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A Review of Pathophysiology and Management Options for Delayed Ejaculation.

Daniel J Sadowski1, Michael J Butcher2, Tobias S Köhler1

  • 1Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.

Sexual Medicine Reviews
|August 18, 2016
PubMed
Summary

Delayed ejaculation (DE) is a condition causing distress due to delayed or absent orgasm. Treatment requires identifying the cause and may involve therapy, off-label medications like cabergoline or bupropion, and penile vibratory stimulation.

Keywords:
Delayed EjaculationEjaculatory DysfunctionManagementSexual DysfunctionSexual HealthTreatment

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Area of Science:

  • Urology
  • Sexual Medicine
  • Pharmacology

Background:

  • Delayed ejaculation (DE) is a poorly defined condition characterized by delayed or absent orgasm, leading to personal distress.
  • The causes of DE are numerous, necessitating etiology-specific management for successful treatment.
  • Current management strategies encompass psychological and sexual therapy, pharmacotherapy, and penile vibratory stimulation.

Purpose of the Study:

  • To review the existing literature on the pathophysiology and treatment options for delayed ejaculation (DE).
  • To evaluate the efficacy and safety data for various DE management strategies.

Main Methods:

  • A comprehensive literature review was conducted to identify and assess studies on DE treatment success.
  • Evaluation criteria included method of administration, supporting evidence for efficacy, and potential risks or side effects of each treatment.

Main Results:

  • Psychosexual therapy strategies for DE have limited supporting efficacy data.
  • No medications are FDA-approved for DE; evidence for off-label use is low, though cabergoline and bupropion are commonly reported.
  • Penile vibratory stimulation is noted as an adjunctive treatment option for DE.

Conclusions:

  • Various treatment options for DE exist, but evidence supporting their efficacy is generally limited.
  • Accurate diagnosis of the underlying cause of DE is crucial for targeted and effective therapy.
  • A multimodal treatment approach, potentially combining psychosexual therapy, pharmacotherapy, and penile vibratory stimulation, is likely to yield optimal patient outcomes.