSM. The ESSM Manual of Sexual Medicine. 2nd updated ed: Medix; 2015.
5. Brackett NL, Ferrell SM, Aballa TC, Amador MJ, Padron OF, Sonksen J, et al. An analysis of 653 trials of penile vibratory stimulation in men with spinal cord injury. J Urol 1998; 159 : 1931-4.
6. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. Sex Med 2014; 2: 41-59.
7. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington2013.
8. International Statistical Classification of Diseases and Related Health problems 10th Revision 2016.
9. Bernard S. Premature ejaculation: A review of 1130 cases. New York: The Journal of Urology; 1943: 374-9.
10. Waldinger MD. The pathophysiology of lifelong premature ejaculation. Transl Androl Urol 2016; 5: 424-33.
11. Gao J, Zhang X, Su P, Liu J, Xia L, Yang J, et al. Prevalence and factors associated with the complaint of premature ejaculation and the four premature ejaculation syndromes: a large observational study in China. J Sex Med 2013; 10: 1874-81.
12. Serefoglu EC, Yaman O, Cayan S, Asci R, Orhan I, Usta MF, et al. Prevalence of the complaint of ejaculating prematurely and the four premature ejaculation syndromes: results from the Turkish Society of Andrology Sexual Health Survey. J Sex Med 2011; 8: 540-8.
13. Janssen PK, Bakker SC, Réthelyi J, Zwinderman AH, Touw DJ, Olivier B, et al. Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation. J Sex
Med 2009; 6 :276-84.
14. Janssen PK, Schaik RV, Olivier B, Waldinger MD. The 5-HT2C receptor gene Cys23Ser polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Asian J Androl 2014; 16: 607-10.
15. Janssen PK, van Schaik R, Zwinderman AH, Olivier B, Waldinger MD. The 5-HT₁A receptor C(1019)G polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Pharmacol Biochem Behav 2014; 121: 184-8.
16. McMahon CG, Jannini EA, Serefoglu EC, Hellstrom WJ. The pathophysiology of acquired premature ejaculation. Transl Androl Urol 2016; 5: 434-49.
17. Waldinger MD, McIntosh J, Schweitzer DH. A five-nation survey to assess the distribution of the intravaginal ejaculatory latency time among the general male population. J Sex Med 2009; 6: 2888-95.
18. Senkul T, IşerI C, şen B, KarademIr K, Saraçoğlu F, Erden D. Circumcision in adults: effect on sexual function. Urology 2004; 63: 155-8.
19. Gao J, Xu C, Zhang J, Liang C, Su P, Peng Z, et al. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China. Biomed Res Int 2015; 2015: 417846.
20. Waldinger MD, Zwinderman AH, Olivier B, Schweitzer DH. Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data. J Sex Med 2005; 2: 498-507.
21. Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M. A multinational population survey of intravaginal ejaculation latency time. J Sex Med 2005; 2: 492-7.
22. Patrick DL, Althof SE, Pryor JL, Rosen R, Rowland DL, Ho KF, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med 2005; 2: 358-67.
23. Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med 2007; 357: 762-74.
24. Montorsi F. Prevalence of premature ejaculation: a global and regional perspective. J Sex Med 2005; (2 Suppl 2): 96-102.
25. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al. Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005; 17: 39-57.
26. Saitz TR, Serefoglu EC. The epidemiology of premature ejaculation. Transl Androl Urol 2016; 5: 409-15.
27. Althof SE, McMahon CG. Contemporary Management of Disorders of Male Orgasm and Ejaculation. Urology 2016; 93: 9-21.
28. Rowland DL, Patrick DL, Rothman M, Gagnon DD. The psychological burden of premature ejaculation. J Urol 2007; 177: 1065-70.
29. Gao J, Zhang X, Su P, Shi K, Tang D, Hao Z, et al. Prevalence and impact of premature ejaculation in outpatients complaining of ejaculating prematurely: using the instruments of intravaginal ejaculatory latency time and patient-reported outcome measures. Int J Impot Res 2014; 26: 94-9.
30. Burri A, Giuliano F, McMahon C, Porst H. Female partner's perception of premature ejaculation and its impact on relationship breakups, relationship quality, and sexual satisfaction. J Sex Med 2014; 11: 2243-55.
31. Kaya C, Gunes M, Gokce AM, Kalkan S. Is sexual function in female partners of men with premature ejaculation compromised? J Sex Marital Ther 2015; 41: 379-83.
32. Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, et al. Development and validation of a premature ejaculation diagnostic tool. Eur Urol 2007; 52: 565-73.
33. Patrick DL, Giuliano F, Ho KF, Gagnon DD, McNulty P, Rothman M. The Premature Ejaculation Profile: validation of self-reported outcome measures for research and practice. BJU Int 2009; 103: 358-64.
34. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, et al. An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE). J Sex Med 2014; 11: 1392-422.
35. Oztürk M, Koca O, Tüken M, Keleş MO, Ilktaç A, Karaman MI. Hormonal evaluation in premature ejaculation. Urol Int 2012; 88: 454-8.
36. Semans Jh. Premature ejaculation: a new approach. South Med J 1956; 49: 353-8.
37. William H Masters, Virginia E Johnson. Human Sexual Inadequacy. Boston: Brown; 1970.
38. Cayan S, Serefoğlu EC. Advances in treating premature ejaculation. F1000Prime Rep 2014; 6: 55.
39. Barnes T, Eardley I. Premature ejaculation: the scope of the problem. J Sex Marital Ther 2007; 33: 151-70.
40. de Carufel F, Trudel G. Effects of a new functional-sexological treatment for premature ejaculation. J Sex Marital Ther 2006; 32: 97-114.
41. Gilles T, Sylvain P. Treatment of Premature Ejaculation by Bibliotherapy: An Experimental Study. J Sex Marital Ther 1987; 2: 163-7.
42. Hawton K. Treatment of sexual dysfunctions by sex therapy and other approaches. Br J Psychiatry 1995; 167: 307-14.
43. Althof SE, Abdo CH, Dean J, Hackett G, McCabe M, McMahon CG, et al. International Society for Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med 2010; 7: 2947-69.
44. Frühauf S, Gerger H, Schmidt HM, Munder T, Barth J. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch Sex Behav 2013; 42: 915-33.
45. Melnik T, Althof S, Atallah AN, Puga ME, Glina S, Riera R. Psychosocial interventions for premature ejaculation. Cochrane Database Syst Rev 2011: CD008195.
46. Atikeler MK, Gecit I, Senol FA. Optimum usage of prilocaine-lidocaine cream in premature ejaculation. Andrologia 2002; 34: 356-9.
47. Busato W, Galindo CC. Topical anaesthetic use for treating premature ejaculation: a double-blind, randomized, placebo-controlled study. BJU Int 2004; 93: 1018-21.
48. Xia JD, Han YF, Zhou LH, Chen Y, Dai YT. Efficacy and safety of local anaesthetics for premature ejaculation: a systematic review and meta-analysis. Asian J Androl 2013; 15: 497-502.
49. Andersson KE, Mulhall JP, Wyllie MG. Pharmacokinetic and pharmacodynamic features of dapoxetine, a novel drug for 'on-demand' treatment of premature ejaculation. BJU Int 2006; 97: 311-5.
50. Mirone V, Arcaniolo D, Rivas D, Bull S, Aquilina JW, Verze P, et al. Results from a prospective observational study of men with premature ejaculation treated with dapoxetine or alternative care: the PAUSE study. Eur Urol 2014; 65: 733-9.
51. Montejo-González AL, Llorca G, Izquierdo JA, Ledesma A, Bousoño M, Calcedo A, et al. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther 1997; 23: 176-94.
52. Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry 2001; 62 Suppl 3: 10-21.
53. Salonia A, Rocchini L, Sacca' A, Pellucchi F, Ferrari M, Carro UD, et al. Acceptance of and discontinuation rate from paroxetine treatment in patients with lifelong premature ejaculation. J Sex Med 2009; 6: 2868-77.
54. Sunay D, Sunay M, Aydoğmuş Y, Bağbancı S, Arslan H, Karabulut A, et al. Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial. Eur Urol
2011; 59: 765-71.
55. David Prologo J, Snyder LL, Cherullo E, Passalacqua M, Pirasteh A, Corn D. Percutaneous CT-guided cryoablation of the dorsal penile nerve for treatment of symptomatic premature ejaculation. J Vasc Interv Radiol 2013; 24: 214-9.
56. Basal S, Goktas S, Ergin A, Yildirim I, Atim A, Tahmaz L, et al. A novel treatment modality in patients
with premature ejaculation resistant to conventional methods: the neuromodulation of dorsal penile nerves by pulsed radiofrequency. J Androl 2010; 31: 126-30.
57. Simões Paço J, Jorge Pereira B. New Therapeutic Perspectives in Premature Ejaculation. Urology 2016; 88: 87-92.
58. Moncada I. The importance of follow-up in patients with premature ejaculation. J Sex Med 2011;8 Suppl 4:353-9.
2. Martin C, Nolen H, Podolnick J, Wang R. Current and emerging therapies in premature ejaculation: Where we are coming from, where we are going. Int J Urol 2017; 24: 40-50.
3. Clement P, Giuliano F. Physiology and Pharmacology of Ejaculation. Basic Clin Pharmacol Toxicol 2016; 119 Suppl 3: 18-25.
4. Educational Committee of the ESSM. The ESSM Manual of Sexual Medicine. 2nd updated ed: Medix; 2015.
5. Brackett NL, Ferrell SM, Aballa TC, Amador MJ, Padron OF, Sonksen J, et al. An analysis of 653 trials of penile vibratory stimulation in men with spinal cord injury. J Urol 1998; 159 : 1931-4.
6. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. Sex Med 2014; 2: 41-59.
7. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington2013.
8. International Statistical Classification of Diseases and Related Health problems 10th Revision 2016.
9. Bernard S. Premature ejaculation: A review of 1130 cases. New York: The Journal of Urology; 1943: 374-9.
10. Waldinger MD. The pathophysiology of lifelong premature ejaculation. Transl Androl Urol 2016; 5: 424-33.
11. Gao J, Zhang X, Su P, Liu J, Xia L, Yang J, et al. Prevalence and factors associated with the complaint of premature ejaculation and the four premature ejaculation syndromes: a large observational study in China. J Sex Med 2013; 10: 1874-81.
12. Serefoglu EC, Yaman O, Cayan S, Asci R, Orhan I, Usta MF, et al. Prevalence of the complaint of ejaculating prematurely and the four premature ejaculation syndromes: results from the Turkish Society of Andrology Sexual Health Survey. J Sex Med 2011; 8: 540-8.
13. Janssen PK, Bakker SC, Réthelyi J, Zwinderman AH, Touw DJ, Olivier B, et al. Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation. J Sex
Med 2009; 6 :276-84.
14. Janssen PK, Schaik RV, Olivier B, Waldinger MD. The 5-HT2C receptor gene Cys23Ser polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Asian J Androl 2014; 16: 607-10.
15. Janssen PK, van Schaik R, Zwinderman AH, Olivier B, Waldinger MD. The 5-HT₁A receptor C(1019)G polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Pharmacol Biochem Behav 2014; 121: 184-8.
16. McMahon CG, Jannini EA, Serefoglu EC, Hellstrom WJ. The pathophysiology of acquired premature ejaculation. Transl Androl Urol 2016; 5: 434-49.
17. Waldinger MD, McIntosh J, Schweitzer DH. A five-nation survey to assess the distribution of the intravaginal ejaculatory latency time among the general male population. J Sex Med 2009; 6: 2888-95.
18. Senkul T, IşerI C, şen B, KarademIr K, Saraçoğlu F, Erden D. Circumcision in adults: effect on sexual function. Urology 2004; 63: 155-8.
19. Gao J, Xu C, Zhang J, Liang C, Su P, Peng Z, et al. Effects of adult male circumcision on premature ejaculation: results from a prospective study in China. Biomed Res Int 2015; 2015: 417846.
20. Waldinger MD, Zwinderman AH, Olivier B, Schweitzer DH. Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data. J Sex Med 2005; 2: 498-507.
21. Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M. A multinational population survey of intravaginal ejaculation latency time. J Sex Med 2005; 2: 492-7.
22. Patrick DL, Althof SE, Pryor JL, Rosen R, Rowland DL, Ho KF, et al. Premature ejaculation: an observational study of men and their partners. J Sex Med 2005; 2: 358-67.
23. Lindau ST, Schumm LP, Laumann EO, Levinson W, O'Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med 2007; 357: 762-74.
24. Montorsi F. Prevalence of premature ejaculation: a global and regional perspective. J Sex Med 2005; (2 Suppl 2): 96-102.
25. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al. Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005; 17: 39-57.
26. Saitz TR, Serefoglu EC. The epidemiology of premature ejaculation. Transl Androl Urol 2016; 5: 409-15.
27. Althof SE, McMahon CG. Contemporary Management of Disorders of Male Orgasm and Ejaculation. Urology 2016; 93: 9-21.
28. Rowland DL, Patrick DL, Rothman M, Gagnon DD. The psychological burden of premature ejaculation. J Urol 2007; 177: 1065-70.
29. Gao J, Zhang X, Su P, Shi K, Tang D, Hao Z, et al. Prevalence and impact of premature ejaculation in outpatients complaining of ejaculating prematurely: using the instruments of intravaginal ejaculatory latency time and patient-reported outcome measures. Int J Impot Res 2014; 26: 94-9.
30. Burri A, Giuliano F, McMahon C, Porst H. Female partner's perception of premature ejaculation and its impact on relationship breakups, relationship quality, and sexual satisfaction. J Sex Med 2014; 11: 2243-55.
31. Kaya C, Gunes M, Gokce AM, Kalkan S. Is sexual function in female partners of men with premature ejaculation compromised? J Sex Marital Ther 2015; 41: 379-83.
32. Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, et al. Development and validation of a premature ejaculation diagnostic tool. Eur Urol 2007; 52: 565-73.
33. Patrick DL, Giuliano F, Ho KF, Gagnon DD, McNulty P, Rothman M. The Premature Ejaculation Profile: validation of self-reported outcome measures for research and practice. BJU Int 2009; 103: 358-64.
34. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, et al. An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE). J Sex Med 2014; 11: 1392-422.
35. Oztürk M, Koca O, Tüken M, Keleş MO, Ilktaç A, Karaman MI. Hormonal evaluation in premature ejaculation. Urol Int 2012; 88: 454-8.
36. Semans Jh. Premature ejaculation: a new approach. South Med J 1956; 49: 353-8.
37. William H Masters, Virginia E Johnson. Human Sexual Inadequacy. Boston: Brown; 1970.
38. Cayan S, Serefoğlu EC. Advances in treating premature ejaculation. F1000Prime Rep 2014; 6: 55.
39. Barnes T, Eardley I. Premature ejaculation: the scope of the problem. J Sex Marital Ther 2007; 33: 151-70.
40. de Carufel F, Trudel G. Effects of a new functional-sexological treatment for premature ejaculation. J Sex Marital Ther 2006; 32: 97-114.
41. Gilles T, Sylvain P. Treatment of Premature Ejaculation by Bibliotherapy: An Experimental Study. J Sex Marital Ther 1987; 2: 163-7.
42. Hawton K. Treatment of sexual dysfunctions by sex therapy and other approaches. Br J Psychiatry 1995; 167: 307-14.
43. Althof SE, Abdo CH, Dean J, Hackett G, McCabe M, McMahon CG, et al. International Society for Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation. J Sex Med 2010; 7: 2947-69.
44. Frühauf S, Gerger H, Schmidt HM, Munder T, Barth J. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch Sex Behav 2013; 42: 915-33.
45. Melnik T, Althof S, Atallah AN, Puga ME, Glina S, Riera R. Psychosocial interventions for premature ejaculation. Cochrane Database Syst Rev 2011: CD008195.
46. Atikeler MK, Gecit I, Senol FA. Optimum usage of prilocaine-lidocaine cream in premature ejaculation. Andrologia 2002; 34: 356-9.
47. Busato W, Galindo CC. Topical anaesthetic use for treating premature ejaculation: a double-blind, randomized, placebo-controlled study. BJU Int 2004; 93: 1018-21.
48. Xia JD, Han YF, Zhou LH, Chen Y, Dai YT. Efficacy and safety of local anaesthetics for premature ejaculation: a systematic review and meta-analysis. Asian J Androl 2013; 15: 497-502.
49. Andersson KE, Mulhall JP, Wyllie MG. Pharmacokinetic and pharmacodynamic features of dapoxetine, a novel drug for 'on-demand' treatment of premature ejaculation. BJU Int 2006; 97: 311-5.
50. Mirone V, Arcaniolo D, Rivas D, Bull S, Aquilina JW, Verze P, et al. Results from a prospective observational study of men with premature ejaculation treated with dapoxetine or alternative care: the PAUSE study. Eur Urol 2014; 65: 733-9.
51. Montejo-González AL, Llorca G, Izquierdo JA, Ledesma A, Bousoño M, Calcedo A, et al. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther 1997; 23: 176-94.
52. Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatry 2001; 62 Suppl 3: 10-21.
53. Salonia A, Rocchini L, Sacca' A, Pellucchi F, Ferrari M, Carro UD, et al. Acceptance of and discontinuation rate from paroxetine treatment in patients with lifelong premature ejaculation. J Sex Med 2009; 6: 2868-77.
54. Sunay D, Sunay M, Aydoğmuş Y, Bağbancı S, Arslan H, Karabulut A, et al. Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial. Eur Urol
2011; 59: 765-71.
55. David Prologo J, Snyder LL, Cherullo E, Passalacqua M, Pirasteh A, Corn D. Percutaneous CT-guided cryoablation of the dorsal penile nerve for treatment of symptomatic premature ejaculation. J Vasc Interv Radiol 2013; 24: 214-9.
56. Basal S, Goktas S, Ergin A, Yildirim I, Atim A, Tahmaz L, et al. A novel treatment modality in patients
with premature ejaculation resistant to conventional methods: the neuromodulation of dorsal penile nerves by pulsed radiofrequency. J Androl 2010; 31: 126-30.
57. Simões Paço J, Jorge Pereira B. New Therapeutic Perspectives in Premature Ejaculation. Urology 2016; 88: 87-92.
58. Moncada I. The importance of follow-up in patients with premature ejaculation. J Sex Med 2011;8 Suppl 4:353-9.
| Files | ||
| Issue | Vol 13, No 3 (September 2019) | |
| Section | Review Articles | |
| DOI | https://doi.org/10.18502/jfrh.v13i3.2125 | |
| Keywords | ||
| Premature Ejaculation Physiology Treatment Sexual Dysfunction | ||
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How to Cite
1.
Lourenco M, Brito D, Pereira B. Premature Ejaculation: From Physiology to Treatment. J Family Reprod Health. 2019;13(3):120-131.
