Relationship between plasma melatonin levels and the efficacy of selective serotonin reuptake inhibitors treatment on premature ejaculation.
OBJECTIVE
To examine the relationship between premature ejaculation and plasma melatonin levels, and assess the efficacy of selective serotonin reuptake inhibitors in treating premature ejaculation.


METHODS
A total of 60 men with lifelong premature ejaculation and 40 healthy male controls were included in the present study. For each participant, a medical history was obtained, a physical examination was carried out, and intravaginal ejaculation latency time and melatonin levels were measured. Premature ejaculation patients were randomly categorized into three treatment groups: group 1 received fluoxetine (20 mg/day), group 2 received paroxetine (20 mg/day) and group 3 received sertraline (50 mg/day).


RESULTS
The mean baseline plasma melatonin levels in men with premature ejaculation were significantly lower than in the healthy controls (5.34 vs 14.84 pg/mL). After 4 weeks of treatment, the mean intravaginal ejaculation latency time scores for all of the premature ejaculation treatment groups showed a significant improvement from the baseline values. The plasma melatonin levels were also significantly increased (P < 0.05) from baseline (5.34 pg/mL) to 9.50 pg/mL, 10.24 pg/mL or 13.30 pg/mL for groups 1, 2 and 3, respectively.


CONCLUSIONS
Our findings show that premature ejaculation is associated with decreased plasma melatonin levels. After treatment with selective serotonin reuptake inhibitors, an increased plasma melatonin level can retard ejaculation, presumably by both central and peripheral mechanisms. This is the first study to evaluate the possible role of serotoninergic interactions on the melatoninergic system in premature ejaculation.
Department of Urology, Sisli Etfal Research and Training Hospital, Istanbul, Turkey.
Sinan Levent
SL
Kirecci
Abdulmuttalip
A
Simsek
Zafer Gokhan
ZG
Gurbuz
Saban
S
Mimaroglu
Alpaslan
A
Yuksel
Pervin
P
Vural
Suzan
S
Degirmencioglu
D000328:Adult; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008550:Melatonin / Q000097:blood*; D008875:Middle Aged; D017374:Paroxetine / Q000627:therapeutic use*; D061686:Premature Ejaculation / Q000097:blood* / Q000188:drug therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D005473:Fluoxetine; D008550:Melatonin; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline
fluoxetine; melatonin; paroxetine; premature ejaculation; selective serotonin reuptake inhibitors; sertraline