For instance, the arbitrary time of 1 minute from vaginal penetration to ejaculation was suggested by some while others defined the condition in terms of the number of penile thrusts (at least 15) inside the vagina before ejaculation. A quantitative element was subsequently added to the definition. However, initial definitions of PE revolved around ejaculation which regularly occurs at or around initial vaginal penetration. Some consider it controversial that PE is even considered to be a sexual dysfunction at all, since all male upper mammalian species, including primates ejaculate almost immediately on penetration of the vagina. ![]() Over the years, PE has been defined in various ways. In the near future, the topical aerosol PSD502 is due to be licensed for the treatment of PE, increasing IELT by up to a factor of 6 but having minimal local and negligible systemic side effects. Dapoxetine, which is a on-demand SSRI, is the only licensed drug for the treatment of PE, increasing IELT by a factor of 2.5 to 3 with limited and tolerable side effects. Daily SSRIs such as paroxetine, although efficacious, do have a substantial and prolonged side effect profile. Most of these treatments increase the intravaginal ejaculation latency time (IELT) and patient satisfaction scores, with the most convincing evidence for SSRIs and topical creams. Once the diagnosis of PE is established through a thorough history, a variety of medical therapies is available, including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), centrally acting opiates, phosphodiesterase 5 inhibitors and topical desensitizing creams. ![]() Advances in PE research have been hampered owing to a nonstandardized definition of PE, until the definition by the International Society of Sexual Medicine (ISSM) in 2009. Premature ejaculation (PE) is a common male sexual dysfunction.
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