How to manage premature ejaculation - part 4, medical treatment options
As discussed earlier, premature ejaculation (pe) occurs when a man reaches the peak of sexual excitement and ejaculates before he wants it to happen. When pe interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.
Several factors such as psychological problems (eg. Anxiety), penile hypersensitivity, habituation of quick sex / masturbation, alcohol abuse, hormonal imbalance (e. G. Thyroid problem), and even genetic problems may cause pe.
Medical (allopathic) therapy for pe treatment:
Drugs used for the management of pe reduce sensitivity and anxiety, improve blood flow or even affect some chemical mediators present in the brain. These classes of drugs include local anaesthetics, antidepressants, and phosphodiesterase 5 inhibitors.
Anaesthetic compounds were the first medical treatment proposed for pe management. They were applied topically to the surface of the skin. Lidocaine-prilocaine sprays or creams decrease the sensation of the penis and increase the time taken to ejaculate during vaginal penetration. These sprays / creams are applied 10 to 20 minutes prior to sexual activity. Side effects of topical agents include partial loss of sensation of the penis, absorption in vagina resulting in vaginal numbness and irritation.
Treatment medications include selective serotonin reuptake inhibitors (ssris), which interact with a receptor (5-ht2c) present in brain and increases the production of serotonin. They also help in reducing anxiety and depression associated with pe. Through this mechanism, they prolong the time to reach ejaculation.
Several ssris have increasingly become used as" off-label" for pe. Among the available ssris, paroxetine and dapoxetine are more beneficial with lesser side effects as compared to other ssris. These medications are associated with sexual side effects including decreased fertility and erectile dysfunction. Dapoxetine is a recent ssri which acts quickly and cleared rapidly from the body. Adverse effects with ssris are usually minor and include fatigue, mild nausea, loose stools and sweating. Other side effects may include decreased sexual urge and increased tendency to suicide, especially with long-term paroxetine.
Related Tip: Knowing Premature Ejaculation - PART 3: Management and Techniques (Non-medical methods)