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Evidence summaries

Psychosocial Interventions for Premature Ejaculation

There is insufficient evidence regarding the effectiveness of psychological interventions for the treatment of premature ejaculation. Level of evidence: "D"

The level of evidence is downgraded by study limitations, inconsistency and imprecise results

Summary

A Cochrane review [Abstract] 1 included 4 small studies.

In one study behavioral therapy (BT) was significantly better than waiting list for duration of intercourse (MD 407.90 seconds, 95% CI 302.42 to 513.38), and couples' sexual satisfaction (MD -26.10, CI -50.48 to -1.72). BT was also significantly better for a new functional-sexological treatment (FS) (MD 412.00 seconds, 95% CI 305.88 to 518.12), change over time in subjective perception of duration of intercourse (Women: MD 2.88, 95% CI 2.06 to 3.70; Men: MD 2.52, CI 1.65 to 3.39) and couples' sexual satisfaction (MD -25.10, 95% CI -47.95 to -2.25), versus waiting list.

One study showed that the combination of chlorpromazine and BT was superior than chlorpromazine alone for IELT (MD 1.11, 95% CI 0.82 to 1.40), SAS (Self-rating Anxiety Scale) (MD -8.72, 95% CI -11.09 to -6.35) and for some CIPE (Chinese Index Premature Ejaculation) questions ('anxiety in sexual activity', 'partner sexual satisfaction', 'patient sexual satisfaction', 'control ejaculatory reflex' and 'ejaculatory latency').

One study showed that citalopram significantly improved IELT (RR 0.52, 95% CI 0.34 to 0.78) and the number of couples satisfied with their sex life after treatment (RR 0.60, 95% CI 0.39 to 0.93), versus BT.

In the fourth study, 31 patients received 1 of 4 drugs administered on an as-needed basis 35 hours before anticipated coitus (clomipramine, sertraline, paroxetine, sildenafil), or were instructed to use the pause-squeeze technique. The study consisted of five four-week periods of treatment, separated by two-week washout periods. Anxiety score and ejaculation latency time were measured before treatment, after each treatment and during washout periods. Sexual satisfaction scores were measured after each treatment. However the available data from the article were not sufficient to be included, and the related database was not available.

Clinical comments

Note

Date of latest search: 2012-08-10

References

  • Melnik T, Althof S, Atallah AN et al. Psychosocial interventions for premature ejaculation. Cochrane Database Syst Rev 2011;(8):CD008195. [PubMed]

Primary/Secondary Keywords