Tramadol for the management of premature ejaculation: a timely systematic review

Premature ejaculation (PE) represents a common sexual dysfunction and is associated with a negative impact on quality of life and relationships. Recent evidence suggests that on-demand dosing of tramadol is effective at increasing intra-vaginal ejaculatory latency time (IELT) and improving subjective measures of satisfaction. A literature review was performed of journal articles published between January 2000 and July 2014 that matched the keywords 'tramadol' and 'premature ejaculation'. We identified eight relevant articles with the criteria that each article be published in a peer-reviewed journal, represent original work and be written in English. IELT was used as the primary outcome in each of the papers reviewed for efficacy. Additional subjective outcome measures were reviewed where available. Safety was assessed using adverse event data from the individual studies. We found that tramadol in on-demand dosing is effective at lengthening IELT in men with varying degrees of PE and improves patient satisfaction. Tramadol was generally well tolerated, particularly among those taking 25 and 50 mg doses. Although there is a risk of abuse and dependence, these events are rare, particularly at low doses taken intermittently. In conclusion, tramadol is an effective oral therapy for PE that is overall safe and well tolerated.