Premature ejaculation: current medical treatment and new directions (CME).
BACKGROUND
Premature ejaculation (PE) is the most common form of male sexual dysfunction. Until very recently, scientific investigation of PE has been hampered by a lack of standardized definitions and objective, validated questionnaires. Small numbers of randomized controlled studies evaluating various treatment options have also added to the challenges facing the clinicians who manage PE.


OBJECTIVE
This article provides a summary of some of the more relevant the peer-reviewed literature pertaining to the medical therapy of premature ejaculation.


METHODS
A retrospective review of peer reviewed publications relevant to the field of premature ejaculation and related medical therapies.


METHODS
Review of safety and efficacy of various medical therapies for premature ejaculation.


RESULTS
Selective serotonin release inhibitors have been the most promising agents to date. The on-demand "PRN" use of these agents is more convenient, but its efficacy is less well established. Chronic use of this class of medications has been associated with minor, but bothersome side effects. More recently, concern over the risk of an increased suicide rate in young men upon initiation of SSRIs has dampened enthusiasm. Recent experience with the use of Tramadol raises the hope that this might prove to be an agent as effective as SSRIs with less worrisome risk of side-effects. New trials on novel formulations of topical solutions are currently underway in the United States.


CONCLUSIONS
Interest in medical therapy for PE is rapidly increasing and reflected in a disproportionate number of publications in this field in the past few years. Clinical research in this field is hampered by the complexity, variability among different men and cultures, and subjectivity of PE. Reliable, appropriately controlled and assessed studies are generally lacking and carefully devised, methodically conducted research is much needed.
Sadeghi-Nejad
Hossein
H
UMDNJ New Jersey Medical School-Surgery, Division of Urology, Newark, NJ, USA; Hackensack University Medical Center-Urology, Hackensack, NJ, USA. Electronic address: hossein.sadeghi-nejad@med.va.gov.
Watson
Richard
R
UMDNJ New Jersey Medical School-Surgery, Division of Urology, Newark, NJ, USA; Hackensack University Medical Center-Urology, Hackensack, NJ, USA.
D000287:Administration, Topical; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D004542:Ejaculation; D006801:Humans; D007267:Injections; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D011613:Psychotherapy; D012306:Risk; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D013405:Suicide; D014147:Tramadol / Q000627:therapeutic use
D000317:Adrenergic alpha-Antagonists; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D010726:Phosphodiesterase Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors; D014147:Tramadol