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Pharmacotherapy for premature ejaculation.

Marcel D Waldinger1

  • 1aDivision of Pharmacology, Department of Pharmaceutical Sciences, Faculty of Beta Sciences, Utrecht University, Utrecht bPractice for Psychiatry and Neurosexology, Amstelveen, The Netherlands.

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This review covers drug treatments for premature ejaculation (PE). Lifelong and acquired PE often require medication, while other subtypes benefit from counseling or local anesthetics. Treatment choice depends on individual patient needs.

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Area of Science:

  • Urology
  • Sexual Medicine
  • Pharmacology

Background:

  • Premature ejaculation (PE) is a common sexual dysfunction.
  • Various pharmacological and non-pharmacological treatments exist.
  • Understanding current drug options is crucial for clinical practice.

Purpose of the Study:

  • To review current drug treatments for premature ejaculation (PE).
  • To provide guidance for daily clinical practice regarding PE management.

Main Methods:

  • Literature review of existing studies on premature ejaculation treatments.
  • Analysis of drug efficacy, administration (on-demand vs. daily), and off-label status.

Main Results:

  • Four subtypes of PE identified: lifelong, acquired, variable, and subjective.
  • Drug treatment is primary for lifelong and acquired PE.
  • Counseling and local anesthetics are indicated for variable and subjective PE.
  • Most PE treatments are off-label, except for on-demand dapoxetine.

Conclusions:

  • Pharmacological treatment is the first-line approach for lifelong PE.
  • Drug therapy may also be suitable for acquired PE.
  • Personalized treatment strategies should be chosen collaboratively between clinician and patient.