Identifying and treating premature ejaculation: importance of the sexual history.
Premature ejaculation (PE) is one of the most common sexual dysfunctions in men, with prevalence rates ranging from 21% to 31%. Because many physicians do not inquire about sexual dysfunction and patients are reluctant to offer it as a medical complaint, PE is underreported in clinical practice. A sexual history is therefore necessary to uncover the diagnosis. PE can have a significant impact on the quality of life of the patient and his sexual partner, and may lead to psychological distress and loss of self-esteem. It appears that PE has no single etiology, and treatments have been based on both its neurophysiologic and behavioral components. Although no therapies are currently approved for PE by the US Food and Drug Administration, medications that have shown some success include selective serotonin reuptake inhibitors, tricyclic antidepressants, phosphodiesterase type 5 inhibitors, and topical anesthetics. Behavioral techniques have been the mainstay of PE treatment, and include techniques to decrease sensory input.
Payne
Richard E
RE
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, USA. repayne@ncfmg.com
Sadovsky
Richard
R
D000287:Administration, Topical; D000777:Anesthetics / Q000008:administration & dosage; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001596:Benzylamines / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D009281:Naphthalenes / Q000627:therapeutic use; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012731:Sex Counseling; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological
D000777:Anesthetics; D000929:Antidepressive Agents, Tricyclic; D001596:Benzylamines; D009281:Naphthalenes; D017367:Selective Serotonin Reuptake Inhibitors; C080598:dapoxetine