Given the fact that there are completely safe ways for men to learn to control premature ejaculation , techniques that come with no negative side effects, it may seem surprising that men would be interested at all in finding drugs to prevent rapid or premature ejaculation. But learning to control ejaculation requires sexual communication, and a little bit of homework, and there are always those who want the quickest and easiest fix to a problem. Men who live with premature ejaculation aren't the only ones interested in finding a little pill either. Pharmaceutical companies looking everywhere for the next big sex drug have certainly noted the fact that far more men complain of premature ejaculation than complain of erectile dysfunction.
The pharmaceutical industry's interest in developing drugs for premature ejaculation is understandable. Some studies put the prevalence of premature ejaculation between 27 percent and 34 percent of men across all age ranges. This is more than double the incidence of erectile dysfunction, for which Viagra was developed. If a pharmaceutical treatment for premature ejaculation can be developed and approved, it could become a financial bonanza that would far outstrip the billion dollar Viagra industry.
What Drug Treatments Are Available for Premature Ejaculation?
There is currently no prescription drug that has been approved by the FDA for the treatment of premature ejaculation.
ALZA Corporation, which is owned by Johnson & Johnson, has been developing a drug called dapoxetine specifically as a treatment for premature ejaculation. Dapoxetine is a milder SSRI, a family of drugs that have been used to treat depression for many years. They have taken the drug through clinical trials and in 2005 they submitted it to the FDA for approval. In October 2005 the FDA issued a non-approval letter. The manufacturer says they will continue to work toward developing a drug that will meet FDA approval.
In August of 2006 a journal article in The Lancet reported on another two trials with the same drug of 2,600 men who have premature ejaculation. This study found that ejaculation was delayed after 12 weeks of taking the drug, and there was a three- to four-fold increase in the time to ejaculation. Mind you in actual time, this increase went from less than one minute to just under three and a half minutes (at the highest dosage). One has to wonder how they are measuring “success” in these trials, and exactly how much time bought is worth the side effects (which were reported as including nausea, diarrhea, headache and dizziness). However in an editorial which accompanied the article one physician argued that the research shows the drug to be both safe and tolerable.
A number of studies have found that selective serotonin reuptake inhibitors (SSRIs) which are commonly used to treat depression, have the side effect of delaying ejaculation. It seems as if off label prescribing of SSRIs for premature ejaculation may be a common occurrence. This should be a cause for concern, given that SSRIs come with a variety of side effects, including other forms of sexual dysfunction. Studies have looked at paroxetine, fluoxetine, and sertraline, among others.
Another group of drug products that are used to treat premature ejaculation are the desensitizing creams and sprays that contain local anesthetics (most often benzocaine). Available in both drugstores and retail sex stores, these products simply numb the skin, which ensures a man will maintain an erection longer by eliminating most of his sexual pleasure. In clinical studies these desensitizing creams have been found effective in delaying ejaculation.
But choosing to forgo sexual sensitivity and pleasure in the name of “lasting longer” is a sad choice for men to have to make. These products come with other drawbacks, usually related to problems in use. If applied too early, the decreased sensation may make it difficult for a man to get an erection. If applied too late, and not allowed to absorb in the skin, the product can rub off on a sexual partner and desensitize their genital area as well.
The Lancet 2006; 368:929-937. “Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomised controlled trials.”
Off-label SSRI use for premature ejaculation gains momentum. Richard White, National Review of Medicine, November 15, 2004.
Topical anesthetic use for treating premature ejaculation. W. Busato & C.C. Galindo, British Journal of Urology, Vol. 93, May 2004.