When are phosphodiesterase type 5 (PDE5) inhibitors used to treat premature ejaculation (PE)?

Updated: Jan 15, 2019
  • Author: Samuel G Deem, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Some studies have demonstrated that combining phosphodiesterase type 5 (PDE5) inhibitors with SSRIs provides better results in the treatment of premature ejaculation than using SSRIs alone. [43] The reason for this is unknown, but part of the explanation may be that the improved (firmer, longer-lasting, or both) erection resulting from the PDE5 inhibitor provides inhibition of ejaculation via downregulation of receptors involved in somatosensory latency times. In addition, a reduction in performance anxiety may exist on a subconscious level.

Regardless of the mechanism, PDE5 inhibitors have been found to be safe and effective as a therapeutic adjunct for premature ejaculation in men for whom such therapy is not otherwise contraindicated. The only PDE5 inhibitors studied to any significant degree in the setting of premature ejaculation are sildenafil and tadalafil [44, 45] ; vardenafil may also work, but the available data are insufficient to support its use.


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