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Tramadol for premature ejaculation: a systematic review and meta-analysis.
Marrissa Martyn-St James1, Katy Cooper2, Eva Kaltenthaler3
1School for Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK. m.martyn-stjames@sheffield.ac.uk.
BMC Urology
|February 1, 2015
Summary
Tramadol may effectively increase time to ejaculation for men with premature ejaculation (PE). However, evidence quality is limited, and tramadol has more side effects than placebo.
Area of Science:
- Pharmacology
- Urology
- Clinical Trials
Background:
- Tramadol, a centrally acting analgesic, is used off-label for premature ejaculation (PE).
- Evidence supporting tramadol's efficacy in PE is limited, and concerns exist regarding addiction and respiratory depression.
- This study systematically reviews randomized controlled trials (RCTs) on tramadol for PE management.
Purpose of the Study:
- To systematically review the evidence from randomized controlled trials (RCTs) evaluating tramadol for the management of premature ejaculation (PE).
Main Methods:
- Searched MEDLINE and other databases for RCTs up to August 2014.
- Assessed methodological quality of included RCTs.
- Conducted a meta-analysis of between-group differences in intra-vaginal ejaculatory latency time (IELT) and other outcomes, assessing heterogeneity.
Main Results:
- Eight RCTs were included; most had unclear methodological quality.
- Pooled evidence from four RCTs (721 participants) showed tramadol significantly increased IELT compared to placebo (p = 0.0007), with high heterogeneity (I-squared = 74%).
- Tramadol was associated with more adverse events than placebo or behavioral therapy, but long-term effects and addiction potential were not assessed.
Conclusions:
- Tramadol appears effective for treating PE, but findings require cautious interpretation due to heterogeneity and evidence quality.
- Variability in dosage and duration across trials prevents determining a safe and effective minimum daily dose.
- Long-term effects and side effects, including addiction potential, remain unevaluated in the current evidence base.
