Drug treatment options for premature ejaculation

ABSTRACT

Introduction: Various drugs are available for lifelong and acquired premature ejaculation (PE), but only dapoxetine and Fortacin^TM have been officially registered. On the other hand, all sorts of pharmacologically not-investigated over-the-counter-products (OTCs) are used by men with complaints of PE with normal ejaculation time durations (subjective PE). There is a need to critically review the current state of registered and nonregistered drugs for PE.

Areas covered: In this review, the authors use the guideline of the International Society for Sexual Medicine (ISSM) for the treatment of PE and provide evidence-based recommendations for the pharmacotherapy of lifelong and acquired PE. This should always be accompanied by psychoeducation, counseling, and information about common and rare side effects of the various available drugs.

Expert opinion: As long as subjective PE is not officially recognized as the third PE subtype, registration authorities will continue to demand drugs for subjective PE to be studied in men with lifelong PE. This is unfortunate as the method and design of studies of drugs for subjective PE differ from those of lifelong PE but also because drugs for subjective PE need to be investigated in men with subjective PE and not in men with lifelong PE.

KEYWORDS:

• Premature ejaculation
• SSRIs
• dapoxetine
• Fortacin ^TM
• Promescent
• Stud-100
• clomipramine

Article highlights

• Praejaculin has been launched in 1932 as the first oral drug for PE

• Although daily use of 20 mg paroxetine exerts the strongest ejaculation delay, the producers of paroxetine and the other SSRIs have never been interested in their registration for the treatment of PE

• Despite its weak ejaculation delaying effect, on-demand use of 30 mg dapoxetine is the first registered oral drug for the treatment of lifelong and acquired PE

• Fortacin topical Spray has been the second registered drug for the treatment of lifelong and acquired PE

• There are no registered drugs for the treatment of subjective PE

• Drug treatment research of subjective PE needs to be performed in men with subjective PE and not in men with lifelong PE and requires a method and design of study that differs from what is required in lifelong PE

This box summarizes key points contained in the article.

Declaration of interest

M Waldinger is an advisor for Emotional Brain B.V. He has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This manuscript was not funded.