Future treatments of premature ejaculation

Abstract

The central serotonergic system remains the most important system that can be manipulated to delay ejaculation. Based on animal research, combination of an SSRI with a 5-HT 1A antagonist may lead to an acute strong ejaculation delay. This may form the basis for the development of new powerful on-demand drugs to treat lifelong PE. Currently available drugs can only delay ejaculation but cannot cure PE in case of lifelong PE. It may well be that we still do not know all the characteristic clinical features of lifelong PE, and therefore miss an important link to other central pathways or neurotransmitter systems that are involved in lifelong PE. More research of the phenotype lifelong PE is therefore warranted. Relevant to this research is that future research should not only focus on finding more detailed features of lifelong PE but should also focus on finding clinical differences among the four PE subtypes. By applying this strategy, research can focus on more homogenous subgroups of PE. This may increase the odds to find new therapeutic targets, that are essential for psychopharmacological research. However, research on finding new therapeutic targets is not only limited to pharmacological strategies that delay ejaculation. Also nonpharmacological strategies that effectively delay ejaculation should be investigated to find the neurobiological mechanisms by which they intervene with the ejaculation process.