New Drug Offers Hope for Premature Ejaculation

Before Bob Dole went on television to talk about ED and Viagra, men’s sexual problems were rarely discussed in public. Impotence was a source of shame.
Now that ads for Viagra, Cialis and Levitra are commonplace, people no longer seem reluctant to discuss erectile dysfunction. But there is another aspect of men’s sexual health that remains taboo.
Premature ejaculation is still forbidden territory. Few men can bring themselves to talk about this issue with their partners, much less their doctors. But PE, as it is abbreviated, is extremely common and can have devastating consequences for a relationship. Experts estimate that nearly one man in three suffers from this condition (International Journal of Impotence Research, Sept./Oct. 2006).
Defining PE precisely has been a challenge. Investigators haven’t had an objective measure for diagnosis. A large study found that most men lasted a little more than seven minutes, on average. Those with PE lasted less than two minutes.
Many men suffering with severe PE last less than one minute. They often feel that they have little or no control over their ejaculation and they believe that PE has a negative effect on their relationship. Because they cannot satisfy their partners in such a short time, many men feel inadequate. Their self-confidence may suffer, but they often don’t know what to do to solve the problem.
Until recently, doctors had little to offer. Sex therapists recommended behavioral strategies to delay orgasm, but not all men were able to master the techniques. Anesthetic creams that reduce sensation have been marketed for the problem, but the FDA has not approved such products for this use.
In fact, there is no FDA sanctioned treatment for PE. Nevertheless, physicians are prescribing antidepressant medications off-label for premature ejaculation. Drugs such as Prozac, Paxil and Zoloft frequently delay ejaculation as a side effect.
The problem is that these powerful medications have other side effects as well. In addition, men who are not depressed may be reluctant to take an antidepressant daily just to prolong intercourse.
A new drug called dapoxetine may some day offer men an alternative approach to treating PE. This medication is in the same family as other SSRI (selective serotonin reuptake inhibitor) antidepressants, but it is not as powerful or long lasting. Dapoxetine has been developed specifically to be used “on-demand��? rather than on a daily basis.
A new study in the journal The Lancet (Sept. 9-15, 2006) reports that men taking dapoxetine one to three hours before sexual activity were able to extend intercourse from less than one minute prior to treatment to nearly three minutes after using the drug. That may not seem like much improvement, but many men reported better control over ejaculation and greater sexual satisfaction. Partners seemed to benefit as well.
No one knows whether the FDA will approve dapoxetine for PE. The agency rejected an initial application last year. The drug can cause nausea, diarrhea, headache and dizziness.
Perhaps now with the hope of an effective treatment, PE will come out of the closet and more men will seek help for this common condition.