Drug to curb early ejaculation
A new drug is now available to assist men with premature ejaculation.
IT HAS been said that Viagra kickstarted the first sexual revolution for men. Before the days of the little blue pill, erectile dysfunction (ED) was plagued with myths and misconceptions that led to much confusion among men.
Some even confused ED with premature ejaculation (PE).
Now that a new medical solution for PE has been found, the second sexual revolution can take off.
Previously, anaesthetic cream, which numbs the penis, and antidepressants were used to help men overcome PE.
But now, with PE recognised as a medical condition, there is an oral medication called Piligry – the first in the world to be approved for treatment of the problem.
PE has long been a condition that has been under-reported and under-diagnosed, mainly because of the embarrassment faced by sufferers, who have to put up with the social stigma related to the condition.
But few know that it is a very common condition – reports show that as many as 29% of Malaysian men suffer from PE.
The Asia-Pacific Premature Ejaculation Prevalence and Attitude Study carried out among more than 5,000 heterosexual men found awareness of the condition to be low.
The study also found that most men are reluctant to talk about it, while the majority of couples do not completely understand the condition.
PE has been defined by the International Society Of Sexual Medicine as “ejaculation which always, or nearly always, occurs prior to, or within about one minute of, vaginal penetration.”
Women who are happy with the way things are should not insist that their man take Priligy just to prolong sexual intercourse, says urologist Prof Datuk Dr Tan Hui Meng (pic inset).
Previously, PE was largely thought to be psychological, but now it is known to have neurobiological causes.
The central nervous system is controlled by the serotonin system, which controls mood, appetite, anger, pain and sexual pleasure.
When serotonin inhibitors are manipulated, the threshold of sexual climax can be elevated. That is why anti-depressants are found to be effective in treating PE.
However, anti-depressants are long-acting, and there are none licensed for treating PE.
Priligy works in the same way, but is short-acting, and clears out of the body after around 24 hours.
The drug was evaluated in placebo-controlled clinical trials that involved more than 6,000 men with PE, and their partners.
“We have specifically designed and developed a short-acting SSRI (selective serotonin reuptake inhibitor), so it has the effect of extending the time before ejaculation; but at the same time, it is rapidly cleared from the body,” said JanssenCilag medical affairs manager Joyce Seak.
“The patient needs to take the tablet one to three hours before sexual activity. After 24 hours, less than 5% of the medication remains in the body.”
Priligy is a prescription drug, produced by Janssen-Cilag.
Both the 30mg and 60mg packs come with three tablets per pack. Each 30mg tablet is sold at the recommended retail price of RM39, while the 60mg tablet is RM55.
Seak added that patients with significant pathological heart conditions, moderate to severe liver problems, schizophrenia or mental disorders, should not take the medication.
Treat the problem
PE can affect a couple’s sex life and relationship, and lead to distress, anxiety and disappointment, not just for the man, but also for the woman.
However, if a couple is happy despite the man experiencing PE, then no treatment is necessary.
Consultant urologist Prof Datuk Dr Tan Hui Meng explained: “You must also consider if the couple treats sex as only for procreation, not for recreation.
“According to their own understanding, they have infrequent sexual activity, it’s fast and there is no problem.
“But things may change. When their children grow up and leave the house, the couple will have more time to themselves.
“So, if they realise that this is a medical condition, and that the man has been having premature ejaculation his whole life, then there’s no harm in taking medication.”
The Malaysian Society of Andrology and The Study Of The Aging Male honorary president added that while the man’s part- ner may feel that medication is not necessary, the couple can get treatment if they want to be more intimate and a better sex life.
“But you should never treat a patient when there is no problem; you’ll only be asking for trouble,” he said.
Can Priligy also be used to treat those whose PE is secondary, and due to psychological reasons, such as performance anxiety?
“If you improve their serotonin pathway and signals, you would probably still help them,” said Prof Tan.
“It is akin to people with ED who have it as a psychological problem, and are on medication. No matter what the underlying causes, they will still achieve a good erection.
“So it is the same thing with those having PE.
“If it is just transient PE, which happens once in a while, then as a doctor, I would just counsel the patient and tell him to avoid situations that cause PE. But if it happens too frequently, you can treat it.”
Of course, the drug has to be used judiciously and properly, and the doctor plays a key role in selecting the patients for the best results, Prof Tan added.
Expectations of the PE sufferer’s partner could sometimes be a factor in leading a man to think he needs treatment.
Prof Tan cautioned that a man should not be encouraged to seek medical treatment just because his partner has certain expectations about how long sexual activity should last.
The situation is different with ED, which has been recognised to be the prelude to cardiovascular disease, and must be treated.
“If normal duration is five minutes, and there is nothing wrong with the man, you cannot push him to take medication just to enable him to last 30 minutes,” he said.
“So we must take into consideration the couple’s expectations.”
However, many men actually ejaculate very fast without even knowing it is a problem. Their partners may also not be aware of the problem.
“The man still achieves orgasm and is relaxed and gratified,” said Prof Tan.
“Both partners are happy and do not need help.
“But studies have shown that women do not climax easily. Many men are aware of that. So it is the man’s sensitivity to his partner as well.”
Prof Tan said that sexual medicine is now a recognised medical discipline, and he expects it to become even more prominent in the coming years.
“There will be people in the future who are sexual medicine physicians, and deal with nothing but sexual medicine,” he said.
“It is not unusual or embarrassing to walk in and see a sexual medicine physician because sexual health is a very, very important aspect of life.”