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Current Medical Treatment of Premature Ejaculation

Current Medical Treatment of Premature Ejaculation

Over the past 20-30 years, the Premature Ejaculation (PE) treatment paradigm, previously limited to behavioural psychotherapy, has expanded to include drug treatment. Animal and human sexual psychopharmacological studies have demonstrated that serotonin and 5-HT receptors are involved in ejaculation and confirm a role for SSRIs in the treatment of PE. Multiple well-controlled evidence-based studies have demonstrated the efficacy and safety of SSRIs in delaying ejaculation, confirming their role as first-line agents for the medical treatment of lifelong and acquired PE. Daily dosing of SSRIs is associated with superior fold increases in IELT compared to on-demand SSRIs.

On-demand SSRIs are less effective but may fulfill the treatment goals of many patients. Integrated pharmacotherapy and CBT may achieve superior treatment outcomes in some patients. PDE-5 inhibitors alone or in combination with SSRIs should be limited to men with acquired PE secondary to co-morbid ED. Drug combinations of on-demand rapid acting SSRIs and 5-HT1A receptor antagonists and/or oxytocin receptor antagonists, or single agents that target multiple receptors may form the foundation of more effective future on-demand medication.

Areas of Interest / Categories: ASH 2011, Erectile Dysfunction, Premature Ejaculation

ASH 2011

Client feedback and satisfaction with an express STI screening service at an inner city sexual health centre

Sydney Sexual Health Centre (SSHC) commenced an express STI clinic (Xpress) for asymptomatic clients in March 2010, utilising CASI and self-collected samples. Client feedback and satisfaction was assessed over 6 months and comparisons made between priority groups. This was a cross sectional study questionnaire. Results were stratified by gender, MSM status, age (<25/>25) and sex work.

Improvement in antenatal testing for sexually transmissible infections (STIs) and blood-borne viruses (BBVs) in Western Australian hospitals, 2007 to 2010.

Antenatal testing for STIs and BBVs has been recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) since 1992. In 2007, the Department of Health, Western Australia (DoH) issued an Operational Directive (OD) recommending additional testing for chlamydia, repeat testing at 28-36 weeks gestation if at high risk and further testing, including gonorrhoea, for those in the STI-endemic region of WA.

Women who have sex with women, why should we care?

Pelvic inflammatory disease in the era of the Microbiome Project and evolving antimicrobial resistance: implications for clinicians

Download to Diagnosis: Reinforcing the Net - Testing for Chlamydia one year on.

Western Australia’s (WA) Online Chlamydia Program was launched in February 2010 as a case-finding vehicle aimed to address increasing rates of genital Chlamydia trachomatis (CT). The free test can be accessed via two websites (http://www.getthefacts.health.wa.gov.au & http:// www.couldihaveit.com.au). Participants must be 16 years or older, have a mobile telephone, access to a computer with printer and the ability to visit a PathWest specimen collection site. Specimens are tested for both chlamydia and gonorrhoea. All results are faxed to Fremantle’s B2 sexual Health Clinic. Positive results are actioned, negative results are available via a toll-free number.

You've got to respect Today Tonight

In the Plenary session ‘Communicating Healthy Sexuality’ I focused on the ways in which sexuality is represented in entertainment media. In this session I explore how an understanding of entertainment as a form can inform our interactions with media.

The CaddyShack Project: overcoming barriers in access to Chlamydia screening for young people

The concerning high prevalence of Chlamydia within the population of young people aged 16 – 25 in Australia has been well established. Creative strategies are required to overcome barriers to screening for this population, as improved screening rates will promote better understanding and management of this condition. Various initiatives have been designed to increase access to screening for young people, from awareness and education campaigns, to mail out home testing kits. Many initiatives have had limited success in overcoming inherent barriers to testing for this important population.