premature ejaculation

Introduction

Persistent or recurrent ejaculation with minimal sexual stimulation before, upon, or shortly after penetration & before the person wishes it.

Etiology

organic factors are rarely the cause

Epidemiology

• most prevalent form of male sexual dysfunction
• affects 30% of men

Clinical manifestations

• generally present with onset of sexual activity

Management

• behavioral strategies focusing on awareness
  • limited benefit
• selective serotonin-reuptake inhibitors 1st line
  • paroxetine may be most effective SSRI
• topical lidocaine
• clomipramine of modest benefit

More general terms

• ejaculatory dysfunction