In spite of its high prevalence and long history, the ambiguity regarding the definition, epidemiology, and management of premature ejaculation continues . Topical anesthetic creams and daily or on-demand selective serotonin reuptake inhibitor (SSRI) treatment forms the basis of pharmacotherapy for premature ejaculation today, in spite of low adherence by patients. Psychotherapy may improve the outcomes when combined with these treatment modalities.
Tramadol and phosphodiesterase type 5 inhibitors have a limited role in the management of premature ejaculation. The American Psychiatric Association defined premature ejaculation and, contrary to previous versions of this manual, it included the parameter of approximately one minute intravaginal ejaculatory latency time (IELT) to determine the status of premature ejaculation. They also listed potential exclusionary conditions, to include…
