A Review of Pathophysiology and Management Options for Delayed Ejaculation

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.