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Ketabchi AA. Clomiphene Effects on Idiopathic Premature Ejaculation. Nephrourol Mon 2015; 7:e27281. [PMID: 26543830 PMCID: PMC4630386 DOI: 10.5812/numonthly.27281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/12/2015] [Indexed: 11/16/2022] Open
Abstract
Background: Premature ejaculation (PE) is the inability to delay ejaculation, occurring sooner than they or their partner would like during sexual activities. PE is a challenging problem that can affect sexual enjoyment and may harm relationships of couples and affect their quality of life. In idiopathic PE, several helpful techniques and medicines are recommended, but none of them has yielded satisfactory results. Objectives: Our objective in this study was to evaluate the efficacy and safety of clomiphene as a selective estrogen receptor modulator on the treatment of idiopathic PE. Patients and Methods: In a randomized clinical trial, 178 married men with idiopathic PE defined according to the Diagnostic and Statistical Manual of Mental Disorders Third Revised Version (DSM-III-R) who referred to urology clinics over a 10-month period in 2012 were randomized into two groups, namely the study (clomiphene) and control (placebo) groups. They completed self-administered questionnaires that included intravaginal ejaculatory latency time (IELT), erectile dysfunction indexes, quality of life (QOL), sociodemographic characteristics, lifestyle, and medical illness. After 6 months of intervention, all data were compared with the baseline data and between the groups. Results: Within the 10-month study course, 126 patients (70.8%) completed this study. After intervention and comparison of the results between the two groups, IELT, sexual indexes, and QOL improved in the study group, but significant differences were observed only in the IELT and QOL findings. Conclusions: Clomiphene seems to be useful in the pharmacological treatment of PE compared to the placebo.
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Affiliation(s)
- Ali Asghar Ketabchi
- Department of Urology, Bahonar Hospital, Kerman Medical Sciences University, Kerman, IR Iran
- Corresponding author: Ali Asghar Ketabchi, Department of Urology, Bahonar Hospital, Kerman Medical Sciences University, Kerman, IR Iran. Tel: +913-1412131, Fax: +98-3432239188, E-mail:
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153
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Abstract
Sexual problems are highly prevalent among patients with psychiatric disorders. They may be caused by the psychopathology of the psychiatric disorder but also by its pharmacotherapy. Both positive symptoms (e.g., psychosis, hallucinations) as well as negative symptoms (e.g., anhedonia) of schizophrenia may negatively interfere with interpersonal and sexual relationships. Atypical antipsychotics have fewer sexual side-effects than the classic antipsychotics. Mood disorders may affect libido, sexual arousal, orgasm, and erectile function. With the exception of bupropion, agomelatine, mirtazapine, vortioxetine, amineptine, and moclobemide, all antidepressants cause sexual side-effects. Selective serotonin reuptake inhibitors (SSRIs) may particularly delay ejaculation and female orgasm, but also can cause decreased libido and erectile difficulties. SSRI-induced sexual side-effects are dose-dependent and reversible. Very rarely, their sexual side-effects persist after SSRI discontinuation. This is often preceded by genital anesthesia. Some personality characteristics are a risk factor for sexual dysfunction. Also patients with eating disorders may suffer from sexual difficulties. So far, research into psychotropic-induced sexual side-effects suffers from substantial methodologic limitations. Patients tend not to talk with their clinician about their sexual life. Psychiatrists and other doctors need to take the initiative to talk about the patient's sexual life in order to become informed about potential medication-induced sexual difficulties.
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Affiliation(s)
- Marcel D Waldinger
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of BetaSciences, Utrecht University, Utrecht, The Netherlands.
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154
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Cormio L, Massenio P, La Rocca R, Verze P, Mirone V, Carrieri G. The Combination of Dapoxetine and Behavioral Treatment Provides Better Results than Dapoxetine Alone in the Management of Patients with Lifelong Premature Ejaculation. J Sex Med 2015; 12:1609-15. [PMID: 26077706 DOI: 10.1111/jsm.12925] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION It is not known whether the efficacy of dapoxetine, the only drug approved for the on-demand treatment of premature ejaculation (PE), can be increased by the addition of sexual behavioral treatment (SBTx). AIM To test the hypothesis that combined dapoxetine and SBTx provide better result than dapoxetine alone in the management of patient with lifelong PE. METHODS After a 4-week run-in period, 50 patients with lifelong PE entered a 24-week, open-label, prospective study with a 1:1 assignment. Twenty-five patients (group A) received on-demand dapoxetine 30 mg alone, and the remaining 25 patients (group B) combined on-demand dapoxetine 30 mg and SBTx. The CONSORT 2010 statement was adhered to where possible. MAIN OUTCOME MEASURES The intravaginal ejaculatory latency time (IELT), the premature ejaculation diagnostic tool (PEDT) score, and the treatment-emergent adverse events (TEAEs) were analyzed. RESULTS Mean age was 34.16 years in group A and 34.44y in group B. From baseline to 4-, 12- and 24-week evaluation, both groups experienced a significant (P < 0.0001) increase in mean IELT and decrease in mean PEDT score, but patients in group A showed a significantly lower increase in mean IELT (85.0; 84.8; 130.7; 160.0 vs. 92.0; 137.9; 232.7; 370.7 seconds, respectively; P < 0.0001) and a significantly lower decrease in mean PEDT score (20.4; 18.16; 15.88; 14.68 vs. 19.56; 16.0; 11.96; 7.92, respectively; P < 0.0001) than those in group B. At 24-week evaluation, no patient in group A reached a PEDT score ≤8 (absence of PE) as opposed to 80% of patients in group B. There was no difference between groups in TEAEs rate (16% vs. 16%; P = 1.00). Limitations included the absence of a group receiving SBTx alone or group crossover. CONCLUSIONS Combined dapoxetine and SBTx proved to be more effective than dapoxetine alone in treating patients with lifelong PE, up to restoring a normal ejaculatory function in most of them.
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Affiliation(s)
- Luigi Cormio
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Paolo Massenio
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Roberto La Rocca
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Paolo Verze
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Vincenzo Mirone
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Giuseppe Carrieri
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
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155
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Tramadol for the management of premature ejaculation: a timely systematic review. Int J Impot Res 2015; 27:121-7. [DOI: 10.1038/ijir.2015.7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 01/02/2015] [Accepted: 03/30/2015] [Indexed: 11/08/2022]
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156
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Rowland DL, Kolba TN. Understanding the Effects of Establishing Various Cutoff Criteria in the Definition of Men with Premature Ejaculation. J Sex Med 2015; 12:1175-83. [DOI: 10.1111/jsm.12881] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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157
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Silangcruz JMA, Chua ME, Morales ML. Prevalence and factor association of premature ejaculation among adult Asian males with lower urinary tract symptoms. Prostate Int 2015; 3:65-9. [PMID: 26157771 PMCID: PMC4494636 DOI: 10.1016/j.prnil.2015.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 01/09/2015] [Indexed: 01/01/2023] Open
Abstract
Purpose To determine the prevalence of premature ejaculation (PE) among adult Asian males presented with lower urinary tract symptoms (LUTS) and characterize its association with other clinical factors. Methods A cross-sectional study was conducted at a tertiary medical center to determine the prevalence of PE among adult male participants with LUTS during the Annual National Prostate Health Awareness Day. Basic demographic data of the participants were collected. All participants were assessed for the presence and severity of LUTS using the International Prostate Symptom Score (IPSS), and for the presence of PE using the PE diagnostic tool. Digital rectal examination was performed by urologists to obtain prostate size. LUTS was further categorized into severity, storage symptoms (frequency, urgency, and nocturia), and voiding symptoms (weak stream, intermittency, straining, and incomplete emptying) to determine their association with PE. Data were analyzed by comparing the participants with PE (PE diagnostic tool score ≥11) versus those without PE, using the independent t test for continuous data, Mann–Whitney U test for ordinal data, and Chi-square test for nominal data. The statistical significance was set at P < 0.05. Results A total of 101 male participants with a mean ± standard deviation age of 60.75 ± 10.32 years were included. Among the participants, 33% had moderate LUTS, and 7% severe LUTS. The most common LUTS was nocturia (33%). The overall prevalence of PE was 27%. There was no significant difference among participants with PE versus those without PE in terms of age, marital status, prostate size, or total IPSS score. However, significant difference between groups was noted on the level of education (Mann–Whitney U, z = −1.993, P = 0.046) where high educational status was noted among participants with PE. Likewise, participants with PE were noted to have more prominent weak stream (Mann–Whitney U, z = −2.126, P = 0.033). Conclusions Among the participants consulted with LUTS, 27% have concomitant PE. Educational status seems to have an impact in the self-reporting of PE, which may be due to a higher awareness of participants with higher educational attainment. A significant association between PE and weak stream that was not related to prostate size suggests a neuropathologic association.
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Affiliation(s)
| | - Michael E Chua
- Institute of Urology, St. Luke's Medical Center, Quezon City, Philippines
| | - Marcelino L Morales
- Institute of Urology, St. Luke's Medical Center, Quezon City, Philippines ; Department of Urology, National Kidney and Transplant Institute, Quezon City, Philippines
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158
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Bronner G, Kitrey ND, Uziel N, Eli I, Raviv G, Ramon J, Elran E. Correlation between premature ejaculation and female vaginal penetration difficulties. Int J Impot Res 2015; 27:152-6. [PMID: 25716748 DOI: 10.1038/ijir.2015.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 11/29/2014] [Accepted: 01/07/2015] [Indexed: 01/16/2023]
Abstract
Male and female sexual dysfunctions encompass biological, psychological and interpersonal aspects. Premature ejaculation (PE) and female vaginal penetration difficulties (VPD) are problems that may concurrently impair the couple's sexual relationship. We have studied the correlation between PE and VPD in the female partner, in a cross-sectional study of 125 heterosexual couples (male age 35.01±10.63; female age 32.36±10.07). VPD included tampon insertion, gynecological examination, inserting self-finger or partner-finger and penile-vaginal intercourse. Female sexual function index (FSFI) and a validated PE questionnaire were used to measure the female sexual function and PE in their male partners. We found that female partners of men with anteportal ejaculation were found to experience significantly more VPDs, especially with regard to difficulties in penile penetration and tampon use. The intensity of pain in VPD was higher in females whose male partners presented anteportal ejaculation. No significant correlation was found between total male PE score and the total FSFI or separate domains of female sexual function. The results suggest that female VPD and male anteportal ejaculation are interrelated. Such severe couple sexual problems should be addressed in parallel. Further research is required to study the causation of PE and VPD.
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Affiliation(s)
- G Bronner
- Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel-Hashomer, Israel
| | - N D Kitrey
- Department of Urology, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - N Uziel
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - I Eli
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - G Raviv
- Department of Urology, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Ramon
- Department of Urology, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - E Elran
- Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel-Hashomer, Israel
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159
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Brody S, Weiss P. Erectile Dysfunction and Premature Ejaculation: Interrelationships and Psychosexual Factors. J Sex Med 2015; 12:398-404. [DOI: 10.1111/jsm.12738] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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160
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Ventimiglia E, Capogrosso P, Colicchia M, Boeri L, Serino A, La Croce G, Russo A, Capitanio U, Briganti A, Cantiello F, Mirone V, Damiano R, Montorsi F, Salonia A. Peyronie's disease and autoimmunity—a real-life clinical study and comprehensive review. J Sex Med 2015; 12:1062-9. [PMID: 25630575 DOI: 10.1111/jsm.12825] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Although heavily investigated over the last decades, Peyronie's disease (PD) pathogenesis remains unclear. AIM We sought to investigate the association between PD and autoimmune diseases (ADs) in men seeking medical help for sexual dysfunction in the real-life setting. METHODS Complete sociodemographic and clinical data from a homogenous cohort of 1,140 consecutive Caucasian-European men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index and ADs were stratified according to International Classification of Diseases, Ninth Revision classification. MAIN OUTCOME MEASURES Descriptive statistics and multivariate logistic regression models tested the association between ADs and PD. RESULTS PD was diagnosed in 148 (13%) of the 1,140 men; of PD patients, 14 (9.5%) had a comorbid AD; conversely, the rate of ADs in non-PD patients was significantly lower (χ(2) = 24.7; P < 0.01). Both patient age and AD comorbidity achieved multivariable independent predictor status for PD (odds ratio [OR]: 1.05; P < 0.01 and OR: 4.90; P < 0.01, respectively). CONCLUSIONS Our observational findings showed that ADs are highly comorbid with PD in a large cohort of same-race individuals seeking medical help for sexual dysfunction in the real-life setting.
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Affiliation(s)
- Eugenio Ventimiglia
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
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Zhang X, Tang D, Xu C, Gao P, Hao Z, Zhou J, Liang C. The relationship between self-estimated intravaginal ejaculatory latency time and International Prostate Symptom Score in middle-aged men complaining of ejaculating prematurely in China. J Sex Med 2015; 12:705-12. [PMID: 25630352 DOI: 10.1111/jsm.12811] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Some factors associated with the four premature ejaculation (PE) syndromes have been studied, but the association between International Prostate Symptom Score (IPSS) and the four PE syndromes has not been investigated. AIMS We performed this study to evaluate the association between IPSS and intravaginal ejaculatory latency time (IELT) in men with the four PE syndromes. METHODS From June 2012 to January 2014, a total of 690 men aged 40-59 years complaining of ejaculating prematurely and another 452 male healthy subjects of the same age without these complaints were included in this study. Men with the complaints of ejaculating prematurely were classified as one of the four PE syndromes: lifelong PE, acquired PE (APE), variable PE, and subjective PE. Each of them completed a detailed questionnaire including information on demographics, medical and sexual history (e.g., self-estimated IELT), IPSS, and International Index of Erectile Function-5. MAIN OUTCOME MEASURES Associations between IPSS and self-estimated IELT in middle-aged men with the four PE syndromes. RESULTS Men complaining of ejaculating prematurely reported higher IPSS (11.2 ± 6.0 vs. 5.5 ± 3.3 ) and shorter self-estimated IELT (2.1 ± 1.6 minutes vs. 4.8 ± 3.3) than men without complaints (P < 0.001 for each). By unilabiate analysis, self-estimated IELT in men with the four PE syndromes showed significant correlations with IPSS (P < 0.001 for all). After adjusting for age, self-estimated IELT was negatively associated with IPSS in men with PE complaints (adjusted r = -0.378, P < 0.001). Also, the association was stronger in men with APE (adjusted r = -0.502, P < 0.001). CONCLUSIONS Men complaining of ejaculating prematurely reported worse IPSS than men without these complaints. Self-estimated IELT was negatively associated with IPSS in men complaining of ejaculating prematurely, and the correlation was the strongest in men with APE.
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Affiliation(s)
- Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Effects of adult male circumcision on premature ejaculation: results from a prospective study in China. BIOMED RESEARCH INTERNATIONAL 2015; 2015:417846. [PMID: 25695078 PMCID: PMC4324807 DOI: 10.1155/2015/417846] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 11/18/2022]
Abstract
The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE). Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group) were evaluated. Detailed evaluations (including circumcision and control groups) on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT), Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P < 0.001 for all). Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P < 0.001 for all). These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.
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163
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Sexual dysfunction in 2014: Men enjoy a year of significant progress. Nat Rev Urol 2015; 12:73-4. [PMID: 25582521 DOI: 10.1038/nrurol.2014.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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164
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Lee JH, Lee SW. Relationship between premature ejaculation and chronic prostatitis/chronic pelvic pain syndrome. J Sex Med 2014; 12:697-704. [PMID: 25475760 DOI: 10.1111/jsm.12796] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common etiology of premature ejaculation (PE). However, the current data are insufficient to explain this relationship and to support routine screening of men with PE. AIMS This study aims to evaluate the relationship between PE and CP/CPPS. METHODS A cross-sectional study was conducted that included 8,261 men who had participated in a health examination. The Premature Ejaculation Diagnostic Tool (PEDT), the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and the International Index of Erectile Function-5 (IIEF) were used for assessment of symptoms. A full metabolic work-up and serum testosterone level checks were also performed. We then investigated the relationship using the Spearman correlation test, multiple linear regression, and logistic regression analyses. MAIN OUTCOME MEASURES Associations of PEDT with NIH-CPSI. RESULTS The mean age was 50.4 ± 5.5 years. In total, 2,205 (24.9%) men had prostatitis-like symptoms (NIH-CPSI pain score of ≥4 and perineal or ejaculatory pain), and 618 (7.0%) men had moderate to severe symptoms (NIH-CPSI pain score of ≥8). Additionally, 2,144 men (24.2%) were classified as demonstrating PE (PEDT > 10). The PEDT score was found to have a significant positive correlation with the NIH-CPSI pain domain score (correlation coefficient = 0.206; P < 0.001). After adjusting for age, metabolic syndrome status, testosterone level, and IIEF score, there was no change in the positive correlation between the NIH-CPSI pain domain score and PEDT score (Beta = 0.175; P < 0.001). After adjusting for age, testosterone level, metabolic syndrome, and IIEF score, the odds ratio (OR) for PE significantly increased with the severity of pelvic pain (mild prostatitis-like symptoms, OR for PE: 1.269, 95% confidence interval: 1.113-1.447; moderate to severe symptoms, OR for PE: 2.134: 95% confidence interval: 1.782-2.557). CONCLUSIONS Our data showed a significant correlation between the PEDT score and the NIH-CPSI score. We suggest routine screening for CP/CPPS in men with PE and PE in men with CP/CPPS.
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Affiliation(s)
- Jun Ho Lee
- Department of Urology, National Police Hospital, Seoul, Korea
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165
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Bellastella G, Maiorino MI, Olita L, Della Volpe E, Giugliano D, Esposito K. Premature ejaculation is associated with glycemic control in Type 1 diabetes. J Sex Med 2014; 12:93-9. [PMID: 25424355 DOI: 10.1111/jsm.12755] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Premature ejaculation (PE) is the most common male sexual dysfunction. Its prevalence in Type 1 diabetes is unknown. AIM The aim of this study was to assess the prevalence of PE in Type 1 diabetes and the influence of glycemic control on ejaculatory function. METHODS One hundred Type 1 diabetic male patients (age < 40 years) and 51 age-matched nondiabetic control subjects were evaluated for PE. A subgroup of 30 diabetic patients (20 with PE and 10 without) were also evaluated for blood glucose variability. MAIN OUTCOME MEASURES The presence of PE was assessed with the premature ejaculation diagnostic tool (PEDT) and the self-estimated intravaginal ejaculatory latency time (IELT). Glucose variability was evaluated by continuous glucose monitoring for a 7-day period with a DexCom G4 CGM system: the mean amplitude of glycemic excursions (MAGEs), low (LBGI) and high (HBGI) blood glucose indices, and the standard deviation of blood glucose (BGSD) were calculated. RESULTS PE prevalence did not differ significantly between the two groups: pathological values of the PEDT score (>8) and IELT score (<1 minute) were recorded in 24 out of 100 diabetic patients (24%) and in 12 out of 51 controls (23.5%). There were significant associations between hemoglobin A1c and the PEDT score (r = 0.27; P = 0.006) and IELT (r = -0.3; P = 0.01). In the subgroup assessed for glucose variability, the PEDT score was associated with LBGI (r = 0.43; P = 0.01), but not with BGSD (r = 0.1, P = 0.6), MAGE (r = -0.1; P = 0.4), or HBGI (r = 0.1; P = 0.6). CONCLUSIONS Our results show a similar prevalence of PE in young male patients with Type 1 diabetes and in the age-matched control population; in diabetic patients with PE, a higher glycemic variability in the hypoglycemic domain is significantly associated with the PEDT score.
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Affiliation(s)
- Giuseppe Bellastella
- Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Division of Endocrinology and Metabolic Diseases, Second University of Naples, Naples, Italy
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Abstract
PURPOSE OF REVIEW As there are various drugs and different treatment strategies to delay ejaculation, a review of the current drug treatments for premature ejaculation is relevant for daily clinical practice. RECENT FINDINGS There are four premature ejaculation subtypes: lifelong premature ejaculation, acquired premature ejaculation, variable premature ejaculation and subjective premature ejaculation. These premature ejaculation subtypes vary in the duration of the intravaginal ejaculation latency time, their course in life and frequency of early ejaculations. Drug treatment is mainly required for lifelong and acquired premature ejaculation. On the other hand, counseling, psychoeducation and local anesthetics are particularly indicated for variable premature ejaculation and subjective premature ejaculation. Apart from the efficacy of various drugs, drugs against premature ejaculation can be taken on-demand or on a daily basis. However, apart from the on-demand use of dapoxetine, all other premature ejaculation treatments are off-label. SUMMARY Drug treatment is the first choice of treatment for lifelong premature ejaculation and may also be indicated for acquired premature ejaculation. Together with the patient, the clinician can choose which drug and which treatment strategy is most suitable for the patient and his partner.
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