Document Detail

A review of the current status of topical treatments for premature ejaculation.
MedLine Citation:
PMID:  17608824     Owner:  NLM     Status:  MEDLINE    
We examine the progress that has been made towards the development of topical treatments for premature ejaculation (PE). Although generally regarded as one of the most common male sexual problems, the lack of approved pharmacological agents for PE means that treatment options are limited to behavioural therapy, where available, and the use of drugs 'off-label'. There are various theories on the aetiology of PE, but it seems likely that both biological and psychological factors are important. One theory, that men with PE might have a heightened sensory response to penile stimulation, provides the rationale for using topical therapy; reducing the sensitivity of the glans penis with topical desensitizing agents (e.g. local anaesthetics) might improve ejaculatory latency without adversely affecting the sensation of ejaculation. Off-label topical treatments are now relatively widely used, despite limited supportive efficacy data. There are also new topical treatments in various stages of development, designed specifically for use in PE. Treatments reviewed include TEMPE spray, containing a eutectic mixture of the topical anaesthetics lidocaine and prilocaine, and several creams, including one containing natural products (SS-cream), and preliminary results from another containing the local anaesthetic dylonine, with alprostadil (prostaglandin E1). Despite wide variations in the methods of clinical trials, it is possible to conclude that all placebo-controlled studies of topical treatments have reported a significant increase in intravaginal ejaculatory latency time compared to baseline and placebo. Topical treatments for PE are appealing in that they can be applied as needed and only minimal systemic effects are likely. However, without well-controlled drug delivery there is the theoretical possibility of penile hypoaesthesia and/or transvaginal contamination. Unlike the cream formulations, the TEMPE spray has a well-controlled delivery system, making it easy to administer locally, and it appears to be well tolerated in early clinical trials. It appears that topical treatments might be able to satisfy many of the requirements of an ideal treatment for PE, and certainly have the potential for use as a first-line treatment.
Alvaro Morales; James Barada; Michael G Wyllie
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Publication Detail:
Type:  Journal Article; Review     Date:  2007-07-03
Journal Detail:
Title:  BJU international     Volume:  100     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-02     Completed Date:  2007-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  493-501     Citation Subset:  IM    
Centre for Applied Urological Research, General Hospital & Queens University, Kingston, Ontario, Canada.
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MeSH Terms
Administration, Topical
Anesthetics, Local / administration & dosage*,  adverse effects
Ejaculation / drug effects*
Patient Satisfaction
Sexual Dysfunction, Physiological / drug therapy*
Treatment Outcome
Reg. No./Substance:
0/Anesthetics, Local; 0/Ointments

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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