Drug treatment and psychotherapy of premature ejaculation

Abstract

Drug treatment of lifelong premature ejaculation (PE) consists of daily use of SSRIs, particularly paroxetine 20mg and sertraline 50-100mg, on-demand use of clomipramine 20-50mg (3-6 hour prior to coitus) and/or topical anesthetics, such as lidocaine and prilocaine [1].

PE is a common male sexual complaint in approximately 20-40% of men. However, not all these men require treatment. PE has been distinguished in Lifelong and Acquired PE. Recently, two other PE syndromes have been classified [2,3]. In “Normal Variable PE” the occurrence of early ejaculation is rather inconsistent and should be regarded as a normal pattern of ejaculatory performance [2]. In “Premature-like Ejaculatory Dysfunction” men complain of an early ejaculation while the duration of the IELT is in the normal range (about 5 minutes) or even longer (5-10 min) [3]. The four PE syndromes require different forms of treatment. Lifelong PE should be treated with medication. Acquired PE needs medication and/or psychotherapy. Normal Variable PE requires psycho-education and Premature-like PE requires either psychotherapy, psycho-education or counselling.