Premature ejaculation (PE) is a most common sexual dysfunction, for which dapoxetine, a novel selective serotonin (5-HT) re-uptake inhibitor (SSRI), is the only licensed oral medicine at present. With the advantages of fast absorption, rapid action, on-demand medication, and short half-life time, dapoxetine has been proved by clinical trials to be effective in prolonging the intravaginal ejaculation latency time (IELT) and improving the overall condition of PE patients in various areas and populations. Compared with the traditional SSRIs, dapoxetine has a better safety and tolerability. The most frequently reported dapoxetine-related adverse events include nausea, diarrhea, headache and dizziness, but with very few severe or serious cases.
Benzylamines ; therapeutic use ; Biomedical Research ; Ejaculation ; drug effects ; Humans ; Male ; Naphthalenes ; therapeutic use ; Premature Ejaculation ; drug therapy ; Reaction Time ; drug effects ; Serotonin Uptake Inhibitors ; therapeutic use ; Treatment Outcome

Premature ejaculation (PE) is a common male sexual disorder with an incidence rate of 20-30%. Recent clinical trials have demonstrated that phosphodiesterase type 5 inhibitors (PDE5i), as the first-line drug for erectile dysfunction (ED), can improve ejaculatory function probably by acting on the peripheral and central adrenergic nerves. The possible action mechanisms of PDE5i may involve lessening of the central sympathetic output, modulation of the contractile responses from the vas deferens, seminal vesicles, prostate and urethra, induction of peripheral analgesia, and prolonging of the total erectile duration, increasing the confidence of ejaculation control, and reducing the post-ejaculation refractory time. This review discusses the possible mechanisms and clinical application of PDE5i in the treatment of PE.
Ejaculation ; drug effects ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Muscle Contraction ; Phosphodiesterase 5 Inhibitors ; therapeutic use ; Premature Ejaculation ; drug therapy ; Seminal Vesicles ; physiology ; Vas Deferens ; physiology

OBJECTIVETo observe the clinical effectiveness of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation (PE).

METHODSA total of 120 patients with secondary non-consolidated kidney qi PE were randomly assigned to groups A (aged [35.5 ± 5.4] yr), B (aged [36.2 ± 5.7] yr), and C (aged [35.2 ± 5.3] yr) in the ratio of 1:1:1 to receive Qilin Pills (once 6 g, bid), sertraline (once 50 mg, qd), and Qilin Pills plus sertraline, respectively, all for 4 weeks. The intravaginal ejaculatory latency time (IELT) and PE diagnostic tool (PEDT) scores were obtained before and after medication and at 1 month after drug withdrawal, and comparative analyses were made among the three groups of patients.

RESULTSThe IELT was dramatically prolonged in groups A, B, and C after treatment ([3.23 ± 1.84], [3.87 ± 2.43], and [5.92 ± 3.11] min) and at 1 month after drug withdrawal ([1.85 ± 1.27], [1.52 ± 1.06], and [ 4.26 ± 1.88 ] min) as compared with the baseline ([0.88 ± 0.45], [0.84 ± 0.47], and [0.85 ± 0.50] min) (P < 0.01), even longer in group C than in A and B (P < 0.01). The PEDT scores of the three groups were 5.1 ± 1.8, 4.9 ± 1.7, and 3.8 ± 1.2 after treatment and 8.2 ± 2.4, 8.1 ± 2.4, and 6.5 ± 2.1 at 1 month after drug withdrawal, significantly improved in comparison with 13.2 ± 3.2, 12.8 ± 3.1, and 13.1 ± 3.4 before treatment (P < 0.01), even more significantly in group C than in A and B (P < 0.01).

CONCLUSIONQilin Pills combined with sertraline has a definite efficacy in the treatment of secondary non-consolidated kidney qi PE and therefore deserves wide clinical application.

Adult ; Drug Therapy, Combination ; methods ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; drug effects ; physiology ; Humans ; Male ; Premature Ejaculation ; drug therapy ; Qi ; Sertraline ; therapeutic use

SS-cream (Severance Secret cream) is made up of extracts from 9 natural products for treating premature ejaculation (PE). SS-cream has been proved to be effective in the treatment of PE in pilot clinical studies. It has also been found to have a potentiating effect of their erectile capacity in some patients. Therefore, we investigated the pharmacological actions of SS-cream and the extracts of its individual components in rabbit corpus cavernosal smooth muscle to realize the effect of SS-cream on penile erection. Extracts of Bufonis Venenum induced a dose-related contraction of rabbit corpus cavernosal muscle, which was significantly inhibited by phentolamine. Extracts of Caryophylli Flos induced a dose-related relaxation in the muscle strips precontracted with phenylephrine (5 x 10(-6)M; PHE). Caryophylli Flos caused a dose-dependent inhibition of the PHE induced contraction and also inhibited the contractility of Bufonis Venenum. Other extracts, when used individually or in a mixture, induced a dose-related relaxation in the precontracted muscle strips with PHE. SS-cream began to exert a relaxing effect at the concentration of 0.05 mg/ml in the muscle strips precontracted muscle strips with PHE (5 x 10(-6)M); causing dose-dependent relaxation with a maximal effect at 0.2 mg/ml. The relaxation effect of SS-cream was partially inhibited by endothelial disruption and by pretreatment with methylene blue, pyrogallol, atropine, and indomethacin, although they were not statistically significant. The results show that SS-cream has a relaxing effect on cavernosal smooth muscle. And it is partly related with enhancing the NO/cyclic GMP pathway although the relaxation mechanism in detail remains to be elucidated. Therefore, SS-cream may be effective for future treatment of mild erectile dysfunction, in addition to its role for premature ejaculation.
Animal ; Ejaculation/drug effects ; In Vitro ; Male ; Muscle Contraction/drug effects ; Muscle, Smooth/drug effects ; Penile Erection/drug effects ; Penis/*drug effects/physiology ; Plant Extracts/*pharmacology ; Rabbits

SS-cream is a topical agent for treating premature ejaculation (PE) which is made with extracts from 9 natural products. We evaluated the efficacy of SS-cream in the treatment of PE. An open pilot study was performed in 186 patients with PE. The mean ejaculatory latency from intromission to ejaculation was 1.5 minutes. Sixty-four of the 186 patients (34.4%) were combined with mild erectile dysfunction in whom penile rigidity was not sufficient to be satisfied in sexual activity. Patients were instructed to apply 0.1 gm. of SS-cream on the glans penis 1 hour before sexual contact and to wash out the cream before sexual intromission. Patients were asked to complete a report form including ejaculatory latency, the degree of satisfaction in the sexual lives of both themselves and their partners, and any adverse effects after each application. One hundred and sixty-six out of 186 patients (89.2%) reported they were satisfied with the application of the SS-cream and the mean ejaculatory latency was significantly prolonged to 10.89 +/- 5.60 minutes. The mean ejaculatory latency was 9.85 +/- 3.58 minutes in 52 out of 64 patients (81.2%) with mild erectile dysfunction. There was no significant difference in the changes of ejaculatory latencies between patients with pure PE and patients with mild erectile dysfunction. Twenty patients (10.8%) claimed to have no changes of ejaculatory latencies after the application of SS-cream. Adverse effects were noted in 11 patients (5.9%), which were mild local irritation symptoms in 7 patients, and delayed ejaculation of more than 30 minutes in 4 patients, the symptoms subsided spontaneously within 4 hours. These results indicate SS-cream is effective in the treatment of PE and also PE combined with mild erectile dysfunction with a few side effects. Further studies on the action mechanisms of SS-cream and a double blind placebo-controlled trial are needed.
Administration, Topical ; Adult ; Drugs, Chinese Herbal/administration & dosage* ; Ejaculation/drug effects* ; Human ; Male ; Middle Age ; Penile Erection/drug effects

OBJECTIVETo compare therapeutic effects of acupuncture and medication on primary simple premature ejaculation.

METHODSOne hundred and eleven cases were randomly divided into an acupuncture group (n = 56) and a medication group (n = 55). The acupuncture group was treated by acupuncture with acupoint group I Xinshu (BL 15), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23) and acupoint group II Guanyuan (CV 4), Zhongji (CV 3), Sanyinjiao (SP 6), Taixi (KI 3), Taichong (LR 3) alternately selected, one acupoint group daily. The medication group was treated with oral administration of Sailete tablets, 20 mg each tablet, one tablet each night. After they were treated for one course, their therapeutic effects were compared.

RESULTSThe total effective rate was 82.1% in the acupuncture group and 63.6% in the medication group; the cumulative score after treatment was 12.56 +/- 3.84 in the acupuncture group and 11.50 +/- 3.77 in the medication group, with a significant difference between the two groups in the therapeutic effect (P < 0.05).

CONCLUSIONAcupuncture has a better therapeutic effect on primary simple premature ejaculation.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Ejaculation ; Humans ; Male ; Middle Aged ; Sexual Behavior ; drug effects ; Sexual Dysfunctions, Psychological ; drug therapy ; therapy

OBJECTIVESTo evaluate the effects of antidepressant Seroxat on premature ejaculation.

METHODSAfter having taken Seroxat 20 mg every noon for four weeks, the patients were asked to fill the investigating questionaire about the effects and side effects before and after the treatment.

RESULTSAfter the treatment, 43 cases in our study had increased their ejaculation latency time, enhanced the quality of their sexy lives and their wives', and had significant difference compared with pre-treatment(P < 0.001). They had good effects on improving premature ejaculation after taking Seroxat (11.26 +/- 5.79) days; and after having stopped taking seroxat for (20.94 +/- 8.04) days, the situation of premature ejaculation in 32 cases were as same as that of before. There were seven cases whose sexuality and oomph increased, and two cases whose sexuality were decreased. A few patients had constipation, dry in mouth, insomnia and itch in skin, after taking the drugs.

CONCLUSIONSAntidepressant Seroxat has rather good effects on premature ejaculation and should be used and studied further.

Adult ; Antidepressive Agents ; adverse effects ; therapeutic use ; Ejaculation ; drug effects ; Humans ; Male ; Middle Aged ; Paroxetine ; adverse effects ; therapeutic use ; Sexual Dysfunction, Physiological ; drug therapy ; Time Factors ; Treatment Outcome

The cause of premature ejaculation (PE) has been thought to be psychological in the majority of patients but we investigated penile hypersensitivity for an organic basis of PE. For another organic basis of PE, we have suggested hyperexcitability of the ejaculation center. SS-cream is a topical agent containing 9 oriental herbs for treating PE. Clinically SS-cream has been effective in the treatment of PE. Therefore, in order to implicate the organic basis of PE and realize the effect of SS-cream on PE, we investigated the somatosensory evoked potential (SEP) in patients with PE(16 cases) and the effects of SS-cream on SEP for treating PE. The latencies and amplitudes of the evoked responses were measured by two different places in stimuli, one was on the penile shaft with ring electrode and the other on the glans penis with a surface electrode. The latency of SEP stimulated at the glans penis was significantly longer than that stimulated at the penile shaft (p< 0.05). The latency stimulated at the glans penis after applying SS-cream was significantly longer than before applying SS-cream (p< 0.05), which was near the level of a normal potent man. But the latency stimulated at the penile shaft has no significant difference between before and after the application of SS-cream (P > 0.05). The amplitudes of the evoked responses stimulated at the glans penis were significantly higher than those stimulated at penile shaft (p< 0.05). And both these amplitudes were significantly reduced with the application of SS-cream (p< 0.05). With these result, we can suggest that the patients with PE have glans penile hyperexcitability and it provides further implications for an organic basis of PE, SEP stimulated at the glans penis can be a very useful method to evaluate PE, along with SEP stimulated a penile shaft and SS-cream prolongs the sensory conduction and reduces the penile hyperexcitability of the patient with PE.
Adult ; Drugs, Chinese Herbal/*therapeutic use ; Ejaculation/*drug effects ; Evoked Potentials, Somatosensory/*drug effects ; Human ; Male ; Middle Age ; Sexual Dysfunctions, Psychological/*drug therapy/physiopathology

OBJECTIVETo objectively evaluate the efficacy and safety of Yimusake Tablet in the treatment of premature ejaculation (PE) through a multi-centered large-sample trial.

METHODSWe conducted a multi-centered, open, fixed-dose, and self-compared clinical trial among 300 patients with diagnosed PE. The trial lasted 12 weeks, including 4 weeks without any medication and 8 weeks of treatment with Yimusake Tablet, 2 pills (1 g) per night. We observed the intravaginal ejaculation latency time (IELT) before and after treatment, evaluated the safety of medication, and performed a questionnaire investigation on the patients' satisfaction.

RESULTSOf the 300 PE patients, 288 accomplished the clinical trial. The patients ranged in age from 22 to 60 years, averaging at 31.6 years. The mean IELT of the patient was 62.5 seconds at baseline, 168.9 seconds after 4 weeks of treatment with Yimusake Tablet, and 222.2 seconds after 8 weeks of medication. Among the 157 patients with normal erectile function (IIEF >21), the mean IELT was 71.4 seconds before treatment, 147.4 seconds after 4 weeks of medication, and 172.5 seconds after 8 weeks of medication. The patients' satisfaction was significantly increased after treatment. Those complicated by mild to moderate erectile dysfunction achieved different degrees of improvement in the IIEF-5 score, with a mean increase of 3.8. Only a few patients experienced mild adverse events, including constipation, dry mouth, nose bleeding, abdominal pain, and lumbosacral pain, which were all relieved without drug withdrawal.

CONCLUSIONYimusake Tablet is a safe and effective medicine for the treatment of PE.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; drug effects ; physiology ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Penile Erection ; Phytotherapy ; Premature Ejaculation ; drug therapy ; Surveys and Questionnaires ; Tablets ; Time Factors

AIMTo study the influence of enterococci on human sperm membrane in vitro.

METHODSEjaculated human sperm were artificially infected with beta-hemolytic or non-beta-hemolytic enterococci at the bacteria: sperm ratio of 50:1 at 37 degrees . Sperm membrane integrity was examined after incubation for 1, 3 and 5 h by hypoosmotic swelling (HOS) test and electron microscopy.

RESULTSSperm infected with beta-hemolytic enterococci had lower HOS scores compared with non-beta-hemolytic strains or uninfected control (P < 0.01). The HOS test scores of sperm infected with beta-hemolytic enterococci increased in the presence of phosphatidylcholine, an inhibitor of hemolysin. Non-beta-hemolytic strains showed no significant difference in swelling rate, compared with the control group (P > 0.05). It was shown by electron microscopy that beta-hemolytic enterococci caused significant rupture of human sperm membrane.

CONCLUSIONBeta-hemolytic enterococci caused human sperm membrane injury, and might be mediated by the hemolysin of enterococci.

Cell Membrane ; drug effects ; microbiology ; Ejaculation ; Enterococcus ; physiology ; Feces ; microbiology ; Humans ; Male ; Phosphatidylcholines ; pharmacology ; Reference Values ; Spermatozoa ; drug effects ; microbiology ; ultrastructure