Safety and efficacy of medications used to delay ejaculation

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premature ejaculation

Premature ejaculation (PE) occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. Premature ejaculation is a common sexual complaint.

premature ejaculation

Explain Premature ejaculation

The timing of ejaculations is generally used as an objective measure of ejaculatory control. Therefore, there is no fixed time for defining ‘too soon’ and it varies among the individuals or couples.

Say for an example, if a man/couple wants to ejaculate after 20 minutes of sexual intercourse and if he ejaculates at 10 minutes that is still premature ejaculation for him /couple. On the other hand, if the man/couple wants to ejaculate in 3 minutes but actually ejaculated in 1 min, that is still premature ejaculation for him/them.

In fact, premature ejaculation is the most reported sexual problem for all different ages. An estimated 50% of men at some cultures experienced PE at some point in their life, whilst they do not suffer from any other sexual problem. Premature ejaculation is definitely more common among younger men, perhaps because of their lack of experience or insecurity about sex.

Causes of premature ejaculation:

Causes of acquired premature ejaculation varies between physiological, physical and social issues.

Social and psychological causes:

  • Stress and depression.
  • Lack of experience.
  • Insecurity issues.
  • Relationship conflicts.
  • Low libido of female partner.

Physical causes:

  1. Thyroid problems and prostate disease
  2. Erectile dysfunction
  3. Multiple sclerosis.

Premature ejaculation treatment:

Medical treatment is not recommended unless all other treatments have proven inefficiency in curing premature ejaculation.

Try to find the underlying cause for premature ejaculation and treat it, if it was physiological reduce dissatisfaction, frustration, stress and performance-related anxiety.

used to help delay ejaculation

Behavioral treatment:

Longer foreplay can increase satisfaction of your partner as well as delay your ejaculations. Thus, longer foreplay can improve your relationship.
Using some behavioral techniques which involve stimulating the penis and stopping just before you feel you are about to ejaculate. Stop the stimulation for 30-60 seconds and start again once you feel that you have regained control. Repeat this process 4-5 times, stopping and “resting” every time you feel that you are about to have an orgasm. Finally, let the ejaculations occur, so that you can identify the “point of no-return”.
Use the “squeeze” technique; it works by squeezing the penis in the area between the shaft and the glans (for about 30 seconds), just before you are about to ejaculate. This stops the ejaculation, but may affect your erection, at least until you are stimulated again. You should then repeat this process 4-5 times until you decide not to delay orgasm anymore.

Pharmacological treatment:

Oral medications: ” delay ejaculation “

Antidepressants, a side effect of certain antidepressants is delayed orgasm. For this reason, antidepressant medications such as serotonin and noradrenaline are used to help delay ejaculation.

There are different types of antidepressant used to help delay ejaculation like:

  • Selective serotonin reuptake inhibitors (SSRIs): that type of antidepressants increase serotonin only. Thus, it is considered the first choice in treating premature ejaculation.
  • If SSRIs do not improve the timing of your ejaculations, your doctor might prescribe the tricyclic antidepressant clomipramine (Anafranil), it release serotonin and noradrenalin as well. Unwanted side effects of antidepressants might include nausea, perspiration, drowsiness and decreased libido.
  • Dapoxetine new antidepressant has found to be safe and more effective. However, it is not approved yet and study continues.
  • Opioid analgesics; Tramadol (Ultram) is a medication commonly used to treat pain. Tramadol increase the release of serotonin, consequently It delays ejaculations. In addition to, numerous of unwanted side effects that might include nausea, headache, sleepiness and dizziness. Moreover, the potential of addiction which prevented Tramadol from becoming a preferred treatment for PE.
  • Phosphodiesterase-5 inhibitors: Some medications used to treat erectile dysfunction, such as sildenafil, tadalafil, and vardenafil might help premature ejaculation.

Topical anesthetics: “delay ejaculation “

Anesthetic creams and sprays that contain a numbing agent are sometimes used to treat premature ejaculation. These products are applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation.

Although topical anesthetic agents are effective and well tolerated, they have potential side effects. For example, some men reported temporary loss of sensitivity and decreased sexual pleasure. Sometimes, female partners also have reported these effects. Topical anesthetics at rare cases cause allergy.

Herbal oral and topical remedies:

Like all natural remedies, there is no study to affirm the effectiveness of those herbs to delay ejaculation.

Likewise, there are oral herbal treatment known from centuries to delay premature ejaculation like:
  • Maca
  • St. John Wort
  • Griffonia
  • Epimedium.

Topical herbal remedies, with essential oils when applied to the penis it help delay ejaculation.

Food supplements:

  • v  L-Arginine
  • vi  L-Glutamine
  • vii  L-Tyrosine

No conclusive or reliable research has been conducted on the effects of long-term use of the above mentioned food supplements in order to cure premature ejaculation.

 

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