title: Understanding the Pathophysiology of Premature Ejaculation: Bridging the Link between Pharmacological and Psychological Interventions.
abstract: Premature ejaculation (PE) is one of the commonest male sexual dysfunctions. It is characterized by ejaculation which occurs before or soon after vaginal penetration, which causes significant psychological distress to the individual, and his partner. The exact cause of PE is still unknown but several mechanisms are proposed, and these involve complex interactions of neurophysiological, psychosocial, and cognitive factors. We discuss the role of serotonin, nitric oxide, phosphodiesterase enzymes and other neurotransmitters. Treatment of PE tends to co-occur with other sexual difficulties, especially erectile dysfunction (ED). Treatment with selective serotonin reuptake inhibitors (SSRIs) and Dapoxitene are also discussed in detail. The treatment strategy requires a comprehensive holistic approach incorporating both combination of psychopharmacological agent and cognitive-behavioral therapy (CBT). The present review highlights the integration of the hypothalamic-neural and reverberating emotional circuit and discusses the etiology and treatment for patients with PE.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia.
authors.forename: Farid
authors.initials: F
authors.lastname: Yusof
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia.
authors.forename: Hatta
authors.initials: H
authors.lastname: Sidi
authors.affiliation: Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia.
authors.forename: Srijit
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia.
authors.forename: Marhani
authors.initials: M
authors.lastname: Midin
authors.affiliation: Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia.
authors.forename: Jaya
authors.initials: J
authors.lastname: Kumar
authors.affiliation: Zwirki I Wiguri 62, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Muhammd Hizri
authors.initials: MH
authors.lastname: Hatta
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D004542:Ejaculation / Q000187:drug effects*; D006801:Humans; D008297:Male; D018377:Neurotransmitter Agents / Q000378:metabolism; D061686:Premature Ejaculation / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011619:Psychotropic Drugs / Q000008:administration & dosage* / Q000494:pharmacology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D018377:Neurotransmitter Agents; D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Cognitive behaviour therapy; SSRIs; dopexetine; erectile dysfunction; pathophysiology; premature ejaculation.