Premature Ejaculation Guidelines

Updated: Aug 08, 2017
  • Author: Samuel G Deem, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Guidelines

Current Guidelines for Management of Premature Ejaculation

International Society of Sexual Medicine

The International Society of Sexual Medicine (ISSM) has developed evidence-based guidelines for patients suffering from lifelong premature ejaculation (PE), which include definitions of lifelong and acquired PE; discussions of the epidemiology, etiology, diagnosis, and treatment of PE; and a flow chart for the management of PE. The guidelines were most recently reviewed and revised in 2013. [47]

American Urologic Association

The American Urologic Association (AUA) published guidelines on the pharmacologic management of PE in 2004; the guidelines were reviewed and validated in 2010. [48] Guideline statements were as follows:

  • The diagnosis of PE is based on sexual history. A detailed sexual history should be obtained from all patients with ejaculatory complaints.
  • In patients with concomitant PE and erectile dysfunction (ED), the ED should be treated first.
  • Before initiating any intervention, clinicians should discuss the risks and benefits of all treatment options. Patient and partner satisfaction is the primary target outcome for the treatment of PE.
  • Any of several serotonin reuptake inhibitors or topical anesthetics can provide effective treatment for PE. The optimal treatment choice should be based on both physician judgment and patient preference.

The AUA also noted the following:

  • Although not approved by the US Food & Drug Administration for treatment of PE, oral antidepressants and topical anesthetic agents are effective and have minimal side effects when used for this purpose.
  • Oral antidepressants should be started at the lowest possible dose that is compatible with a reasonable chance of success
  • The choice of additional therapy is based on the patient and partner reports of efficacy, side effects, and acceptance of the therapy as well as on a regular review of alternative approaches
  • Support and education of the patient and, when possible, the partner are an integral part of PE therapy.