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Update on the Management of Premature Ejaculation

Update on the Management of Premature Ejaculation

Normative community based stopwatch studies demonstrate that the distribution of the IELT is positively skewed, with a median IELT of 5.4 minutes (range, 0.55–44.1 minutes), decreases with age and varies between countries, and supports the notion that IELTs of less than 1 minute are statistically abnormal compared to men in the general western population. The off-label use of anti-depressant SSRIs including paroxetine, sertraline, fluoxetine, citalopram and fluvoxamine, and the serotonergic tricyclic clomipramine has revolutionized the approach to and treatment of PE.

Dapoxetine (Priligy®, Menarini) is the first compound specifically developed for the treatment of PE. It is a potent selective serotonin re-uptake inhibitor, which is administered on-demand 1-3 hours prior to planned sexual contact. Dapoxetine is rapidly absorbed and eliminated, resulting in minimal accumulation and has dose-proportional pharmacokinetics, which are unaffected by multiple dosing. Dapoxetine 30mg and 60mg has been evaluated in 7 industry sponsored randomized, double-blind, placebo-controlled studies in over 7000 men aged 18 years. Outcome measures included stopwatch-measured intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) inventory items, clinical global impression of change (CGIC) in PE, and adverse events. Mean IELT, all PEP items and CGIC improved significantly with both doses of dapoxetine versus placebo (P <0.001 for all).

The most common treatment related adverse effects included nausea (11.0% for 30mg, 22.2% for 60mg), dizziness (5.9% for 30mg, 10.9% for 60mg), and headache (5.6% for 30mg, 8.8% for 60mg), and evaluation of validated rated scales demonstrated no SSRI class-related effects with dapoxetine use. Dapoxetine, as the first drug developed for PE, is an effective and safe treatment for PE and represents a major advance in sexual medicine.

Areas of Interest / Categories: Society of Australian Sexology 2014

Society of Australian Sexology 2014

The Complexity of Male Sexual Desire?

Much debate and controversy has ensued regarding the contentious and subjective definition, diagnosis, measurement and treatment of desire problems for both men and women as various editions of the Diagnostic Statistical Manual (DSM) have been published (DSM V edition). Despite the recent changes for women, the fact that the criteria for men remains the same, reflects a huge paucity in understanding how male sexual desire varies; how ‘lower’ desire manifests, how it is diagnosed and subsequently managed (Bitzer, Giraldi, Pfauss 2013). 

The use of an interdisciplinary approach to ejaculatory disorders

Offering clients an interdisciplinary and approach in dealing with sexual dysfunctions has been shown to positively impact on client and relational outcomes. Viewing a sexual concern from one lens or perspective i.e. medical or psychological can fail to achieve the best outcome for clients. Ejaculatory disorders are the most common presenting problems for men. 

Menopause: a discussion

Female Genital Cosmetic Surgery: A new phenomenon and dilemma for health professionals

This is the first community based empirical study to explore Australian women's genital image perceptions and their views towards female genital cosmetic surgery (FGCS). There has been a significant increase in the requests for female genital cosmetic surgery over the last 20 years. Labiaplasty is the most requested type of FGCS requested and has caused concerns amongst health professionals.

Prevalence of Women's Sexual Desire Problems: What Criteria Do We Use?

Problems of sexual desire are often cited as the most prevalent of the female sexual dysfunctions. Despite this finding, considerable variability exists when comparing prevalence figures across studies, highlighting the inconsistency in how these problems are defined and therefore measured. The current study was designed to determine how the prevalence estimates of women's sexual desire problems vary according to the diagnostic criteria adopted to define such problems.

'It's just for you, leave me alone'. Changes in sexuality meaning and experienced by Malay women living with sexual dysfunction.

Female sexual dysfunction is a public health concern. It can have an overwhelming effect on a women’s physical and psychological health as well as their relationship with their husband. Many researchers had examined the meaning of sexuality among woman, however there is a paucity of evidence regarding the potential impact of sexual dysfunction on women’s sexual experiences and their meanings of sexuality. This study aims to gain an in-depth understanding of sexuality meanings and its changes among Malay women with sexual dysfunction.

How important are self-perceptions of genital appearance for sexual wellbeing?

Genital image concerns are a prevalent issue in many Western societies. However, little is actually known about the importance of genital self-perceptions for an individual's sexual wellbeing. An online study was conducted to examine the relationships between genital image and various aspects of sexual wellbeing, as well as whether these relationships are mediated by genital self-consciousness during sexual activity. The analyses were compared across gender and sexual orientation.