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  • Review Article
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Psychological intervention for premature ejaculation

Nature Reviews Urology volume 6, pages 501–508 (2009)Cite this article

Abstract

While psychological issues are present in most patients with premature ejaculation (PE), whether as a cause or a consequence of the disorder, the effectiveness of psychological intervention for PE is not clear. Searches of the MEDLINE, EMBASE, PsychINFO, LILACS and the Cochrane Library electronic databases find little high-quality evidence for the psychosexual and behavioral approaches to treatment of PE. Five randomized and four quasi-randomized trials were included in this Review. Little evidence was found that psychological interventions are effective in the treatment of PE. Three studies showed strong evidence in support of improved intravaginal ejaculatory latency times following psychosexual therapy combined with pharmacotherapy, compared with monotherapy. One study found that functional–sexological treatment markedly improved duration of intercourse, sexual satisfaction, and sexual function. Limitations of published studies include a lack of randomization, uncertain clinical significance of outcomes, absence of compelling follow-up data that show long-term response and lack of reproducibility. Randomized trials with large sample sizes are still needed to expand the currently available evidence on psychological intervention for treating PE. Besides examining the main effects of treatment, trials in this field should also address the complex interactions between patient characteristics, PE subtype and treatment approach.

Key Points

  • The effect of premature ejaculation (PE) on affected men and their sexual relationships is significant; such men have decreased sexual self-confidence, difficulty in establishing relationships, and poor quality of life

  • Currently available trials yield inconsistent and poor conclusions on the effectiveness of psychotherapy for PE

  • Limitations of studies include lack of randomization, uncertain clinical significance of outcomes, absence of compelling follow-up data on long-term response and lack of reproducibility

  • One study shows significant improvements from baseline in duration of intercourse, sexual satisfaction and sexual functioning with new functional–sexological treatment

  • Three studies show improvement in intravaginal ejaculatory latency time for combined psychosexual therapy and pharmacotherapy, compared with monotherapy

  • Large randomized trials are still needed that will further explore psychological interventions for treating PE; these trials should have long follow-up to investigate delayed effects of psychological interventions

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Author information

Authors and Affiliations

  1. Department of Internal and Therapeutic Medicine, Federal University of São Paulo, São Paulo, Brazil

    Tamara Melnik

  2. Department of Urology, Instituto H. Ellis, São Paulo, Brazil

    Sidney Glina

  3. Department of Sexology, Instituto Paulista de Sexualidade, São Paulo, Brazil

    Oswaldo M. Rodrigues Jr

Authors
  1. Tamara Melnik
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  2. Sidney Glina
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  3. Oswaldo M. Rodrigues Jr
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Correspondence to Tamara Melnik.

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Melnik, T., Glina, S. & Rodrigues, O. Psychological intervention for premature ejaculation. Nat Rev Urol 6, 501–508 (2009). https://doi.org/10.1038/nrurol.2009.147

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