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Ejaculatory dysfunction: progress in a rarely recognized sexual problem

International Journal of Impotence Research volume 18, pages S3–S4 (2006)Cite this article

Premature ejaculation (PE) is a common sexual disorder associated with profound effects on quality of life and sexual function of both patients and partners. This condition, that is often undiagnosed and rarely treated, is more common than erectile dysfunction (ED). Over the last decade, ED has garnered significant attention in the media, amongst patients, and physicians because effective treatment is available. With medical and invasive treatment, most patients with ED can be treated and their condition resolved. PE is more common in many epidemiologic studies and affects as many as a third of men in all age groups. Although ED is most common as patients age and have progressive vascular diseases, PE can affect young patients as well as older age groups. Indeed, PE is the most common sexual dysfunction in patients under 40. Because it is common, PE affects the quality of life for patients and partners. Because it has received less attention in medical investigation and media, it is less commonly diagnosed and often untreated. Currently, there is no approved specific medical therapy for PE that reduces its awareness amongst patients and physicians. Indeed physicians often diagnose PE as sexual dysfunction equivalent to ED and treat patients with PDE5 inhibitors that are often unsuccessful.

Basic science investigation into the physiology of ejaculation and PE has elucidated the central nervous system (CNS) centers and neurotransmitters associated with ejaculatory function. Recent investigations strongly suggest that serotonin is the primary neurotransmitter associated with ejaculatory function supplemented by dopamine and dopamine receptors. This enhanced understanding has led to the use of selective serotonin reuptake inhibitors (SSRIs) in off-label fashion with satisfactory response in many patients with PE. Although these agents, taken as off-label treatment, may be effective, they must be taken chronically and on demand medication for PE is not yet available. Innovative agents in late stages of development, however, may provide a solution to this lack of treatment and enable physicians to identify patients at risk for PE, make an effective PE diagnosis, and focus treatment on the CNS locations responsible for ejaculatory function and PE.

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References

  1. Arafa M, Shamloul R . Efficacy of sertraline hydrochloride in treatment of premature ejaculation: a placebo-controlled study using a validated questionnaire. Int J Impot Res 2006: March 23, [e-pub ahead of print] PMID: 16554853.

  2. Safarinejad MR . Safety and efficacy of tamsulosin in the treatment of painful ejaculation: a randomized, double-blind, placebo-controlled study. Int J Impot Res 2006 March 16, [e-pub ahead of print] PMID: 16541114.

  3. Badran W, Moamen N, Fahmy I, El-Karaksy A, Abdel-Nasser TM, Ghanem H . Etiological factors of unconsummated marriage. Int J Impot Res 2006 January 19, [e-pub ahead of print] PMID: 16421602.

  4. Olivier B, Chan JS, Pattij T, de Jong TR, Oosting RS, Veening JG, Waldinger MD . Psychopharmacology of male rat sexual behavior: modeling human sexual dysfunctions? Int J Impot Res 2005 April 21, [e-pub ahead of print] PMID: 15843803.

  5. Goldstein I . Premature to early ejaculation: a sampling of manuscripts regarding the most common male sexual dysfunction published in the IJIR: The Journal of Sexual Medicine. Int J Impot Res 2003 15(5): 307–308. Review. No abstract available. PMID: 14562128 [PubMed-indexed for MEDLINE].

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  1. Department of Urology, University of North Carolina, Chapel Hill, NC, USA

    C C Carson III

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Correspondence to C C Carson III.

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Carson, C. Ejaculatory dysfunction: progress in a rarely recognized sexual problem. Int J Impot Res 18 (Suppl 1), S3–S4 (2006). https://doi.org/10.1038/sj.ijir.3901514

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