What are the AUA guidelines on the pharmacologic management of premature ejaculation (PE)?

Updated: Jan 15, 2019
  • Author: Samuel G Deem, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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The American Urologic Association (AUA) published guidelines on the pharmacologic management of PE in 2004; the guidelines were reviewed and validated in 2010. [57] Guideline statements were as follows:

  • The diagnosis of PE is based on sexual history. A detailed sexual history should be obtained from all patients with ejaculatory complaints.
  • In patients with concomitant PE and erectile dysfunction (ED), the ED should be treated first.
  • Before initiating any intervention, clinicians should discuss the risks and benefits of all treatment options. Patient and partner satisfaction is the primary target outcome for the treatment of PE.
  • Any of several serotonin reuptake inhibitors or topical anesthetics can provide effective treatment for PE. The optimal treatment choice should be based on both physician judgment and patient preference.

The AUA also noted the following:

  • Although not approved by the US Food & Drug Administration for treatment of PE, oral antidepressants and topical anesthetic agents are effective and have minimal side effects when used for this purpose.
  • Oral antidepressants should be started at the lowest possible dose that is compatible with a reasonable chance of success
  • The choice of additional therapy is based on the patient and partner reports of efficacy, side effects, and acceptance of the therapy as well as on a regular review of alternative approaches
  • Support and education of the patient and, when possible, the partner are an integral part of PE therapy.

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