Ways to Cure Premature Ejaculation
Ways to cure premature ejaculationAlthough conventional psychotherapeutic sex therapy is effective, it is long-term and slow - and you need a partner who is happy to help. This has led to a tendency to prescribe drugs, which, no doubt, represent a simple and easy approach to therapy in the eyes of many men and their doctors. Unfortunately the facts are that all the drugs which are used for the treatment of premature ejaculation were originally designed for other conditions, and they may therefore be inappropriate for this problem. They certainly do not have regulatory approval for this purpose. The treatments which are available for premature ejaculation in this context are desensitizing agents applied to the skin of the penis, anti-depressive drugs, Viagra and related compounds, and alpha blockers. Desensitizing drugsThe oldest drug therapy for premature ejaculation is a local anesthetic which is applied to the penis - the idea being that premature ejaculation was caused by hypersensitivity of the penis. However, this has never been proven by experimental investigation and there are few benefits to this approach as a treatment. For one thing, the local anesthetic diminishes penile sensation and pleasure, which seem like high prices to pay for a slightly longer intravaginal time span. Furthermore, unless applied to the inside of a condom, they have the unfortunate side-effect of numbing the vagina, a somewhat distracting effect for the partner of the man concerned. There may be skin reactions, and there may be the delay in intercourse prompted by the need to apply the cream to the penis. However, this approach is still available in the form of a delay condom made by several of the large condom companies, and it may work for some men. There are various medications which have been used for this purpose, and they are listed below. 1 Lidocaine-prilocaine creamLidocaine and prilocaine mixed together in equal amounts form a preparation which is known as EMLA. This is widely used to treat premature ejaculation, although accounts of its effectiveness are not widely available. It needs to be applied 20 minutes before insertion of the penis into the vagina; after 45 minutes, penile numbness and loss of erection are common effects. Overall, however, treatment results in a 5.6 fold increase in the length of intercourse (the time between insertion and ejaculation). Most men were very pleased with the treatment, though 16% of men had adverse effects including penile numbness and retarded ejaculation, penile irritation, and one man's partner reporting decreased vaginal sensations. 2 SS creamSS cream, which is made and sold in Korea, is applied to the glans about sixty minutes before intercourse, then washed off. There is an unfortunate smell with the product which makes it less desirable than some other products, due no doubt to the fact that it is made of a cocktail of nine ingredients, including those with local anesthetic and vasodilatatory qualities. It seems to be effective in extending the length of intercourse, although it also produces considerable irritation of the penis (one in five men). 3 Lidocaine-prilocaine sprayThis mixture (known as TEMPE) for control of premature ejaculation is delivered as a metered-dose spray combination of lidocaine and prilocaine. The formulation is designed to maximize tissue penetration and therefore produce a fast reaction in the penis, enabling intercourse to proceed without a condom. Unfortunately the compound does not penetrate keratinized skin, and its effectiveness on circumcised men is therefore somewhat questionable (circumcised men often having a keratinized glans). Treatment consists of three applications squirted onto the glans penis a quarter of an hour before sex: this regime produces a significant increase in time between penetration and ejaculation, and is reported to produce a significant improvement in a man's control over the time when he ejaculates. There are few side-effects, although 12% of men reported numbness of the penis and erectile dysfunction (the latter only being experienced by one man). TEMPE produces an average increase in intra-vaginal time from 1 minute to 4.9 minutes. It is not as effective as EMLA cream but apparently produces fewer side-effects. 4 Dyclonine / Alprostadil A mixture of local anesthetic called dyclonine and the vasodilator alprostadil (used in men with erectile dysfunction to stimulate and maintain erection), is being developed - as yet, no data are available for the success rate of the product. Oral medication - anti-depressive drugs 1 Clomipramine Clomipramine is a tricyclic antidepressant whose
effectiveness in the treatment of premature ejaculation was demonstrated as long
ago as the mid 1970s. As reported elsewhere on this website, Waldinger has shown
that if it is used on a daily basis, clomipramine has the ability to increase
the length of time between penetration and ejaculation by 4.6 times. This
mirrors the results from sertraline or fluoxetine. Clomipramine must be used
between three and six hours before intercourse: clomipramine 25 mg produces a 4
times increase in intra-vaginal ejaculatory latency time. Unfortunately, an
adverse side effect is nausea which lasts for two days - the day the drug is
taken and the day after. There are also certain criteria which apply to the men
who take this drug, and which have been shown to be the conditions which make it
most effective (i.e. they are satisfied with sex as demonstrated by a
self-rating of five on a seven point scale, and they ejaculate twice or more
each week). SSRIs are not approved for the treatment of PE, although
they are commonly prescribed. They delay ejaculation in between 30 and 50% of
men, and at the moment, there are four varieties which find a sue in this way:
fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).
Other SSRI's are not effective at increasing the duration of sexual intercourse;
the producers of dapoxetine - a related compound - have tried (but been denied)
formal approval for the drug to be listed as a treatment of premature
ejaculation. Having said that, this set of drugs is pretty well tolerated by men with premature ejaculation, who seem to have a different side effect profile than men with depression on these drugs. However, one has to ask if these are desirable side-effects: yawning, nausea, perspiration, fatigue and loose bowel movements! Even if, as is claimed, these adverse effects gradually disappear with use, ingesting these antidepressives still seems a dramatic way to treat premature ejaculation! Furthermore, some men using these drugs to gain a longer period of sex will experience much worse symptoms, which include SSRI discontinuation syndrome, diabetes, bleeding, and so on. It seems ironic that all of this can lead to a claim that these drugs are known to be efficient in the treatment of premature ejaculation! But there are still researchers asking whether they should be taken daily or on-demand (i.e. when sex is planned)! Premature ejaculation, based upon the Asian Journal of Andrology, 2008 Jan; 10: 102-109 Drug treatment for premature ejaculation Effect of premature ejaculation on a man and woman's sex life Premature ejaculation - and your relationship What is an ejaculation - the physiology of ejaculation The medical view of premature ejaculation Drugs and premature ejaculation
|