title: An overview of pharmacotherapy in premature ejaculation.
abstract: BACKGROUND
  With increasing interest and clinical research in male sexual disorders, it has become clear that not only psychological but also organic, neurobiological, and genetic factors may play an important role in premature ejaculation (PE).
  
  
  OBJECTIVE
  This article provides an overview of the different treatment options both for lifelong (primary, "congenital") and acquired (secondary) PE.
  
  
  METHODS
  Review of the literature.
  
  
  METHODS
  Currently used treatment options for PE.
  
  
  RESULTS
  Treatments reviewed include psychological/behavioral/sexual counseling therapy, topical anesthetics, dapoxetine, and other selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and phosphodiesterase-5 (PDE-5) inhibitors.
  
  
  CONCLUSIONS
  Before starting any therapy for PE, correct diagnosis has to be made considering the patient's reported intravaginal ejaculatory latency time (IELT) and the duration and type of PE. Concomitant erectile dysfunction (ED) should be either ruled out or proven by appropriate means. In uncomplicated cases of PE with stable partnerships, medical treatment represents the first-choice option with a high likelihood of success. Dapoxetine, where available, or other SSRIs provide suitable therapeutic options with a good risk/benefit profile for patients. In complicated ("difficult-to-treat") PE patients, a combination of medication and sexual counseling should be considered the first treatment option. Combination therapies of PDE-5 inhibitors and PE-related medications should be offered to patients suffering from comorbid PE and ED, with ED treatment starting first. In those patients with severe PE-IELTs of <30-60 seconds or anteportal ejaculation-combination therapy of topical and oral medications can be offered and may considerably increase IELT, compared with either monotherapy.
authors.affiliation: Private Urology and Andrology Practice and Hospital, Hamburg, Germany. porst20354@aol.com
authors.forename: Hartmut
authors.initials: H
authors.lastname: Porst
mesh_terms: D000779:Anesthetics, Local / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001521:Behavior Therapy; D001596:Benzylamines / Q000627:therapeutic use; D003376:Counseling; D004542:Ejaculation / Q000187:drug effects*; D006801:Humans; D008297:Male; D009281:Naphthalenes / Q000627:therapeutic use; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012735:Sexual Dysfunction, Physiological / Q000188:drug therapy* / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000188:drug therapy* / Q000628:therapy
chemical_list: D000779:Anesthetics, Local; D000929:Antidepressive Agents, Tricyclic; D001596:Benzylamines; D009281:Naphthalenes; D058986:Phosphodiesterase 5 Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors; C080598:dapoxetine