The Burden of Premature Ejaculation: The Patient's Perspective

Abstract

Premature ejaculation (PE) remains an underdetected and under-treated condition, despite the advances in available treatment options. Men with PE often feel stigmatized by the condition and embarrassment is a key barrier to discussing the problem with healthcare professionals. Men with PE perceive themselves as having little control over ejaculation and this lack of control is mirrored in diminished satisfaction with sexual intercourse. The burden of PE is both emotional and physical. Premature ejaculation is associated with low self-esteem, anxiety, and feelings of shame and inferiority. In some studies there is an association with depression. Premature ejaculation places a significant burden on the patient–partner relationship and there is evidence to suggest that there is a higher prevalence of female sexual dysfunction associated with PE. Patients with PE often view the condition as purely psychological or as a problem that will resolve with time and many are unaware that medical treatment could be of benefit. This endorses the particularly important role of healthcare professionals in recognizing the barriers to patient diagnosis and promoting the view that PE is not only a common but also a treatable medical condition.

Tadalafil and Fluoxetine in Premature Ejaculation: Prospective, Randomized, Double-Blind, Placebo-Controlled Study

“…There is a speculative association between PE and depression, with low self-esteem and anxiety in sexual relations [18] . The effect of SSRIs in the depression state of these men could perhaps be evaluated better by using a validated questionnaire, in order to try to identify a link between the two conditions.…”

Stereoselective synthesis of (S)-dapoxetine starting from trans-cinnamyl alcohol

“…Dapoxetine is well tolerated, with a favorable pharmacokinetic profile that allows for on-demand use. Dapoxetine hydrochloride is an SSRI with a short half-life developed specifically for the treatment of men with PE, [5][6][7][8] but is slightly different from the SSRIs (such as zoloft, paxil, and prozac) ( Figure 1) widely prescribed for depression and other psychiatric disorders such as bulimia or anxiety. The American Urological Association as well as the International Consultation on Sexual Dysfunctions now recommends the off-label use of SSRIs, which increase 5-HT neurotransmission, for the management of PE.…”

The role of orgasm in the development and shaping of partner preferences

“…In this way, an animal's sexual arousal, desire, and partner preferences are primed by the presence of cues associated previously with sexual reward, and sexual behaviors that generate the reward state become sensitized across an acquisition period. Ejaculation in men, for example, is typically associated with orgasm (Kinsey, Pomeroy, & Martin, 1948), although ejaculation can occur with a diminished or absent orgasm, for example, in some instances of premature or rapid ejaculation (Sotomayor, 2005), and orgasm can occur without ejaculation (Roehrborn, Kaplan, Lepor, & Volinn, 2011). In most male rats, ejaculations, but not penile intromissions, are necessary for the development of a CPP.…”