Introduction into the diagnostics and treatment of premature ejaculation

Abstract

Introduction: Premature ejaculation (PE) is a subjective experience characterized by a short intravaginal ejaculatory latency time and decreased ejaculatory control. The prevalence of premature ejaculation is approximately 25%. The etiology is unknown and there is no causal treatment. The significant role of serotonin during ejaculation is currently being widely discussed. Besides behavioural treatments, specific serotonin reuptake inhibitors (SSRIs) as well as phosphodiesterase 5 inhibitors are being used with success. Methods: Selective literature review using PubMed with the keywords premature ejaculation, prevalence, etiology, diagnostics, therapy. Results: A thorough sexual history is mandatory in order to evaluate the potential causes of PE. Although the exact etiology of PE is not fully understood it is becoming increasingly clear that this condition has a neurophysiological, pychogenic, and psychological element, with probable serotonin involvement. Effective treatment requires a thorough understanding of the underlying pathophysiology. Besides psychotherapy there are effective treatments, which can significantly improve the patient's sexual quality of life.