Differences and Commonalitiesby PEhomepage.com Editorial Team
Studies of men reporting problems with premature ejaculation (PE) indicate that anywhere from 5 – 40% of men report it. One of the most common difficulties in diagnosing it correctly is the lack of a single definition on which physicians and therapists who work with these patients can agree on. Most professionals rely heavily on self-report and expressed patient dissatisfaction with their sexual performance.
By contrast, erectile dysfunction (ED) is well-defined and occurs in approximately 10-15% of men. It varies with age, and usually men age 40 and older report it most often. There are both pathological and organic causes for ED, and usually a physician can pinpoint the cause. ED can be effectively treated. Dr. Gregoire admits, however, that much testing needs to be performed in order to determine the effectiveness of some treatment options.
Men with ED sometimes present with PE as the primary complaint, and upon investigation, the physician finds that ED is actually the root cause. For example, some men may be accustomed to rushing to ejaculation before they lose an erection. Sharlip states that in these cases, treating the ED often resolves PE.
The causes of PE are less defined. Even with a comprehensive medical history, physicians are dependent upon the patient to identify PE as a cause for dissatisfaction in their sexual health. Not all men with low intravaginal ejaculatory latency time (IELT) – the time between entering the vagina until ejaculation occurs – report of having PE is. Clearly, there is more research that needs to be performed in order to understand the underlying causes and appropriate treatment methodology.
Treating ED with Sildenafil (ViagraTM) has provided relief for many men. In fact, the success of the medication is one of its largest limitations; there is evidence that misuse of the drug is a real issue for the ED community which could cause limitations on prescribing it to patients.
By contrast, a number of medications have been tested for PE but none of these treatments is currently approved for use in patients with PE. Selective serotonin reuptake inhibitors (SSRIs) can treat PE to some extent, yet some men do not want to take them over a long period of time to treat a condition that is episodic in nature. In addition, SSRIs do not work for all men, and can even cause uncomfortable side effects. They must also be taken several weeks in order to work. There are behavioral and therapeutic approaches that can be used to treat PE, although more research is needed in order to determine if they are effective. High relapse rates after the patient discontinues treatment have been reported, although Dr. Sharlip still feels that some type of behavioral intervention could accompany pharmacological treatment.
Both disorders are still areas ripe for research. While some could argue that ED is better understood and more effectively treated, advances in PE identification and treatment are on the horizon. Men are beginning to understand that PE is a medical condition that can be discussed with their physician. The medical community working with these men on a daily basis need to become more familiar with ways to communicate with them in order to determine if PE is an issue for them and their sexual partners. As advances in the research field make identification possible, better understanding about PE treatment options will be forthcoming with, possibly providing it the same level of recognition that ED has in the medical community today.
Source:
Gregoire, Alain, “ABC of Sexual Health: Assessing and Managing Male Sexual Problems,”
BMJ, 1999, (318), p. 315-317.
Sharlip, Ira, MD, “Diagnosis and Treatment of Premature Ejaculation: The Physician’s Perspective,”
Journal of Sexual Medicine, 2005, Supplement 2, p. 103-109.
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