‘Up and coming’ treatments for premature ejaculation: progress towards an approved therapy

Abstract

It is generally accepted that premature ejaculation (PE) is a more common problem than erectile dysfunction, although at present the options currently available for the treatment of PE are limited to behavioural psychotherapy and 'off-label' prescribing of pharmacological therapies. A sexual complaint with such a high prevalence together with an increasing understanding of the psychosocial consequences of PE has naturally stimulated the interest of the pharmaceutical industry and the first products designed specifically for the treatment of PE are either in late-stage clinical development or are already under regulatory review. Most of the new treatments for PE have been developed for 'on-demand' use, which may prove to offer the most favourable risk: benefit profile as well as the flexibility to adapt to differing frequencies of sexual activity. This paper reviews a number of emerging therapies in various stages of development that show potential for use in the treatment of PE.

Psychological impact of premature ejaculation and barriers to its recognition and treatment

“…Increased IELT and improvements in distress and interpersonal difficulty have been reported following such treatment 55,58,61 . The opioid receptor agonist, tramadol, has also been evaluated as on-demand treatment for PE and was shown to prolong IELT compared with placebo 64 ; however, concern about the risk of abuse and dependence with an opioid drug may limit the use of tramadol 60 . The PDE-5 inhibitors do not prolong IELT in men with PE, but limited data suggest a possible role for the combination of a PDE-5 inhibitor and an SSRI in men with ED and comorbid PE 59,60 .…”

Neurogenic Ejaculatory Disorders: Focus on Current and Future Treatments

“…This cream contains nine different compounds, some with local anesthetic and vasodilatatory properties. SS cream is available for use only in Korea and, to date, all the studies conducted on its efficacy were published by the same group and took place there [38].…”

“…Nevertheless, it has been postulated that "on-demand" treatment of PE with conventional SSRIs would only be successful when combined with a 5-HT1 A receptor antagonist or some other treatment that would acutely stimulate serotonin release [38].…”

Ancient ChineseFangzhongshu(Sexual Skills and Methods) Therapy for Premature Ejaculation

“…First, psychological interventions can help men develop sexual skills for delaying ejaculation by increasing their sexual confidence and diminishing their performance anxiety. Second, it can resolve psychological and interpersonal issues, which may have precipitated, maintained, or been consequences of PE symptoms for the man, his partner, or the couple [61516]. However, the outcomes in a majority of psychotherapy studies are not well controlled or randomized, and few of them meet the requirements of evidence-based studies.…”