Safety and Tolerability Profile of Sildenafil for Ejaculation Disorders

Department of Urology, People's Hospital of Hainan Province, Haikou, China.

How Premature Ejaculation Differs from Erectile Dysfunction

It may be brought on by an underlying medical condition, such as vascular disease or diabetes, that constricts blood flow to the penis, resulting in difficulty achieving and maintaining an erection firm enough for sexual intercourse. Erectile dysfunction can also have psychological roots, including performance anxiety, relationship difficulties, and even depression. Science, not to mention plenty of happy guys and their partners, have proven that both sildenafil and tadalafil do a bang-up job treating ED. Because these medications are now available as generic prescriptions, the cost has plummeted, mainly when purchased online from reputable pharmacies, such as MediSuite. Erectile dysfunction isn’t the only sexual challenge guys can face.

Viagra after one year

Premature ejaculation is another sensitive topic that the American Urological Association estimates 30-40% of men will experience at some point in their lives. The Mayo Clinic reports that as many as one out of three males sometimes report experiencing it. The big question many men have is, “Can Viagra® or Cialis® cure premature ejaculation?” Let’s start with the spoiler alert. Both of these drugs were initially designed to treat heart conditions and were quickly found to improve symptoms of erectile dysfunction. The world pivoted, and ED is what they came to be prescribed for. Medical treatment for premature (early) ejaculation includes several options. Any serious primary medical condition (eg, angina) should be treated; for the purposes of the following discussion, the patient is assumed to be healthy, and premature ejaculation is assumed to be his only problem.

In addition, any accompanying erection problem (eg, erectile dysfunction [ED]) should be treated; various methods are available, and excellent success can be expected.

• Erectile function and PE may influence each other.
• Sildenafil can improve erectile rigidity, indirectly helping PE.
• Psychological factors often underpin PE.
• A detailed sexual history is essential for diagnosis.
• PE is a common condition, not a reflection of masculinity.
• Non-pharmacological methods include start-stop techniques.
• Partner cooperation enhances treatment outcomes.
• Some men experience placebo effects from medications.
• Regular follow-up is necessary to assess progress.
• Emotional well-being is linked to sexual health.
• Combining therapy modalities can provide best results.

Accordingly, treatment of concomitant ED is mentioned only in passing. To achieve the best outcome, the female partner should be included as fully as possible in the treatment and counseling sessions.

Counseling and Sex Therapy

And there is an abundance of scientific evidence that when it comes to getting a man hard enough for penetration, they are both effective. However, very little is known about the impact sildenafil and tadalafil have on PE. One small study of 180 men published by the National Institutes of Health back in 2007 showed that some men did, indeed, experience improvements in sexual performance and a decrease in the severity of premature ejaculation after taking Viagra®. The study went so far as to conclude that sildenafil is a very effective and safe method of treating premature ejaculation. Many men use these drugs and claim that taking sildenafil or tadalafil has helped them last longer and improve sexual performance.

Construction of scales for the Center for Marital and Sexual Health (CMASH) sexual functioning questionnaire

The scientific community tends to be on the fence about this because so little is known about how these medications might help with PE. One theory suggests these medications may inhibit the connection between the brain and the urogenital system. Another theory is that they give guys an added boost of confidence, and that helps with premature ejaculation. While there is no concrete evidence that ED meds can aid with premature ejaculation, we do know that they can shorten the refractory period for a lot of men – the time it takes to achieve an erection again after climaxing. We also know that sildenafil (Viagra®) has been shown to keep some men hard post-ejaculation, allowing them to continue performing sexually even after they’ve climaxed. Pharmacologic therapy may include selective serotonin reuptake inhibitors 50 mg sildenafil price (SSRIs) or topical desensitizing agents. Outpatient care can be scheduled as appropriate for the clinical circumstances.

Other Therapy

With these facts in mind, there is an argument to be made that the reason some men insist these ED medications help with PE is the boost of confidence they get after taking them. After all, if sexual performance and satisfaction are heightened for both the individual suffering from PE and his partner because taking sildenafil or tadalafil provides added stamina and a quicker sexual turnaround time, perhaps that equates to minimizing the impact of premature ejaculation. Another thing to consider is that the causes of PE and ED often mirror each other. In fact, according to the Mayo Clinic, one of the common factors that can play a role in premature ejaculation is erectile dysfunction itself. Being nervous about getting and keeping an erection might sildenafil generic cause a man to rush to ejaculate.

Disorders of orgasm and ejaculation in men

In this case, it’s logical that solving the ED problem might also solve the PE problem. Anxiety is another cause of premature ejaculation. Whether the anxiety is due to worries about sexual performance, problems in a relationship, or even stressing out over a job, it can contribute to PE. The first thing to do is stop ignoring the problem and speak with a physician about potential solutions. You can talk to your doctor or arrange a confidential consultation through MediSuite’s telemedicine platform to see if sildenafil or tadalafil might be worth trying. To date, no drug has been specifically approved by the US Food and Drug Administration (FDA) for the treatment of premature ejaculation. However, numerous studies have shown that selective serotonin reuptake inhibitors (SSRIs) and drugs with SSRI-like side effects are safe and effective to treat this condition, and many physicians use these agents for this purpose. Topical desensitizing therapy with local anesthetic agents can also be useful in some men with premature ejaculation. Premature ejaculation that relates to erectile dysfunction may resolve if the erectile dysfunction is treated successfully. If a patient has depression-related erectile dysfunction but not premature ejaculation, a drug with minimal adverse sexual effects might be considered so as to avoid causing delayed ejaculation or even anorgasmia. [24] However, if the patient has premature ejaculation, erectile dysfunction, and depression, an antidepressant with SSRI side effects has the added benefit of possibly alleviating the premature ejaculation. In Korea and other areas of the Far East, SS (Super Secret) cream (a combination of 9 ingredients, mainly herbal) has been shown to desensitize the penis, decrease the vibratory threshold, and help men with premature ejaculation to delay their ejaculatory response significantly.

About this article

However, no definitive scientific proof exists that these medications directly treat PE. Yes, erectile dysfunction can contribute to premature ejaculation. Men with ED may feel anxious about maintaining an erection, leading them to ejaculate quickly to avoid losing their erection during sexual activity. MediSuite is committed to men’s healthcare by providing doctor-prescribed medications at affordable prices delivered directly and discreetly to your door. Cochrane Central Register of Controlled Trials (CENTRAL) Cochrane Central Register of Controlled Trials (CENTRAL) Department of Urology, People's Hospital of Hainan Province, Haikou, China. [26, 27] This preparation is not yet approved by the FDA.

Simple combinations of lidocaine cream or related topical anesthetic agents can also be effective. These combinations are safe as long as the patient has no history of allergy to the substance. [28, 29, 30, 31] A metered-dose lidocaine-prilocaine cutaneous spray (Fortacin) is approved in Europe. The most effective pharmacologic therapy for premature ejaculation is to administer a drug from the SSRI class. Normally, these drugs are used as antidepressants in the clinical setting. Many of these agents were found to have the side effect of significantly delaying the achievement of orgasm in both male and female patients, and it was for this reason that such agents were applied to the treatment of premature ejaculation.

Cited by (15)

Particularly if you are experiencing both ED and PE, which is not uncommon, it may very well be worth trying one of these proven medications. Other possible ways to treat PE include desensitizing sprays and creams. Condoms can also provide a barrier that decreases sensitivity to help you last longer. Many condoms today also offer “climax control” numbing agents to further desensitize the penis. Another method that can help with PE is called the pause-squeeze technique.

Selective serotonin reuptake inhibitors and similar agents

The end of the penis is squeezed (by you or your partner) as soon as you feel as though you’re about to ejaculate. Squeeze sildenafil syrup for several seconds until the urge to climax passes, and then continue sexual activity. You may need to repeat this more than once. Do ED medications also help with premature ejaculation? We don’t know for sure, but there is significant evidence and a good deal of word of mouth that they very well might. Some tricyclic antidepressants (TCAs) with SSRI-like activity have the same effect in orgasm that SSRIs do. The TCA that has been most frequently studied for treatment of premature ejaculation is clomipramine. [33, 34, 35, 36] Many investigators find that clomipramine is more effective for premature ejaculation than many SSRIs are.

• Misusing sildenafil for PE can cause serious health risks.
• The drug's primary purpose is erectile dysfunction.
• Off-label use for PE should be supervised by a doctor.
• Performance anxiety often exacerbates PE.
• Proper medication adherence improves results.
• Natural remedies lack strong scientific support.
• Combining drugs without guidance is dangerous.
• Behavioral adjustments can sometimes eliminate PE.
• It is vital to address both physical and psychological aspects.
• Clinical trials explore sildenafil's role in PE management.
• Open communication with a healthcare professional is key.

Results of a multicenter, randomized, double-blind, placebo-controlled, fixed-dose clinical phase III study in 159 Korean patients suggest that 15 mg of clomipramine taken approximately 2-6 hours before sexual intercourse is effective and safe for treatment of premature ejaculation.

Preparing for your appointment

If you are experiencing PE, talk with a physician about possible treatments. Premature ejaculation (PE) happens when a man ejaculates before or shortly after sexual penetration, often within 3 minutes. Lifelong PE: Occurs consistently from the first sexual experience. Acquired PE: Develops after a period of normal sexual function. While Viagra® and Cialis® are primarily used to treat erectile dysfunction (ED), some studies and personal accounts suggest they may help with premature ejaculation (PE) by improving sexual performance and lasting longer. [37] However, a systematic review and meta-analysis concluded that below a dose of 50 mg, a higher dose of clomipramine results in a longer delay of ejaculation without an increased risk of adverse events.