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New agents in the treatment of premature ejaculation

Authors Chris G McMahon, Chelsea N McMahon, Liang Joo Leow

Published 15 December 2006 Volume 2006:2(4) Pages 489—503

Chris G McMahon1, Chelsea N McMahon2, Liang Joo Leow3

1Australian Centre for Sexual Health, Sydney, Australia; 2St Vincent’s Hospital, Sydney, Australia; 3Austin Health, Melbourne, Australia

Abstract: Premature ejaculation (PE) is a common male sexual disorder. Recent normative data suggest that men with an intravaginal ejaculatory latency time (IELT) of less than 1 minute have “definite” PE, while men with IELTs between 1 and 1.5 minutes have “probable” PE. Although there is insufficient empirical evidence to identify the etiology of PE, there is limited correlational evidence to suggest that men with PE have high levels of sexual anxiety and inherited altered sensitivity of central 5-HT (serotonin) receptors. Pharmacological modulation of the ejaculatory threshold using off-label daily or on-demand selective serotonin re-uptake inhibitors (SSRIs) offers patients a high likelihood of achieving improved ejaculatory control within a few days of initiating treatment, consequential improvements in sexual desire and other sexual domains and is well tolerated. Investigational drugs such as the ejaculo-selective serotonin transport inhibitors (ESSTIs) such as dapoxetine and UK-390,957 represent a major development in sexual medicine. These drugs offer patients the convenience of on-demand dosing, significant improvements in IELT, ejaculatory control, and sexual satisfaction with minimal adverse effects.

Keywords: premature ejaculation, selective serotonin re-uptake inhibitors (SSRIs), ejaculoselective serotonin transport inhibitors (ESSTIs), dapoxetine, UK-390,957, intravaginal ejaculatory latency time (IELT).

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