Erectile Drugs Might Help Premature Ejaculation
By Kerry Grens
NEW YORK (Reuters Health) Feb 13 – Most studies looking at whether erectile dysfunction drugs can help men overcome premature ejaculation problems agree that the pills make a difference, but much of the research is flawed, according to a new review of the evidence.
Of the 14 studies included in the review, 11 found that phosphodiesterase type 5 (PDE5) inhibitors helped extend the length of time men could have intercourse before orgasm, but Dr. Anastasios Asimakopoulos, lead author of the report, urged caution in interpreting the findings.
There is still inadequate evidence to propose the use of PDE5 inhibitors in treating premature ejaculation, he told Reuters Health by email.
There’s been an interest in also using the drugs to address the problem of premature ejaculation, because one of their side effects is a delay in ejaculation, the authors wrote online January 16th in the Journal of Sexual Medicine.
Dr. Asimakopoulos, from the University of Tor Vergata in Rome, Italy, said that anywhere from 4% to 39% of men suffer from premature ejaculation.
His group collected data from 14 studies that analyzed the time during intercourse before orgasm, technically referred to as the “intravaginal ejaculatory latency time.”
Nine of the studies used a PDE5 inhibitor by itself, while four combined the drug with an antidepressant medication, and one combined the drug with behavioral therapy.
Most of the studies asked men to use a stopwatch before and after treatment, to measure if they were able to extend the time having sex. Some also asked the men to rate changes in their anxiety and sexual satisfaction.
Dr. Asimakopoulos and his colleagues ran into problems trying to compare the studies. For example, researchers didn’t always agree on the definition of premature ejaculation.
He said that future studies should use the definition provided by the International Society for Sexual Medicine, which says the disorder involves an inability to last longer than one minute before ejaculating, and includes problems such as frustration or avoiding sexual intimacy.
The other stumbling block to the group’s analysis was that fewer than half of the studies compared the drugs to a placebo.
Among four studies, including about 300 men, that did compare PDE5 inhibitors to a placebo, Dr. Asimakopoulos found a positive effect.
After taking a placebo, men had intercourse lasting from about a minute to a little more than a minute and a half. Among the men who used a medication, intercourse lasted from more than two and a half minutes to about six.
Similarly, the PDE5 inhibitors, when combined with an antidepressant, worked better than an antidepressant alone.
Dr. Asimakopoulos said the results show that these drugs have “a high impact…on prolonging ejaculatory times.”
“There seems to be a global positive effect of these drugs in delaying ejaculation; however, the existing evidence is still partial and their role remains controversial,” he said.
The drugs are worth further investigation for the treatment of premature ejaculation because antidepressants and topical anesthetics are the only alternatives demonstrated to be effective so far, the team notes in their report.
J Sex Med 2012.