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John J. Bauer, M.D.
www.flinturology.com Urology Services, Inc.
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Zoloft advice for Premature Ejaculation
This question and answer that appeared on Healthy Devil Online patient forum gives an overview of the use of Zoloft:
Posted: May 21, 1996
SUBJECT: Medications for premature ejaculation
QUESTION: I went to see a doctor about premature ejaculation and he prescribed Zoloft one hour before to help. I tried it. It didn't work. Was he going out on a limb or has Zoloft or Prozac ever been used to help with premature ejaculation? Are there any other medications that help? How about alcohol? What can I do?
RESPONSE: Zoloft is not the most common treatment for premature ejaculation, but there have been some recent case reports suggesting that it may help to correct this condition in some patients. Actually, in about 15% of patients, Zoloft has the side effect of ejaculatory delay. It is possible that your doctor was planning on counteracting premature ejaculation with this effect, which is presumably the way in which the drug has worked in the successful case reports. Additionally, the drug may have been prescribed for other reasons, such as its antidepressant actions.
The most commonly employed treatment for premature ejaculation is actually not education but rather discussions with a health care provider or other counselor. Premature ejaculation is not an uncommon condition, especially in younger men, and can be associated with anxiety due to any number of different causes. Often a "stop-and-start" therapy is employed in which ejaculatory control is increased over time. This technique involves stimulation of the penis manually or through intercourse up until the point that ejaculation is about to occur. The stimulation is then stopped for 20 - 30 seconds, and then resumed. Often on the fourth stimulation, ejaculation is permitted to occur. Over time, ejaculatory control increases in over 95% of patients. If you have concerns about this issue, therefore, you should visit a health care provider whom you trust and with whom you will feel comfortable discussing these issues. That person can give you more details about this technique or others that he or she feels may be of benefit to you and can monitor your progress. More information on premature ejaculation and other men's health issues are available in the text section of The Healthy Devil Online.
Source used for answer: Berkow R, et al., eds. The Merck Manual. Merck Research Laboratories: New Jersey, 1992.
Prozac May Help Premature Ejaculation
NEW YORK, Dec 16, 2000 (Reuters Health) -- The antidepressant drug Prozac may be a useful treatment for premature ejaculation, according to a report in the January issue of the Journal of Urology.
The drug appears to delay ejaculation by increasing the "penile sensory threshold." Testing showed that the penile sensory threshold and other factors used to measure premature ejaculation improved in the men taking Prozac compared to those taking placebo. And 80% of the men taking Prozac considered their treatment to be effective compared to just 10% of the men on placebo.
However, the treatment may pose a double-edged sword for men -- the researchers note that side effects, including loss of libido, were more common in those men treated with Prozac. Of men taking Prozac, 15% experienced loss of libido compared to 5% of men taking placebo. Twenty-five percent of the Prozac users felt tired and 5% suffered from anejaculation, a lack of ejaculation, compared to none of the men on placebo.
"Although there were more side effects in the study group, none required withdrawal from therapy," the authors also note.
SOURCE: Journal of Urology 1999;161:107-111.